The early history of behavior modification of stuttering: A view from the trenches

• Published in: Journal of fluency disorders 1993, Vol.18 (1), p.1-11
• Main Author: Perkins, William H.
• Format: Article
• Language: English
• Subjects: Behavior therapy. Cognitive therapy; Biological and medical sciences; Medical sciences; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Treatments
• ISSN: 0094-730X; 1873-801X
• DOI: 10.1016/0094-730X(83)90002-5

Two aspects of stuttering are separable: 4 out of 100 children will stutter; 3 will outgrow it; only 1 will develop a self-image of being a stutterer. Thus, prevention of this self-image would effectually prevent stuttering as a chronic problem. Why stuttering becomes chronic still has not been solved. The only invariant physiological evidence suggests a possibility: stuttering reduces systolic blood pressure, so it may be addictive. No one has cured chronic stuttering. The most popular approaches among clinicians in the last quarter century have been behavioral procedures for establishing fluency. As a pioneer, Perkins eventually disavowed the fluency objective for several reasons. Controlled speech does not feel natural even when it sounds natural, which is rare. People who stutter complain of this approach that they feel like speech actors. The goal of spontaneously fluent controlled speech is an oxymoron. Spontaneous speech is automatically self expressive of affect as well as ideas. Controlled fluency requires attention. The two conditions are mutually exclusive. The value of behavioral approaches is that they can help to build confidence, without which no form of therapy for stuttering will have long-term success. Unfortunately, fluency procedures often provide professionally sanctioned avoidance tactics. The therapies devised by stutterers for themselves emphasize acceptance of stuttering by reducing avoidance of it, & replacement of struggle with easy stuttering. 8 References. AA