Research into self-reported recovery methods?
Greetings everyone! Let me kick off the questions with this one.
While there is a growing body of work by researchers and SLPs to treat stuttering, there is also some evidence of effective methods and techniques that PWS have arrived at. Because these are not backed by rigorous research and methodologies, they are often dismissed by professionals.
Has there been attempt by the profession to do research into, or investigate, such methods and techniques to either prove or disprove their effectiveness?
Thank you Bruce for asking about methods and techniques developed by PWS. These techniques would be considered anecdotal and not evidence based. Our profession is always researching viable options. Our research journals are full of examples and we hold healthy discussions on our professional sites. Do you have a specific method you would like investigated? If so, please be sure to propose it. We are all searching for the best methods and techniques.
I would like to add to my previous reply. Many of the best therapists in our profession are PWS. As a result, the research is often heavily influenced by these wonderful professionals. My professors at Northern Illinois University were individuals who stuttered and often researched devices and techniques. If not for their contributions I would never have developed my passion for stuttering. So to answer your question Bruce, I do believe our profession has and will continue to complete research driven by the suggestions and observations of individuals who stutter. After all, individuals who stutter are the true experts of the experience of their individual stuttering. We would be remiss if those of us who do not stutter didn’t incorporate their observations!
As a PWS and a professor of SLP, I agree. I feel there will be more research coming, but there are some studies out there examining PWS’ use and/or perceptions of certain strategies. For example, I recently read a study by Courtney Byrd and colleagues regarding the use of voluntary stuttering.
Thank you Nancy and Paul, good to know there is activity in this area. I was trying to avoid the mention of specific methods and techniques to avoid getting bogged down in the specifics of an example, when it was the broader concept of PWS techniques vs SLP techniques.
But I also think there’s another aspect here, that of fluent speech vs natural speech. Having been taught an early speech prolongation technique in the 80’s, and while it did give me fluency for some time (but not by intentionally using the technique in public), I felt it was preferable to stutter than to use something that sounded so unnatural and foreign. I won’t add another question, but will let this add to the discussion. Maybe it’s the gap between what PWS are happy to do (in terms of natural sounding speech) vs what SLPs believe to be in the best interest of the PWS to achieve fluency, that keeps PWS searching for a different solution.
I often find myself often listening to the “older” PWS and their words of wisdom. As an SLP who does not stutter, it is my duty to have a well-rounded perspective on stuttering. What I have learned from many people who have lived a lifetime with stuttering has sometimes complimented, and other times conflicted, with the literature available.
One memorable comment that has stuck with me was provided by a 70 year old man who stutters. “If I can say whatever I want, whenever I want, however I want… that is my definition of fluency.” It guides me in therapy and ultimately aids in determining a point of discharge for many PWS. This is one small example of how the methods of PWS impact practicing SLPs.
Important question and comments, Bruce! It is always exciting to be in a dialogue with people who are interested in stuttering treatment! 🙂 Me and some colleagues in Norway and England are in the middle of a process now analyzing and trying to sum up all the information we have received from adults who stutter. It is based on information from 18 adults in a treatment study (21 up to 61 years old), and which is including 12 months follow-up data. In close collaboration with the person him- og herself, we have been able to find ways to cope and deal with stuttering, speech and communication which include some approaches and aspects made both by the clinician and the individuals -within a collaborative process and frame. All the elements which are included in the study, are based on what the person himself find valuable and meaningful. We see that there are great differences in what a person find helpful. Further, what a person defines as an improvement, vary much as well. The key in treatment seems to be that how you integrate the elements, and how you are combining a few or multiple elements are playing a big part. The elements in this study are based on personal differences in the speech, stuttering and communication style, and that the elements are considered helpful in daily life settings. Both speech-restructuring -, and cognitive elements are included. The information from this study will be presented later on, and I am looking forward to share and discuss with you and others when we have finished the work and find time for presenting it. My main intention for sharing this with you now, is to give a confirmation that your comments and reflections are of high importance, Bruce, and that we are trying to find some more answers to the question “What works for whom?”.
I agree with what Hilda wrote, though others would describe similar ideas using different constructs. For example, Bloodstein did his Ph.D. dissertation looking at about 115 different factors that reduce or vary stuttering, a few of which were alluded to in the comments in this thread. But, rather than using the idea of “cognitive load,” he would explain it in terms of “propositionality,” or the idea of some speaking situations hold more importance for the speaker. He developed a “communicative pressure hypothesis,” which basically stated that some of these “fluency enhancing conditions” work because there is less pressure on the PWS to speak (e.g., speaking alone, speaking to a pet or baby, choral reading, etc.). This is certainly not the only plausible explanation for these phenomena, but it was novel in the 1950s for sure, and still has relevance today, in my opinion.