Case Study

Henry: A 35 Year Old Adult with Stuttering

Henry had been stuttering since age five when I met him. He had tried speech therapy several times, first in elementary school and then at his university. Because of his years as a person who stutters and because of irrefutable brain imaging evidence that there are brain structure and function differences in adults who stutter, we treated Henry as someone in whom the stuttering would probably not go away. Instead our job was to make the stuttering less a factor in his life by helping him change his attitude toward stuttering and by giving him tools to manage the stuttering. Henry, like many adults who have stuttered for years, had developed compensatory methods. He was very adept at switching words to a synonym if he thought he was going to stutter. Sometimes inserting “uh” into his sentences helped him say words and he was quite good at pretending these “uh” sounds were thought pauses. The problem with all these methods is that they reinforce avoiding and hiding stuttering. Very often, bringing stuttering out into the open, studying it, talking about it, and even stuttering on purpose (called voluntary stuttering) helps to reduce the anxiety associated with trying to hide the stuttering, and the stuttering itself decreases.

We had two goals for Henry in speech therapy. The first goal was to help him move toward accepting the stuttering. We worked on reducing avoiding stuttering. Instead of substituting a word that might be easier to say, we encouraged him to go ahead and stutter. To do this, we did much voluntary stuttering in our therapy sessions and in short “field trips” to a nearby shopping mall. We also had Henry gradually began talking more about his stuttering to his friends and family, all of whom knew he stuttered but were mostly avoiding the subject because Henry never mentioned it.

Our second goal was to teach Henry methods of stuttering easier. To do this, we had to review how speech sounds are made and then discover what he was doing when he stuttered; how and where in his mouth he was stopping the air flow. We studied his disfluent speech carefully in a calm and matter-of-fact way and I asked him to teach me how he stuttered, which of course required him to learn to be comfortable thinking and taking about his stuttering and also required him to be knowledgeable about the processes involved in talking. Once we knew how he was stuttering, we worked on decreasing the effect of the stuttering. We cannot make the core speech disruption go away (that is the part that is neurological) but we can and did teach Henry to lessen his physical and emotional reaction to the initial disruption in several ways. Once he learned to stutter in an easier manner and as he came to accept his stuttering, his communication significantly improved. Henry learned to tolerate and then accept some stuttering in his daily communication and when he did the severity of the stuttering markedly decreased.

The above description makes the process sound easy; it was not. Henry and I worked together for two years once- weekly and at the same time he joined a local chapter of the National Stuttering Association, a national self help and support group for people who stutter. The most important factor in Henry’s improvement, however, was his willingness to become his own speech therapist, to follow my suggestions and then expand on them and ultimately to create his own practice assignments and goals. I learned a great deal from Henry.

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