From time to time, it happens in our field that people become enamored of a particular speech fluency enhancing technique or method of practice. All of a sudden, people start reading about the near-miraculous success rates--especially in this age of social media influencers and instant sharing of ideas, regardless of whether or not those ideas have been fully and scientifically vetted.
It's understandable that speech-language pathologists tend to get excited about promises of easier therapy for people who stutter: Just do THIS and your client will be fluent and happy! Of course we want that! Why wouldn't we?!?
More and more people jump on the bandwagon, and before you know it it, you find yourself wondering, "shouldn't I be using that too?!?"
Well, I'm here to tell you that it's okay to take a step back, to not get caught up in the rush and frenzy to the simple fix, and to be more than a little bit skeptical of what you read on the 'net. Let's break it down:
First, it is true that there are various methods for improving speech fluency that have been developed and studied over the years. And, it is true that what tends to happen is that these techniques may become 'favored' by one individual or another, and then there is a lot of exciting press about them. (Again, this is particularly easy for marketers to achieve in the digital era.) Then, later, we find that those initial promises of easy success were perhaps a bit overstated... the technique becomes 'less favored,' or something else comes along, and attention shifts.
That's what we're experiencing right now in the field of fluency disorders. Certain techniques are being promoted fairly heavily on social media, and clinicians are noticing. Here are some facts:
***It is not true that the results are so much better with some new approach than with other various approaches that have long been available to SLPs.
*** It is also not true that there is something remarkably new or special that has been discovered. In fact, I fear that it is a bit simplistic for some to be touting new approaches as any type of breakthrough. What you're seeing is a lot being made of a little, in terms of the actual science.
It's happened before (longstanding techniques being repackaged... you know the phrase "old wine in new bottles...") And, it will happen again. This is not to say that ABC technique is bad - it is to say that the enthusiasm behind it is a bit simplistic.
Here's how I approach this, after a bit over 30 years of studying stuttering: Yes, claims will be made about amazing efficacy for different approaches, but the bottom line with stuttering is that it almost never that easy.
- If the presentation that you are reading about a particular approach seems too good to be true, then it is.
- If it seems simple, then it's probably simplistic.
- If it's nice and tidy and "just do this and all will be well," then someone is just not telling you about the true complexity of the stuttering condition.
And, in those cases, I would wonder why.
Seriously, after literally thousands of years of people studying stuttering, including many studies on changes to speech timing, do we really believe that all of a sudden we've found THE answer?!? And that answer is as simple as, "just do this X minutes a day or X times?"
No, as a scientific field, we should not be so credulous. We should instead take what we can learn from such studies and fold them into all of the other knowledge that we have about stuttering and how it's just not that simple, and then not get caught up in the hype.
Here are some more facts:
- At present, we unfortunately do not have anything like a definitive treatment for stuttering that works for everyone.
- There are certainly various techniques that can enhance fluency, and practicing those techniques with regularity will definitely make it easier to use them.
- But, there is absolutely ZERO evidence of such practice permanently "rewiring the brain" in any type of lasting fashion.
Remember, the brain is *always* changing and rewiring in response to our experiences... To say that practice changes the brain is to say that the sun is warm...
The question is not whether the brain changes but whether such changes are lasting, and there is NO support for any statement practicing speech fluency strategies this is going to make a permanent change in either the structure of function of the brain.
And, there is NO evidence that this might be related to durable changes in speech fluency. (If you are disappointed to read this, imaging how generation after generation of people who stutter are disappointed when they find out that these glittery promises turn out to be just more of the same old thing...)
I know that I sound a bit jaded, but really, the field has been through this before - many times. The reason that I take the approach that I take in working on speech fluency enhancement is because I don't want myself - or my clients - to get sucked into the promises of "it worked for me, it will work for you" or "just do this and you'll be fine" or "you can reduce your stuttering by X% if you'll only do this..."
Such promises have been made to people who stutter for millennia -- often by well-meaning and enthusiastic clinicians AND other people who stutter -- but too many people just get let down again, and again, and again.
We owe it to our clients to do better, and I get really frustrated when I see people online and elsewhere over-simplifying (or frankly dumbing down) the complexities of stuttering.
Yes, we can and should make stuttering and stuttering therapy accessible to people, but I am loathe to over-simplify it or make it simplistic. We can--we must--do better than that.
SOooo...that's why I don't pay too much attention to breathless claims about how we can rewire the brain by just using some "new" technique (that's really not all that new). It can help, sure, but so can a ton of other things.
(Oh yes, and this lengthy diatribe doesn't even begin to address the lack of scientific grounding of statements like "reduces stuttering from X to Y percent" - not only because of the huge range that is typically offered in light of the vast individual differences between people who stutter, but also because of the extreme and well-documented variability of stuttering from situation-to-situation. Such claims ignore the difference between speech fluency when one is "using" a technique vs. speaking freely, and the extreme impact on quality of life when people focus too heavily on fluency.)
Bottom line: it's a lot of numbers that don't necessarily signify anything of meaning... WHEW!
/rant... at least until next time!
Stay tuned for more blog posts about what we can do instead...