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Showing posts with label Stuttering. Show all posts
Showing posts with label Stuttering. Show all posts

Wednesday, September 23, 2020

TWELVE TRICKS TO STOP STUTTERING

TWELVE TRICKS TO STOP STUTTERING:

And Some Insights Into Why

By 

Frances J. Freeman, Ph.D.

PART #1


Introduction

For over 50 years I was a clinician, researcher, and university professor with a primary clinical interest in stuttering.  I am author of a number of seminal research reports on stuttering, but I have never published on my clinical work, methods, or insights.  A recent entry in the FaceBook Group “Stuttering Community” intrigued me. The writer asked others to share any “Tricks” that could stop stuttering.  His request made me think.  I had spent 30 years teaching students of communications disorders my “tricks” for stopping stuttering; why shouldn’t I teach people who stutter these “tricks’? This series of Blogs is my response to this question.


The History of “Tricks” for Stopping Stuttering  


From Ancient Times — 

Recorded history chronicles many stories of the successful treatment or “healing” of stuttering by a variety of methods.  From at least the Middle Ages through the early 20th Century, Stuttering was primarily treated by men and women who have been called “stutterer-curers.”  Many were itinerants, moving from place to place, offering their cure at fair-market prices.  Some built “schools,“ and had students who came to them for treatment.  Most, but not all, guarded their “secret” treatments and made stutterers pledge never to reveal how they were cured.  One man who treated stuttering in the mid-19th century,  freely shared his approach.  James Hunt’s  writings on the nature and treatment of stuttering demonstrated wisdom that can still guide us. 


Modern Times —

With the scientific revolution, stuttering became a subject of interest in the developing fields of medicine, education, neurology, psychology, psychiatry, linguistics, and child development.  In the early to mid 1900’s,  leaders in the “scientific” study of stuttering rebuked all of the early treatments of stuttering, and coined the derogatory term “stutterer curers.”  The new experts concluded that the “curers” used “tricks” which stopped stuttering, but that these “tricks” lost their power over time, and the stuttering returned.  They considered the “curers” to be charlatans, cheats and “tricksters.” 

 

The prevailing theory held that the “tricks” worked because they served as “distractors.”  A “distractor” worked until it was  habituated, and then the stuttering returned.  In the view of that period, the “tricks” were ALWAYS temporary panaceas, and NEVER resulted in permanent cures.  This belief was based on reports from stutterers who relapsed after treatment.  However, systematic studies of success/failure rates for the “stutterer curers” were never conducted, so we don’t really know if some were permanently “cured” by their “tricks.”


During the mid 1900’s, stuttering treatments were developed that focused on recognizing, accepting, confronting, modifying, and managing stuttering.  Clinicians developed techniques that minimized overt stuttering, thus producing more fluent sounding speech. Stutterers learned to recognize when they were about to stutter, and to change or modify their speech in order to prevent uncontrolled or involuntary stuttering.  Voluntary stuttering, controlled stuttering, cancelations of “bad” stuttering by more fluent “easy” stuttering, soft contacts, easy onsets and other techniques were used to reduce struggle, tension, and overt stuttering.  These came to be known as “Stutter more fluently” treatments. For almost three decades (1930’s-1960’s), no reputable, professional in speech correction, speech therapy, or speech pathology (the three names used by the profession over those years) would use any of the forbidden “tricks.” 

 

Among the revolutions of the 1960’s was a rapid expansion of the hybrid field of Speech Science. The discoveries in this field led to much that we take for granted today, including (to name only a few) talking computers, Siri, Alexa, captioned TV, text to speech, speech to text, voice identification, and computer translators.  


Reacting to new knowledge from this emerging field, Marcel Wingate in 1969 and 1970, wrote two articles in which he reviewed the known “TRICKS” for stopping stuttering.  He called these  century-old “tricks”  “fluency evoking conditions.”  He didn’t exactly commit the heresy of saying that these “tricks” should be used in therapy; but he hypothesized that the scientific study of the “fluency evoking conditions” would be important in understanding the nature of stuttering, and possibly in developing better treatments.  


Through the 1970’s and the 1980’s a major movement in the field of stuttering focused on the study of the “fluency evoking conditions,” and eventually on treatments based in these speaking conditions.  As a group, these treatments were called “Speak More Fluently,” because they modified the overall speech pattern in order to produce less stuttering.  These treatments used one or more of the old “tricks” as basic “techniques” to induce stutterers to begin to speak without stuttering.  Then the treatments attempted to “shape” or “modify” the induced fluency to sound and feel like “normal,” “fluent” speech.  


The name also provided a contrast with the older treatment programs. As a result, clinical approaches were divided into:  “Stutter More Fluently” or  “Speak More Fluently.”  The Truth be Told, both approaches have basically the same efficacy results:  They help “Some Stutterers All of the Time; and Most Stutterers Some of the Time; but neither Approach helps All Stutterers All of the Time.”  


The lack of complete or perfect success for any behavioral treatment, has subsequently led many to believe that stutterers cannot learn to speak without stuttering, and that we must focus our efforts on changing attitudes and building acceptance of stuttered speech (among both the general public and stutterers).  The goal is to use knowledge, information, and understanding to remove any stigma or shame, and to promote acceptance of stuttering as  another “way of speaking.”  This approach has been facetiously labeled “Stutter More Happily.”


In the midst of the often violent conflict between advocates of these approaches, some clinicians have become eclectic or pragmatic.  They attempt to treat each stutterer as an individual who has specific needs, and who responds differentially to treatment.  Some of these clinicians have  many satisfied clients, but no general recognition of their methods or approach.  Specifically, the efficacy of individualized treatment is difficult to validate.  If each client receives a different treatment, the clinician can’t even demonstrate reliability?  These individualized approaches haven’t even rated a label.  


One thing that has remained constant across the years (ancient to modern) — no one has ever just given the “tricks” for stopping stuttering, and knowledge of why these work to the people who stutter, to let them discover for themselves if, which, when, where, for how long, and under what circumstances these “tricks” help them. 


THEREFORE, I have written this PART #1, and am posting a link to it on the FB GROUP.  If enough people read and respond I will write PART #2.  Specifically, I am asking:

  1. Are any of you interested in reading further?
  2. If you read more, and try any of the “tricks” will you write and tell us about your experiences (give feedback that can be used to help us learn and/or help others)?
  3. Will you view this not simply as a means of improving your own speech, but as participating in stuttering research to: 1). Learn more about your own stuttering and 2). Create new understanding of the nature of stuttering.

If I write more about Stuttering, I promise to end each segment with a true story about stuttering.  The first such story follows:



THE STORY FOR PART #1


How Johnny Stopped His Own Stuttering


As a very young public school speech therapist (we had not yet become Speech Pathologists), I worked with Johnny every Wednesday morning.  Johnny was 7 and in the second grade.  He was a brilliant child, and absolutely beautiful.  He read on a 4th grade level.  His language, vocabulary, and grammar were above average, and his articulation was perfect -- but he stuttered severely.  He prolonged almost every continuant sound, so that it could take Johnny a whole minute to complete a short, simple sentence. 

 

To try to type one of Johnny’s sentences would be like this:


 “MMMMMMMyyyyyyyyy nnnnnnnnaaaaamme iiiiiiiizzzzz Joooooooonnnnyyy.”  


    He never repeated a sound or syllable, and there was very little struggle or tension in his speech. 

 

Nothing in my training or in my reading prepared me to treat Johnny.  I read more; I talked to other clinicians; I called my former professors — I didn’t find an answer.  How was I supposed to help Johnny?  


Finally, one Wednesday morning, in absolute desperation, I asked Johnny: “Johnny, WWWWyyyy dooooo yyyyyoooouuu taaaaalk llllliiiiiik ththththiiisss?”


Johnny looked at me like I was crazy, and then said, “So-so-so-so I-I-I-I wo-wo-wo-won’t stu-stu-stu-stutter.”  


    Johnny had taught himself to prolong sounds to keep from repeating sounds. In Johnny’s mind, and according to his understanding, repetitions were stuttering, so he taught himself to prolong sounds instead of repeating.  Johnny believed he had cured his stuttering.


You will be happy to know that Johnny learned to talk without repetitions or prolongations, and that right after Christmas of second grade, he graduated from speech therapy.  Johnny taught me a lot about stuttering, but most importantly, he taught me to always ask the person who stutters to teach me what I need to know about his/her stuttering.

Monday, November 23, 2015

CENTENIAL JOURNAL ARTICLE -- Frances Jackson Freeman

 CENTENIAL JOURNAL ARTICLE PUBLISHED BY FRANCES J. FREEMAN


Frances J. Freeman, Ph.D., of Logansport, marked the publication of her 100th refereed Journal article this past month, when her research, entitled “Characteristics of Fluency and Speech in Two Families With High Incidences of Stuttering” appeared in the current issue of the Journal of Speech, Language, and Hearing Research. 

A native of Logansport, who has returned to her hometown in retirement, Dr. Freeman has published over 500 professional articles, book chapters, papers, and pamphlets.  However, research reports in refereed professional Journals are the primary measure of a scientist’s productivity.  The publication of her centennial article comes exactly 50 years after her first, “Vowel and Nasal Duration as Cues to Voicing in Word-Final Stop Consonants in American English” appeared in the Journal of speech and Hearing Research.

A 1957 graduate of Logansport High School, Dr. Freeman received bachelor and masters degrees from Northwestern State University before working as a speech-language pathologist in the Caddo Parish Public Schools.  During the turbulent 1960’s, she was active in the civil rights movement, and was among the first teachers to integrate Louisiana’s previously segregated schools.  In 1970 she moved to New York to pursue doctoral studies at the City University of New York.  She conducted her doctoral research in electrical activity in laryngeal muscles during stuttering at Haskins Laboratories of Yale University, and was a visiting scholar at MIT, Bell Laboratories, and Tokyo School of Medicine.

Journals in which Dr. Freeman’s previous work has appeared include: Science; Archives of Neurology; the Journal of Voice; the Annals of Otology, Rhinology, & Laryngology; Brain and Language; Transactions of the American Laryngological Association; Archives of Otolaryngology – Head, Neck, Surgery; Journal of Fluency Disorders; Annals of Internal Medicine; Journal of Phonetics; Journal of the Acoustical Society of America; and the Journal of Communication Disorders.  Her work was featured at the Annual Conference of the American Association for the Advancement of Science (AAAS) in 1979 and again in1989.

Coauthors of the August 2015 article are Sheila V. Stager, Ph.D. and Allen Braun, M.D. of the National Institutes of Health.  Dr. Stager directs Voice Research at George Washington University in D.C.  Their research was supported by the Intramural Division of the National Institute on Deafness and Other Communications, as part of a genetic linkage analysis in developmental stuttering, which included gene mapping in extended kindred and candidate gene analyses.

            Before retiring from Stephen F. Austin State University in 1998, Dr. Freeman taught at Adelphi University, Northwestern University in Evanston, IL, and the University of Texas at Dallas, Callier Center for Communication Disorders.  From 2010 to 2013, Dr. Freeman returned to academia, serving as Associate Vice President for Faculty Diversity at the University of Texas at Dallas. 

            Dr. Freeman’s research has focused on normal and pathological speech production with particular emphasis on stuttering and neurological voice disorders.  Her earliest research used acoustic, electromyographic (EMG), and laryngeal endoscopic measures to characterize stuttering and spasmodic dysphonia.  In this work, she assisted in the development of first clinical laryngeal fiberoptic endoscopes.  In Dallas in the 1980’s her team at the Callier Center and Southwestern Medical School pioneered approaches in correlating Quantitative Electroencephalographic (QEEG) data with static and dynamic brain imaging.   Their work led to the classification of Spasmodic Dysphonia as a neurologic disorder, and to current treatments, including botox.  In the 1990’s she was involved in genetic studies of stuttering, which eventually led to the research on which her most recent publication is based.

            In retirement, Dr. Freeman is engaged with her husband of 56 years, Charles Freeman, in developing Freeman Farms of Joaquin, TX.  The couple has two daughters and four grandchildren, and are expecting their first great grandson in February.  Dr. Freeman serves on the Historical Committee of the Town of Logansport, on the Board of the Friends of the Mansfield Women’s College Museum, and on the Board of the Logansport Chamber of Commerce.