This
is a revision of the original post "Voluntary Stuttering?" posted 12/12/08
In this opinion piece, I ponder the use of voluntary stuttering in speech
therapy. For example, I wonder why voluntary stuttering as it appears in Easy Talker:
A Fluency Workbook for School-Age Children (Guitar &
Reville, 1997) is vastly different from how it appears in Easy Does It for Fluency:
Intermediate (Roseman & Johnson, 1998) . Let's reconsider voluntary stuttering,
especially in light of two recent research studies.
This definition of stuttering
appeared in "Stuttering as Defined by Adults Who Stutter:" “. . . stuttering indicates a sensation of
being stuck or losing control when speaking, a behavior a person might or might
not outwardly show, and various affective or cognitive reactions a person
experiences.” (Tichenor & Yaruss, 2019, p. 4363) Given this
definition, fluency counts may be beside the point. A meaningful assessment of
stuttering may depend primarily upon a client's ability and willingness to
share their thoughts, feelings, and experiences associated with a loss of
control when speaking.
Since stuttering " . . . is
considered to be a complex, multifactorial disorder. . ." (Byrd, Gkalitsiou, Donaher, &
Stergiou, 2016, p. 290)
the following advice found in Easy Does It is inappropriate: “Finally, reassure
the student that there's nothing wrong with him . . . He just needs to learn a
new habit and you’d like to help him.” (Roseman & Johnson, 1998, p. 9) It seems to me that describing more fluent
speech as a "habit" sets the client up for self-blame and failure.
Purportedly, there are at least
three reasons for stuttering on purpose:
Reduce fear: “Pseudo-stuttering
is an excellent desensitization tool and ‘turns stuttering on its head’ by
changing it from a behavior to which a child is seemingly defenseless to one
that the child can turn on and off at will." (Ramig & Dodge, 2015, p. 85)
Move through a stutter:
“Sometimes, when children are experiencing a very tense block, they can
initiate their pull-out with a ‘bounce’ or an easy stutter.” (Reardon-Reeves
& Yaruss, 2013, p. 101)
Identify oral-motor tension:
“First, Annie asked 3B to pretend to get stuck on a word. Then, Annie asked 3B
to stay in the stutter and feel what his body was doing ..." (Guitar & Reville, 1997, p. 113) (I do not find a
definition of voluntary stuttering in the Easy Talker workbook. Children
"pretend" to stutter and produce "cool fakes." Voluntary
stuttering is whatever the speaker feels it to be.)
The headline "Clients Who
Imitate Their Own Stuttering Patterns Claim Favorable Effects" (ASHALeader, 2016) caught my eye. I've
learned to look beyond headlines, so I read the AJSLP article. Let's look at the numbers.
"Seventy-five (42%) of the
177 respondents . . .reported that voluntary stuttering reduced their fear,
eight (5%) reported that voluntary stuttering eliminated their fear. . ." (Byrd, Gkalitsiou,
Donaher, & Stergiou, 2016, p. 294)
". . .81 (45%) stated that
the use had no impact on their fear, eight (5%) stated that the use increased
their fear of stuttering, and five (3%) responded that voluntary stuttering
significantly increased their fear of stuttering." (Byrd,
Gkalitsiou, Donaher, & Stergiou, 2016, p. 294)
While the authors analyze the
data thoroughly, looking at the types of voluntary stuttering respondents used,
these percentages still give me pause. How do I decide which client is a member
of the 47% who felt less fear or of the 53% who found no benefit or an increase
in fear?
The School-Age Stuttering Therapy
workbook proposes that the clinician voluntarily stutter. “Thus, you need
to be willing to ‘put stuttering in your own mouth’ so you can enter real-life
situations and practice with your students. . .” (Reardon-Reeves
& Yaruss, 2013, p. 106) I did this. I practiced voluntary
stuttering on my own at stores, restaurants, and other social situations. Then, I modeled easy repetitions,
prolongations, and blocks with my students. But, how could I be stuttering
voluntarily when the definition of stuttering is a sensation of being stuck
or losing control when speaking? Many years ago, I helped to organize a regional gathering on
behalf of the National Stuttering Association, and I used voluntary stuttering
in my closing remarks at the end of the day. As people leisurely left, an adult
person who stuttered charged up to me and said – quite angrily - that I had no idea what it was like to
stutter. My voluntary stuttering carried none of the affective and cognitive
baggage that was a part of his experience.
In episode 428 of the StutterTalk
podcast, “Caryn Herring, Roisin McManus and Joel Korte of The StutterTalk B Team discuss the different flavors
of voluntary stuttering and how this fits into stuttering management." (Herring, McManus, & Korte, 2013) These three adults
who stutter share their insights about voluntary stuttering – this is the real
deal, and it's fascinating. They did not convince me that I should have expected
my clients to use it.
My favorite book about stuttering
is Stuttering is Cool: A Guide to Stuttering in a Fast-Talking World by Daniele Rossi. I found this book at the
end of my career and it was the best book I ever read about stuttering. Rossi
joins in the chorus of praise for voluntary stuttering. “Yup, stuttering on
purpose! And yes, it is actually, totally, really, honest-to-goodness
advantage!" (Rossi, 2014, p. 30)
But wait - Daniele also says, “I’ve never mastered this technique; however, I know many
people who use it.”
In my opinion, clinicians should
tread cautiously when offering voluntary stuttering as a fluency enhancing
strategy. Looking back over my long career as a speech language pathologist, I
see my earnest attempts to blend research with clinical work. Yet, I must
wonder how often my trust in research and commercially published materials may
have blinded me to the real needs of individual clients. I post this blog to
encourage speech language pathologists to take care in your work. Listen to
your clients, document your rationale, process, progress, and clients' responses
to speech therapy. Be clear about what you are doing and why.
Own your work,
Judy
ASHALeader. (2016, November 1). Clients Who Imitate
Their Own Stuttering Patterns Claim Favorable Effects. The ASHA Leader, https://doi.org/10.1044/leader.RIB2.21112016.13.
Byrd, C., Gkalitsiou, Z., Donaher, J.,
& Stergiou, E. (2016). The Client’s Perspective on Voluntary Stuttering. American
Journal of Speech-Language Pathology, 291-305.
Guitar, B. P., & Reville, J. M.
(1997). Easy Talker: A Fluency Workbook for School-age Children. Austin,
Texas: PRO-ED, Inc.
Herring, C., McManus, R., & Korte,
J. (2013, November 9). StutterTalk: Changing how you think about
stuttering...one podcast at a time. Retrieved from The Flavors of Voluntary
Stuttering (Ep. 428): http://stuttertalk.com/?s=428
Ramig, P. R., & Dodge, D. M. (2015).
The Child and Adolescent Stuttering Treatment and Activity Resource Guide,
Second Edition. Clifton Park, NY: Delmar Cengage Learning.
Reardon-Reeves, N. M., & Yaruss, J.
S. (2013). School-Age Stuttering Therapy: A Practical Guide. Stuttering
Therapy Resources.
Roseman, B. A., & Johnson, K. L.
(1998). Easy Does It for Fluency: Intermediate. Austin, Texas, PRO-ED,
Inc.
Rossi, D. (2014). Stuttering is Cool:
A Guide to Stuttering in a Fast-Talking World. Canada: Mischief, Mayhem and
Mirth Publishing.
Tichenor, S. E., & Yaruss, J. S.
(2019). Stuttering as Defined by Adults Who Stutter. Journal of Speech
Language Hearing Research, 4356-4369.
