The Journal of Stuttering Therapy, Advocacy & Research Vol. 3, Iss. 1: “Stuttering: A
Look at the Problem.” by: George G. Helliesen
This article, which introduces a series on understanding stuttering, provides an
overview of what science and speech therapy practitioners know about the cause and
treatment of stuttering. Published in 2006, it provides an overview of the latest research in the field of speech disorders among other valuable information.
The overview includes recent studies conducted by Dr. Christine Weber-Fox and Dr. Anne Smith of Purdue University (2004), Dr. Ann Foundas (2005) of Tulane University, and Dr. Dennis Drayna (2004) at the National Institute of Deafness and Other Communication Disorders, though these are just a few of the studies in the literature on stuttering. Though many studies have begun to focus on organicity as the primary cause of stuttering, all of these studies agree that stuttering emerges from complex interactions among factors including genetics, language processing, emotional/social aspects and speech motor control. These factors can vary in significance from patient to patient or even in a single patient over time. Dr. Foundas (2005) in particular “believes that developmental stuttering is a complex motor speech disorder with a strong genetic link and that different therapies may benefit different biologically specific types of stuttering.”
Within this overview of studies it is clear that dysfluencies observed in individuals who stutter may be reduced under a number of conditions including choral reading (where a group reads aloud in unison) and altered auditory feedback (AAF). Therapy using delayed auditory feedback (DAF) is a vital part of Van Riperian therapy and enhances the client’s oral proprioceptive feedback, which is used in teaching a stutterer to monitor the movement of their speech articulators. This decreases dependency on auditory feedback, thus helping to maintain appropriate fluency. This greatly helps a stutterer change focus from listening to their speech production to feeling the movement of their articulators as they are speaking. This is one of the primary therapy techniques used to help a stutterer maintain control over their stuttering and decrease dysfluencies. According to Van Riper (1973), “In terms of servo theory, since speech seems to be
automatically controlled by feedback and there seems to be some real evidence that some failure in the auditory processing system produces the basic disruptions, we train the stutterer to monitor this speech by emphasizing proprioception thus bypassing to some degree that auditory feedback system.”
Helliesen concludes the article by pointing out that timing of therapy is also crucial. A candidate must be “ready” for therapy and have support to stick with their program. Programs related to stutter correction often elicit a rediscovery of self, are difficult and teach “controlled speech” which will have to be used continually to maintain any degree of control, and it may not be pleasant at times. The benefits however, are measurable, but only evident over time.
I found this article very helpful in my search for understanding stuttering and the music therapies related to its treatment. Though I have been aware that music is often a tool in the approach to easing dysfluency, I didn’t know why until now. As a singer much of this makes perfect sense. The idea that DAF is simply a way of decreasing dependency on auditory feedback clarifies several points for me. Though research is still ongoing, evidence leans to confirming that stuttering is, at least in part, a disorder of the auditory processing system, and research of treatments further corroborates that addressing the ear leads to successful revision of dysfluency. I am also interested in the concept that DAF is just one method of reducing dependence on auditory feedback. This explains why playing music to obscure ones voice (a la The King’s Speech) is also effective.
In the study of singing, one learns early on that there are many pitfalls to listening too intently to oneself. In fact, many voice pedagogies advocate blocking or delaying auditory feedback so a singer is not dependant on their ears to assess their sound but rather puts the emphasis on sensation. This seems to parallel the therapeutic strategies for stuttering, which might explain why some stutterers find freedom from their dysfluency in song. Could it be that they have learned to because less dependent on auditory feedback while singing?
In some respect I have more questions after reading this article then I did before, however I feel confident that this overview of stuttering has set me on a clearer path to understanding the possible benefits music therapies have in its treatment.