Thursday, January 14, 2010

Killed By An Ugly Fact

[Addendum: I've just found a very interesting blog by Silvano Columbano that collects entries from the STUTT-L list during the 1990s. I'll add a link to the blog, but specifically relevant to the topic of this entry is this post.]

One of the basic tests of a scientific theory is whether it explains observations of the subject of interest. Or, turning that around, is there anything we know about the subject that conflicts with the theory? There’s a famous saying in science regarding a beautiful theory being killed by an ugly fact. It appears from a casual reading in the world of stuttering that those who propose theories are not constrained by such unfortunate facts.

Barbara Dahm is a well-known name in speech therapy, and .is the founder and Director of CTI Communication Therapy Institute. After working as a speech therapist for many years, she developed her own therapy program: Generating Fluent Speech: A Comprehensive Speech Processing Approach.

In a short article reprinted in the book Stuttering: Science, Therapy and Practice, Ms Dahm describes here education, from graduate school through the study of Gestalt psychology, to training in the Precision Fluency Shaping Program. Finally, after working with clients and feeling unsatisfied with fluency shaping, she developed her own Comprehensive Speech Processing Therapy (yes, these programs are apparently all worthy of capitalization).

Ms Dahm‘s therapy program is based on an insight she had when working with stutterers. She states: “My firm belief is that people stutter when they are exercising control over speech processes that are meant to function on an automatic mode.” Hmmm…. let’s think about that. She doesn’t say that some people stutter, or people stutter some times; she makes a general statement that stuttering occurs when there is active control over the speech effort, rather than the natural, un-self-conscious process present in non-stutterers. This brings to mind the classic parable of the centipede, who loses his ability to walk when he stops and thinks about the necessary coordination and movement of all his one hundred legs.

In order to make sure I’m not taking the above quote out of context, lets look at another:

During the Generating Fluent Speech program, people who stutter relearn the speech production process. While doing the various exercises, they learn to vibrate their vocal folds in an easy effortless manner that eliminates the feeling that they do not have enough air to speak. They learn that it is not only not necessary, but, actually, debilitating to monitor words and speech sounds. The Generating Fluent Speech exercises help them to move their focus of attention away from this activity. As a result their language development process is simplified and becomes subconscious. In addition, they learn to give up control of their speech muscles. Articulation becomes an automatic process that works efficiently at a rapid rate.” (My emphasis added).

I think it’s fair to take from the above quotes the assumption that it is the attempt to consciously monitor and control the speaking process that causes stuttering behavior. Like the poor centipede who tries to consciously coordinate all one hundred legs and becomes paralyzed by the complexity, so the stutterer tries and fails to monitor and consciously control the highly complex process of speech production.

Assuming I’ve been fair in interpreting the above quotes, let’s stop and think about this. At the beginning of this article, I said that one of the basic tests of a scientific theory is whether it explains observations. Here, the claim is that stuttering occurs when the speaker is “exercising control over speech processes that are meant to function on an automatic mode.” Are there any observations that conflict with this assertion?

Ask yourself, does stuttering only occur when the speaker has had an opportunity to assert conscious control over his or her speech? Or turn the question around and ask “Does stuttering behavior ever occur when there has been no opportunity for conscious control of the speech process?” More simply, does stuttering ever occur without warning? To me, the question is rhetorical - because the answer is so obvious.

With the exception of the most extreme cases, stuttering is defined by its episodic occurrence Although there are situations in which stuttering behavior can be expected - and might fit the theory, at least in part - most stutterers encounter blocking without warning as well. We can stutter when we are with family, when we are relaxing, or in the middle of an otherwise fluent sentence. Any observation of stuttering behavior over time would reveal many such examples. Self-consciousness may aggravate stuttering frequency or severity, but self-consciousness is not synonymous with conscious control of the speaking process.

We can look at this question from another angle. If the hijacking of the automatic speech process by conscious effort produces stuttering, then shouldn’t we expect people who are asked to speak with conscious control to stutter? Does an actor stutter when learning his or her lines? In fact, stutterers have been known to gain total fluency by speaking with a special accent. For the average American, much less and American stutterer, speaking with a fake accent would surely require constant monitoring and control. How does Ms Dahn’s theory of stuttering explain this observation?

When children are asked to read aloud in class, they are in a situation that restrains natural speech and requires much more control than conversational speaking. Does reading aloud in school produce stuttering? I am not familiar with the scientific literature, but I have never heard such an assertion.

We are left with observations of stuttering that conflict directly with the theory proposed by Ms Dahm. I am confident that the disparities between theory and observation are so great that the theory must be rejected. So what does that say about Ms Dahm’s work in stuttering therapy? Perhaps, not much. Perhaps she is successful as she claims to be. How do we explain this?

It could be that her therapeutic methods work - when they do - for reasons divorced from her understanding of the justification for them. You might say that she is doing something right for the wrong reason. In the end, her correct methods work in spite of her theoretical understanding, not because of it. Another possibility is that her success comes less from her method than from a generalized therapeutic effect. That is, all that work on speech and support from instructors makes the client feel like they are doing something valuable, and so they gain benefit. This would help explain why different therapy programs, with very different theoretical underpinnings, report similar success rates. It may be that it’s less important what you do than that fact that you’re doing something.

The point of the article is to show that a person who has worked professionally for decades, and has developed their own stuttering therapy method, can miss an observation that has been staring them in the face for years. Conscious effort does not cause stuttering - stuttering causes conscious effort, which may aggravate stuttering frequency and severity. To understand the causes of stuttering, and to provide the best possible therapy, at a minimum you have to get the direction of cause and effect correct. Pain and a limp do not cause a ruptured disk in the back, and conscious speaking effort does not cause stuttering.


Generating Fluent Speech: A Comprehensive Speech Processing Approach

Stuttering: Science, Therapy and Practice
, by Thomas David Kehoe.


  1. It's not at all obvious to me that most stutterers encounter blocking without warning. All Dahm needs for her theory is for there to be a warning just a split-second before the block.

    Saying that most stutterers stutter in a variety of situations (with family, when relaxing, etc) is not the same as saying that it happens with no warning.

    Regarding the "conscious control --> stuttering" claim, I think you're interpreting Dahm's words out of context. She's not necessarily saying that the only thing that leads to stuttering is conscious control. Dahm's claim is consistent with this the theory that it requires both a fear of stuttering and also a conscious attempt to not stutter in order to trigger stuttering.

    Since your interpretation is off, I don't think your analysis holds up.