Information—Appendix

Self-Help Groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144

Explaining Effect of Fear . . . . . . . . . . . . . . . . . . . . . . 145
On Breath Control . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Electronic Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Using the Telephone . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Relevant and Interesting Quotations . . . . . . . . . . . . 152
Replies to questions such as
Does stuttering tend to come and go?
Why are you apt to have difficulty saying
your name?
Does recovery take long?
Can you be temporarily helped by
practically any type of treatment?
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Authors of Quotations . . . . . . . . . . . . . . . . . . . . . . . . 186
Index—Complete . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189

143
 Sharing Problems with Others

Self-help or support groups have been organized in many

places across the country. At their regularly scheduled meet-
ings, those who stutter have the opportunity to discuss their
problem with others who are having the same difficulty. Some
meetings are organized by speech clinicians in conjunction
with university or college speech pathology departments.
At such group meetings, it is comforting to talk over and
share experiences with others who are sympathetic and
understanding because they have been though the same
trouble. Counseling with others, including the use of speech
in social situations, should help you.1
These meetings are an ideal place to work on emphasizing
the desirable modification procedures designed to help you
become a better communicator. Talking in front of a group helps
to build self confidence, something which is badly needed by
all who stutter. Participating in such a group may help you
develop a better insight and understanding of how others react
to their communicator. When the group has the right sort of
leadership, we urge their support. It also gives one the oppor-
tunity to reach out and help others with the same difficulty.

1
Common sharing of feelings is one of the hallmarks of these self-help
groups and this is very therapeutic. (Gregory)

144
 Explaining to a Non-Stutterer the
Effect of Fear

If you should have occasion to explain to a non-

stutterer how fear of difficulty can affect one’s speech, the
following illustration could be used. Assuming the non-
stutterer has nothing wrong with his legs, you could
point out that probably he could walk easily without
trouble or quite “fluently” along a long plank, twelve
inches wide, when it is placed on the ground.
But if that same plank is placed on a wall high above
the ground, then, if asked to walk along the plank, he
would probably develop a fear of falling. As a result, it
would be difficult for him to walk along the plank in a
normal way. In fact he would probably put on a poor
exhibition of walking normally or “fluently.”
This example is somewhat parallel to the problem of
stuttering. Nearly all stutterers have the physical
equipment to talk properly, but in many cases the fear of
stuttering causes them to try to force trouble-free speech.
And since it is difficult to force the articulative mecha-
nism of speech, he does not speak fluently.

145
 On Breath Control

Although easy, quiet breathing is helpful in enabling the

stutterer to speak more freely, it is not suggested that the
stutterer try to consciously control the inhalation and
exhalation of his breath. Trying to consciously control breath
can too often result in breathing abnormalities including
speaking at the end of breath, gasping or hyperventilation
with a resulting increase in tension.1
When the stutterer speaks slowly and smoothly,
particularly in the initiation of words, in an easy onset
manner with soft contacts, it will help to influence natural
and proper breathing.
In an effort to eliminate stuttering, some speech patholo-
gists recommend that the stutterer should make a slight
“sigh” as he tackles a block with the thought that this would
keep his vocal cords open and relaxed which would enable
him to move more easily through the block. This is some-
what similar to the recommendation that a stutterer make or
breathe a silent “h” sound when starting to say a feared word.
Such techniques can work, as they will help release
tension in the vocal cords because they distract the mind from
fear. However, as such distractive effect wears off, the stut-
terer may be left with abnormalities such as mentioned above.
To sum it up, it takes very little breath to speak.
So since breathing is more or less automatic, it should
usually not be necessary for a stutterer to try to keep it
under conscious control.2
1
There are dangers in the deliberate control of the breath for speaking.
(Van Riper)
2
Breath control is best when it is automatic and not under conscious
control….Breathing should be relatively automatic and unconscious so, in
general, the less attention you give to it, the better. (Luper)

146
 Electronic Devices Used in Conjunction
With Stuttering Treatment

Electronic aids and other devices have been around

for many years. Some people who stutter have found
them to be helpful, at least in limited situations such as
on the telephone or when giving a speech. Others who
may have hoped for a “magic cure” have been dis-
appointed because the devices can be cumbersome and
make conversation difficult.
Our advice, before you spend a considerable sum of
money on an electronic aid for stuttering, is to consult
with qualified speech-language pathologists who have
experience in prescribing and fitting the aid.
If possible, you may also want to log on to a discussion
group of individuals who stutter and parents of children
who stutter where you can ask for advice and feedback
about using such a device. Such a forum should provide
you with relatively unbiased testimony from those who
have tried these aids and found them helpful, or, in some
cases, not helpful.
You may call the Stuttering Foundation at 800-
992-9392 for a list of electronic aids or see them listed at
www.stutteringhelp.org.

147
 Some Tips On Using the Phone

Many people—whether they stutter or not—have

difficulty using the telephone.
Listen to some non-stutterers dealing with phone calls.
Some take several seconds to answer. Others may “Um” and
“Ah” a lot. Others may be very expressive with their hands
or faces, perhaps talking loudly and aggressively.
If, as a person who stutters, you have a problem using the
telephone, then you may find the following advice helpful.
Using the phone can cause a great deal of anguish, and each
person must learn to cope with it in his or her own way.

Making Calls To Others

Making a call can usually be split into three phases:
preparation, the call, assessing how you did.
䡵 Preparation
Make sure you know why you are calling. Write the
key points on paper and have it in front of you when
you call.
Try phoning a friend or relative just before the big
call. This may help relax you.
If you have a number of calls to make, list them in
ascending order. Start with the easiest and work your
way up to the most difficult.
Do not keep putting off the call you need to make.
That will make it even more stressful and difficult.

148
䡵 The Call
Quite often the difficult part is getting through to the
right person. If you are confronted by a switchboard
operator, for example, would an extension number or
department be easier to say than someone’s name? Have
some alternative first words in mind; be flexible in what
you want to say. If you do start to block, stutter openly,
gently and easily; try not to force the words out and most
importantly remember to speak slowly.
Do not worry too much about silences; they occur in
all conversations. Concentrate on what you have to say,
rather than worry about any blocks. Your purpose is to
communicate, whether you stutter or not. Pay attention
to your fluent speech. Many stutterers forget about their
times of fluency and dwell on the stuttering. Savor your
fluency; make other calls when feeling more fluent;
strike while the iron is hot. Fluent speech breeds
confidence, and confidence breeds fluent speech.
Watching yourself in a mirror while phoning can be
helpful as you will be able to see where the tension lies
in your face and other parts of your body. If you perse-
vered with a difficult call and felt you communicated
well, then praise or treat yourself and remember the
good feeling that a successful call gave you.

䡵 Assessing How You Did

Most people, not just those who stutter, sometimes
make calls when they feel they have been less than
fluent or have not managed to get their message across.
If you felt that a particular call was stressful and
you stuttered more than usual, try to forget it. Adopt
a positive attitude; remember there will be other
conversations when you will stutter less. It is not a
disaster to stutter, and you can learn from each speak-
ing experience. At home, tape-record your telephone

149
 conversations if you can. Note your speech carefully,
especially the speed and the lead up to any blocks. Try
to learn from each recording, and prepare a strategy for
the next call. Doing this over a period of time will help
to identify certain recurring problems and words.

Receiving Calls
This is the area over which you have least control.
However, even here you can go part way to easing some of
the pressure you may feel. Always answer the call in your
own time. Don’t rush to the telephone. Again have key word
options ready: your extension number, name of your organi-
zation, or even just your name. Use whatever comes easiest
to you at that moment.
If you receive a call within earshot of other people,
concentrate solely on that call.
Accept that others may hear and see you block, but do
not allow their presence to distract you from your phone
call.
Don’t be afraid of initial silence on the phone if you
struggle for your first word. It is quite common for someone
to answer the phone and then not speak, either because
they’re finishing a conversation with a colleague or because
they have picked up someone else’s phone and are waiting
for them to return to their seat.
The person phoning you may also stutter. Be patient
with others who may be just as anxious as you and may be
putting into practice some of the above points.

150
 Eliminating Stereotypes About Stuttering

• People who stutter are as intelligent and well-adjusted

as those who don’t.

• Don’t assume that people who stutter are prone to be ner-

vous, anxious, fearful, or shy. While stuttering behaviors
may sometimes resemble the behaviors of those who expe-
rience these emotions, people who stutter exhibit the same
full range of personality traits as those who do not.

• Stuttering is not the result of emotional conflict or fear-

fulness.

• People who stutter often have excellent communications

skills. They should not be seen as deficient at verbal com-
munication. Some are very often qualified for and inter-
ested in positions requiring them to deal with members
of the public on a daily basis.

• People who stutter have the same ambitions and goals

for advancement as non-stutterers. To an extent consis-
tent with their abilities, they should be offered leader-
ship opportunities and paths for promotion within an
organization.

• Stuttering varies widely in different people and varies

in the same person over different times and places.
People who stutter often have “good” and “bad” days
with their speech.

• For people who stutter, a job interview is perhaps the sin-

gle most difficult speaking situation they will ever
encounter and is not indicative of how they would speak on
the job. It is important to consider the actual job require-
ments and conditions.

This information is from the brochure Answers for Employers,

which can be downloaded at www.stutteringhelp.org, click on
“Brochures for all ages.” This brochure is perfect for job interviews.

151
 Relevant Questions and
Interesting Quotations

How many people stutter?

Few realize that almost one percent
of the population stutter, that there are
more than three million stutterers in the
United States today. That many famous
people from history have had essentially
the same problem, including Moses,
Demosthenes, Charles Lamb, Charles
Winston Churchill
Darwin, and Charles I of England. More
recently George VI of England, Winston Churchill,
Somerset Maugham, Marilyn Monroe, and the television
personalities, Garry Moore and Jack Paar have been stut-
terers at some time in their lives. In your speech problem
you may not be as unique or as much alone as you had
thought! (Sheehan)

The incidence of stuttering amounts to

about 3,000,000 in this country alone. It
has been placed at about one percent of the
general population, roughly half of them
are children. Stuttering has no respect for
social or economic status, religion, race or
intelligence.
James Earl Jones

Is there a Web site where I can download informa-

tion on stuttering?
The Stuttering Foundation’s Web sites, www.stutter-
inghelp.org and www.tartamudez.org, contain information
for the general public as well as specific help for those who

152






















































stutter and
their families.
This
online



source

an

is proving
extremely
useful
tool

in raising awareness


about

stuttering,



dispelling

common


myths,


and
providing

helpful
resources.
Is anything being done to increase public aware-
ness
of stuttering?










The following nationally-recognized spokespersons have
worked with the Stuttering Foundation to promote National
Stuttering Awareness Week.

ȶȶȓDZ?ȪDZȶȶ ZɀȎȶšɯɀɥɥDZȪ “ɀǤDZɞɯiDZɞɞȓȪȪ ɀǤ`ɀʐDZ

iDZȪ¤ȓȪȪȓɥ Ken Venturi Dr. Alan Rabinowitz Darren Sproles

ȓȪȪÄLjȪɯɀȶ ,ȳȓȪʗȪɸȶɯ Ed Sheeran

153
Does stuttering tend to come and go?
Stuttering is intermittent. Even severe stutterers often
speak more words normally than in stuttered fashion.
The intermittency, however, makes the experience more
distressful, since it is difficult to adapt to unpleasantness
which comes and goes. (Van Riper)

When is stuttering apt to get worse?

When your morale or ego strength is high because of
achievements, success or social acceptance, you will tend to
stutter less. If in any given communicative situation you
expect or feel communicative stress, penalties and frustra-
tions, you will stutter more.
You will stutter more if you are experiencing or
anticipating anxiety, guilt and hostility. You will also stutter
more if in scanning ahead you see words or situations
coming which have been associated with past experiences
of stuttering.
Those who stutter have more trouble talking to
authority figures, to people who have become impatient or
mock or suffer when listening to stuttering. Most are very
vulnerable to listener loss, to interruptions, to rejections,
penalty, frustration, anxiety and hostility.
The pressures then, which create more stuttering can
come from within or without, from the pressures of the
present, the expected agonies of the future or the miseries
of the past. (Van Riper)

Why are you apt to have difficulty saying your

name?
It is especially hard for someone who stutters to say his
name, as there is not only the problem of having to speak
the name usually quickly, but one’s name carries a heavy
self-concept psychological load. It identifies one. It repre-
sents the whole person—all of his ideas that others have
about him as well as his own self-concepts.
In addition, there is virtually no possibility of
substituting another name for one’s own name. Of all the

154
words in a person’s vocabulary, our name is representative
of something we should know and utter with unhesitating
automaticity. To do otherwise implies all sorts of possibili-
ties, none of them associated with normality. Since most
stutterers have innumerable failures trying to say their
own names, their names as cue words acquire immense
compulsive force. (Murray)

Should you work to be less sensitive?

During my first two years in college I began to see more
clearly that a stutterer has to take responsibility for making
others feel comfortable in his presence. If he can be less
sensitive about his stuttering, those around him will be
more comfortable. This will make him more at ease, and he
will stutter less, and so it goes; the vicious circle will be put
into reverse. Since I was doing something constructive
about my speech, I could smile about difficulty more. I could
even feign some voluntary disfluency. (Gregory)

Should you face up to fear?

My youth, as is the case with so many stutterers, was
filled with alternate hope and despair as I hungered for some
relief from my stuttering. This of course is not unique; most
stutterers have had similar feelings. But have you ever
asked yourself what it is that really bothers you, what it is
that causes despair? Is it your stuttering or is it your fear of
people’s reactions to your stuttering? Isn’t it the latter? Most
stutterers have too much anxiety about what they think
people might say or do as a result of the stuttering.
These anxieties can be lessened.
I remember well these feelings of worry, anxiety, and
despair. If you can learn to dissipate some of these terrible
feelings—you will be able to help yourself as many other
stutterers have done.
There is one effective method you can utilize to achieve
this goal. Face your fears! This advice is easy to give and
admittedly difficult for many of you to take; however, it is
advice that has helped many stutterers and it can help you.

155
 Somehow you must learn to desensitize yourself to the
reactions of others and refuse to let people’s actual or
imagined responses to your stuttering continue to affect
your mental health or your peace of mind. (Adler)

Can you be temporarily helped by practically any

type of treatment?
The fact is that stutterers may be helped for some time
by practically any type of therapy in which they believe
strongly has some important implications. It means that
they may be especially likely to obtain short-term benefit
from a therapist who is deeply convinced of the effectiveness
of the methods used, who happens to be endowed with
charisma and who has a prestigious role (e.g. physician,
psychiatrist or the like). (Bloodstein)

Why is it hard to pause?

Many stutterers show a fear of silence and any
momentary pause or cessation of sound in their own speech
brings on reactions approaching panic. Perhaps because
most stuttering occurs on initial syllables and the stutterer
has more trouble when he starts, he learns to dread the
necessity for starting. He learns to dread any period of
silence in his own speech, to fear it, and to become quite
intolerant of it. (Sheehan)

Should you take responsibility for your problem?

I also found, in working on my speech, that one makes
many discoveries that can be applied advantageously to
daily living. From the time I began therapy I have realized
that I must take responsibility for my behavior and the way
in which others evaluate me. In addition, I became aware of
the tendency to lean on my stuttering as an excuse for not
participating in some activity or for not being as successful
as I might strive to be. (Gregory)

156
How severe can a block be?
The writer was a student at Stanford University and
came home for a two week vacation and at that time was
stuttering badly. As he tells it: “One afternoon I was study-
ing in my room, writing with an ink pen. I accidentally
knocked the ink bottle over, and ink spilled over my papers,
my book, the fresh blotter, the wood of the desk, and down
onto the rug beneath. My mother, sitting in the next room,
heard my gasp and called to me asking what had happened.
I went to the door of her room, and, as I stood there, trying
to answer, I felt as though someone had grabbed me by the
shoulders and was shaking me violently. My face, twisted
with my struggle to break the tremor, turned red and then
purple. I felt as though a gigantic balloon were stretching
bigger and bigger, about to burst with a devastating force,
and I had no way to protect myself from it. Just then the
word ‘ink!’ exploded out of me. That was the worst block
I have ever experienced. It must have been forty or fifty
seconds long.” (Murray)

Has rhythmic beat been used extensively in the

treatment of stuttering?
In his younger days, the author attended several of these
commercial stammering institutes and, from what he has
read, they were typical of most of the others that exploited
stutterers in the early years of the century….One used arm
swinging, another the swaying of eyes or hands or body, the
third a lalling rhythmic form of continuous utterance in
which all words were joined and all consonants were
slurred. (Van Riper)

What kind of job should I look for?

On the whole, people who stutter are highly intelligent
and capable. Yet there appears to be a discrepancy between
their realistic capacities and potentialities and what they
unrealistically expect of themselves. Although there are
many areas of productivity through which an individual can
express his capacities and earn a comfortable living, I have

157
 found that many people who stutter
seem to be drawn toward jobs or
professions where the use of verbal
communication is paramount. It is not
uncommon to find people who have
difficulty speaking becoming salesmen,
lawyers, psychologists, and radio
announcers. (Barbara) Editor’s note:
Download the brochure Answers for
Employers at www.stutteringhelp.org for more information.

Isn’t it better to substitute words which are easier

said?
You will feel better about your speech if you reduce the
number of times you substitute non-feared words for feared
ones. To test this out make five telephone calls and keep an
account of the number of times you substituted non-feared
words for feared ones. Then make five more telephone calls
in which you try to make as few substitutions as possible.
You should feel better about your speech when you are not
substituting words or switching phrases to avoid stuttering.
You may find that your fear of stuttering is actually more
of a problem than your stuttering. (Trotter)

Shouldn’t you just avoid trouble when speaking?

Above all, keep in mind that the less you struggle in
your efforts not to stutter, and the less you avoid feared
words and situations, the less you will stutter in the long
run. (J. D. Williams)

In his efforts to speak fluently, the stutterer becomes

more and more fearful of being unable to cope with the
intermittent stuttering that may occur. The more he
struggles to avoid possible stuttering or attempts to hide or
disguise his stuttering that cannot be avoided, the more he
denies that he has a problem. (Czuchna)

158
The only disability some people still laugh at.
Perhaps the day shall come when I can completely
forgive those who have ridiculed and imitated my stutter-
ing. As yet I have failed to find any more excuse for this
than laughing at the crippled or the blind. I believe that
those who torment the stutterer do so to compensate for
some weakness or shortcoming of their own. (Wedberg)
Working on introducing yourself.
Between the ages of fifteen and twenty I worked rather
intensely on my speech and gradually realized that I would
need to work on situations of increas-
ing difficulty by planning, experienc-
ing and then planning again, etc.,
until I became more and more confi-
dent. For example, during my fresh-
man year in college I worked on intro-
ducing myself. After working to keep eye contact with my
listener, I worked on modifying my speech and using some
voluntary disfluency when saying “I’m Hugo Gre-Gregory.”
By the end of the year I never avoided introducing myself or
making introductions. (Gregory)
Shouldn’t you try for perfect fluency?
Normal speech contains disfluencies of many types.
(Moses)

It is good for you to realize that much of your own

hesitating and fumbling in speaking is like that of other
folks. If you are like other speakers who think of themselves
as stutterers, you tend to suppose that unless your speech
flows as smoothly as a meadow brook, you are not talking
normally. Actually, many of your disfluencies are like those
of normal speakers and are so regarded by them when they
hear you. (Johnson)

159
 A perfect flow of language formulation and speech
production is a rare
skill. Most of us have
errors in formulation “…make your expectations more
and imperfections in reasonable….”
our speech produc- —Barbara
tion….Compare what
you do with what your
friends do. They also repeat sounds, words and phrases,
interject “uh” or stop while saying a difficult word. Therapy
should lead toward acceptable, free flowing speech but not
perfect fluency. (Boehmler)

The stutterer has a Demosthenes* complex. He makes

demands on his speech and intellect which are excessive
and impossible to achieve. This verbal perfectionism creates
inner chaos and turmoil. The person who tends toward stut-
tering feels that he should always speak calmly, never
appear ruffled and constantly be in control of his listener.
When he speaks he demands of himself the ultimate and
impossible. He feels he should be the master of his words
and have a reservoir of everflowing facts and ideas. He
should speak in a clear and concise manner, pause at the
right time, and never run ahead of his ideas and be contin-
ually spontaneous when talking….To avoid this dilemma
make your expectations more reasonable. (Barbara)

*Demosthenes lived in the fourth century B.C. and is considered

one of the greatest orators of all time. He was such a powerful speaker
that his orations rallied the citizens of Athens to oppose and defeat
Alexander the Great, which significantly affected the history of ancient
Greece. Supposedly, he overcame a speech defect (stuttering?) by stand-
ing on the seashore with pebbles under his tongue and shouting above
the roar of the waves.

160
Maybe Demosthenes had the right idea?
Growing up as a severe stutterer, I would hear such
stories almost daily, starting with the legend of
Demosthenes’ pebbles. After trying everything else, I did
attempt to talk with pebbles myself once. I didn’t quite
believe the legend, but I felt I should leave no stones
untried. I almost swallowed the pebbles and quickly
resumed the search for new crutches. (Sheehan)

Should you beware of following everybody’s advice?

Stuttering is a disorder which can be worsened by ill
treatment. Many well-meaning but ignorant individuals, by
their suggestions and reactions, have made the stuttering
not only more difficult to bear but also more severe and
frequent. As in all speech disorders, this one needs special
understanding. (Van Riper)

For years most adults who stutter have received well

meaning suggestions that have been directly or indirectly
aimed at stopping the stuttering altogether. These sugges-
tions imply miraculously quick cures and fluent speech.

Every stutterer grows up with the naive advice of

neighbors and casual strangers ringing uselessly in his
ears. “Relax, think what you have to say, slow down, take a
deep breath, did you ever try to talk with pebbles in your
mouth, etc., etc.”
Stuttering is a complex problem whose nature forever
tempts people to offer simplistic cures. Neighbors and
casual acquaintances usually do not offer advice on treating
cancer or diabetes. But stuttering has a persistence along
with a now-you-see-it-now-you-don’t quality, so it fosters
irresponsible and/or fraudulent claims for every solution.
Simplistic “cures” abound, and the history of medicine is
littered with them. Even intelligent people who should
know better are taken in, and ensnare themselves.
(Sheehan)

161
Should you explain stuttering to others?
Sometimes it is helpful to explain something about your
stuttering to people who are important to you. This person
might be a parent, teacher, friend, employer or a fellow
worker. You might explain, for example, how you like to be
treated by your listener when you are stuttering. The
purpose of this is to make you and the people you speak
with more relaxed concerning your stuttering. If you feel
that a person understands your stuttering, you are likely to
stutter less to that person. An open and honest attitude is
healthy for all people involved. (Trotter)

A reason to become a “professional stutterer.”

At about this time I began my training as a speech
pathologist and embarked upon a career, as my wife and
children tell friends, of being a “professional stutterer.” By
the way, I’ve always noticed that when my wife tells some
person “Hugo is a professional stutterer,” the person looks
somewhat perplexed as if to say, “Does he stutter?” or, “Why
do you mention it?” The point is we should be very open
about our stuttering. I found out very early that this atti-
tude is an important ingredient in therapy. (Gregory)

Can you change?

“The leopard can’t change his spots.” If you are in the
habit of thinking and saying things like that, you are likely
to tell yourself also “once a stutterer always a stutterer”—
you might then go on to the depressing thought that there’s
really no hope for you.
Or if there is, there is the wishful hope that somewhere
sometime you will be lucky and find someone who will take
away, or drive away, what you have and transform you, as
though by sorcery, from the stutterer you are into the
normal speaker you long to be one day.
Such wishfulness makes for dreams, particularly day-
dreams, about magical potions in the form of pills, or secret
or mysterious methods that can work wonders. It does not

162
encourage you to face up to the problem yourself and do
something constructive about it here and now by your own
efforts.
What you have learned to do that keeps you from speak-
ing better than you do, you can unlearn. (Johnson)

Does recovery take long?

Recovery is going to be a long gradual process. (Murray)

If the stutterer is going to change radically his accus-

tomed manner of stuttering, he must work persistently and
diligently over a long period of time. (Johnson)

Licking the problem of stuttering, mastering your own

mouth, takes time; it cannot be accomplished overnight.
How long will it take you I cannot say, for no two stutterers
approach the challenge in the same way or move at the
same rate but all have in common a beckoning mirage
luring them ahead. (Emerick)

A memorable experience.
One score and seven years ago, in a desperate attempt
to cure their son’s chronic speech problem, my parents spent
their meager savings to send me to a commercial school for
stammering. Alas, to their dismay and my deepening feel-
ing of hopelessness, it was just another futile attempt.
While I rode woefully toward home on the train, a kindly old
gray-haired conductor stopped at my seat and asked my
destination. I opened my mouth for the well-rehearsed
“Detroit” but all that emerged was a series of muted
gurgles; I pulled my abdominal muscles in hard to break the
terrifying constriction in my throat—silence. Finally, the old
man peered at me through his bifocals, shook his head, and
with just the trace of a smile, said, “Well, young man, either
express yourself or go by freight.”
The conductor had shuffled on down the aisle of the
rocking passenger car before the shock waves swept over
me. Looking out the window at the speeding landscape

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through a tearful mist of anger and frustration, I felt the
surreptitious glances of passengers seated nearby; a flush of
crimson embarrassment crept slowly up my neck and my
head throbbed with despair. Long afterwards I remembered
the conductor’s penetrating comment. For years I licked
that and other stuttering wounds and nursed my wrath to
keep it warm, dreaming that someday I would right all
those unrightable wrongs. But in the end his pithy pun
changed my life. The old man, incredibly, had been right.
(Emerick)

How well did King George VI of England speak in

his radio broadcasts?
One of the people whose activities I followed closely was
King George VI of England. I tuned in to his first Christmas
broadcast with considerable excitement, because I had heard
that he was a stutterer. Even though
pre-recording was beginning to be
available in those days, he had chosen
to make his speech a live one.
I got the BBC at the right time
and heard, through the static,
“Ladies and Gentlemen, His
Majesty, King George VI.” He start-
ed without difficulty, but then his
speech began to be more and more
labored. He paused between words,
first briefly and then the spaces
King George VI
grew longer. I could sense from the
rhythms that a block was coming;
and I held my breath waiting for it. There was one long
silence, brief sounds of vocal struggle, and then quick
repetitions out of which burst the word. This happened
several times during that early broadcast.
In spite of his impediment, King George continued to
speak publicly. He inspired his country when it needed him
most. I heard him declare war on Germany. He was so emo-
tional he could hardly speak, and yet his message was clear.

164
 Although he was never completely free of all traces of
stuttering, King George’s speech improved enormously
during his reign. His speeches were carefully pruned so that
he wouldn’t have to say words that usually caused him to
block. His final illness began to sap his strength, and he
stuttered considerably in his Christmas broadcast that year.
(Murray)

About how much would it cost to engage the ser-

vices of a professional speech therapist—a special-
ist in stuttering—to help you work on your speech?
Therapy charges can vary by geographic area and also
the therapist’s level of skill/specialization in working with a
particular population. Private practitioners charge from $60
to $150 per hour. Most often the fee will be $70 to $85 an
hour. Total cost could be from one to several thousand dollars.
Of course, in the case of short term treatment such as
that described for some children beginning to stutter, it
could be less. University clinics where students are being
trained or publicly supported institutions charge on a slid-
ing scale according to ability to pay, and the therapy will
be less expensive. For example, the range might be from
$20 to $80 an hour.
You should be satisfied with progress as therapy pro-
ceeds and feel free to inquire about the prognosis and
costs. Health insurance policy coverage of stuttering
therapy varies. If insurance reimburses for therapy,
expect to pay a co-payment similar to what you would pay
for other specialists such as physical therapists. You
should consult with your agent and request that the
speech clinician send reports or any other required infor-
mation to the company.
For more information on how to find a therapist and on
how to deal with insurance claims, call the Stuttering
Foundation toll free number, 800-992-9392, or visit
www.stutteringhelp.org.

165
Boyhood recollections…

What I remember most acutely about my stuttering is

not the strangled sound of my own voice, but the impatient
looks on other people’s faces when I had trouble getting a
word out. And if their eyes happened to reflect some of the
pain and frustration I was feeling, that only made me more
uneasy. There was nothing they could do to help me, and
I certainly didn’t want their sympathy. I was nine or ten at
the time.
Like most people with a stuttering problem, I had
already learned to live by my wits in a way that normally
fluent people cannot begin to appreciate. Whenever
I opened my mouth, I mentally glanced ahead at the
sentence I wanted to say to see if there was any word I was
likely to stutter on.
For me, speaking was like riding down a highway and
reading aloud from a series of billboards. I knew that to
speak normally I had to keep moving forward at a steady
pace. Yet every once in a while I became aware of an obsta-
cle, like an enormous boulder, blocking the road some five or
six billboards ahead of me. I knew that when I got to that
particular word I would be unable to say it. I never figured
out why I stuttered on one word rather than another.
Some sounds—like the “m” sound at the beginning of a
word—were particularly troublesome; but, even with these,
the context was all-important. A sentence might have two
words beginning with “m,” such as “I’ll have to ask my
mother.” The moment I framed this sentence in my mind,
I knew that I would have no trouble pronouncing “my” but
that “mother” would be impossible. My usual strategy at
such times was to speed up and try to crash through the
obstacle. When I succeeded, the sentence came out like this:
“I’ll (pause for deep breath) havetoaskmymother.”
This trick worked just often enough to convince some
people that I stuttered because I talked too fast. But when
it failed I found myself struck dumb in midsentence, unable
to go forward or turn back. There were times when I got as

166
far as the first sound in the difficult word and could do noth-
ing but repeat it like a broken record, in the classic stutter
that is imitated—usually for laughs—in books and movies.
More often, I had a complete block; I would try to form the
first sound in the word and something inside me would snap
shut, so that if I opened my mouth nothing came out.
At that point, I usually backed up and looked for a detour.
Sometimes all I had to do was find a less
troublesome word that meant the same
thing. For example, I might be able to get
away with something like “I’ll have to
check with my folks.” If I couldn’t think of
a synonym quickly enough, I had no
choice but to rephrase the sentence, to try
to sneak up on the difficult word from
another direction; the result might come out as… “You know
how mothers are, I better ask her first.”
I didn’t have the slightest idea why the same word
should be easier to say in one context than in another, but
whenever it worked out that way I felt absurd pride in my
accomplishment; no one else knew that in order to speak
with any fluency I had to become a kind of walking
thesaurus. But the strategies of substitution and circumlo-
cution created their own problems. The farther I strayed
from the original wording of the sentence, the more I had to
guard against letting subtle changes of meaning creep in.
If I wasn’t careful, I could find myself saying things
I didn’t quite mean, just to be able to say something. In a
way, my situation was not so different from that of a writer
in a totalitarian country who tries to communicate under
the constant threat of censorship. The fact that I carried the
censor around inside my head did not make the situation
any less oppressive.
(This last quotation comes from the book “Stuttering, The Disorder of Many
Theories” by Gerald Jones, published by Farrar, Straus & Giroux.)

167
Some Final Thoughts about Stuttering

Having recently experienced con-

gestive heart failure and informed that
I should put my affairs in order, I find
an urge to summarize what I have
learned about stuttering in 85 years.
When I was a youth of sixteen I
swore an oath to a birch sapling that I
would devote my life to finding the cause and cure of
stuttering. Decade after decade I returned to that tree and
confessed I had found neither. That birch tree died a long
time ago but if it were still living I would have to say the
same thing today.
I have known thousands of stutterers and have studied
the disorder in them and in myself. I have done research and
written much about the disorder. I have read most of the
world literature. I have explored most of the different kinds
of treatment, have helped many to untangle their tongues,
and have failed to help others. What then are my final
conclusions about stuttering? I believe:

• That stuttering is essentially a neuromuscular disorder

whose core consists of tiny lags and disruptions in the
timing of the complicated movements required for speech.
• That the usual response to these lags is an automatic part
word repetition or prolongation.
• That some children, because of heredity or as yet unknown
brain pathology, have more of these than others do.
• That most children who begin to stutter become fluent
perhaps because of maturation or because they do not
react to their lags, repetitions, or prolongations by
struggle or avoidance.

168
• That those who do struggle or avoid because of frustration
or penalties will probably continue to stutter all the rest of
their lives no matter what kind of therapy they receive.
• That these struggle and avoidance behaviors are learned
and can be modified and unlearned though the lags
cannot.
• That the goal of therapy for the confirmed stutterer should
not be a reduction in the number of dysfluencies or zero
stuttering. Fluency-enhancing procedures can easily
result in stutter-free speech temporarily but maintaining
it is almost impossible. The stutterer already knows how
to be fluent. What he doesn’t know is how to stutter. He
can be taught to stutter so easily and briefly that he can
have very adequate communication skills. Moreover,
when he discovers he can stutter without struggle or
avoidance most of his frustration and other negative
emotion will subside.
Have I anything more to say? Yes, that I still have hope
that sooner or later others will fulfill the vow I made to that
birch tree. Meanwhile I wish to testify that it is possible to
live a happy and useful life even though you stutter.
Charles Van Riper

169
For more information about stuttering:

Advice to Those Who Stutter

Offers practical advice written by twenty-eight men and
women speech pathologists who themselves stutter,
advising what helped them and what they believe will
help anyone who stutters control his or her difficulty.
Publication No. 0009 116 pages

If Your Child Stutters:

A Guide for Parents
An authoritative and understandable book for parents.
Contains examples of what to do to help the disfluent
child. Can be used as a supplement to clinical advice.
Publication No. 0011 64 pages
Translated versions also available:
Spanish: Publication No. 0015 French: Publication No. 0017

Do You Stutter: A Guide for Teens

Because you are a teen and because you sometimes
stutter, some problems are uniquely yours. This book is
written to and for you in the hope of helping you solve
some of these problems. Each chapter is written by a
specialist in the field of stuttering.
Publication No. 0021 80 pages

Stuttering and Your Child:

Questions and Answers
For parents, teachers and all those wanting to help the
child who stutters. Is often used as a supplement to
clinical treatment. Written by seven leading authorities.
Publication No. 0022 64 pages

Sometimes I Just Stutter

A book for children between the ages of 7 and 12. This
new book has information on teasing, letters to family
members and teachers, why stuttering varies day to
day, and a wealth of other information.
Publication No. 0031 40 pages
Spanish Version No. 0032

170
 Glossary

Many speech pathology words are listed in this glossary

which are not used in the book. These are inserted for the
education of readers who may not be familiar with the
meanings of expressions frequently used in books about
stuttering.
accent. The components of increased stress, loudness, or emphasis placed on
certain syllables in a word, or group of words. Accent may also be related to
linguistic stress and “dialect.” (See prosody.)
acceptance approach. Based on the hypothesis that although stutterers
may not have a choice as to whether or not they stutter, they do have a choice
as to how they stutter. Accordingly, stuttering can be fully accepted, since it is
possible to stutter in a variety of ways, including fluent stuttering.
accessory behaviors (secondary behaviors or symptoms). The abnormal
actions and behaviors exhibited by the stutterer in attempting to avoid and/or
escape from the core behaviors of stuttering. Avoidance behaviors include such
things as pausing, postponing, using gestural timing devices or verbal starters,
and trying to disguise the stuttering. Escape behaviors used to interrupt the
stuttering and gain release from moments of stuttering include movements such
as eye blinks, arm swinging, grimaces, head and jaw jerks, finger snapping,
throat clearing and hand/finger tapping, etc.
acquired stuttering. Neurogenic-Acquired Stuttering: As differentiated from
“developmental stuttering,” this refers to the stuttering-like behaviors in children,
adolescents or adults following damage to the central nervous system (CNS) in
persons who have no prior history of stuttering. The onset of neurogenic (acquired)
stuttering is usually sudden. Causes include head trauma, stroke, anoxia, tumor
and drug use. Often co-occurs with features found in aphasia, and dysarthria.
Psychogenic-Acquired stuttering: As differentiated from “developmental
stuttering,” this has been used to refers to stuttering acquired during adulthood
which is at least partially a post-stress response to chronic or acute psycholog-
ical disturbances in persons who have no prior history of stuttering. It has also
been used to refer to document cases of stuttering associated with a conversion
reaction. The onset of psychogenic (acquired) stuttering is usually sudden, and
related to significant events associated with extreme psychological stress.
adaptation effect. A temporary reduction in the frequency and/or severity of
stuttering behaviors resulting from repeated oral readings of the same or highly
similar verbal material. Adaptation is sometimes measured in terms of the
observed frequency of stuttering during successive readings of the same passage.

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In addition to a reduction in the frequency of stuttering there is often a concomi-
tant reduction in associated effort (tension-struggle) and duration of moments of
stuttering.
adjacency effect. During repeated oral readings of the same material,
when the previously stuttered words have been omitted from the passage,
there is a tendency for stuttering to occur on words that are adjacent to
where stuttering previously occurred during the earlier readings.
advertising. Clinical programs that emphasize helping the stutterer learn to
cope with stuttering and become desensitized to stuttering ask the client to
advertise his stuttering by doing a lot of voluntary stuttering in public.
affective reactions. Affective reactions are the feelings and emotions that the
stutterer experiences during the time period before, during, and after the
moment of stuttering. Affective reactions also appear to be related to feelings of
denial and/or avoidance. Prior to stuttering the person may experience anticipa-
tion and apprehension ranging from minimal awareness up to devastating fear
and panic; during the moment of stuttering there may be a sense of detachment
and confusion or “mental blankness” and a lack of “contact with the self.”
Following release from the moment of stuttering there may be feelings of shame,
guilt, embarrassment and feelings of anxiety over the fact that stuttering may
occur again.
airflow management. A clinical approach wherein the stutterer attempts
to integrate a long, relaxed, passive sigh with the slow initiation of the first
syllable of a word in order to maintain air flow by reducing tension and
pressure within the vocal track.
anticipatory behaviors. Those behaviors in which the stutterer engages in an
attempt to avoid, disguise or otherwise prevent stuttering.
anticipatory emotions. Those anticipatory feelings, emotions or attitudinal
reactions that result from the stutterer’s dread of feared sounds, words,
situations or interpersonal relationships.
anticipatory struggle. The anticipatory-struggle hypothesis, which permits a
wide array of etiological possibilities, suggests that stuttering involves both the
prior anticipation and expectation that speech is a difficult task to perform, as
well as the tensions, fragmentations and struggle (effort) associated with
attempts to gain release from the moment of stuttering itself.
aphasia. The partial or complete loss of the receptive and/or expressive use
of language as a result of damage to the central nervous system. Persons
suffering from expressive aphasia (e.g., nonfluent aphasia) frequently have
problems maintaining speech fluency, but this is considered a fluency
disorder which is different from stuttering. These patients frequently experi-
ence word finding and word retrieval problems and often compensate for this
difficulty with word substitutions and circumlocutions.
approach-avoidance conflict. This term describes the conflict which the stut-
terer experiences as he approaches a feared word or situation. His desire for
avoidance of verbal difficulty struggles for mastery against his desire for speak-

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ing, and the conflict may be expressed overtly in stuttering behaviors that inter-
fere with speaking. The stutterer is caught in a conflict where he wants to talk
and communicate but wants to avoid stuttering: at the same time, he wants to
not stutter, but not abandon communication.
approximation. As used in operant conditioning and learning, the reward or
positive reinforcement given to productions that come progressively or succes-
sively closer and closer to the desired target. In stuttering, this is used to refer
to deliberate attempts on the part of the stutterer to speak in a manner that
comes successively closer and closer to the desired target.
articulation. Literally, a joining: in speech, the utterance of the individual
sounds of speech in connected discourse; the movements during speech of the
organs that modify the stream of voiced and unvoiced breath in meaningful
sounds: The speech function performed largely through movements of the
mandible, lips, tongue and soft palate.
auditory feedback. As related to the self-monitoring of one’s own speech
through self-hearing. (See feedback, delayed auditory feedback.)
avoidance behaviors. Actions or patterns of behavior which the stutterer uses
in trying to avoid difficulty. These include abnormal variations employed such as
postponements, word substitutions, circumlocutions, vocalized or nonvocalized
pauses, or the complete refusal to speak. Such maneuvers usually tend to
increase any fear of difficulty the stutterer may have. Unlike the escape
behaviors that occur during the moment of stuttering itself in an attempt to
permit release, avoidance behaviors occur prior to the moment of stuttering in
an attempt to totally prevent its occurrence.
behavior modification. A general term for any of a variety of clinical proce-
dures based on learning theory and conditioning principles. Such procedures are
used both to modify the disruptive negative emotional responses of the stutterer
to words and situations, and to reduce the maladaptive avoidance and escape
behaviors that confirmed stutterers tend to display.
between-word disfluencies. Listeners make perceptual judgments of
disfluency and stuttering, and sometimes it is helpful to determine whether
disfluencies occur within words or between words. Within word disfluencies such
as sound or syllable repetitions, prolongations, disrhythmic phonations and tense
pauses are more apt to be considered “stuttered” and represent a greater danger
sign than disfluencies that occur in between words such as interjections, revisions,
phrase repetitions and multisyllabic whole-word repetitions.
biofeedback. The measurement of physical activity and the display of this
activity to the user in real-time so that the person can develop awareness and
control of the activity. Some clinical programs make use of biofeedback to help
the stutterer modify the activities needed for fluent speech production: e.g.,
respiration, phonation and articulation.
blending. A technique in which the stutterer gradually shifts from one part of
the sound or syllable into the next.

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block. One of several types of stuttering in which the fixation (closure) is total.
The flow of speech is obstructed completely at any one, or several locations:
larynx, lips, tongue, etc. The abnormality is perceived by the listener through
visual awareness that the person is attempting to speak, even though little or
no sound is heard. Some people use this term to refer to any type of stuttering
moment. (See tonic block: clonic block.)
bounce. A stuttering pattern in which there are voluntary repetitions, usually of
the first syllable of the word, as in “base-base-base-ball.”
cancellation. The technique used in therapy of responding to the occurrence
of a moment of stuttering by a deliberate pause followed by a second attempt
on the word in which a different and more fluent form of stuttering is used. This
consists of coming to a complete halt after the stuttered word has been finally
uttered, pausing a moment and then attempting to say the word again with less
struggle and avoidance. This does not imply that on the second trial the stut-
terer is to be fluent; rather, he should attempt a modified and easier form of
stuttering. This procedure is called post-block correction by some clinicians.
carryover. Procedures designed to assist the stutterer in transferring and
maintaining newly learned speech therapy techniques to everyday situations.
classical conditioning. A form of conditioning in which a previously neutral
stimulus is paired with an unconditioned stimulus. In time, the neutral
stimulus becomes conditioned, and elicits a conditioned response which is
similar to the unconditioned response originally elicited by the unconditioned
stimulus. (Synonyms: Pavlovian conditioning, respondent conditioning, reflex
conditioning.) (See conditioned stimulus.)
clinician, (speech-language). See speech-language pathologist.
cluttering. A disorder of both speech and language processing that frequently
results in rapid, disrhythmic, sporadic, unorganized, and often unintelligible
speech. Additional problems include repetition of sounds, syllables, words and
phrases, false starts and revisions, sequencing errors, word retrieval problems,
run-on sentences and the excessively fast and irregular production of syllables.
Persons who clutter usually have great difficulty with self-monitoring.
conditioned response. After the repeated paring of a neutral stimulus with
an unconditioned stimulus, the neutral stimulus becomes a conditioned
stimulus, and elicits a conditioned response.
conditioned stimulus. A previously neutral stimulus, after contiguous pairing
with an unconditioned stimulus, takes on properties similar to the original uncon-
ditioned stimulus and has the ability to elicit a conditioned response that is
similar to the original unconditioned response.
conditioning. The process of acquiring, establishing, learning, modifying, or
extinguishing behavioral and/or emotional responses. Forms of conditioning
include: classical (Pavlovian, respondent, reflex) conditioning; counter
conditioning; operant (Skinnerian, instrumental) conditioning; vicarious
conditioning; deconditioning. When a response that formerly occurred only

174
rarely or not at all is “conditioned” to occur more frequently, learning is
assumed to have taken place, provided that the change is relatively long last-
ing. Conditioning may occur by chance, or by conscious manipulation of
antecedent stimuli and/or contingent consequences.
consonant. A conventional speech sound other than a vowel, and characterized
by constriction or total closure at one or more points along the vocal tract. Can
be voiced or unvoiced.
constitutional origin. The theory that some stutterers possess, or possessed
at the time of onset, a “physical or genetic difference,” or malfunctioning of the
nervous system, which was sufficient to create, under stress, disruptions in the
fluent flow of speech.
continuous phonation. As a means of maintaining fluency, some
clinicians suggest that the stutterer maintain voicing throughout the production
of the utterance. This produces an effect whereby the duration of the sounds and
syllables is increased by degrees that can range from minimal to extreme.
A similar effect can result from the use of Delayed Auditory Feedback.
core behaviors (core features). Most researchers and clinicians
differentiate between the core features of stuttering and the accessory (secondary)
features that develop as a means of avoiding and/or escaping from the core
features. Core features are generally thought to include the repetition of sounds,
syllables and single-syllable words; the vocalized and nonvocalized sound prolon-
gation, and complete stoppages due to tense pauses, hard contacts and silent
blocks. In the early developmental stages of stuttering these “core features” are
easy, effortless and relaxed: later, however, they coexist with accessory behaviors
when they are accompanied by effort, tension, and struggle.
covert features. Unlike the overt behaviors of stuttering which can be seen
and/or heard and are relatively easy to measure in terms of their frequency,
intensity, duration, and type, the covert behaviors are not openly shown and less
easily determined. They include such cognitive and emotional factors as fear,
anxiety, negative emotion, shame, guilt and frustration, etc. These “concealed or
invisible” features are often difficult to determine. (See interiorized stuttering.)
delayed auditory feedback (DAF). When speaking under conditions of
delayed auditory feedback, we hear what we have said a short time after we
have said it. Most normally fluent speakers become highly disfluent when
exposed to DAF and many stutterers experience decreased stuttering under
DAF. DAF can also be used clinically both to help establish fluency as well as
control/modify the stuttering.
Demands and Capacities Model. This model states that stuttering is likely
to occur when demands for fluent and continuous speech exceed the child’s
capacities to perform at a level required by these demands. Factors that affect
fluent speech include (1) motoric coordination, (2) linguistic ability, (3) social and
emotional functioning, and (4) cognitive development. Clinically, attempts are
made to reduce demands placed upon the child and increase the child’s capaci-
ties for dealing with them.

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desensitization. Desensitization generally takes place at two levels: emotional
and behavioral. Emotionally, desensitization therapy attempts to help the client
feel increasingly relaxed and comfortable in situations that previously were
associated with fear, anxiety and other forms of negative emotion. Behaviorally,
desensitization attempts to help the client tolerate periods of physical tension
during moments of stuttering accompanied by tension and struggle. To accom-
plish desensitization, stutterers are often exposed to a hierarchy of increasingly
stressful situations where they work to remain calm and relaxed in activities
such as voluntary stuttering, pseudo-stuttering or faking.
developmental disfluencies/developmental hesitations. The develop-
mental repetitions, prolongations and stumblings in the speech of children
learning to talk. In the natural development of speech, while learning to talk,
most children’s speech is marked by effortless developmental hesitations to some
extent. Included in this category are word and phrase repetitions and such acces-
sory vocalizations as the Interjection of “um” and “ah.” These “normal develop-
mental” hesitations are particularly common during times of linguistic stress,
which is a part of language learning, and situational stress under conditions of
situational and interpersonal difficulty.
diagnosogenic theory. The theory that “stuttering” as a clinical problem and
as a definite disorder, was found to occur not before being diagnosed but after
being diagnosed. According to this theory, the problem of stuttering arises when
a listener, usually a parent, evaluates or classifies or diagnoses the child’s
developmental hesitations, repetitions, and prolongations as stuttering, and
reacts to them as a consequence with concern and disapproval. As the child
senses this concern and disapproval he reacts by speaking more hesitantly and
with concern of his own, and finally, with the tensions and struggle involved in
efforts to keep from hesitating or repeating.
disflyency (dysfluency). Used interchangeably by some clinicians and differ-
entially by others. Some feel that the prefix “dys-” should be used where there is
reasonable suspicion of “organicity” to warrant the more medical terminology.
The prefix “dis-” is used to denote mislearning and more psycho-emotional com-
ponents. Other clinicians opt for the term “nonfluency.” In any event, the terms
refer to speech which is not smooth or fluent. All speakers talk disfluently at
times; i.e., they hesitate or stumble in varying degrees. All stutterers are
disfluent, but not all disfluency is stuttering. For instance, “disfluency” could
describe the developmental hesitations of a child learning to talk, or the
disrhythmic breaks in the speech of an adult. Other disfluencies are associated
with neuropathology such as the speech characteristics associated with
apraxia, parkinsonism, multiple sclerosis, myesthenia gravis and others.
distraction. The diversion of attention: filling the mind with thoughts of other
things so that the expectancy of stuttering is minimized. Keeping the anticipa-
tory emotions of stuttering from consciousness, thus temporarily affecting
release from fear of stuttering and the act of stuttering.
dysphonia. Impairment of the voice, manifested by hoarseness, breathiness or
other defects of phonation due to organic, functional or psychogenic causes.

176
easy onset (gentle onset). Starting the voicing of a sound, syllable or word at
a slow, smooth rate. The duration of each syllable within a word is stretched for
up to two seconds. The easy onset is relaxed, and produced without effort: also
referred to as gentle onset.
escape behaviors. The behavioral reactions of a stutterer to release, interrupt or
otherwise escape from a moment of stuttering. Since escape behaviors allow
release from the unpleasant, aversive or noxious stimulus of stuttering, they are
negatively reinforced and tend to persist.
extrovert. A person whose attention and interests are largely directed toward
what is outside the self; one primarily interested in social or group activities and
practical affairs; contrasted with “introvert.”
eye contact. Looking the listener in the eye while talking to him. Generally a
natural, although not a constant interaction, of the speaker’s eyes with the
listener’s eyes. Maintaining eye contact is considered a technique in stuttering
therapy recommended to help the stutterer combat feelings of shame,
embarrassment or inadequacy.
fear. The apprehension of unpleasantness which arises when the stutterer
consciously perceives situations which lead him to anticipate difficulty talking.
This fear of difficulty may be and often is intense. It can and sometimes does
temporarily paralyze thought and action. Stuttering is usually relatively
proportionate to the amount of fear present. Stuttering fears may be of persons,
of sounds or words, or of situations such as talking in groups or on the
telephone, etc.
feared word/feared sound. This term refers to a word or sound upon which
the stutterer anticipates difficulty. Stutterers frequently attempt to avoid feared
words and sounds by word substitutions, circumlocutions or paraphrasing the
utterance.
feedback. The process of modifying one’s own responses based on either
internal or external cues. Returning a portion of the output of a transmitted
signal as input for self regulation. The reinforcing effect of the stutterer’s
auditory or proprioceptive perceptions of his own speech. (Also see corrective
feedback and delayed auditory feedback.)
fixation. The maintenance of an articulatory or phonatory posture for an
abnormal duration; the temporary arresting of the speech muscles in a rigid
position. The airway is abnormally constricted, but not completely blocked.
Fixations typically result in the production of sounds which may be both
audible and vocalized (vvvvvine) or audible but not vocalized (fffffine.)
fluency. Fluent speech involves the ability to talk with normal levels of continuity,
rate, rhythm and effort. Fluency involves the smoothness with which units of
speech (sounds, syllables, words, phrases) flow together. Fluent speech flows easily
and is usually made without effort. Abnormally broken, slow, or effortful speech is
not fluent.

177
fluency shaping. Fluency shaping therapy is usually based on operant
conditioning and programming principles; e.g., breath stream management,
successive approximations, reinforcement of fluency targets such as fluency
enhancing behaviors, etc. Some form of fluency is first established in a
controlled stimulus situation. This fluency is reinforced and gradually
modified to approximate normal conversational speech in the clinical setting.
This speech is then transferred to the person’s daily speaking environment.
frustration tolerance. The capacity of the stutterer to resist feelings of
frustration because of his inability to speak without difficulty; the ability to put
up with or endure the communication handicaps resulting from not being able
to talk freely.
genetic. Inherited, as determined through genes, but not necessarily congeni-
tally present at birth. Some persons believe that stuttering, or at least some
stuttering subtypes, may have an etiologic (causative) basis in genetically
inherited traits, tendencies or predispositions.
group therapy. The counseling of and among stutterers in a group, including
the use of speech within such a social situation. The interchange of feelings,
ideas and discussions about stuttering problems in a group gives the
stutterer emotional release and helps him to develop better insights and
understanding through a knowledge of how others react to their problems.
hard contact. The result of tightness or tension in the muscles of the tongue
and/or lips and/or jaw, etc., when the stutterer fears and attempts to say plosive
consonant sounds such as p, b, t, d, k, g.
in-block correction. This refers to a process the stutterer goes through to
correct the production of a stuttered word while he is stuttering on it. See
pull-out.
incidence. The incidence of stuttering refers to how many people have stut-
tered at some time in their lives. Although researchers have used different
methodologies to gather these data, and since they have used slightly different
definitions of stuttering, it is estimated that about 5% of the population have
experienced periods of stuttering lasting longer than six months. Estimates of
incidence, inclusive of children who may have evidenced periods of stuttering
lasting for only a short time period, are as high as 15%. (See prevalence.)
inhibition. Restraint on one’s ability to act by either conscious or subconscious
processes: the partial checking or complete blocking of one impulse or mental
process by another nearly simultaneous impulse or mental process. The fear of
stuttering tends to inhibit the stutterer’s impulse or desire to speak.
introvert. An inward oriented personality; one who prefers his own thoughts
and activities to association with others; one primarily interested or preoccupied
with self. Contrasted with extrovert.
labial. Pertaining to the lips; speech sounds requiring the use of the lip or lips
such as “p, m, f, v.”

178
larynx. The primary source of phonation resulting from vocal fold vibration; the
“voice box” which houses the vocal folds. Located at the top of the trachea, below
the bone or bones which support the tongue and its muscles.
laterality theory. Refers to the theory that a shift in handedness or confused
cerebral dominance is a factor in the cause or in the maintenance of stuttering.
According to this theory, the use of the non-preferred hand in written and other
skilled activities contributes to a cerebral instability affecting speech control
in such a way as to generate stuttering. Laterality theory refers to insuffi-
ciently established dominance of one cerebral hemisphere over another.
learned behavior. Any relatively permanent change in a person’s behavior
resulting from his reaction to or interaction with environmental influences or
from reinforced practice: an acquired neuro-muscular, verbal, emotional, or other
type of response to certain stimuli.
light contact. Loose, relaxed or non-tense contacts of the lips and/or tongue on
plosive sounds. Contacts of the lips and/or tongue which are optimal for the
production of speech sounds as contrasted to the hard, tense contacts which are
often a part of a stuttering pattern.
maintenance. In stuttering usually refers to the continuation of improvement
as related to the effectiveness of treatment. Procedures for keeping a desired
learned behavior at a high level of frequency, e.g., procedures for preventing
relapse.
masking. An interference with perception of a sound or pattern of sounds by
simultaneously presenting another of a different frequency, intensity, quality, or
pattern to one or both ears of the subject. Masking is usually presented via head
phones and is used to interfere with the stutterer’s perception of his own voice.
The usual effect, especially at sufficiently high levels of loudness, is increased
fluency.
modifying the stuttering pattern. Refers to the stutterer changing what he
does when he stutters. Clinicians suggest that the stutterer can deliberately
change his stuttering behavior and learn to stutter in an easier manner. Clinical
emphasis is reducing the overall severity of the stuttering rather than replacing
it with fluent speech. In so modifying his stuttering pattern he learns to change
his way of speaking and develop a style of talking which is less abnormal and free
of excessive tensing. A basic fact revealed by laboratory and clinical studies is that
the behavior called stuttering is modifiable. (See slide, pull-out, proprioceptive
monitoring, easy onset, cancellation, preparatory set.)
monitoring. A self-observation technique in which the stutterer seeks to
become highly aware of the articulatory movements of his speech, as well as
other behaviors which make up his characteristic and habitual pattern of
stuttering. This would include continuous self-observation of the crutches and
tricks he uses in his act of stuttering.
monotone. Voice characterized by little or no variation of pitch or
loudness.

179
neurosis. A personality disorder generally characterized by anxiety, phobias,
obsessions or compulsions which are irrational but nevertheless real to the
possessor, and which are probably caused by interpersonal conflict. There is
no gross personality disorganization, and there may not be any behavioral
manifestations. Neurosis is a mental disorder that prevents the victim from
dealing effectively with reality.
objective attitude. Referring to the attitude that it is desirable for the
stutterer to have toward his stuttering; a feeling relatively independent of
one’s personal prejudices or apprehensions and not distorted by shame or
embarrassment; the acceptance of his stuttering as a problem rather than
a curse.
onset. The onset of stuttering usually occurs during childhood, with some cases
of developmental stuttering occurring up through the time of puberty. The
median age at onset is at about age four. Onset occurring after puberty is
usually attributable to extreme cases of physical or psychological trauma.
operant conditioning. The process by which the frequency of a response may be
changed as a result of controlling its consequences. There are a variety of
procedures in which a clinician can arrange for contingent stimulation to occur
following a response. If the consequence is positive, the response (acquisition)
should increase in frequency; if the consequence is negative, the response should
decrease (extinction). This process is often theorized to be the way in which the
voluntary behaviors of avoidance and escape are learned. Behaviorists consider
this as the basic strategy for achieving behavior change. (Synonym: instrumental
conditioning, Skinnerian conditioning.) (See conditioning.)
oscillation(s). In stuttering, the tremorous vibrations or repetitions of speech
muscle movements temporarily interfering with ongoing speech, as opposed to
the fixation or prolongation of an articulatory sound or posture.
overt behavior. Clearly visible and/or audible behavior. The opposite of covert.
pantomime. The art of conveying a thought or story by expressive bodily
movements. As part of cancellation, some clinicians ask the stutterer to
pantomime the moment of stuttering in order to identify its components and aid
in desensitization.
phobia. An excessive and objectively inappropriate degree of fear or dread.
An anxiety reaction that is focused on a particular object or situation.
phonation. Vocalization; the act or process of producing voice; production of the
voiced sounds of speech by means of vocal fold vibration.
pitch. The listener’s perception of the highness or lowness of sounds depending
on the frequency of the vocal fold vibrations.
play therapy. The use of play activities in psychotherapy or speech therapy
with children, in which the child is given opportunities, within defined limits,
for the free expression of socially or personally unacceptable feelings in the
presence of an accepting therapist. In individual play therapy sessions the
therapist may observe the child as he plays with materials (such as puppets,

180
clay or toys) permitting him within reason to freely express emotional
feelings and conflicts for purposes of catharsis or insight.
plosive. A speech sound made by impounding the air stream momentarily until
pressure has been developed and then suddenly released, as in “p,b,t,d,k,g.”
post-block correction. This is a process the stutterer goes through to correct the
production of a stuttered word after he has stuttered on it. See cancellation.
postponement behaviors. Any behavior or technique used to avoid stuttering
by pausing, delaying or stalling the attempt to produce a feared sound or word in
the hope that the fear will subside enough to allow production.
pre-block correction. This is a process the stutterer goes through to prepare
to produce a word on which he expects to stutter. See preparatory set.
preparatory set. The anticipatory response to the conditioned stimuli of an
anticipated act of stuttering. The covert rehearsal behavior of the stutterer
which he uses in getting ready for the difficulty which he anticipates. This
procedure is called the pre-block correction by some clinicians.
primary stuttering. The label sometimes used to describe the speech of a young
child when it is marked by repetitions and/or hesitations or prolongations which the
observer regards as abnormal, but which do not seem to embarrass the child nor
does the child seem to feel that these disfluencies constitute a difficulty or abnor-
mality. Such disfluent speech occurs during the growth and development of the
child’s ability to talk and may be observed to increase when the child is under
certain kinds of emotional or communicative or linguistic stress. Many clinicians
protest labeling such speech as stuttering, although it may be the beginning stage
of a stuttering problem.
prolongation. As related to stuttering, the involuntary lengthening or
prolonging of vocalized speech sounds (rrrrunning, aaaapple), or nonvocalized
sounds (sssseven, ffffourteen). Sometimes refers to prolongation of an articu-
latory position, as when the person stops completely and holds his mouth
in the position to say “p<pause>icture.” Prolongations are frequently accom-
panied by increases in loudness and/or pitch.
As related to therapy, the easy voluntary prolongation of sounds and
syllables on feared and nonfeared words is used quite extensively to modify
the stuttering pattern. (See modifying the stuttering pattern; disrhythmic
phonation.)
pseudo-stuttering. Deliberately faked or false stuttering produced to imitate
difficultly which a stutterer might experience. Sometimes used to aid in
desensitization. (See voluntary stuttering.)
psychotherapy. The treatment of behavioral or emotional problems, such as
stuttering, by counseling, or by reeducating and influencing the person’s
mental approaches and his ways of thinking, or of evaluating his problems; any
procedures intended to improve the condition of a person that are directed at a
change in his mental approach to his problems; particularly his attitudes
toward himself and his environment.

181
pull-out. Based on the hypothesis that it is possible for a stutterer to pull out of
difficulty during a moment of stuttering, this term refers to a voluntarily
controlled, gradual, release from the stuttering moment. In pulling out of blocks,
the stutterer does not let the original blocking run its course. Instead he makes
a deliberate attempt to modify it before the release occurs and before the word
is spoken. This procedure is called in-block correction by some clinicians.
rate control. A technique with which the stutterer attempts to speak slowly
and deliberately, often with each syllable given equal or nearly equal stress. The
extent to which rate control is used to “facilitate fluency” or “repress stuttering”
is highly controversial.
regression. As related to relapse, having more speech difficulty usually as a
result of reverting back to an earlier faulty method of talking.
relapse. Pertaining to regression. See this term.
repetition. The repeating of a sound, syllable, word or phrase. Some clini-
cians differentiate between repetitions which are vocalized (l-l-lit) and
nonvocalized (f-f-fit), and whether the syllable is correctly co-articulated
(base-base-baseball) or contains the schwa vowel (buh-buh- baseball). Word
repetitions may be of single syllable whole words (he-he-he has it) or words of
more than one syllable (“David-David-David has it.”)
residual air. Generally referred to as the amount of air remaining in the lungs
following exhalation.
rhythm. The overall melody, cadence and flow of speech, as influenced by such
factors as syllable, stress and rate of articulation.
rhythm method. Attempts to help the stutterer speak fluently by altering the
rhythm of speech through such means as singing or speaking in singsong
manner, speaking in time with a regularly recurring rhythm such as to the best
of a metronome, or timing the speech and syllable gestures to an arm swing.
secondary stuttering. As opposed to primary and transitional stuttering,
secondary stuttering is a hesitating or stumbling in uttering words with an
awareness that this way of talking is abnormal and constitutes a difficulty;
speech interruptions plus struggle and accessory behaviors, plus fear and
avoidance reactions.
secondary symptoms. The abnormal actions, behaviors and positions exhibited
by a stutterer in trying to escape speech difficulty. These include movements such
as eye blinks, arm swinging, grimaces, head and body jerks, finger snapping,
clearing the throat, and hand tapping, etc. These refer to the movements which a
stutterer characteristically and abnormally uses when approaching and escaping
from a feared word and when struggling to release himself from the moment
of stuttering. (See accessory behaviors.)
semantics. The scientific study of word meanings.
sensitivity. In the case of stutterers, usually refers to the tendency toward
being easily upset, embarrassed or otherwise easily affected. Feelings of
hypersensitivity may relate to both speech and non speech parameters.

182
situational fears. Concerns regarding certain places or events in which the
speaker expects to have increased stuttering difficulty.
slide. Uttering the different sounds of a syllable with prolonged, slow motion
transitions: moving slowly through the syllable or word. In the slide technique
the stutterer prolongs slightly the initial sound and the transition to the rest of
the word, keeping the release as smooth and gradual as possible, and maintain-
ing sound throughout.
spasmodic (spastic) dysphonia. Persons with spasmodic dysphonia experi-
ence intermittent blockages of phonation resulting from spasms of the adductor or
abductor muscles of the larynx resulting in intermittently choked or strangled
production of voice. This has been referred to as “stuttering/stammering of the
vocal cords,” or “laryngeal stuttering.”
speech-language pathologist. A person professionally educated in the assess-
ment, prevention and treatment of disorders of articulation, voice, language and
fluency. Although terms such as speech correctionist, speech therapist and
speech clinician are frequently used, the American Speech-Language-Hearing
Association prefers use of the term Speech-Language Pathologist. Academic
requirements include a master’s degree and the completion of the supervised
clinical fellowship year following formal academic course work, and passing a
national examination.
speech-language pathology. The science or study of normal and
disordered articulation, language, voice and fluency and their diagnosis and
treatment.
stammering. Synonymous with “stuttering.” (British usage.)
starter. Unlike stallers and postponements, starters are used to
initiate or reinitiate forward movement into an utterance. This may involve
the use of a stereotypic phrase such as “well, let me see” or “you know” in
order to get a “running start.”
stress. Psychologically, an emotional and cognitive factor that causes bodily or
mental tension. Physically, as associated with effort, tension or struggle.
struggle behavior. This includes a wide range of secondary or accessory
behaviors performed by the stutterer in attempt to escape from a moment of
stuttering. Devices used to interrupt and release, involving excessive effort,
tension, changes in pitch or loudness, and escape behaviors such as head-jerks,
eye-blinks, arm movements and jaw jerks, etc.
stuttering. Stuttering is a communication disorder characterized by excessive
involuntary disruptions in the smooth and rhythmic flow of speech, particularly
when such disruptions consist of repetitions or prolongations of a sound or
syllable, and when they are accompanied by emotions such as fear and anxiety,
and behaviors such as avoidance and struggle.

183
stuttering pattern. In the case of the individual stutterer, refers to the
particular way he experiences difficulty in talking, or the specific things he does
and the order in which he does these things that interfere with his speaking;
the particular sequence of reactions in his stuttering speech behavior.
syllable. A unit of spoken language consisting of a vowel, usually with one or
more consonant sounds preceding and/or following it; v, vc, cv, cvc, ccvc, etc.
(i.e., v= vowel c=consonant.)
tension. Mental, emotional, nervous or physical strain, often resulting in
unnecessary intensity that disturbs normal functioning of the organs of speech.
therapy. The prevention, early intervention and treatment of any clinically
significant condition such as stuttering.
tic. A sudden spasmodic and purposeless movement of some muscle or muscle
group, particularly of the face, usually occurring under emotional stress.
Possibly organic or psychogenic in origin.
time pressure. At the moment the stutterer is expected to speak he often has
an almost panicky feeling of haste and urgency. He feels he is under “time
pressure” and with no time to lose, and so he has a somewhat compulsive
feeling that he must speak instantly without allowing time for deliberate and
relaxed expression.
transfer. The process of generalizing a newly acquired behavior to new and
different environments: for example, the transfer of improved fluency from the
therapy room to the classroom or to the home or office. Sometimes referred to as
“carry-over.”
tremor. A localized quivering or vibratory motion of a muscle or muscle
group when an articulatory position is suddenly invested with localized
hypertension.
vocal cords. Synonymous with vocal folds. The opening and closing of the vocal
folds is responsible for the production of laryngeal voicing.
voice. Sound produced by vibration of the vocal folds and modified by the
resonators.
voice onset time (VOT). The length of time, measured in milliseconds,
between the onset of an external signal such as a tone or light and the
initiation of phonation.
voluntary stuttering. This may refer to attempts made by the stutterer to
imitate or duplicate as closely as possible, or with specific predetermined
modifications, his usual, habitual, pattern of stuttering. It may also take the
form of easy prolongations or relatively spontaneous and effortless repetitions
of sounds, syllables or the word itself. This style of talking may be used as a
deliberate replacement for the usual stuttering behavior and is intended to
reduce fear of difficulty by voluntarily doing that which is dreaded. This
conscious, purposeful stuttering is also designed to eliminate other avoidance

184
reactions. For the purpose of desensitization some clinicians ask the
stutterer to add tension and struggle to these voluntary stutterings in order
to learn how to better cope with them. (See pseudo-stuttering.)
vowel. A voiced speech sound in which the oral part of the breath channel is not
blocked and is not constricted enough to cause audible friction: broadly, the most
prominent sound in a syllable.
whisper. Speech without vibration of the vocal cords.

185
 Authors of Quotations

★ SOL ADLER, Ph.D. EDWARD G. CONTURE, Ph.D.

Professor of Speech Pathology Professor of Speech Pathology
University of Tennessee, Vanderbilt University, Nashville
Knoxville ★ PAUL R. CZUCHNA, M.A.
★ JOSEPH G. AGNELLO, Ph.D. Director of Stuttering Programs
Professor of Speech Pathology Western Michigan University,
University of Cincinnati Kalamazoo
MERLE ANSBERRY, Ph.D. DENNIS DRAYNA, Ph.D.
Professor of Emeritus of Speech Senior Fellow, National Institute
Pathology on Deafness &
University of Hawaii, Honolulu Other Communicative
★ JAMES T. ATEN, Ph.D. Disorders
Chairman of Speech Pathology National Institutes of Health
Section ★ LON L. EMERICK, Ph.D.
V.A. Hospital, Long Beach, Professor of Speech Pathology
California Northern Michigan University,
★ DOMINICK A. BARBARA, Ph.D., Marquette
M.D. ★ HENRY FREUND, M.D.
Psychiatrist Fellow, American Psychiatric
Karen Horney Clinic, New York Association
City Milwaukee, Wisconsin
★ OLIVER BLOODSTEIN, Ph.D. ★ SCOTT GARLAND, M.D.
Professor of Speech Pathology Occupational Medicine
Brooklyn College, City University Winston-Salem, North Carolina
of New York
★ HUGO H. GREGORY, M.D.
★ C. S. BLUEMEL, M.D. Professor and Head, Speech and
Late Fellow of the American Language Pathology
Psychiatric Association Northwestern University,
and the American College of Evanston, Illinois
Physicians
★ RICHARD M. BOEHMLER, Ph.D. ★ BARRY E. GUITAR, Ph.D.
Professor of Speech Pathology Associate Professor, Speech
University of Montana, Missoula Pathology
University of Vermont,
★ JOHN L. BOLAND, Ph.D. Burlington
Clinical Psychiatrist
Oklahoma Psychological and ★ LLOYD M. HULIT, Ph.D.
Educational Center, Associate Professor of Speech
Oklahoma City Pathology
Illinois State University, Normal
★ DORVAN BREITENFELDT, Ph.D.
Professor of Speech Pathology ★ GERALD F. JOHNSON, Ph.D.
Eastern Washington University Professor of Speech Pathology
University of Wisconsin, Stevens
★ SPENCER F. BROWN, Ph.D., M.D. Point
formerly Associate Professor of
Pediatrics
University of Iowa, Iowa City

★ Authorities who have been stutterers.

186
★ WENDELL JOHNSON, Ph.D. ★ THEODORE J. PETERS, Ph.D.
formerly Professor of Speech Professor of Speech Pathology
Pathology and University of Wisconsin, Eau
Director of Speech Clinic Claire
University of Iowa, Iowa City ★ MARGARET RAINEY, Ph.D.
★ ALAN G. KAMHI, Ph.D. Director, Speech Pathology
Assistant Professor of Speech Shorewood Public Schools,
Pathology Wisconsin
University of Memphis, Memphis, ★ PETER R. RAMIG, Ph.D.
Tennessee Professor of Speech Pathology
★ GARY N. LaPORTE, M.A. University of Colorado, Boulder
formerly Coordinator of Speech PETER ROSENBERGER, M.D.
Pathology Programs Director, Learning Disorders Unit
University of Tampa, Florida Massachusetts General Hospital,
★ HAROLD L. LUPER, Ph.D. Harvard Medical School, Boston
formerly Professor and Head, ★ JOSEPH G. SHEEHAN, Ph.D.
Speech Pathology Department Professor of Psychology
University of Tennessee, University of California, Los
Knoxville Angeles
★ GERALD A. MAGUIRE, M.D. ★ HAROLD B. STARBUCK, Ph.D.
Associate Professor of Clinical Distinguished Service Emeritus
Psychiatry Professor of Speech Pathology
University of California, Irvine State University College,
School of Medicine Geneseo, New York
★ FREDERICK MARTIN, M.D. ★ COURTNEY STROMSTA, Ph.D.
formerly Superintendent of Professor of Speech Pathology
Speech Corrections Western Michigan University,
New York City Schools Kalamazoo
★ GERALD R. MOSES, Ph.D. ★ WILLIAM D. TROTTER, Ph.D.
Associate Professor of Speech Director, Communicative
Pathology Disorders
Eastern Michigan University, Marquette University, Milwaukee
Ypsilanti
★ CHARLES VAN RIPER, Ph.D.
★ FREDERICK P. MURRAY, Ph.D. Distinguished Professor Emeritus
formerly Director, Division of of Speech Pathology
Speech Pathology Western Michigan University,
University of New Hampshire, Kalamazoo
Durham
★ RONALD T. VINNARD, M.D.
★ MARGARET M. NEELY, Ph.D. The Center for Fluent Speech
Director, Baton Rouge Speech and Madera, California
Hearing Foundation
Baton Rouge, Louisiana ★ CONRAD WEDBERG, M.A.
formerly Director of Speech
WILLIAM H. PERKINS, Ph.D. Therapy
Director, Intensive Therapy Alhambra City Schools,
Program for Stuttering California
University of Southern
California, Los Angeles ★ DEAN WILLIAMS, Ph.D.
Professor of Speech Pathology
University of Iowa, Iowa City
★ J. DAVID WILLIAMS, Ph.D.
Professor of Speech Pathology
★ Authorities who have been stutterers. Northern Illinois University,
DeKalb
187
Most of the quotations used in this book came from the
following publications:
A Clinician’s Guide to Stuttering; Sol Adler
(Charles C. Thomas).
Questions and Answers on Stuttering; Dominick A. Barbara (Charles C.
Thomas).
The Riddle of Stuttering; C. S. Bluemel
(Interstate Publishing).
Speech Motor Control in Normal and Disordered Speech; B. Maassen, R.
D. Kent, H.F.M. Peters, P.H.H.M. van Lieshout & W. Hulstjin, Eds.
(Oxford University Press).
Stuttering, A Second Symposium; Jon Eisenson, Ed.
(Harper & Row).
An Analysis of Stuttering; Emerick and Hamre, Ed.
(Interstate Publishing).
Psychopathology and the Problems of Stuttering;
Henry Freund (Charles C. Thomas).
Controversies About Stuttering Therapy; Hugo Gregory, Ed. (University
Park Press).
Learning Theory and Stuttering Therapy; Hugo Gregory, Ed.
(Northwestern University Press).
People in Quandaries; Wendell Johnson (Harper & Brothers).
Stuttering and What You Can Do About It; Wendell Johnson (University
of Minnesota Press).
A Stutterer’s Story; Frederick Pemberton Murray
(Stuttering Foundation of America).
Stuttering, Research and Therapy; Joseph Sheehan, Ed.
(Harper & Brothers).
Handbook of Speech Pathology; Lee Edward Travis, Ed. (Appleton-
Century-Crofts).
Speech Correction; Charles Van Riper (Prentice-Hall).
The Nature of Stuttering; Charles Van Riper (Prentice-Hall).
The Treatment of Stuttering; Charles Van Riper (Prentice-Hall).
Speech Therapy, A Book of Readings; Charles Van Riper, Ed. (Prentice-
Hall).
The Stutterer Speaks; Conrad Wedberg (Expression Co.),
and from the publications of the Stuttering Foundation of America.

188
 Index
abnormal movements, 45, 77 easy onset, 33, 34, 36, 42, 61,
admitting stuttering, 43, 69 177
advice from others, 26, 27, 144, electronic devices, 147
159 eliminating abnormal
alcoholic drinks, 22 movements, 45, 77
all important ground rules, 37 eliminating avoidances, 46, 85
analyzing blocks, 49, 97, 99, 101, eliminating postponements, 46,
107 85
anticipatory reactions, 170 eliminating secondary
appendix, 143 symptoms, 45,77
approach to self-therapy, 13 eliminating substitutions, 46,
assertive, 139 85, 156
authors of quotations, 186 emotions, 19, 154
avoidances, 46, 76, 85, 87, 158 enlisting support, 25, 26, 144
equipment, desirable, 59
beneficial practices, 37 exercises, 23, 24
block corrections, 51, 113, experimental therapy
115, 123 procedure, 33
body exercises, 23 explaining effect of fear, 145
bounce, 109, 174 eye blinking, 45, 77
boyhood recollections, 166 eye contact, 48, 95, 177
breath control, 146
factors affecting therapy, 19
cancellation, 115, 174 famous stutterers, 152
cause of stuttering, 18 fear (of difficulty), 17, 21, 43, 44,
cerebral dominance, 18 67, 135, 138, 145, 155, 177
changing speech, 28, 29, 30 feelings and emotions, 19
commitment, 27 finding out what you do when
conclusion, 137 you stutter, 49, 99
conditioning, 174 fluency shaping therapy, 33, 178
cost of therapy, 165 following advice, 26, 161
forcing speech, 21, 42
delayed auditory feedback, 175 frequency and severity, 154
Demosthenes, 160 frustration, 20, 130, 178
desensitization, 43, 176
determination, 15, 27 gestures, 45, 77
diagnosogenic theory, 176 getting job, 157
differences in stutterers, 16, glossary, 171
166 ground rules, 37–60
discouragement, 129 group therapy, 144, 178
distractions, 24, 25, 176 guidelines, 37–60
drinking, 22
drug therapy, 22 handicap, 13, 28, 140, 176, 188
dysphonia, 176 hard contact, 178
“he” or “him,” 8

189
head jerking, 45, 77 perfect speech, 131, 140, 158
hereditary factors, 18 phonation, 180
hierarchy, 55, 56 physical exercise, 24
humor, 74 play therapy, 180
hypnotism, 22 post-block correction, 115, 181
postponement, 46, 85, 181
identifying secondary posture, 24
symptoms, 45, 77 pre-block correction, 123, 181
in-block correction, 121 premise and program, 29
inferiority, 20, 96 preparatory set, 123, 181
inflection, 53 professional stutterer, 162
inherited stuttering, 18 program, 29
intelligence of stutterers, 17 prolongation, 33, 42, 65, 73, 181
introducing oneself, 159 pull-out, 121, 182

job, getting, 157 quotation authors, 186

joking about stuttering, 74
rate control, 41, 61, 182
King George VI, 164 recorder, 60, 104
recovery time, 161
laterality theory, 179 regression, 129, 182
light contact, 65, 118, 179 relapse, 129, 182
relaxation, 21
maintaining eye contact, 48, 95 relevant and interesting
melodious voice, 53 quotations, 152
memorable experience, 163 responsibility for problems, 11,
mirror, 59, 79, 102 156
modifying attitude, 29, 37–44, results from comparison, 112
46, 47, 48 review, 133
modifying stuttering behavior, rewarding habits, 37
41, 42, 45, 49, 51, 52, 178 rhythmic beat, 157, 182
monitoring speech, 162, 179 rules, ground, 37–60
motivation, 15, 27
moving forward, 52 saying your name, 108, 154
secondary symptoms, 45, 77, 80,
neurotic, 14 182
number of stutterers, 11, 152 self-help groups, 144
semantics, 182
on this approach to self- sensitivity, 20, 27, 155, 182
therapy, 13 severity, 157
operant conditioning, 180 sex ratio, 8
original cause, 18 shame and embarrassment, 20
sharing problem with others, 144
pause, 41 sigh, 146
pausing, 62, 156 singing, 17
paying attention to fluent slow speech, 33, 41, 61
speech, 53

190