The role of eye-gaze diversion in the breakdown of communication
It’s refreshing to see a legitimately new research idea in press. And if the idea is of good quality, I get all the more excited. This research article measures the eye gaze of listeners as they are exposed to stuttering. (In other words, special equipment recorded where the listeners were looking as they saw stuttered speech.) Such an idea isn’t new; I remember having a conversation about this very research idea with one of the authors some 10 years ago–but it’s great to see that someone actually went out and did it.
There’s so much to like about this article. First off, the breakdown of communication relative to stuttering is always blamed on the stutterer. (The unconfident/diffident stutterer has bad eye contact because they’re nervous, which causes them to stutter.) This study turns that assumption on its ear, and collects data on the fluent listener. And what did they find? Sure nuff, fluent listeners break eye contact when looking at stuttering. So it appears as if no one is looking at anyone when stuttering is involved. All parties are involved here… (Looks like all could benefit from desensitization…)
This is where the authors and I differ. They report that this break in eye contact is a response to the communication breakdown… Nah. Incomplete. Innaccurate. This break in eye contact *represents* a breakdown in communication. They’re still under the mindset that ‘communication’ is the audible signal alone. It’s not–the visual signal is an important part of communication, and when there is stuttering present, people are turning this modality off.
It’s a safe assumption to make that when listeners break eye contact, that can be a shameful realization for the speaker. And that shame has consequences…
Episode 38 of the Stuttering.Me micropodcast is up
Being broke, poor, and having peace. Learning lessons from the Millionaire Mind and applying them to life with stuttering.
Podcast: Play in new window | Download
The interpretation of therapy results fails when the treatment teaches to the test
I’m really at a loss if I should keep pointing out the cargo-cult pseudoscience in the field of SLP. But alas, here’s another example–including many of the same researchers on this little gem. This study is measures the effects of syllable-timed speech to treat preschool children who stutter. In English–this means…”Does talking like a slow monosyllabic robot cure kids from stuttering?” The abstract says “yes, but it takes 6 visits.” I couldn’t bring myself to read the article. Sorry.
What’s the flaw? The kids are being taught to the test. Talk in such an unnatural way that overt stuttering is impossible. Measure that the kid isn’t overtly stuttering. (Profit!) Assume that this unnatural “fluency” will result in a life-long recovery from stuttering. So gang….are we buying this? Make a kid talk like a robot and assume stuttering is cured?
No–I’m not saying that direct pediatric stuttering therapy is bad… not by a long shot. But this research group has to recognize that they can’t quantify the stuttering phenomenon. And their attempts to quantify the disorder results in them fooling themselves into success that they’re likely not really having.
A perfect example of how flawed thinking results in flawed (and useless) data
This article is both rich and ripe with fodder. I hardly know where to begin, but let’s trudge through this together. The title: “The relationship between mental health disorders and treatment outcomes among adults who stutter.“ Again, let’s look at the assumptions the authors are making. Do we see articles on mental health disorders and the treatment of cerebral palsy? Do we see articles on mental health disorders and heart disease? Liver malfunction? No, you don’t; “that’s silly” is what you’re probably thinking. But this is an anchor to the negative stuttering stereotype: unexplained phenomenon below the neckline is usually viewed as physical or medical. Unexplained phenomenon occurring above the neckline (such as stuttering, cluttering, Tourette’s, etc) is generally not viewed as “medical”, but rather a character flaw (or character weakness) of the person. This prejudice is encapsulated in the title.
So let’s look at the article’s premise. The authors cite that only 1/3 of those that go through stuttering treatment have any real kind of lasting result. And they’re trying to figure out what makes this 1/3 ’successful’, and the other 2/3’s failures. So they make the assumption that only those without mental disorders can retain therapeutic success post-treatment.
Let’s delve into this a little further. What they’re implying is that stuttering children and adults have mental health disorders. Ipso facto, it’s our fault. If we were strong enough not to have these mental health disorders, then we could make stuttering therapy work for us. It’s the old (bad) SLP playbook: “If first you don’t succeed, blame the client.”
But back to the study…The authors are predicting that only those without mental health disorders will retain therapeutic success. Stutterers that fail to succeed have mental health disorders. And what do you think they found? Data that supports their prejudicial assertion.
Now–how is this utterly and fatally flawed? It’s flawed in the hearts of the “researchers”. They’re pairing the cause of stuttering and the failure of stuttering treatment with psychological disorders. These are the predjucial glasses that they wear. And if you look for something, predjicially, you’ll be sure to find it. This is a perfect example of both: (a) pseudoscience, and (b) cargo-cult science. The authors fail to even respect or recognize that the cause of stuttering and failures in stuttering treatment are entirely beyond the realm of psychological or mental health disorders. But let me invalidate their entire study with one or two sentences. Those participants that scored as having a mental health disorders were more severe from the start; the stuttering ti-ger has been kicking their ass for an undocumented period of time, and this is being revealed in their psychological metric.
Looks like I just found yet-another crappy research article to use as an example in my classes. Keep it coming folks–this material helps my students become better and more critical scientific thinkers…
Stuttering, circa 1950
About 12 years ago, I was at my wife’s grandparents house…where I ran into a relic of the past. An encyclopedia set. (!) So I looked up “stuttering”, and here’s what I got:
Stuttering, sometimes called stammering, is a form of anxiety tension, manifested as a disturbance in the fluency of speech, motivated by an apprehensive anticipation of difficulty in initiating or maintaining an adequate flow of speech.
Pertinent surveys indicate that nearly 1 per cent of American school children stutter. According to Prof. Charles VanRiper, Dr. C. S. Bluemel, Dr. Emil Froeschels, and other authorities, stuttering generally begins in early childhood and nearly always consists of easy, simple repetitions and hesitations in its early stages. This general view has been confirmed and elaborated by studies reported from the State University of Iowa Speech Clinic, which indicate that the average age of onset of the difficulty is three years. The studies also indicate that children who develop stuttering do not differ as a group from nonstuttering children so far as intelligence, health, physical development, speech development, and general behavior are concerned. It is of particular importance that stuttering is usually originally diagnosed by laymen, usually the parents. What they diagnose as stuttering appears in the usual case to be indistinguishable from the ordinary repetitions and hesitations in the speech of normal young children, between the ages of two and five, who have been found to average 45 repetitions per 1,000 words.
As to treatment, there is general agreement that stuttering should be treated as a form of anxiety tension. The main objective is to reduce the anxiety of fear regarding stuttering, and by this means, and in direct ways also, to reduced the hesitancy and tension characteristics of the stutterer’s speech. Mental hygiene, or personality re-education, also is indicated in many cases to counteract the maladjustive effects of stuttering. The treatment of young children is chiefly a matter of parent education designed to change the parental policies, so as to remove the sources of the child’s anxiety tension, which may be harmfully increased by parental demonstration of concern or by actually instructing the child to stop and start over, to speak more slowly, or to stop and think.
– (W.J.)
Collier’s Encyclopedia
Frank W. Price (editorial director)
Charles P Barry (editor in chief)
P.F. Collier and Sons Corporation, New York
1950
First edition
Manufactured in the United States of America
Volume /S/ p. 258
And the sad thing is… this view (largely based on a predjudice second to the fundamental attribution error) is still pretty prevelant today…
Speech-activated myoclonus masquerading as stuttering?
Ran across an interesting teaser article from pubmed entitled Speech-activated myoclonus masquerading as stuttering. No, it has no abstract. No, it’s not printed yet. No, I can’t seem to download a digital pre-print. No, I’ve not read the freakin’ article. Yes, I’ll have to wait until it magically shows up at our library. So what is myoclonus? Well, I did a little reading on it–and it seems pretty interesting. (Funny, pretty much all the online resources say the *same*exact*thing*; so there’s a whole lotta copy/pasting going on!)
So what is myoclonus? Well, let’s break it apart. Myo meaning “muscle”; clonus meaning “violent, confused motion”. So we’re talking about confused muscle motion–such as involuntary jerks or spasms. The most identifiable example is that body jerk that we all get from time to time *right* when we’re about to fall asleep.
Now–there are (behaviorally identified) subtypes of myoclonus out there…and the one that seems most stutter-esque is “action myoclonus”. This is “characterized by muscular jerking triggered or intensified by voluntary movement or even the intention to move. It may be made worse by attempts at precise, coordinated movements.” So I can see it… Maybe. I’d like to read more about myoclonus and read the article as well.
The “cause” of myoclonus seems to be pretty wishy-washy. The best description that I could gather is that there is “decreased inhibitory signaling from cranial neurons.“ And this could make a bit of sense relative to stuttering–as there have been a few long-standing theories suggesting that stuttered speech may stem from errors in physiological speech “feedforward” and “feedback”. (Postma & Kolk come to mind…)
Anyway–interesting to see what all comes from this… And to get my grubby little paws on some data 
Update 1: A reader was kind of enough to pass along the article, and the format was more interesting than the paper itself. It was a single page, 2 paragraph paper (with embedded video of the client). Anyway–pretty interesting. The client got sick around age 21 and “stuttered” ever since. I’m suspecting that there was some viral infection that passed the blood/brain barrier and likely effected the basal ganglia-thalamocortical circuit–thereby resulting in the involuntary neural activations. (But let’s get serious–I’ve got no clue..) Further, the idea of linking speech myoclonus and stuttering isn’t new at all; Larry Molt wrote a good article on the concept for ISAD.
Update 2: Interesting. I viewed the video of the client, and his speech does represent some aspects of “stuttering” in the textbok sense, but my stutter-senses weren’t tingling while watching the video. Another nugget of trivia was revealed when the client said that stress and anxiety have an impact on his severity. (This should give creedance to BGTC involvement.)
Cluttering is not the same as stuttering
While most people at least recognize stuttered speech and pick it out from a line-up, most people (even SLPs) don’t have a clue about cluttering phenomenon. This is a *great* resource that provides some of the basics. They ought have called it Cluttering 101.
Stuttering: Myths, Beliefs and Straight Talk
Some knuckleheads wrote this pamphlet; it may or may not be worth your time.
How bad stuttering therapy teaches to the test
Over the years, I’ve come to realize that we only understand a concept after we teach it (effectively). Until then, understanding may largely be an illusion. Anyway, this past semester, I realized that much of traditional stuttering therapy is largely teaching to the test. (In other words, the (a) therapist sets the goal as being some kind of fluency objective, (b) skills are taught that meet that objective, (c) treatment is measured in such a way such that the objective is met.)
So I just read a post over at the stuttering forum that describes this phenomenon very well:
I see a speech therapist on a regular basis. I am perfectly fluent during sessions and use my “skills” with no difficulty. The minute I step outside her office, all that goes out the window. I know exactly what to do but my stress level prevents me from doing what I need to. Should I continue therapy? I don’t know that I can benefit any further from it. It’s costly and I feel I’ve learned all I can about speaking fluently. The problem seems to be my negative thinking and poor stress management.
First off–despite my best efforts, I still can’t get an account over at Stuttering Forum. So mods, feel like showing me some love? Secondly, it’s time to change therapists–because we’ve got problems. (1) What are the therapeutic principles? (i.e., how is stuttering fundamentally viewed by both clinician and client?) (2) What are the therapeutic values (i.e., what are the long term objectives?) (3) What are the therapeutic goals? (i.e., what are the short term objectives?) Just by reading this short post, I’m thinking that the clinician is confused at step 1, and thus has botched 2 and 3. Sorry, I call them like I see them.