A very important question to Onslow and Packman

Onslow and Packman write in a response to the controversy of Lidcombe becoming the state-sanctioned treatment of choice:

"Indeed, if such evidence emerges for the efficacy of another treatment for early stuttering, we would encourage Speech Pathology Australia to approach the Australian government to consider it also for taxpayer-assisted support."

Here is the key question to them:

The Franken study has shown that there is no difference in efficacy between Lidcombe and a second treatment approach Demands And Capacities. So I ask:

As Lidcombe is effective (according to you) and the Franken study shows a similar efficacy for Demands & Capacities, does that constitute enough evidence to use Demands & Capacities in Australia too?

Deborah Theodoros has been misinformed about the efficacy of Lidcombe

The Australian Speech and Language Association's president Deborah Theodoros seems to be badly misinformed about the efficacy of Lidcombe as she wrote in her statement on Graig Coleman's concern about making Lidcombe the treatment of choice in Australia:

"early stuttering intervention at a level which is demonstrated to be highly efficacious and supported by the strongest level of evidence."

As I understand she is not an expert in stuttering so someone must have whispered in her ear and she refused, so far, to lend her other ear to an opposing opinion. Her statement is completely overblown. (check also my first response to the debate)

Let's deconstruct her statement: "demonstrated to be highly efficacious:"

This is simply not the case if you look at the long-term data and if you know, like me, the many cases clinicians tell me about where it did not work. Even Onslow, Packman, et al's recognize that

At the time of this follow-up, the children were aged 7-12 years, with a mean of 5 years post-randomization in the 2005 trial. Twenty of the 29 children in the treatment arm and eight of the 25 children in the control (no treatment) arm were able to be contacted. Of the children in the treatment group, one (5%) failed to complete treatment and 19 had completed treatment successfully and had zero or near-zero frequency of stuttering. Three of the children (16%) who had completed treatment successfully had relapsed after 2 or more years of speech that was below 1% syllables stuttered. Meaningful comparison with the control group was not possible because an insufficient number of control children were located and some of them received treatment after completing the trial.

To conclude, the treatment was not "highly efficacious" at all, especially if you compare it to the natural recovery rate of 70%-80%. And due to the small number of 29 children, the statistics are bad. And there was no control group to control for natural recovery, so you cannot actually judge the relative performance to a non-treated group.

The statement "supported by the strongest level of evidence." is, as you can see, completely overblown.

Deborah Theodoros should seek independent counsel on this matter to counter the notion that her statement and her association projects a certain carelessness regarding dissenting opinion. She cannot just hear the arguments of those that have worked hard to create and establish, and then also measure the treatment; a clear conflict of interest. All in good intention but nevertheless Lidcombe is neither "highly efficacious" nor supported by "the strongest level of evidence."

Lidcombe the only effective treatment in Australia?

US cultural imperialism, this time for good reasons, has struck Australia. The Australian government and speech and language association has plans to make Lidcombe the unique treatment option available for clinicians to treat stuttering kids, because it is the most studied and has been proven effective. As we all know, this campaign is very likely led by Prof Onslow and his people. He is very much Mr Stuttering in Australia, and sucks up most of the research funding and probably sits on the research council board to decide on other people's funding. He was also so kind to send me a nice letter from his university's lawyer a few years ago, and was very eager to have a few nice chats with the director of a Dutch researcher who wanted to compare Lidcombe with another treatment option - an episode that she has still not spoken publicly about. I wonder what would happen if she were to write an open-ed in a main Australian newspaper about this episode?

So as you see, we again need the Americans to police the world! Soft power of course. Australia deserves an opinion that opposes the opinion of the lords of the lands down under. A petition by Craig Coleman does exactly this:

Recently, Speech Pathology Australia (the national speech-language pathology association of Australia) submitted a proposal to the Australian Government Department of Treasury that would require Medicare rebates be made available for children who stutter, but only if they are treated using the Lidcombe Program. 

The ramifications for this action are significant. As expected, many speech-language pathologists from the U.S. and abroad do not support this action for several reasons. First, this action gravely limits the scope of treatment for stuttering. Many interventions for preschool stuttering have shown to be effective (Millard, Nicholas, & Cook, 2008; Yaruss, Coleman, & Hammer, 2006; Franken, Kielstra-Van der Schalk, & Boelens, 2005).

So what is my opinion?

To those obsessed by p-values

I have always looked with horror at the near religious and blind application of p-values in hundreds of stuttering research papers.

Here is a blog post discussing p-values:

The journal Basic and Applied Social Psychology has come out with a ban on p-values. To be precise, they've banned the “null hypothesis significance testing procedure” from articles published in the journal. This ban means that authors in the journal can’t claim that an effect they see in their data is “statistically significant” in the usual way that we’re all accustomed to reading.

Australian study screens baby's brains

Here is a report on an Australian research study which screens baby's brains. Those babies have stuttering siblings, which make them more likely to develop stuttering. How successful is this study going to be?

As always in Australia, Mark Onslow is involved. He was probably the person who worked hard to get the money and the people together, something he is good at. The outcome of his studies is not always so good unfortunately. First, the outcome study of Lidcombe early childhood intervention was problematic and a review a few years later was unable to locate all the kids who actually had taken part in the treatment. Second, there was a long-term study on stuttering on a large scale, but I haven't heard of the results at age 5, for example, even though the study should have those data. Long-term studies are always sensitive to many factors, e.g. people leaving, money running out, people using interests.

Lidcombe is dead: long live any treatment?

It took Peter years to get Marie-Christine Franken on StutterTalk. So enjoy the podcast! And it took her years to have the 2007 comparative study between Lidcombe and Demands&Capacities analysed and published: a true source of frustration to me as this is such a key piece of research to dispel claims of supremacy by Lidcombe. Already in 2012, they had the data but it took more than 2 years to write it up and get it published.

The listener will note that Marie-Christen is a bit scared of misspeaking and of her findings... She might be an overly cautious person by nature, but if a friend of a friend told you that she actually got bullied from someone in a distant land and was concerned about her job security, you can understand why she behaves the way she behaves.

The key statements are

• The large-scale study started in 2007 did not find a significant overall difference between the two treatment approaches: Lidcombe and Demand and Capacities treatment.
• She expects the study to be published within months.
• She refutes that it is only ethical to use Lidcombe.

How the tower of information leads to an integrated framework for biopsychosocial ideas

I have published an article with a friend of mine on a new framework on how to classify all drivers of human behaviour and experience. I have specifically designed it to include all possible drivers of stuttering behaviour in one single framework, and it turned out to be generic to all behaviour and disorders. More details on our website bps2.com.

Here is the abstract:

The biopsychosocial model is the prevailing conceptual model in relationship to which clinicians organize their analysis, evaluation and intervention. Since its promotion by Engel, little work has been done to provide a more solid conceptual basis for the relationship between the biological and the psychosocial processes in sickness and in health. We propose such a framework, using the perspective of life forms as information gathering and utilizing systems. We derive the simplest non-trivial model, the four domain model, which consists of the physical domains determining human processes: the environment, the body, the confined memories, and the communicable memories. We then re-visit Engel's case study to contrast our model with his systems approach, and apply it to issues in psychosomatics and the mind-body connection.

If you want a complimentary copy, please send me an email: tom dot weidig at gmail dot com

Check out and support Dylan's work!

My name is Dylan Madeley, and I've struggled to come to terms with two different aspects of my life. The first one set me on a path of frustration and retrying, constant self-improvement, bouts of social isolation, and has ultimately played a huge role in defining who I am today. The second one is stuttering, which I've lived with since about age five. In both cases, I spent some time running away in one form or another; in both cases, I have felt more whole as a person by accepting them and being more open about them. I live in a suburb north of Toronto with two chinchillas, write and copy edit for Auxiliary Magazine, and in my spare time pursue a career as a novelist. I have written one manuscript of minimum 50,000 words each year since 2008.

Since this blog has a stuttering/cluttering focus, I'll share my views about how these two things relate to each other. I took up creative writing a few years after developing a stutter, and my dad inspired me to tell stories. While I can't reach into my thought processes at the time, I strongly suspect that here I was with very real and seemingly insurmountable communication difficulties, immediately setting me apart from every other kid I knew (for years, the only other two stutterers I had ever met were two guys who also attended Sick Kids for speech therapy). The written word has its own challenges, vast and not perfectly understood by me at a

Ice Bucket Challenge Hijacked for Stuttering

Lecture material from Antwerp Stuttering Conference

You can find my presentation here. I talk again about how we need to find a common framework encompassing all elements that drive stuttering behaviour.

All other presentations are on this webpage listing all the speakers and parallel sessions here.

World Conference on Cluttering

If you are interested in cluttering, check out the website of the 2nd world conference on cluttering: here.

Fear of public speaking is the most common phobia among fluent people!

Source: BestMastersInCounseling.com

Facial expressions may lead to miscommunication during a business video meeting

Michael Yunat from GetVIOP suggested the below "infographic, where we demonstrate how facial expressions may lead to miscommunication during a business video meeting." More here.

Press release from The Stuttering Foundation

For Immediate Release

Contact: Greg Wilson

greg@curleycompany.com

571-239-7474 

Picture caption: Stuttering Foundation President Jane Fraser (second from left) honors authors Scott Damian, Dr. Alan Rabinowitz, Anna Olswanger and Vince Vawter during its National Stuttering Awareness Week gala at the Lotos Club in New York City.

Download picture  

                                                                   

Stuttering Foundation Honors Four Courageous, Inspirational Authors

NEW YORK (May 13, 2014) — To celebrate National Stuttering Awareness Week, May 12-18, the Stuttering Foundation (www.StutteringHelp.org) honored four authors whose recent books are widely acclaimed by both critics and readers alike.

Stuttering New York

I am back from my US / New York. Jelena and myself, we met a few people from the stuttering community. First of all, a big thank you to Ora, a long-term reader of TSB and a person who stutters, and Dan for their hospitality. I met Ora the last time I was New York when he had responded to my call through the TSB blog to meet up with people from the NY stuttering community.

I also met up with Eric Jackson, the ex co-host of StutterTalk and his fiancee. He is currently doing a PhD in stuttering (what else?), and they took us to a concert at Williamsburg. We didn't have enough to talk through details.

We also met up with Chaya, who is a person who stutter and an SLT. 

And finally, the American Institute for Stuttering (AIS) (many thanks to Carl Herder) invited me to give a presentation / lead a discussion round on stuttering research. I presented my framework that allows to describe all aspects of stuttering, and I talked about my neurologically based demands and capacity theory. But it was not a monologue (or at least I hope so!) with many questions and comments on theories of stuttering. Again, not enough time really. It was so noisy, and I asked Carl if he could close the windows, and Heather said: they are closed, it's Manhattan! ;-)

ELSA Youth Meeting this summer: Deadline is soon!

For young people who stutter and are under 28, go to a free youth meeting in the Netherlands. I was there and I really enjoyed it. Made friends for life. Check out the ELSA website.

Meet me on my US trip

I will be in the US from April 11th to April30th.

Meet me in New York, Tucson, or San Diego area! I am always happy to meet readers, especially if they stutter! ;-)

Contact me via email! My gmail address is tom DOT weidig!

Discuss with me at AIS in NY on April 17th

Come to the American Institute for Stuttering on Thursday April 17th from 6-7:30pm in New York. They invited me to talk about research in stuttering. There will probably be a round table discussion on the latest understanding, what the future might hold, and how it could impact treatment!

Stuttering: a short animation film

Check out Bertrand and Timmy's animation film about stuttering. I met them at the Antwerp stuttering conference.

Let me know what you think, and help the creators with your feedback!

Friday key note speakers at Antwerp ECSF Conference

I am sitting here in the entrance hall close to the reception desk of the Antwerp Conference.

Here is my report on the three Friday key note speakers:

The first keynote speaker was Ann Packmann. Her speech was about Exploring the relationship between treatment and causal theory in stuttering. She also presented her model of the moment of stuttering, developed by herself and Attanasio. She started out with talking about how one needs to find the cause for a heart issue and back pain before treating it. Unfortunately, that was not a good example, because many people now recognize the biopsychosocial aspects of these issues. Back pain and heart issue can certainly come from or be modulated by psychosocial causes, and treating the physical cause might not be enough. he then talks about  verbal communication & complexity theory. She correctly says that speaking is the most complex thing humans do and which sets them apart from other primates. She goes into complexity theory

Guest Blogger Richard Harkness: Stuttering's Primary Paradox and How it Tricks Us

Here is a guest post by Richard Harkness. If you want to be a guest blogger, please contact me.

Stuttering's Primary Paradox and How it Tricks Us (Richard Harkness) 

Some readers might remember me from workshops I've presented on the brain basis of stuttering and neuropatterning at National Stuttering Association (NSA) conventions in San Diego, Denver, Buffalo, and Atlanta. My most recent project was completing the new neuropatterning Home Course [http://neuropatterningforstutterers.com].

What I call the primary paradox, more than any other aspect of stuttering, accounts for the tremendous confusion that has always surrounded this perplexing disorder. It's easy to fall into this pothole.

The paradox is this: If PWS (Persons Who Stutter) can be fluent in some situations, why can't they be fluent in all situations? That is, why can most PWS speak fluently when speaking alone or to a pet--but stutter when aware of a human listener? And why can most PWS speak fluently when chorus reading (reading aloud in unison with someone else)? What could explain this except some kind of emotional or psychological issue? (This seeming paradox can be explained neurologically-by the excitation feedback component of stuttering-as discussed in The Two Components of Stuttering [http://neuropatterningforstutterers.com/?page_id=1056].

Arya Kumar Sinha believes that stuttering is totally curable.

Arya Kumar Sinha wrote to me that stuttering is curable. Read his email to me. I am not sure about his "By the laws of physics .Many-worlds interpretation , which successfully explained , loopholes of quantum physics , and today Dr. Stephen Hawking is a great supporter of this theory."

Hi Tom , I am Arya Kumar Sinha. I would like to contradict the view that is propagated in your web-site like stammering is not curable. My view is that : stammering is totally curable. I will place good arguments in favor of it. I am from India. At one point , I used to stammer severely with block/repeat on "A" "E" "I" "M" O" "U" "P" "D" "R" "L". From there , today i have achieved total fluency. I can speak fast like any normal speaker , without a single block on any letter. Why stammering is curable : The argument is : 1) Consider flipping of coin . P(head) = P(tail) =1/2. Similarly if we assume 2 states of stammering , then P(cure)=P(non-cure)= 1/2. So I rule out your 1st argument that stammering is not curable, by showing that there is equal possibility of both the cure/non-cure states. Its perfectly up to you to choose one. Both of these states exist in nature. 2) A computer i.e the logical processing area of a computer is composed of 3 parts. 1) Software 2) Operating system 3) Hardware. A programming error/bug appears if there is malfunction/error in the software part or OS or hardware. If in case of stammering there was a hardware error . then the individual would face it , while singing or while talking to himself. But in such cases a stammerer finds himself totally fluent thereby signalling that there is

100% guarantee that Anna Deeter does NOT make you stutter-free in 3 days!!

A TSB reader sent me the following email. If you have been in contact with her, contact the authorities!

You might be interested to take a look at Carl Herder's FB posting on Anna Deeter, an unlicensed speech therapist in California who's offering speech therapy in the guise of "training". Not only that, but a "I offer 100% success guarantee that at the end of the 3-day STUDY COURSE they will be stutter-free!! 

Carl is urging people to let the California licensing authorities know of her illegal activities.

Her program costs only $8000.

I suggest to Anna Deeter that she should charge the $8000 only after the person is cured. I am sure if she offers a 100% success guarantee, she is willing to wait for three days for the $8000! I would be very happy to give her the money for a cure!!!!

IFA Conference: July 6th-8th 2015

Here some information about the next IFA conference:

IFA’s 8th World Congress will be held at Catholic University in Lisbon, Portugal, where Jaqueline Carmona and Goncalo Leal are looking forward to serving as co-convenors. IFA’s Meetings and Conferences Committee received an array of excellent bids from Argentina, Australia, India, Portugal and USA. After careful consideration, the event was awarded to the bidding team from Portugal because their bid is the most advantageous for IFA and is responsive to the feedback received from IFA’s membership. Consistent with that feedback, holding the conference in Portugal will facilitate considerably more affordable congress registration fees. The 2015 IFA World Congress will be an exciting collaboration between IFA, ICA, and the Portuguese team, and will address stuttering, cluttering and other fluency disorders within its remit. This congress will also invite participation from the stuttering community, and will encourage collaboration between professionals and people with fluency disorders. More details regarding the 2015 congress will be published early in 2014, so watch www.theifa.org for more information!

Antwerp Stuttering Conference March 28th & 29th 2014

Check out the Antwerp Stuttering Conference on March 28th & 29th 2014: here.

I will be giving a workshop on how stuttering fits into a biopsychosocial framework. You find the 2012 version here.

I hope to see you there!

Let's meet up in New York, Tucson, or San Diego!

I will be in

New York (April 11th-18th),

Tucson/Arizona (April 18th-27th), and 

San Diego/California (April 27th-29th)!

If you live around there and want to meet up, send me an email tom . weidig @ gmail . com !!

Happy New Year to all of you!

I have not been very busy with my blog lately. I mainly posted links to events, and did not do a deeper analysis. Let's hope I have more time this year. Facebook has been taking up most of my time, and Luxembourgish politics. It's fun to see how that all works, but that phase of exploration is finite.

I am currently working on my book on the biopsychosocial model, and also in relationship to understanding stuttering better: check out the link.

Who can organise a cheap IFA congress?

IFA has sent around this email to its members seeking candidates for organizing the IFA congress 2015. I very much appreciate that IFA is seeking to organize a cheap conference where many different parties can participate, even those from less wealthy nations and those who are self-paying.

IFA’s Meetings and Conferences Committee has been working on a proposal for the 2015 World Congress to be held in Canada. However, we have been unable to contain costs to the extent that was requested by IFA members in the feedback received from the 2012 IFA survey.

Therefore, we are expanding our options with 21 months available for planning. We have received an expression of interest from a southern European country. For the sake of openness and inclusiveness, however, we would like to hear from any other groups that might be willing to host the 2015 IFA World Congress. Others who hosted the IFA’s World Congress have reported that it is a wonderful way to contribute to the mission of IFA and to “show off” your part of the world while gaining international attention.

Minimum requirements are:
·         Conference facilities for 250-300 delegates
·         Large main conference room plus two rooms for parallel sessions/posters
·         Good connection to international airport
·         Affordable/modestly priced accommodations nearby

To facilitate timely communication, please contact any member of the committee with your preliminary questions as soon as possible. We will need to receive your completed proposal by November 15, 2013.

Thank you in advance for your prompt attention to this request that promises to result in an exciting 2015 IFA World Congress.

Kind regards,
Hilda Sønsterud, on behalf of the IFA Meetings and Conferences Committee

What happened to this study?

Is anyone aware of the outcome of the dopamine study apparently completed in 2010 in the US: see here.

Senna herb gives fluency?

Blog readers often approach me to share their fluency "wonders". I cannot take away their experience, and believe that they indeed have had significant fluency gains. I can only disagree with their interpretation. I find that their stories follow a similar pattern: A takes X for Y. Suddenly, A experiences much greater fluency and is amazed that he/she can speak so fluently. Interestingly, they do not report 100% fluency but only a significant reduction of fluency. This pattern suggest to me that an underlying neurological issue is still present but that a change in brain chemicals (including being more relaxed or depressed) significantly influence fluency. I also want to warn you that I cannot check their stories or check their backgrounds. They could of course just try to manipulate me in promoting the substance because they have commercial interests in it. Anyway, here is the story:

About 6 months ago I had stomach issues so someone suggested to try senna herb it's known as a laxative for the stomach to make your bowl move after drinking the tea. So I bought the leaves from the Internet and started making it into a tea I started with not alot about 5 grams and 200 ml of water boil it for 5 min and drink it.. After 2 weeks or so I noticed a strange thing I started stuttering and blocking less.. M
aybe it was just a placebo effect. But continue using it the stuttering was i would say improved by 90% I would talk to people and not stutter, I would phone people and not stutter. I would have the occasional here and there but all in all it's such a big improvement.. Now the science part the stuff that makes u have diarrhea is senneniods in the senna herb that is what scientist have discovered. I am pretty sure it's not that that makes u stutter less. If scientists can remove the sennionds from the herb. I am sure there is something in this herb that doesn't make you stutter, if u cut down in it u will stutter again I tried leaving the herbs for 2 weeks and the stutter came right back. I hope someone can do research about this wonderful herb surely smth in it a chemical helps stuttering, I have given it to a friend who stutters as well after a while his stuttering was improved by 80%. Thanks thus was my experience with senna herb

Portuguese Stuttering Association: National Conference

On the 26th October, the Portuguese Stuttering Association will organize its VII Stuttering NAtional Conference. The program will be the following: 9:30- Opening session I and my stutter: life testimonies of people who stutter Speakers: Paulo Guerra, José Pedrosa, Tiago Almeida, Carlos Ferreira. Stuttering and employability Speakers: Maria Amélia Marques, André Carmo, Joana Caldas Success in therapy: What does it mean? Speakers: Iris Bonança, Brito Largo, Jaqueline Carmona, Gonçalo Leal, Mónica Rocha Rapporteur: Helena Germano SHGs and the online forum: The experience in Portugal Speakers: Rosa Paula Neves, José Carlos Domingues, Joana Caldas, André Caiado, Jorge Silva Commentators: Daniel Neves da Costa, Brito Largo 18:00- Closing session Registrations: members, relatives and students: 10 €, Professionals: 20 € Information and registrations on www.gaguez-apg.com

Please help researchers in Boston

Please contact Shanqing Cai (scai@bu.edu) to participate in a scientific study on the Rhythm Effect in Stuttering. It is very important that we help others:

The Speech Laboratory of Boston University is looking for volunteers who stutter to participate in an NIH-funded research on persistent developmental stuttering. Persistent developmental stuttering is a disorder of speech fluency characterized by frequency involuntary disruption of the normal flow of speech by syllable or sound repetitions, prolongations and blockages. It usually starts during early speech development between the age of 2 and 6 and persists into adulthood. This study focuses on the rhythm effect, also known as the metronome effect, which refers to the dramatic decrease in dysfluency when a person who stutters speaks to a regular rhythm. By using a combination of psychophysical and MRI techniques, we aim to elucidate the neural basis of this potent fluency enhancing effect in stuttering, which may also provide further insight into the basis of this disorder.

A letter from Africa

I received a letter from Dieudonn Nsabimana about an initiative on stuttering:

Background: Africa has a population of approximately 10 million people who stutter. Using the universally accepted incidence of stuttering What is the issue or challenge? Still now, People in Africa are not sufficiently informed about stuttering. Because of this lack of information, people who stutter are still mocked and humiliated. For now, almost all resources on stuttering are in internet in English language but 92% Africans people do not have access on internet And still now, there is also little information about any appropriate treatment for stuttering and almost, people who stutter in Africa, do not have access on stuttering therapy How we will solve those problems? AFRICA STUTTERING RESEARCH CENTRE have launch and have objective to promote research, to train Africans Speech & Language Therapists and to educate on stuttering in Africa About research, for moment a study on stuttering treatment from African Traditional Healers will be launched soon and a study of challenge and strategies on Telepractice in africa will be launched About stuttering treatments, Currently, Telepractice is only the therapy method that can be accessed by people who stutter in Africa. Call for applications Volunteer Speech & Language Therapists have launched and nine Therapists from America state have accepted to give stuttering therapy the PWS in Africa, first group will be treated stuttering, in this month of October About educate on stuttering issues in Africa, we have a project for translating, multiplication and distribution the many resources exist on stuttering For now we would like to translating, multiplication and distribution the fee books and brochures for America stuttering foundation The books and brochures will be translated in Swahili language. Swahili is most widely spoken African language. Swahili is spoken in 11 Africa countries and more than 120 million speakers. That makes Swahili the largest African language. Soon as possible we will be launched a fundraising campaign for raising money for translating, multiplication and distribution the books and brochures on stuttering in Swahili language, in 11 Africa countries What you can do for us: -You can interest Speech & Language Therapists in your community to be involved in research and stuttering treatment in Africa -When we launching our fundraising campaign, we would like that you can interest your community to be involved .fundraising campaign will be online fundraising on website Your contribution can help achieve a solution and I will be really appreciated all your great advice All the best, Dieudonne Nsabimana Kigali-RWANDA

Invitation to Second World Conference on Cluttering in Eindhoven

If you are interested in cluttering, Yvonne van Zaalen is inviting to the second world conference:

You receive this email because of your interest in fluency disorders. In 2014 the second World Conference on Cluttering will be organized by the International Cluttering Association (ICA). Let us all put the intriguing disorder of cluttering and cluttering-stuttering on the map. A good step in doing so is to forward this email to other Speech Language Pathologists that might be interested to learn more about cluttering. If you receive this message more than ones, that means that colleagues around the world are familiar with your interest in fluency disorders, especially cluttering. I hope you will take that as a compliment.

Yvonne van ZaalenChair of the ICA (ica2thworldconference@gmail.com)

Breast feeding may protect against stuttering???

Today, every single "science" news outlet jumped on the story that breastfeeding may protect against persistent stuttering: see a Science Daily post based on direct sources.

This is a hyped-up science story. Typically, a student does a study of ridiculously low sample size using a questionnaire asking about 100 questions. Then magically a strong correlation comes up. The PR department of the university gets to know about it, and off we go with a press release. If they are lucky, it's also a female student, so they can at the same time satisfy politically correctness and show that girls do great science!

The truth is of course that 95% of this kind of research is completely irrelevant, for various reasons. The biggest one is that the more variables you look for, the more likely one is correlated by chance. And even if you only look for a few variables. Ten students looking for few variables has the same effect combined with the publication bias. Only the one of the ten students finds a strong correlation by chance, and only their research gets paraded around.

And of course nutrients play a great role in giving the infant brain and its DNA the needed resources to create the best possible brain from what the DNA has in store. 100s of things can get wrong in an infant's brain development. But this story just does not make sense to me even on a theoretical level.

Here some sanity checks:

1) If this is really the case and as more girls recover, are we now suppose to believe that boys gets less breastfeeding. Of course not. So why do more girls recover if breast feeding is a key factor?

2) Millions of kids did not get breastfed, do they stutter? No! Do have they neurological deficits?? Not that I am aware of.

To conclude, the research is likely irrelevant, and its marketing damaging, and in my view unethical. Nicoline Ambrose who is known for sound research should have known better. At best, I accuse her of being naive about the media and not having reigned in the PR department of the University of Illinois at Urbana-Champaign for over-blowing this piece of research. Now, millions read this and are misled! :-(

Controversial honoring of Theo Schoenaker at the ISA-congress 2013

Robert van de Vorst wrote to TheStutteringBrain to make us aware of the controversial honoring of Theo Schoenaker who holds views that clash with science. Make up your own mind!

Controversial honoring of Theo Schoenaker at the ISA-congress 2013: Stuttering a neurosis?

By Robert van de Vorst

Recently, on the 10th of June in Lunteren, Theo Schoenaker has been honored for his pioneering work in the field of stuttering (see here). For those unknown with his work, Ton and Theo Schoenaker were the first to offer group-therapy for adult people who stutter in the sixties, under the name ‘Doetinchemse Methode’ (1966-2001). In 1974, Schoenaker emigrated to Germany where he became profoundly influenced by the Individual Psychology developed by Alfred Adler.

In short, based on a psycho-analytical approach, Schoenaker believes that (all) stuttering is a psycho-somatic disorder, a neurosis. He seems thereby to contradict evidence of stuttering as a neurobiological developmental disorder, including subtypes and genetic predispositions.

Visit me in Luxembourg

To all those that will attend the ISA Congress in Lunteren (The Netherlands), I will be there this Saturday and Sunday to attend a meeting of the consumer and self-help group of the International Fluency Association (IFA).

And as Luxembourg is less than 4 hours car drive from the venue, for any one coming from far take the opportunity to visit me in Luxembourg! My email is tom.weidig at gmail.com!

Switch to a new Reader of my blog feeds!

Keep in mind that Google Reader will be switched off from July 1st onwards. So if you haven't yet done so, use an alternative reader and transfer your links RSS feeds!

Enzyme related to Stuttering determined

I am in exam stress, but check out this article. Chemists have unravelled the internal structure of a protein linked to stuttering in 5% or so of the stuttering population.

This information is useful in understanding how the structure of this "abnormal" protein might cause neuro-anatomical difference in people's brains. But proteins complex 3D beasts that change their structure with temperature and pressure, so any clear cut statements might be difficult to reach unless in a few exceptions.

Post-doctoral position in neuroimaging of stuttering

To all scientists, check out Soo-Eun Chang's job opening for a postdoctoral position in neuroimaging of stuttering: see here. She is moving to the University of Michigan this summer to a position that was endowed for research in stuttering at a medical school, which is a very special opportunity!

Here is the job opening:

The University of Michigan Department Of Psychiatry is seeking candidates for a postdoctoral research fellow position in a brain imaging laboratory that studies the neural bases of stuttering and other related speech-language and developmental disorders.

And become a friend of her group's Facebook page, here.

Specialist course on stuttering

Check out the ECSF course if you want to do a specialist course in stuttering:

CALL FOR APPLICATIONS COURSE 2013-2014

The ECSF consortium would like to announce that the registration for the 2013-2014 course cycle is open. The ‘ECSF’ is a one-year program, providing both the knowledge and the clinical skills, to assist speech-language therapists in becoming European Fluency Specialists. The program is a well-designed combination of lectures, clinical practice and home assignments. If you are already working as an SLT, this specialization course is compatible with your current workload. Lectures are provided during two intensive weeks, scheduled during the academic year. These modules are combined with follow up sessions in the home country of the participant. The local sessions take place outside the intensive weeks. Preparatory reading and home assignments form an integral part of the course. The specialized clinical training, under supervision of a fluency specialist, can begin after the first intensive week. Application procedure and application forms can be downloaded here.

How the Internet saved people who stutter

I know that I have not been following up on my video posts. My apologies. I have been and will be quite busy and need to rethink my video-blog strategy. ;-)

Today I want to talk about the Internet and how it has revolutionized our lives in several ways.

Email was just the gift from heaven for me, because I did not have to call people or go to them and explain in spoken words. I could just write an email, fine-tune the email, and send it off. I felt like a normal person not impeded by my stuttering. Of course, that led to all kind of other problems, because now all the bad things that happened to me in response to an email could not be blamed to stuttering! Including unsuccessful talking to girls!

Blogging was another gift, as I could reach the whole community and again was not limited by my speaking. Again. That led to all kinds of other problems, as I decided to say whatever I had on my mind. Maybe as a reaction to all the things that I had on my mind but could not say in all those years. The barrage of to-be-told ideas broke.

The Internet in general provided me with the perfect source of information on stuttering. I could email people, they could email me, I could read all kinds of scientific articles, I could get into other people's mind by reading their first-person experiences, and I could influence the thinking of many people. And it opened up a level playing field to challenge those in positions of power in academic research or therapy that thought they were the God.

Facebook was not really a gift for me. I already had email and blogging to express myself. In fact, Facebook is democratisation of the Internet taking one step too far. Nowadays, everyone can just post anything on stuttering. Millions of logical fallacies which drive me insane. Even more so, because they are inextricably entangled with many interesting and diverse experiences of people who stutter. As I always say, your experience of stuttering is your experience and true on its own, but your interpretation of your stuttering, i.e. its causes and its treatments, is mostly likely marred with fallacies. Any reasonable message is drowned in the vast amount of messages. It's a bit like at stuttering conferences...

5 minutes on stuttering: Cultural Differences or not?

I am still not happy with the final product. It is much more difficult to speak unprepared without being able to go back and correct your English or fine-tune your message. I am also wondering if the 5 minutes should really be about how to deal with stuttering, and the more science part should be left to the written word.

And apologies to Einar again for mispronouncing his name... I am as bad as Peter Reitzes pronouncing mine! ;-)

5 minutes on stuttering: It's not the technique that matters but that they are delivered in a social environment made of fellow stutterers.

5 minutes on Stuttering: Toastmasters

The video cuts out at the end, because the connection was lost. I wanted to say that getting on stage is always a gamble: if I am fluent, it is a great performance. if I am not, I struggle through the words. Typically, the more I practised the better. One of my next video posts will be about tips for public speaking.

5 minutes on Stuttering: Is coastal breathing effective?

Patience. I am still not very good at speaking unprepared: I mess up my English at times, and swallow words. It's probably because I spend a lot of resources to come up with a message...

5 minutes each day on stuttering

Irresponsible marketing by Tony Robbins?

Check out this video (at 4:15), where Tony Robbins claims that he makes someone who stutters fluent after 20 years of stuttering! We have all experienced spontaneous fluency, that goes away very quickly. In my opinion, Tony engages in irresponsible marketing.

Tony is inspirational, in general, but he should stick to change the possible and not the impossible. Tony's mission is to change other people's lives, maybe we as a community should change Tony's life and increase his understanding of stuttering. Stuttering is not a learned behaviour; it is an adaptation of a brain that is prone to jamming due to neurobiological issues.

As he is coming to England with this video in 2013, the BSA might be able to report him to the I-cant-remember-the-name agency for irresponsible marketing. NOTE: Maybe we can find this guy called Waschad (spelling?) and get him to "say" a few words. I doubt he is still fluent.

Ousmane's theory on stuttering

Ousmane sent me his theory of stuttering. So I give him here the opportunity for others to get to know his theory. I am sure he would happy if you comment on it.

I did:

"I disagree with your theory. 1) you can still have neurological issues even when speaking fluent when alone. it could be that your system is too sensitive to stress and other demands because it is not optimally developed. 2) some people sometimes stutter when alone and sometimes not. 3) i believe there is a continuum in neurological issue: from severe to mild. 4) speaking on your own is NOT the same as speaking to others, which demands much more resources even if you have no stress."

Here is Ousmane's theory:


 DRAFT OF A THEORY ON STUTTERING

Preamble

  -It’s not the situation itself that generates stress but the perception we have of it. Also, before a stressful situation, there is an automatic interior answer that is not managed by our will. For fluent people, the answer is proportional to the level of stress. If the stress lasts for a certain period of time, that answer will be recorded and served by the

Reddit talks about stuttering

Joe sent me an email: "I'm a moderator at r/stutter on reddit. We're trying to expand our subreddit and turn it into one the go-to places for people to discuss stuttering. We have 218 members right now, but we know there are more out there. We are big fans of your blog and have you linked to our reddit page. If you could help us out we would greatly appreciate it."

Of course, I will do so, even though I kind of support that further traffic on commenting about stuttering goes from my blog to social media sites!

Here is the link: www.reddit.com/r/Stutter

Predictions for 2013

StutterTalk has published a discussion between Peter Reitzes and myself. Lots of interesting stuff. One of the interesting things is that, yet again, I say that I set myself the goals to speak slower with pauses, and yet again after a few sentences I speak too fast...

We talked about my predictions for 2012, and what materialized and what didn't. I also made a prediction for 2013, talked about my upcoming book, and more more.

Frank's gene mutation

Frank was so kind to write up his experience of having been diagnosed with a gene mutation that correlates to stuttering. I am not exactly sure whether it is the 3-gene system that everyone talks about. What is also interesting is that people with Ashkenzi ("Central/Eastern European") Jewish ancestry seems to be more likely to have this gene mutation. It is very likely that as genetic subtypes seems to exist, they are more prevalent in some ethnic groups.

Frank reports...

I became involved in the study via my participation in the NSA convention that took place in New Jersey (where I live) in 2008. I attended Dr. Drayna's workshop on the genetics of stuttering and during the course of the workshop he asked participants in the workshop who stutter and have family members who stutter to donate a blood sample for inclusion in his study. My father stutters so I volunteered to provide the blood sample. 

Several months later he called me to say that I had the genetic mutation they where studying; that this genetic mutation on chromosome 12 was related to the rare genetic disease of mucolipidosis. He said there was some indication of stuttering in some patients with mucolipidosis. He invited me to come to the NIH in Bethesda, Md. for several days for a complete study of my physical and sensory systems to determine if I had any other physiological changes associated with this disease.I was very interested in this study, after doing a little research about this disease on the web, as some forms of it are more common in members of the Ashkenazi Jewish community of which I am a member. 

I spent three days at NIH. Dr. Drayna mentioned that I had a double copy of the mutation but didn't get the disease as I lack a likely "starter gene" required to get the full blown disease. I received a complete physical while at NIH; they seemed to be especially interested in the skeletal system and took numerous x-rays. I recall receiving EKG and EEG testing and very likely other tests I don't recall. I should mention the staff was very pleasant and accommodating and both my wife and I stayed at the Safra Lodge at NIH that was very pleasant. 

At the conclusion of my stay at NIH I was I was told they didn't find physical abnormalities other than some spinal arthritis common in people my age (I'm 62); they also didn't correlation with severity of stuttering and the presence of this mutation. They were kind enough also to send a copy of the study results as they appeared in the New England Journal of Medicine in 2010. 

This study has had a significant effect on my attitude toward my own stuttering as I now believe my stuttering has a strong genetic component and I'm much more accepting of my disfluencies. 

Navigate through my 1000 posts using dynamic views

Blogger has introduced a new way to visually represent blog posts, which allows the reader to easily skim through all posts. This eliminates the big downside to blogging: the disappearance of old posts. Unfortunately, many good features about the old template are lost so I decided not to switch. But they found a compromise until a further upgrade to the new template. You can directly link to this new template called Dynamic Views and run a dual blog site. That's what I do: see the link below the blog title! An added bonus is that I now restrict the recent posts to be displayed to ten, which makes the blog load four times faster!

Enjoy the huge archive! I was amazed at how much I wrote... a valuable resource that is now accessible to the wider stuttering community. I might not be right each time, but surely the reader gets an idea into his mind to wrestle with!

I can even group them according to topics, but for that I need to give all my 1000 posts topic labels... any volunteer to help me out here? ;-)

Genetics Update or Why our community is at least 14'000 years old

Yes, even the Flint Stones might have had to listen to stutterers...

Check out StutterTalk's Peter's as-always excellent interview with Denis Drayna on the "latest Drayna wants to tell us about genetics as of December 2012". Some exciting news: biochemical experiments show that the gene mutation reduces activity of an enzyme by half, the earliest known mutation happened 14'000 years ago, roughly 10% are of the 3-gene subtype, and many more gene signals found.

All-in-all, congratulations to Dennis Drayna's team for their hard and constructive scientific work.

Here are the key nuggets of knowledge and insight that I picked up and commented:

1) They studied the effect of the mutation of the 3 genes of the identified cycle and they see a reduction of the activity of the corresponding enzymes ( a form of protein that accelerates chemical reactions to help the body to produce the stuff it needs to live) by 50%. This fits neatly to a reduced (but not zero) capacity of the brain to function normally in speech. Think of my motorway analogy: we have 2 lanes instead of 4.

2) As we know, more than one gene mutation in the three-gene cycle causes a severe disorder, but only one mutation correlates to stuttering. They also did the biochemical experiment for 2 or 3 mutated genes out of 3, and got a dramatic reduction of 90 respectively 100% of enzyme activity. This neatly explains why 2 and 3 mutation lead to a severe disorder and a single one does not as the body is just about able to handle it biologically.

Nan's excellent article on What Is Stuttering

Check out Nan's excellent article on What Is Stuttering.

I agree with everything she says on the science side. I mostly agree with what she says about treatment. Except, I would also have mentioned self-help groups and  the importance of effectively dealing with having a handicap, which does not need to involve searching for fluency. She does mention Lidcombe, but only for its ability to move kids who stutter earlier into recovery. That is probably true, but I still do not rule adaptation or measurement effects completely out. And she could have mentioned that other alternatives are no worse.

All-in-all, it shows that she is a regular reader of TheStuteringBrain for many years! ;-)

May Conference at Hotel Croatia

Check out the website of the upcoming May conference in Cavtat at Hotel Croatia: see here.

All the speakers are relatively well-known and some of the most dynamic researchers in the field. I just find it a bit strange that Katrin Neumann talks about the state of genetics, and not about brain imaging, because she is not a geneticist or worked in the area. And as always I am concerned when experienced therapists think they can do proper outcome research. Please share your experience with us not your faulty scientific expertise.

Screening test for stuttering?

The BBC has an article entitled Screening test for stuttering 'closer': see here.

Here some important quotes:

The Wellcome Trust team says a specific speech test accurately predicts whose stutter will persist into their teens. The researchers, based at University College London, used a test developed in the US called SSI-3 (stuttering severity instrument). They found that the SSI-3 test was a reliable indicator of who would still have a stutter and who would recover - while other indicators such as family history, which have been used, were less so.

I am not sure exactly what the hype is about, but it seems to be saying that the more severe you stutter as a child the less likely you recover? That sounds to me obviously true on average. That's also the factor I found in my outcome study that correlates with positive outcome: the less you stutter before treatment, the more likely you are fluent afterwards! I have to read the paper, but I am skeptical.

The most interesting comment is that "researchers also found so-called "whole word repetition" was not a reliable indicator of persistent stutter". I vaguely remember that being a prediction by the EXPLAN theory pushed by Pete Howell. But I could be wrong.

I am also not impressed by Mr Lieckfeldt's BBC comment:

 "At five, there is still a window of opportunity to help those with a stammer."

 And afterwards, no opportunity to help those with a stammer? ;-)


"If we intervene early enough, there is a really high success rate of normal, fluent speaking, whereas for six- to eight-year-olds, the recovery rate drops like a stone."

OBVIOUSLY, due to the natural recovery rate! Those that would recover, recovered already!

Delayed Auditory Feedback wins Nobel Price!

This year's Ig Nobel Price winners:

ACOUSTICS PRIZE: Kazutaka Kurihara and Koji Tsukada [JAPAN] for creating the SpeechJammer — a machine that disrupts a person's speech, by making them hear their own spoken words at a very slight delay.

REFERENCE: "SpeechJammer: A System Utilizing Artificial Speech Disturbance with Delayed Auditory Feedback", Kazutaka Kurihara, Koji Tsukada, arxiv.org/abs/1202.6106. February 28, 2012.

Their "discovery" is that you can use DAF to stop people from speaking. When people hear their own voices with a slight delay, they stop speaking. One proposed application is a portable speech jamming gun, for use in places like libraries, as a quiet way to stop people from speaking, since loud interruptions are more disruptive than the speech itself.

I glanced through the paper, and it does refer to DAF for stuttering:

DAF has a close relationship with stuttering. DAF leads physically unimpaired people to stutter i.e., speech jamming. On the other hand, it is known that DAF can improve stuttering [1], and medical DAF devices are available [6]. We utilized DAF to develop a device that can jam remote physically unimpaired people's speech whether they want it or not. This device possesses one characteristic that is different from the usual medical DAF device; namely, the microphone and speaker are located distant from the target. [Thanks to Ora for his contribution]

How much do stutterers know about stuttering?

I have been stalking the ISAD conference again on Lidcombe as someone asked why Lidcombe is successful without asking first whether it is.

But let me inject some encouraging comments. I really liked to two posts.

From Jon Reilly:

Hello, I'm currently a graduate student at Kean University conducting a thesis regarding "education on stuttering." I was curious if you could recommend any studies that tested the knowledge of PWS on basic facts about stuttering. I researched and found John Van Borsel, but he presented surveys to the general public. I'm looking for PWS. Thank you in advance for any assistance you can offer.

I have never heard anyone do this research, and I really like the topic. Obviously, knowing about stuttering as a person who stutters is important. I was thinking for a while to suggest that a stuttering therapy should have a test for pws about stuttering. And only if you pass the test, can you enter the therapy. I would really be interested in seeing how much they actually know about stuttering. But then I also would like to see the same study done on generalist SLTs! ;-)

From Lynne Shields on common factors for lasting change:

Hello Reuben, There are quite a few factors that contribute to successful management of stuttering for adults. A few that I have seen as important among the people I've worked with are: 1) being ready for change (as opposed to just wanting change to happen), 2) having fairly specific goals (as opposed to wanting the stuttering to go away), 3) developing tolerance of stuttering, allowing them to experiment with their speech, 4) readiness to manage negative feelings and attitudes about their stuttering, if appropriate, and 5) the willingness to experiment, facilitating problem solving and independent management of their stuttering. There are certainly others, and I am sure others will share their viewpoints, as well. Best regards, Lynne

Molly rocks!

Molly shows great courage and determination to speak out. She definitely has taken the right decision, and she will feel more and more liberated from stuttering. She might still keep on stuttering but not be a slave of her stuttering.

How do all those who keep the obvious a secret feel about those public outings?

International Stuttering Awareness Day

Check out the on-line conference for the International Stuttering Awareness Day starting tomorrow! An interesting mix of articles from people who stutter sharing their experiences, therapists talking about treatments, and researchers sharing their research and theories. The good thing is that you the reader can leave questions for the author, that cannot really be ignored and a no-answer is obvious to all! And it's a great retro experience of what the web used to feel like 10 years ago... ;-)

The worse thing about the conference are all those (female) students who start their questions with "Thank you very much for the efforts you have put into your article. I am really fascinated by the topics XYZ...." If  we are lucky, they actually ask a real question after those few sentences! So here is my advice: Just ask your damn question, no-one is interested in whether you find something fascinated, don't think about the consequences of your questions, don't be blinded by authority, and make up your own mind!

P.S. I have hacked the website in 10 seconds and you can already access the conference here. ;-)

Stuttering: Inspiring Stories and Professional Wisdom

Check out Peter Reitzes' book which collects stories and wisdom from people who stutter and professionals. I asked him to send me a summary of what his book is about. Attentive readers will note the ambitious "Publication No. 1." on the title page. I didn't have time to read through the book, but it seems to be cast in the mindset of its editor: providing others the opportunity to talking about their experiences and throwing out ideas while avoiding more definite scientific or generalizing statements that I could take apart! ;-)

 Here is the summary:

The book is titled Stuttering: Inspiring Stories and Professional Wisdom.  

It contains 25 chapters written by people who stutter, leading professionals and the spouse of a person who stutters. All chapters were donated to StutterTalk to help raise money for the free podcast. The book is available in paperback at Amazon for $12.99 and as an ebook and download at Kindle, iTunes and Smashwords for $5.99. Barnes & Noble online will carry the book within a few weeks. I

In Berlin

I will be in Berlin from Wednesday to Saturday with Jelena, and have to attend a business meeting, too. So if someone is from Berlin, let me know and you can join us for drinks or dinner! I am already in contact with Blanka, who had the first (and only) German-speaking blog on stuttering: Stottern usw. I am actually very much surprised that no-one else has a German-speaking blog...

Web-based Cognitive-Behavioural Treatment: an innovative approach

I am not any more on the mailing list of that gold-standard Australia stuttering group except for threatening letters from lawyers. But I have my agents everywhere. So thank you, Agent I!

Here is an initiative that is probably reasonable: a web-based Cognitive-Behavioural Treatment. The idea is that a lot of the suffering and handicap comes not from stuttering but from our psychosocial adaptation to stuttering. CBT is a well-known psychotherapy approach that helps patients to achieve a better psychosocial adaptation by changing unhelpful thoughts or reducing conditioned fears, for example.

You can register from anywhere in the world. So might be an interesting experience with little downside and probably little relapse.

Reading about how they analyse their outcome and then sell it is probably not, but that is my problem not yours! ;-)

Here is their invitation.

Paul's stuttering course

I highly recommend to you Paul Brocklehurst's course: see link here. In a sense it's a revolutionary approach, because he does not focus on treatment, but he only wants to inform people who stutter about their condition. I strongly believe that you can only manage your stuttering well by looking at yourself from a different perspective where you understand where stuttering comes from, what it did to you, how it affects you, and what treatments people have tried.

What I like about it is that no pressure for more fluency is applied. You are not expected to be more fluent, but you just go there to learn more and ask as many questions as you want. Impossible to feel like a loser afterwards as there is no relapse of understanding and knowledge!

And as Paul says, this will prepare you well for a real treatment.Well done, Paul!

Here is a quick summary of what he intends to do:

These classes are designed to provide people who stammer with a clear and detailed insight into their condition, including what factors influence its severity and what practical steps they can take to better control and manage it. The course will be interactive, with plenty of opportunity for questions and answers and to try things out. It will provide an ideal foundation for individuals wishing to enrol on one of the intensive therapy courses. Each meeting is divided into two halves. In the first half we give a presentation, introducing the topic to be discussed. Then, after a short coffee break, the second half will be practical and interactive, giving participants an opportunity to share their experiences and to contribute to the class.

Fill in student's questionnaire

Please help a "poor" student, Beth Harris from De Montfort University at Leicester (England), to collect data for her thesis work. Your participation won't change the way we look at stuttering, but will provide her with good data to learn how to do statistical analysis in the real world.

Go to this link.

A blog on taking meds for stuttering

A PhD student, M.,  has created a new blog:

I've created a blog where I will post information on the experiences people have with various medications they're trying for stuttering. This way we can get as many people as possible to post their experiences so that we have a nice little anecdotal data source for stutterers interested in meds. 

It is a good initiative, but based on experience I know that quite a few have written to me about their successes but then when I re-contacted them months later, they stopped taking them! In fact, I do not know a single person that contacted me that still takes them! NO-ONE!

He wants to stay anonymous. So here is my message to him:

Of course, I will do that. But if you ask me to remove your name from this post, then I think that psychotherapy (and self-help group) might actually be a better choice of treatment for you. You are running away from your handicap. All that effort spent on hiding and taking pills with uncertain outcome...