About the Author: Patrick Campbell is a stammerer and children’s doctor living in Cambridge, England. He has an interest in how public and self-stigma intertwine to produce disability for people who stammer and how this debilitating process can be altered through seeing positive value in stammering. He recently co-edited the book Stammering Pride and Prejudice: Difference not Defect (http://www.jr-press.co.uk/stammering-pride-prejudice.html). In his spare time, Patrick enjoys 5k runs.

People who stammer speak in a unique way that is fundamentally different to people who are fluent. It is generally thought by society that this different way of speaking is less desirable and less useful than fluency. However, as articles published here in previous years have vividly shown, this is not always true (Constantino, 2016). We, as individuals and a society, can grow and gain through having people who stammer speaking in society.

I want to take you through the other side, the anti-matter, of this argument around stammering helping our society to grow. I want to explore what we may lose when we make someone, in particular a child, who stammers become fluent.

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There is a question I like to hear people who stammer try to answer. You have probably heard it yourself. It is one that floats around our community, popping up in podcasts and at conferences. In its classic form, it riffs on a scene from the film the Matrix and goes a little like this:

If as a child you had the chance to take a blue pill, which makes you fluent, or a red pill, with which you keep your stammer, which one would you take it?

I have heard quite a few people tackle this question over the years. I have tackled it myself too. In my experience, the answer often begins with a pause – and not because the person is caught in a block. Rather, it is because coming to an answer can be tricky. It involves a weighing up of life with a stammer.

Life with a stammer can be difficult and depressing, and perhaps most people do end up opting for the blue pill, but the question often forcibly reminds us that stammering has brought some good. While some of this good is tinged in a ‘what-doesn’t-kill-me-makes-me-stronger’ kind of vibe that could be true of any of life’s difficulties, some of it might not be. We may have had unique experiences through stammering: a great conference we once went to, a close friend who also stammers we got to know, or a career path we would have otherwise not followed. The answer tends to come with a few ifs and buts, a bit of toing and froing.

Yet, when it comes to children who start to stammer the question of whether to have therapy that will increase the chance of returning fluency is generally met with a conclusive – no ifs, no buts – answer: Yes. There is a disconnect here, between the difficulty people who stammer can have weighing the question of whether they would have wanted a cure for their stammer and the ease with which society encourages young children who begin to stammer and their families to engage in therapy aimed at returning them to fluency¹.

The pause taken by some adults who stammer faced by the ‘red’ or ‘blue’ pill question asks us to do the same for children who stammer: to take a moment to reflect on what may be lost when a child who stammers is made fluent.

An advocate

Life is hard for people who stammer. We live in a society that is ill-suited to our way of speaking. Each day we may meet with well-definable physical barriers – like voice automated telephone systems – but more often we meet nebulous, pervasive stigma from society. The result is that people who stammer struggle in education, earn less at work, and have more mental health problems than people who are fluent (Butler, 2013; Gerlach et al, 2018; Iverach et al., 2009).

We need to fight to remove the attitudinal, environmental and structural barriers in our society that cause people who stammer to suffer. Nearly all other rights movement have depended upon groups of individuals with lived experience of oppression and discrimination to improve society. For example, the move towards acceptance of LGBTQIA+ people by society has been drive in the most part by LGBTQIA+ people themselves – protesting, changing laws and influencing others. People with lived experience of dysfluency are central to changing our world for the better for those who speak differently. We lose vital potential advocates when we encourage children who begin to stammer to become more fluent.

A thermometer

Dystopian science fiction authors have often pictured a world in which humans are genetically engineered to prevent impairments and disabilities; rarely, have these worlds been a good place to live. The ability of a society to include and accept those with perceived ‘weaknesses’ tends to mirror its fairness and goodness.

A person who stammers can act as a thermometer for whether society is fair and accepting of difference. The difficulties that come with stammering – shame, embarrassment and a decreased chance of living a fulfilling life – are much more often related to stigmatisation of stammering in society than the physical act of stammering itself. If we make children who stammer fluent then we cannot take the temperature of acceptance in our society.

A source of diversity

The changes to the genetic code that make people more likely to stammer are a natural biological event. Evolution has created a process by which each human is subtly different. This is beneficial to our society, as this diversity allows us to utilise each individuals’ unique attributes and characteristics. Stammering is one of these characteristics that can bring benefits to society if it is supported in the right way.

Take the positive impact of the stammered voice on music for example. There are several songs that have become iconic because of their stammered vocals: My Generation by the WHO, Lola by the Kinks and You Ain’t Seen Nothing Yet by Bachman-Turner Overdrive. If we all spoke fluently, music for one would be the worse for it as there would have been little inspiration for these tracks.

A ticket

Many of us have had a great time at stammering conferences. Whilst we may buy airplane, train, and bus tickets to go to these events, our tickets are really given to us when we begin to stammer.

The stammering community is a unique one, and without it my life and many others would not have been the same. Support groups for people who stammer are a safe space in which we can share our worries about stammering, but they also become places to reflect on the bigger questions of life. Conversations around stammering can allow us to explore deeper and more existential issues – like how to accept ourselves as we are, approach our greatest fears and authentically connect with one another. The conversations I have had around stammering have made me a better person in ways unconnected to speech.

A child who is made fluent by therapy loses a ticket into the stammering community and the deep and meaningful conversations and friendships that can be found there.

A wordsmith

The list of writers who stammer is long and noteworthy: Lewis Carroll, John Updike, Somerset Maughan, Adlos Huxley, Philip Larkin. I do not find this a surprise. Stammering gives us a relationship with language that is inaccessible to those who are fluent. This relationship can be a difficult one but it is also one filled with new possibilities and permutations. Blocking, repeating, and word-swapping can all be seen as failures to communicate but at the same time they open up avenues of speech that go unexplored in people who are fluent. Words themselves also have more texture as you stammer – you can feel their weight in your throat and lips as you stammer.

My favourite stammering novelist is David Mitchell. A few years ago, he gave a beautiful speech called ‘Thirteen ways of looking at a stammer’² at the 2014 World Stammering Congress in Holland. In it, he thanked his stammer for being ‘a practical course in linguistics’ for his career. He went on:

“Back when I was 12 or 13…I used to have to ‘self-autocue’ all the time… I learnt that words a finely-calibrated things, whose meaning or force can be adjusted by inflection; that a single stress on a syllable can alter the centre of gravity of a phrase. I also learned about lexical register, that some words and phrases sound more educated and adult and Latinate, while other words and phrases are more ‘street’, more ‘teen’, maybe more Anglo-Saxon… What I want to say is that nowadays as a professional writer, I use this practical knowledge of the mechanics and electronics of speech every single day, and I bless it. Sometimes the difference between a curse and a blessing is about 20 years.”

If David Mitchell had been given ‘early intervention’ as a child and became fluent would he have written the books I love?

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Here, I have envisaged some positive things that may be lost if children who stammer are encouraged to become fluent. I do not wish to deny that some people do grow up to see stammering as a curse and would jump at the chance to have taken the blue pill. However, I do wish to challenge the taken-for-granted opinion we can hold that it would be best if all children who stammer could be encouraged to speak fluently. Not every person who stammers comes to see their speech in strongly negative terms: some grow up to see it as a minor nuisance, and others still a gift.

I think nearly all people who stammer would agree stammering shapes us in ways that are both tangible and intangible. When we make a child who stammers fluent – for better or worse – we change who they will become and what our future society will grow to be like. We should weigh the decision with care.

Acknowledgements

I would like to thank Christopher Constantino and Kathryn Bond for their insightful comments and suggestions. Chris also coined the great phrase ‘stammering novelist’ to describe David Mitchell. I would also like to acknowledge Katy Bailey for her description of stammering as a canary for ‘social toxins’ that begun my own reflections what stammering brings to society. Furthermore, I owe a debt of gratitude to all the contributors to our recent Stammering: Pride and Prejudice: Difference not Defect book who have challenged and changed my own thinking on stammering in many ways (available at http://www.jr-press.co.uk/stammering-pride-prejudice.html).

Footnotes

¹ At times writing this, I worried I was arguing against a strawman. Therapy for children is rarely simply ‘fluency-orientated’. Nearly all therapists take a holistic view looking at the child as well as their communication environment. Many therapists may not even see fluency as the primary outcome of therapy for young children who stammer. Nevertheless, the evidence base that early years stammering therapy rests on is clear that a return to fluency (or reduction in syllables stammered) is an important therapeutic outcome (de Sonneville-Koedoot et al., 2015; Jones et al., 2005; Millard, Zebrowski, & Kelman, 2018). Whilst these therapies (and the individual variants of them therapists choose to use) may also look to improve the general communicative environment, manage stigma, and educate parents, the predominant methods of therapy today have a basis in a drive to facilitate fluency.

² The speech can be found in print online or on youtube as a video (https://youtu.be/IJM0eqfq5fE): https://www.stotteren.nl/images/nieuwsbrief/13_Ways_of_Looking_at_a_Stammer_David_Mitchell.pdf. It was also turned into a lovely print book by Bundesvereinigung Stottern und Selbsthilfe e.V. (the German Stammering Association).

References

Butler, C. (2013). “University?… hell no!”: Stammering through education. International Journal of Educational Research. Retrieved from https://www.sciencedirect.com/science/article/pii/S0883035513000220

Constantino, C. (2016). Stuttering Gain. International Stuttering Awareness Day Online Conference. Retrieved from https://isad.live/isad-2016/papers-presented-by-2016/stories-and-experiences-with-stuttering-by-pws/stuttering-gain-christopher-constantino

de Sonneville-Koedoot, C., Stolk, E., Rietveld, T., & Franken, M.-C. (2015). Direct versus Indirect Treatment for Preschool Children who Stutter: The RESTART Randomized Trial. PloS One, 10(7), e0133758.

Gerlach, H., Totty, E., Subramanian, A., & Zebrowski, P. (2018). Stuttering and Labor Market Outcomes in the United States. Journal of Speech, Language, and Hearing Research: JSLHR, 61(7), 1649–1663.

Iverach, L., O’Brian, S., Jones, M., Block, S., Lincoln, M., Harrison, E., … Onslow, M. (2009). Prevalence of anxiety disorders among adults seeking speech therapy for stuttering. Journal of Anxiety Disorders. https://doi.org/10.1016/j.janxdis.2009.06.003

Jones, M., Onslow, M., Packman, A., Williams, S., Ormond, T., Schwarz, I., & Gebski, V. (2005). Randomised controlled trial of the Lidcombe programme of early stuttering intervention. BMJ , 331(7518), 659.

Millard, S. K., Zebrowski, P., & Kelman, E. (2018). Palin Parent–Child Interaction Therapy: The Bigger Picture. American Journal of Speech-Language Pathology / American Speech-Language-Hearing Association. Retrieved from https://ajslp.pubs.asha.org/article.aspx?articleid=2709702