Four Steps to Freedom

 

I have found that those who have obtained freedom from their stuttering successfully solved four basic problems:

 

a. Identifying the specific nature of their stuttering,

 

b. Developing an effective therapy program,

 

c. Implementing that therapy pro­gram, and

 

d. Maintaining the new speech produc­tion patterns until they became habitual.

 

But first, a word of caution before examining these steps in detail. Stuttering can vary significantly from one individual to another. Therefore, some of the following generalizations may not apply to all stuttering patterns.

 

 

Knowing that you “stutter” is not enough. Your unique stuttering needs to be identified. Self-diagnosis is a difficult task. Put your best effort into this step.

 

Start by describing exactly what you do or do not do when you wish to speak and stuttering occurs. Speech production involves the integration and timing of two major processes: (1) language formulation (the thought process of putting ideas into words) and (2) vocal output (the phonation/voicing process of making sounds with your vocal chords, and the articulation process of making sounds using the lips and tongue and modifying sounds made by phonation.) This integration occurs in short sequences called utterances. An utterance is produced as a continuous sequence of movements without a pause. These movements occur so fast that you often start the movements for one sound before the movements for the previous sound has been completed. Utterances vary in length from one to many syllables. 

 

For example, the utterance “I want to go home” could be said as:

 

one utterance without a pause, “iwanttogohome” 

 

two utterances, with a pause after “I” “I wanttogohome” 

 

five utterances with a pause after “I, want, to, go, home.”

 

each word for emphasis

 

These units of speech are usually produced automatically with near-perfect precision, but errors do occur which may stop the normal flow of speech.

 

Examine utterances in which your stuttering occurs and describe the specific movements, feelings, or actions which characterize that stuttering. If the speech mechanism is blocked, describe exactly which muscles do not move in the appropriate fashion and what you do about the block. For example: my tongue did not move back from behind my teeth to produce the “t” sound; I held my breath which stopped the air flow needed to produce “h”; when I anticipated a block, I either substituted another word or articulated the word with more effort to override the block. Making a video recording or asking a friend for feedback may help. I have found it useful to divide these observations into three categories: (1) speech-flow blocks, (2) block-coping patterns and (3) patterns not associated with blocks.

 

 

Blocks are breaks in the flow of speech which are unintentional and undesired. Speech-flow blocks can occur for numerous reasons. For example: we can have problems with language formulation due to problems remembering a common name or term. Or, we can have difficulty because the brain’s motor command to the speech muscles is not properly timed and results in movements that are not properly sequenced. A third type of problem occurs when the rate of movement for a complex pattern exceeds the ability of our muscles to execute that command. A fourth reason could be when an emotional response (anxiety) interferes with our ability to properly use the speech production mechanism because anxiety can cause the vocal chords and breathing mechanism to respond in ways which are incompatible with smooth speech production. Finally, various other breathing, voicing/phonation, and articulatory patterns such as trying to continue speech-flow when most of the air has been exhaled from the lungs, can contribute to speech-flow stoppages.

 

The block alone occupies only a small fraction of a second. As soon as a block is perceived, the speaker copes by doing something to initiate or maintain speech-flow. When identifying your stuttering, try to distinguish between blocks and block-coping patterns.

 

 

Most individuals learn effective block-coping patterns. However, some of us use patterns which make matters worse by perpetuating the cause of the blocks or by adding undesired behaviors. In many cases these ineffective block-coping patterns make up most of our stuttering. They include such responses as “pushing” to complete the word, adding a movement such as a head jerk to “release” a block, or substituting another word to avoid an anticipated block.

 

 

Some stuttering patterns are not perceived by the speaker as a block, nor are they behaviors to cope with the expectation or occurrence of a block. For example, if the rate of vocal output exceeds the rate of language formulation, extra syllables which have previously been formulated may be automatically produced in order to keep the rhythm of vocal output going. If one has the idea “I want to go home” and starts vocal output after formulating “I” but proceeds at a rate too fast for formulating the complete sentence, the result may be “I - I - I want to go home.” Note that such an idea would usually be produced as one utterance without a break in the movement pattern. The repetition of “I” may not be noticed by either the speaker or listener and no stoppage or block of speech-flow would occur. However, when such repetitions are frequent they might be noticed by the listener and be perceived as stuttering.

 

After identifying your block, block-coping, and non-block associated stuttering patterns, you need to decide what patterns you wish to reduce or eliminate. This decision or goal becomes the basis for designing a self-therapy program.

 

 

The speech production patterns of others can be used as the model for designing a therapy program. The speech of most normally fluent speakers contains a number of characteristics which are important for understanding why you stutter and what skills you need to achieve free-flowing production. It has been my observation that: (1) some blocks in speech-flow are to be expected in normal production, but blocks due to speech-flow anxiety are rare; (2) coping with blocks without increased muscle effort in a smooth efficient manner, and without increasing the likelihood of more blocks, seem to be a common skill; (3) confidence in one’s ability to initiate and maintain speech-flow is typical; (4) the integration of vocal output and language formulation is such that the rate of vocal output is continuously adjusted to match the varying rate of language formulation and the complexity of the muscle sequence of that utterance; (5) most speakers maintain a cushion between their fastest articulation rates and the limits of their speech production skills; and (6) the articulation rates of utterances in syllables per-second varies significantly, with one’s fastest utterances often three times as fast as one’s slowest utterances.

 

Normal speech production is a very complex process requiring exceedingly fine muscle movements and the close integration of those movements and language formulation. Errors, including blocks, are to be expected. Even the less complex patterns involved in typing or playing golf are not executed perfectly every time. Therefore, effective block-coping is often the most critical skill for initiating and maintaining free-flowing speech. This is particularly true when a significant portion of one’s stuttering behavior represents ineffective block-coping. You may need to develop the skill of coping with blocks without avoidance, increased effort, or added extraneous movements as the first step in your therapy program, with reduction of blocks and stuttering patterns not associated with blocks as second or third steps.

 

 

A very common block coping strategy used by normal speakers when anticipating or experiencing a block is to instantaneously reduce the rate of speech movement and execute that movement with greater conscious control than is normally needed for automatic production. This change in articulatory rate over the production of one or two sounds/syllables is done without a pause or stopping the flow of the utterance. Practice counting from one to six as one continuous movement sequence Then repeat the sequence while significantly slowing the rate of movement on just one number without pausing. Practice doing this while reading out loud, randomly selecting various specific movements within each utterance on which to significantly slow down. When you can do this smoothly without a pause, try applying this control when expecting or experiencing a block in speech-flow.

 

 

In some cases the high frequency of speech-flow blocks needs direct attention. In such cases, therapy needs to focus on factors which cause their occurrence. If anxiety is one of the causes, developing an effective block-coping skill to the point that it is applied with confidence may provide a foundation for reducing that anxiety. Other anxiety reducing techniques are also available and discussed by other authors in this publication. Frequent blocks, due to the complexity of the muscle sequence or language formulation difficulties, suggest the need to change the habitual range of one’s articulation rate either by lowering the entire rate range or reducing the rate range by eliminating the fastest rates. There should be a cushion between the fastest articulatory rates and the rate that speech-flow breakdowns begin to occur. Sometimes incorrect breathing, phonation, or articulatory patterns may need attention.

 

 

In most cases stuttering patterns not associated with blocks, such as simple, relaxed syllable repetitions, can be eliminated or reduced by establishing an articulatory rate range which provides more cushion between your fastest rate and the limits of your language formulation/vocal output integration system. I have found this to be a critical therapy component when the individual with frequent, simple syllable repetitions also needs to slide over some sounds in order to maintain their rate of syllable production.

 

 

Stuttering therapy is work! You can’t expect to establish new speaking patterns without a significant amount of effort. My best advice is to “plan your work and work your plan.” Specific daily goals, procedures to reach those goals, and evaluation of your progress should be the norm. A few days without progress suggests a need to revise your problem description, therapy plan, or implementation program.

 

 

 

It is very common for individuals to start self-therapy with a high level of motivation. Careful identification, good therapy planning, and consistent implementation often leads to significant improvement. With that improvement, motivation to work hard at therapy often goes down. There is a strong tendency to let the “little stutters” go by since the listener “probably doesn’t notice them.” Planning is put off and implementation becomes inconsistent. A relapse to old stuttering patterns is likely to follow. The old stuttering habits have not disappeared. Motivation must be kept high until the new skills are habitual and consistently replace the stuttering habits.

 

Freedom to initiate and maintain speech-flow is possible. To achieve this freedom, I advise you to work on these four basic steps: identify, plan, work, then follow-through!