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Stuttering FAQ v.2.21

Newsgroups: alt.support.stuttering,alt.answers,news.answers
From: kehoe@netcom.com (Thomas David Kehoe)
Subject: Stuttering FAQ v.2.21
Message-ID: <kehoeEEALwt.J5o@netcom.com>
Followup-To: alt.support.stuttering
Summary: This document provides general information about stuttering,
         and points to resources available for stutterers.
Keywords: stuttering
Sender: kehoe@netcom10.netcom.com
Supersedes: <none>
Organization: NETCOM On-line Communication Services (408 261-4700 guest)
Date: Sat, 2 Aug 1997 15:34:05 GMT
Expires: Mon, 1 Sep 1997 00:00:00 GMT

Archive-name: support/stuttering
Posting-Frequency: monthly
Last-modified: 1997/07/1
Version: 2.21
URL: http://www.casafuturatech.com/FAQ/faq.html

Stuttering Frequently-Asked Questions (FAQ)

This is short version of the book "Stuttering: Science, Therapy & 
Practice."  The book is available free at www.casafuturatech.com, 
or for $30 from Casa Futura Technologies.  Unless you're short on time, 
you should read the book instead of this FAQ file.  The book has 
more topics and more depth on each topic.  This FAQ fits into the 64K 
limit of some Internet mailers.  The book is about 15 times longer.

This document is available on the World Wide Web at
   http://www.casafuturatech.com
   ftp://rtfm.mit.edu/pub/usenet/news.answers/support/stuttering

This document can also be retrieved by sending email to 
   mail-server@rtfm.mit.edu 
containing the line
   send usenet/support/stuttering
Or send the line "help" to that address.    

A German translation of this FAQ is available at:
http://www.hsp.de/bvss/faq_g.html

The author, Thomas David Kehoe, is owner of Casa Futura Technologies; 
Boulder, Colorado, National Stuttering Project chapter leader; and a 
member of the American Speech-Language Hearing Association.  I am a 
person who stutters, not a speech pathologist.  All legal issues 
discussed in this document refer to United States laws.

Send comments to: kehoe@netcom.com.

TABLE OF CONTENTS

INTRODUCTION
   What's So Great About Stuttering?

SCIENCE
   What Causes Stuttering?
   How Speech Is Produced
   Symptoms of Stuttering
   Physical Constitution and Personality of Stutterers
   Incidence and Prevalence of Stuttering
   Conditions That Increase or Decrease Stuttering
   The Development Of Stuttering In Children
   Neurology Of Stuttering
   Other Fluency Disorders

THERAPY
   Childhood Stuttering Therapy
   Adult Stuttering Therapies
   Effectiveness Of Stuttering Therapies
   Computers And Electronic Devices For Stuttering


SOCIAL ISSUES & RESOURCES
   United States Organizations For Stuttering
   International Organizations For Stuttering
   Internet Resources For Stuttering
   Books And Journals About Stuttering
   Famous People Who Stutter
   Employment Rights
   The Last Word

------------------------------

Subject: What's So Great About Stuttering?

Stuttering is a remarkable disorder.  It's the easiest disease to treat, 
and the hardest to cure.  On occasion, stutterers can talk fluently, 
when they're alone, by changing their manner of speaking, thinking 
differently, using an electronic device, or even just seeing their 
speech therapist walk into the room.

But stutterers can go right back to stuttering, even after weeks of the 
best therapy.  Temporary "cures" are a dime a dozen, but a universal, 
permanent cure has never been found.

Stuttering occurs when we want most to speak well, such as job 
interviews, public speaking, or speaking to authority figures.  
Stuttering is characterized by overtense speech production muscles.  
We try to hard to speak, tense our muscles too muscle, try harder, 
and get more stuck in the vicious cycle.  For many stutterers, 
the most frustrating aspect is that stuttering gets worse when we 
try not to do it. 

Some stutterers have extreme physical symptoms, such as head jerks, 
facial grimaces, and even what listeners might think are seizures.  
Other stutterers hide their stuttering completely, by substituting or 
avoiding words.  The latter can be just as disabling, because the 
stutterer is afraid that people will discover that he stutters.  The 
stutterer may refuse promotions that require more talking, or avoid 
social interaction.

Despite the disabling effects of stuttering, the greatest orators have 
been stutterers.  Demosthenes was the greatest orator of ancient Greece.  
Today, James Earl Jones is the most in-demand voice in Hollywood.

Dozens of stuttering causes have been hypothesized, but none have been 
proven.  Suspected causes have ranged from Freudian anxieties, to 
parental demands, to poor vocal fold control, to neurological 
abnormalities.  

Stutterers are both hyperaware and unaware of their stuttering.  Before 
talking to a stranger, we have fear and anxiety that we will stutter.  
But when we stutter, we don't know what our lungs, vocal folds, lips, or 
tongues are doing.  We lose awareness of our speech.  Our minds seem to 
go "someplace else," and we lose awareness of even the passage of time.

Stuttering is one of few disabilities that gets better over time.  Most 
children outgrow it.  Even adults who stutter severely in their 20s 
usually learn to manage their stuttering in their 30s and 40s, and 
sometimes overcome stuttering completely.  

Stutterers grow up humble, thinking we'll never get a job or marry.  
Later in life, when you realize you can do anything you want, regardless 
of your speech, you get what you need and appreciate what you have.  Or 
you overcome stuttering and find pleasure in simply talking to people.  
Speech pathologists who treat adults who stutter say that we are the 
funnest, best-adjusted, most positive people they know.


------------------------------

Subject: What Causes Stuttering?

The question "What causes stuttering?" is really two questions, one easy 
to answer, one hard to answer.

The easy question is "What causes stuttering in adults?"  The answer is 
that we stuttered when we were children.  The speech patterns we learn 
as children -- accent, grammar, language, etc. -- become "hard-wired" as 
our brains grow.  An adult stutterer can learn to talk fluently about as 
easily as an adult nonstutterer can learn to speak Chinese.

Because stuttering develops as a child's speech and language develops, 
this disorder is called developmental stuttering.  Developmental 
stuttering is distinguished from neurogenic stuttering (caused by 
strokes and head injuries) and psychogenic stuttering (caused by 
psychological trauma).  

The hard question is "What causes stuttering in children?"  Childhood 
stuttering looks simple compared to the complex behaviors of adult 
stuttering.  But while the cause of adult stuttering is simple, the 
cause of childhood stuttering is an enigma.  Many theories have been 
proposed, but none is compelling.  I present the theories in my book, 
but I left it out of this FAQ due to space considerations.


------------------------------

Subject: How Speech Is Produced

Speech begins with breathing.  Your lungs fill with air, more air than 
you would inhale if you weren't talking.  You expand your upper chest, 
as well as your diaphragm, to get all this air in.  Your lung pressure 
and respiration muscle tension increases.

Next, you release air through your throat, past your vocal folds.  Your 
vocal folds are a pair of small muscular folds in your larynx.  If you 
tense these muscles slightly, and release a little air, your vocal folds 
vibrate.  This is called phonation.  If you place your fingers or palm 
across the front of your throat, and hum or talk, you can feel your 
vocal folds vibrating.

If you tense your vocal folds too much, you'll block off your throat and 
prevent any air from escaping your lungs. 

Vowels are produced by your vocal folds, and modified by your 
articulation muscles (lips, jaw, and tongue).  Some voiced consonants, 
such as /b/ and /d/, are also produced with vocal fold vibration, and 
modified by your jaw, lips and tongue.  Other consonants are voiceless, 
such as /p/ and /t/, and are produced only by your articulation muscles 
modifying airflow, without your vocal folds vibrating.


------------------------------

Subject: Symptoms of Stuttering

PRIMARY STUTTERING BEHAVIORS

1) Laryngeal disfunction is widely-believed to be the core stuttering 
behavior.  However, laryngeal disfunction in stuttering is not simple.  
Some studies have found abnormal laryngeal activities with stuttering, 
other studies have not.  Regardless of whether stutterers use our vocal 
folds in a abnormal way, changing how we use our vocal folds is the most 
effective way to improve fluency.  

2) Articulation disorders.  Many studies have found disfunctions of the 
lips, jaw, and tongue in stuttering.  As with the laryngeal 
disfunctions, the unusual muscle activities occur in only some persons 
who stutter, and sometimes when the person is talking fluently, or even 
when not talking. 

3) Breathing abnormalities have been found during stuttering.


SECONDARY STUTTERING BEHAVIORS

1) Avoidance of feared words, such as substitution of another word.

2) Postponement of the feared word, with pauses or filler words.

3) Starting tricks, such as an "uh" before the feared word.

4) Escape tricks, such as head jerks, exhausting one's breath and 
speaking on residual air, "backing up and getting a running start," etc.

5) "Anti-expectancy" speech behaviors to prevent stuttering such as 
speaking in a rapid monotone, or affecting an accent.


WHAT STUTTERING FEELS LIKE

Stutterers report three types of sensations:

1) A sense of being frustrated in the attempt to talk.  Stutterers know 
the word they are trying to say, but the word is stuck.  The advice, 
"Think about what you are going to say before you say it" does not help 
stutterers.

2) A feeling of muscle tension, usually in the speech-production muscles 
(breathing, throat, jaw, lips, and tongue), but sometimes in the arms or 
legs or shoulders.

3) Emotions and anxiety before, during, or after stuttering.  

During stuttering, stutterers usually feel a mental "blankness."  Our 
minds go "someplace else."  

Several studies have found that stutterers lose their ability to use 
their hands during stuttering.  Other studies have found that stutterers 
lose sense of time during stuttering.

This poor awareness makes altering stuttering behavior difficult.  

We may be hyperaware that we are going to stutter before we talk to a 
stranger.  We may experience great anxiety during stuttering.  But when 
we stutter, we have little awareness of how long our blocks are, how 
many times we stuttered, secondary symptoms, etc.


ATTITUDES AND EMOTIONS OF STUTTERING

Stutterers believe that:

1) Stuttering is shameful and embarrassing.  

2) Speech is threatening and difficult.  

3) Stuttering occurs for no apparent reason, and can't be controlled.  

4) Nonstutterers are believed to never experience speech hesitancy, 
anxiety, or fears.  

5) Stutterers may try to overcompensate or gain approval by working 
extra hours, doing favors for people, or excelling at non-speaking 
activities such as music or sports.

6) Stutterers fear using telephones.  On telephone calls, listeners 
can't see the stutterer struggle, and think there's a "bad connection."  
Telephone conversations have more time pressure.  You are expected to 
talk immediately.  In face-to-face conversations, a pause in replying 
is more acceptable.

In spite of all this, many stutterers, especially children, seem 
unconcerned about their stuttering.  Franklin Silverman asked 62 
children who stutter (grades 2 to 5) to make three wishes.  Only four 
made wishes related to speech, and one of these children wished he could 
go to speech class forever!  Younger children don't view themselves as 
inferior to their classmates.  This belief develops as the child grows 
up.


THE FLUENT SPEECH OF STUTTERERS

The "average" stutterer is disfluent of 10% on words.  Stated 
conversely, we are fluent on 90% of words.  But is our fluent speech 
normal, or are there abnormalities even in our fluent speech?

Some studies found that listeners could differentiate the fluent speech 
of stutterers from that of normal speakers.  Other studies found that 
listeners could not hear a difference.  

Spectrographic analysis did not find abnormal pitches in stutterers' 
fluent speech.  But electromyographic and aerodynamic studies found 
abnormalities in stutterers' fluent speech.

The problem may be that in what each research team considered to be 
fluent speech.  Some studies used mild stutterers, other studies used 
severe stutterers.  Some stutterers may have used therapy techniques 
resulting in abnormal muscle activity in order to sound fluent.


DO STUTTERERS TALK TOO FAST?

Stutterers will tell you that they talk too fast, and this results in 
stuttering.  We feel like our minds can produce speech "a mile a 
minute," and that our speech-production muscles can't keep up, and we 
stumble and fall over our words.

Stutterers are capable of fast, fluent speech, when using an electronic 
device or singing.  Stutterers do not have a "timing disorder" making 
them incapable of fast speech.

Martin Schwartz suggests that a fast start on a sentence increases vocal 
fold tension before the first word of a phrase, which then leads to 
stuttering.  He believes, however, that speaking fast on the rest of the 
sentence has much less effect on stuttering than starting the first word 
fast.

Studies of stutterers' fluent speech have found that stutterers seem to 
do some speech movements faster, and other speech movements slower.


------------------------------

Subject: Physical Constitution and Personality of Stutterers

PHYSICAL AND PSYCHOLOGICAL CONSTITUTION

Stutterers' physical and psychological constitutions have been studied 
in every way.  Stutterers are normal in every respect.

Studies have found that parents of stutterers are normal in most 
respects, including their attitudes and behaviors towards their child.


LANGUAGE SKILLS

There is evidence that children who stutter start talking later or are 
slow in developing language skills. But by school age, stutterers have 
caught up with other children in language ability.

Children who stutter often also have articulation disorders, such as 
lisping, indistinct speech, or difficulty saying the sound /r/.  


INTELLIGENCE

Children who stutter score about five IQ points lower than children who 
don't stutter.  

College students who stutter are more intelligent than their peers.  
However, any person with a disability has to be especially intelligent 
and motivated to attempt college work, so this doesn't mean that 
stutterers are more intelligent in general.

Stuttering among mentally deficient individuals appears to be far higher 
than the prevalence in the general population. 


------------------------------

Subject: Incidence and Prevalence of Stuttering

1% of children stutter now.  About 5% of children stutter at some point 
in childhood.  The typical age for stuttering to begin is 2 or 3.  One 
study found that three-quarters of stutterers begin by age 6, and all 
before the age of twelve.  

Researchers used to believe that many young children recovery from 
stuttering without speech therapy.  However, recent research suggests 
that once a child has moved from normal disflunencies to stuttering, he 
is unlikely to spontaneously recover.

No studies have determined how many adults stutter.  0.1% of the 
population is a conservative estimate.


SEX RATIO OF STUTTERING

80% of adult stutterers are men.

Of two- and three-year-olds, equal numbers of boys and girls stutter.5

The sex ratio becomes 3:1 by the first grade and 5:1 by the fifth grade, 
the same ratio as adults.

Girls begin stuttering earlier, but are more likely to outgrow it.  Boys 
start stuttering later, and are less likely to outgrow it.  The earlier 
development of language in girls enables them to cope with stuttering 
better.


GENETICS AND STUTTERING

If you stutter, you are about three times more likely to have a close 
relative who stutters.  This suggests that there may be a genetic 
component in stuttering.

Studies of the families of stutterers failed to find simple Mendelian 
types of inheritance, such as sex-linked, autosomal dominant, or 
recessive. 

It's possible that stuttering is socially conditioned, not genetic.  

A study of 95 identical twins reared apart found 5 stutterers, but none 
of their twins stuttered.  This is in spite of finding similarities in 
talkativeness, pitch, and hoarseness, as well as tastes in clothing, 
books, etc.  This suggests that stuttering is not genetic.

A study of three genes that control dopamine in the brain found that 
people with these genes were far more likely to have ADHD, stuttering, 
Tourette's Syndrome, and several other disorders.  If you stutter and 
have one of these other disorders, you probably have these genes.  If 
you don't have these other disorders, your stuttering probably is not 
genetic.


------------------------------

Subject: Conditions That Increase or Decrease Stuttering

CHARACTERISTICS OF STUTTERED WORDS

Stuttering is most likely to occur on:

- The initial sound or syllable of a word (90% of stuttering).  Initial 
consonants are more difficult than initial vowels.  

- The first word of a sentence.  

- Accented syllables of words.

- Content words (nouns, verbs, adjectives, and adverbs) rather than 
function words ("and," "but," "he").  

- Longer words, than shorter words.  

- Less-frequently-used words.

- Transitions from voiceless to voiced sounds (i.e., when switching on 
your vocal fold vibration.)


CONDITIONS THAT INCREASE STUTTERING

- Speaking on the telephone.  In telephone conversations, pauses are 
less acceptable.  You are expected to continuously keep the conversation 
going.  Also, you are unable to use non-verbal communication.

- Saying one's name.  However, I haven't found any studies showing that 
stuttering is more likely on words starting with the initial sound of 
your name.

- Saying something important or meaningful.  Stuttering is less likely 
when, for example, reading a list of numbers.

- Time pressure.

- If you believe a listener is hard to talk to or critical.  You are 
likely to stutter less with someone you perceive as easy-going or 
understanding.

- Talking to an authority figure.  

- Speaking to an audience.  


CONDITIONS THAT DECREASE STUTTERING

- When speaking alone or when talking to animals, many stutterers are 
fluent.  

- Speaking in chorus (unison) with another person.

- Many stutterers can read out loud fluently, especially if they don't 
feel emotionally connected to the book.  However, other people only 
stutter when reading out loud, because they can't substitute words.

- Many electronic devices reduce stuttering. 

- Saying a phrase repeatedly reduces stuttering.

- Some people can reduce stuttering by trying to stutter, saying that 
they stutter, or not hiding their stuttering. 

- Stutterers can sing fluently.  Singing uses continuous phonation and 
diaphragmatic breathing, like stuttering therapy.  Singing uses a 
different part of the brain than speaking.  

- Lowering your vocal pitch reduces stuttering 75-85%, due to relaxing 
your vocal folds and subglottal pressure.

- Various studies have increased or decreased stuttering through 
punishment and reward (operant responses).  Electric shocks contingent 
on stuttering reduce or eliminate stuttering.  Stuttering returns when 
the electrodes are removed. 


DISTRACTION, BELIEF, STRESS, "GOOD DAYS AND BAD DAYS"

Several studies have established that distraction does not reduce 
stuttering.  

Placebo studies have shown that believing you won't stutter has no 
effect on whether you stutter.

Different types of stress have different effects on stuttering.  
Physiological stress, such as elevated heart rate or blood pressure, 
has no effect on stuttering.  Emotional arousal also reduces stuttering.  
Aneurin Bevan, the British labor leader and member of Parliament, 
developed great public speaking skills by getting emotionally involved 
in his subject.  

Cognitive stress is hearing or seeing several things at once, usually 
contradictory things.  For example, talking to someone who is watching 
television.  This increases stuttering.  Time pressure increases 
stuttering.

Stutterers say they have "good days" and "bad days" regarding fluency. 
No research has been done on whether this phenomenon is real or what 
cuases it.  It could be due to changing levels of dopamine in the brain 
(due to diet and other factos).


------------------------------

Subject: The Development Of Stuttering In Children

Stuttering is a developmental disorder.  It begins between the ages 2 
and 6.  

Stuttering develops at the same time that children learn grammar, 
accents, and other fundamentals of speech and language.  Stuttering may 
be a learned behavior.  There appears to be a critical period 
in which children learn speech breathing, vocal fold control, how to 
articulate sounds, etc., and if the child doesn't learn these at the 
right age, it's difficult or impossible to learn these later.

Most children have normal disfluencies.  Some children seem to get onto 
a wrong track, with speech only slightly different from normal speech.  
But as the child goes further on this wrong track, he learns more and 
more of abnormal speech behaviors, and doesn't learn normal speech 
behaviors.  His stuttering develops in severity and becomes resistant to 
treatment.

Early intervention is now considered paramount.  The earlier a child's 
stuttering is diagnosed and treated by a speech pathologist, the more 
likely the child is to outgrow stuttering.  The longer a child stutters, 
the more likely the child will never overcome stuttering.


STAGES OF STUTTERING

STAGE ONE - NORMAL DISFLUENCY (AGES 2-6)

Speech and language are the most complex and difficult skills children 
learn.  Most, if not all, children have problems with speech or language 
at some point.

Disfluencies tend to be single, such as "That my-my ball," or "I want 
some...uh...juice."  

Disfluencies tend to be interjections, revisions, and word repetitions.

The child does not manifest struggle behaviors, or visible tension, or 
frustration or embarrassment.  The child experiences disfluencies as if 
he stumbled while walking, and recovered his balance and continued 
walking without a problem.

Disfluencies occur when the child is planning a long or complex language 
structure.  

Changes in the child's environment may also cause temporary normal 
disfluencies.  This could involve parents' divorce, the birth of a 
sibling, moving to a new home, etc.


STAGE TWO - BORDERLINE STUTTERING (AGES 2-6)

The symptoms of borderline stuttering are:

1) Disfluency on more than 10% of words.

2) More than two units of disfluencies together ("That my-my-my ball").

3) More repetitions and prolongations than revisions or incomplete 
phrases.

4) No secondary symptoms or reactions to stuttering.


STAGE THREE - BEGINNING STUTTERING (AGES 2-6)

The symptoms of beginning stuttering are:

1) Disfluency on more than 10% of words.

2) Episodic disfluency.  The child stutters for weeks or months, between 
long periods of fluency.  

3) Stuttering when excited or upset, when seeming to have a great deal 
to say, or under high environmental demands.

4) Repetitions become rapid, tense, and irregular.  A sound or word is 
repeated three or more times.  The child is substituting the neutral 
vowel ("uh") for the appropriate one (e.g., "luh-luh-luh-like").

5) Prolongations.  Sounds are prolonged at least a half-second.  Fixed 
articulatory postures occur, or freezing of speech-production muscles.

6) Increased speech-production muscle tension.  A rise in vocal pitch, 
caused by tensing the larynx.  Blocking airflow and stopping the voice.    
Wide mouth opening or tongue protrusion.  Irregular breathing patterns.

7) Stuttering only on the first word of a sentence or phrase.

8) Stuttering on both content words and functions words, such as "like," 
"but," "and," or "so".

9) Secondary or escape behaviors, such as rapid eye blinking, nodding 
the head, facial grimacing, quivering lip, raising eye brows, flaring 
nostrils.

10) Unconcern or unawareness of stuttering.  


STAGE FOUR - INTERMEDIATE STUTTERING (AGES 6-13)

At these ages the child begins to fear and avoid stuttering.  

1) Usually this begins with fear and avoidance of certain sounds or 
words.  Word substitution begins.

2) Blocks become common, in addition to repetitions and prolongations.

3) Escape behaviors are used.

4) Stuttering becomes chronic, without periods of fluency.

5) Stuttering occurs on content words -- the major nouns, verbs, and 
adjectives.

6) Stuttering varies between situations, such as talking on the 
telephone, speaking to strangers, etc.


STAGE FIVE - ADVANCED STUTTERING (AGES 14 THROUGH ADULT)

1) Vivid, fearful anticipation of stuttering.

2) Feared words, sounds, and situations.

3) Affects self-image -- thinks of himself as a stutterer.  Chooses his 
friends, social activities, and jobs to avoid talking.

4) Many advanced stutterers develop their substitutions and avoidance 
behaviors so well that you never know that they stutter. 


------------------------------

Subject: Neurology Of Stuttering

CAUDATE NUCLEUS

The caudate nucleus is referred to as the "central switchboard" of the 
brain.  One positron emission tomography (PET) brain scans found 
the left caudate to be underactive in stutterers.  The area is 
underactive whether the person is stuttering or fluent.  Another study 
found normal left caudate nucleus activity when stutterers were not 
talking.

Researchers Joseph Wu and Gerald Maguire suggest that the "thinking" 
signals from the frontal lobes don't connect properly to the speech 
areas of the brain, due to malfunctions in the connecting caudate 
nucleus "switchboard".  The result is poor control of the speech-
production muscles, such as the vocal folds, lips, and tongue.

Wu and Maguire believe that the problem with the left caudate may be 
caused by abnormally high levels of the neurotransmitter dopamine in 
this area of the brain. 


LEFT/RIGHT HEMISPHERE PROCESSING

Normal speakers use both the left and right hemispheres of the brain for 
speech, but the left hemisphere is dominant.  Neurologists believe that 
the left hemisphere is specialized for speech and language, and the 
right hemisphere is used for processing music, environmental sounds, and 
emotions.

One recent study using positron emission tomography (PET) brain scans 
found abnormal right-hemisphere dominance during stuttering, and normal 
left-hemisphere dominance when the stutterers talked fluently (reading 
in chorus with another person).

Another PET scan study found that only stutterers with linguistic 
impairments had the abnormal right-hemisphere dominance.  Stutterers 
with normal language abilities had the normal left-hemisphere dominance.

The abnormal cerebral dominance can be interpreted in several ways: The 
unusual right-hemisphere activity could be the product of emotions and 
anxieties of stuttering.  Or it could be that there is something wrong 
with stutterers' left-hemisphere speech centers, and the inefficient 
right-hemisphere takes over speech activities.


CENTRAL AUDITORY PROCESSING

Some subtle abnormalities have been found in stutterers' brain 
processing of sounds.  These abnormalities are usually in discriminating 
small timing differences between sounds.  Researchers speculate that the 
part of the brain that processes incoming sound timing may also process 
outgoing speech timing.  

PET research has found that the brain's auditory processing areas shut 
down in stuttering.  This diminished central auditory processing may 
explain why stutterers have poor awareness of what we do when we 
stutter.  


CAUSE OR EFFECT OF STUTTERING?

Abnormal brain activity could be a cause or a result of stuttering.  How 
a child learns speech and language affects how his brain's speech 
structures grow.  Stuttering may cause neurological abnormalities, or 
vice versa, or both.


DRUG TREATMENTS FOR STUTTERING

More than 20 drugs have been tested on stutterers.  Only two reduce 
stuttering -- haloperidol and botulism toxin -- and these have severe 
side effects. 


------------------------------

Subject: Other Fluency Disorders

CLUTTERING

Cluttering is defined as "...a disturbance of fluency involving an 
abnormally rapid rate and erratic rhythm of speech that impedes 
intelligibility.  Faulty phrasing patterns are usually present so that 
there are bursts of speech consisting of groups of words that are not 
related to the grammatical structure of the sentence.  The affected 
person is usually unaware of any communication impairment."

Cluttering usually includes repetitions, usually 6-10 units.  Unlike 
stuttering, these are effortless, usually single syllables, short words, 
and phrases (stutterers only repeat initial sounds).

Cluttering may also be characterized by poor concentration and short 
attention span; perceptual weakness; and poorly organized thinking, or 
speaking before clarifying thoughts.

Kenneth St. Louis and Florence Myers provide the following example of a 
cluttering child vs. a stuttering child:

Clutterer: "I want to go to the st...uh...place where you buy...market 
st-st-store and I don't have muh-muh ti-ti-time money."

Stutterer: "I want to go to the sssssssssstore and I don't have muh-muh-
muh-muh-money."


NEUROGENIC STUTTERING

Strokes and head injuries can cause stuttering-like symptoms in adults.  
Neurogenic stuttering has repetitions, prolongations, and blocks.  
However, these sound different from developmental stuttering.  

Neurogenic stutterers lack the facial grimaces, eye blinking, and fears 
and anxieties of developmental stuttering.  

In some cases a person stuttered as a child or young adult, overcame 
stuttering, then had a stroke or head injury, and stuttering came back.  

On the other hand, there are a few cases of development stuttering 
disappearing after neurosurgery for brain tumors, and even after the 
development of multiple sclerosis.  These appear to relate to changes in 
brain lateralism.


PSYCHOGENIC STUTTERING

Adult psychogenic stuttering begins suddenly after an event causing 
extreme psychological stress.  It's characterized by repetition of 
initial or stressed syllables, lack of conditions inducing fluency, an 
indifferent attitude toward the disorder, and maintenance of normal eye 
contact.  Psychogenic stuttering is rare.


SPASTIC DYSPHONIA

Spactic dysphonia is similar to stuttering, except that it is a repeated 
blockage of the larynx only, the onset is in middle age, and the 
disorder affects an equal number of men and women.  For more info, 
contact: Dystonia Medical Research Foundation, One East Wacker Drive, 
Chicago, IL 60601-2098, (312) 321-5710 FAX; National Spasmodic Dysphonia 
Association (NSDA), PO Box 1574, Birmingham, MI 48009-1574, (313) 645-
9352 FAX; or Our Voice, 156 Fifth Ave., Suite 1033, NY, NY 10010-7002.


------------------------------

Subject: Childhood Stuttering Therapy


Evaluate which stage of stuttering the child is in.  Parents should know 
the differences between normal disfluencies and stuttering.  The 
symptoms of each are listed above.

Involve the parents.  The parents should be trained to administer the 
therapy to the child, rather than having the therapy done solely in a 
speech clinic.

Focus on the child's speech, not the parents' behavior.  Research has 
established that changing parents' behavior has no effect on the child's 
speech.  Try it if you want to, but don't rely on it.  For example, the 
speech pathologist may have a turtle hand puppet that walks slowly when 
the child talks slowly.  When the child talks fast, the turtle goes into 
his shell.  This is called "turtle talk."  There are many other therapy 
games.

Early intervention is best.  Don't wait to see if your child outgrows 
stuttering.  Have your child treated by a speech pathologist who 
specializes in childhood stuttering.

Federal law requires your school district to provide speech therapy to 
your child.  Your child can be as young as three years old -- he or she 
doesn't have to be in school.


------------------------------

Subject: Adult Stuttering Therapies

The two main stuttering therapies are stuttering modication therapy and 
fluency shaping therapy.  There are many types of each, but this FAQ 
includes only one example of each.  

There are also psychological stuttering therapies.

Motor skills have two memory components: how to perform the motor skill, 
and when to perform it.  Stuttering is no different -- stutterers know 
how to stutter and how to speak fluently, and they have deep memories 
for when to use each type of speech.  Effective stuttering therapies 
train the stutterer how to speak fluently (e.g., the fluency techniques 
described below) and when to speak fluently (i.e., reconditioning 
psychological cues to stutter).  

Motor skills in general and fluency techniques in particular are best 
practiced slowly at first.  The stutterer may have to speak abnormally 
slowly for a period of time while learning to fluency techniques.  Using 
fluency techniques may require mental effort at first, making the 
techniques difficult to use in conversation.  This may seem like a step 
backward or the stutterer may say, "I'd rather stutter than talk like 
this."  But many stutterers find that over time, fluency becomes easier.  For 
some stutterers fluency becomes automatic, and they are  able to speak fluently 
at normal speaking rates, without abnormal mental effort.  If stuttering is a 
maladaptive motor skill, then the principles of motor learning therapy used for 
training athletes or postal workers can help stutterers reach this autonomous 
stage sooner.

Stuttering therapy is self-therapy.  Stutterers can't expect to go to a 
speech clinic, have therapy done to them, and leave cured.  90% of 
stuttering therapy should be done outside the speech clinic.  This may 
be homework practice, using fluency techniques in conversation, using a 
computer or electronic device, or attending a support group.  

No two stutterers are alike.  Some stutterers have severe physical 
stuttering with little psychological anxiety.  Other stutterers have 
great fear and anxiety but little overt stuttering.  Most stutterers are 
somewhere in between.  Stuttering therapies should be tailored to the 
individual stutterer.  


------------------------------

Subject: Stuttering Modification Therapy

Stuttering modification therapy has two key elements:

a) Teaching you to modify your moments of stuttering, so that your 
stuttering is less severe.

b) Reducing your fear of stuttering, and eliminating avoidance behaviors 
associated with this fear.

The goal of stuttering modification therapy is not to eliminate 
stuttering, but to reduce its severity to an acceptable level, and to 
reduce the fears and anxieties associated with stuttering.

The therapy has four phases:


IDENTIFICATION

You begin by identifying the core behaviors, secondary behaviors, and 
feelings and attitudes that characterize your stuttering.  

Your speech pathologist points out your "easy or effortless stuttering" 
first.  The goal is to improve your awareness of what you do when you 
stutter.

Next, your speech pathologist trains you to identify and become aware of 
your avoidance behaviors, postponement behaviors, starting behaviors, 
word and sound fears, situation fears, core stuttering behaviors, and 
escape behaviors.

Finally, you learn to identify feelings of frustration, shame, and 
hostility associated with your speech.


DESENSITIZATION

Van Riper called this "toughening the stutterer to his stuttering."  You 
do this in three stages.  The goal is for you to become comfortable with 
all three of these aspects of your stuttering.

1) Confrontation, or accepting that you stutter.  

2) Freezing your core behaviors -- repetitions, prolongations, and 
blocks.  When you stutter, your speech pathologist raises a finger, and 
you have to hold what you are doing, until she drops her finger. 

3) Voluntary stuttering. 


MODIFICATION

This is where you learn "easy stuttering" or "fluent stuttering", in 3 
stages:

1) Cancellations.  When you stutter, you stop, pause for a few seconds, 
and say the word again.  You say the word slowly, with reduced 
articulatory pressure, and blending the sounds together.  

2) Pull-outs.  After you master freezing and cancellations, you use your 
"easy stuttering" while you are in a stutter, to pull yourself out of 
the stutter and say the word fluently.

3) Preparatory sets.  After mastering pull-outs, you look ahead to words 
you're going to stutter on, and you use "easy stuttering" on those 
words.


STABILIZATION

The last stage of stuttering modification therapy seeks to stabilize or 
solidify your speech gains.  


------------------------------

Subject: Fluency Shaping Therapy

Fluency shaping therapies first establish fluent, but abnormal-sounding 
speech in the speech clinic.  This fluent speech is then shaped into 
normal-sounding speech.  Lastly, you transfer this fluent speech outside 
the speech clinic, to everyday conversations.

Fluency shaping therapies do not emphasize changing your attitudes, 
desensitizing you about your stuttering, or reducing avoidance 
behaviors.  The belief is that if you experience fluent speech, your 
negative feelings and attitudes about stuttering will diminish.

Fluency shaping therapy emphasizes slow speech.  The therapy begins with 
extremely slow speech -- about 5-10 times slower than normal speech.  

You don't stutter when you talk this slowly.  You start with reading out 
loud, then use slow speech in conversations in the speech clinic.  You 
don't use this slow speech outside the speech clinic.

After establishing extremely slow, fluent speech, you work on five 
"breath flow" motor skills.  These are:

1) Phrasing.  You limit your phrases to 3-8 syllables.  This is to 
maintain enough air in your lungs, so that you don't run out of air.

2) Phrase initiation.  You start each phrase with an easy vocal onset.  
In other words, you relax your vocal folds on the first sound of the 
first syllable.  The Hollins program uses a biofeedback device (the 
Voice Monitor) to help you learn this motor skill.

3) Soft contact.  You articulate consonants softly, keeping your lips, 
tongue, and jaw relaxed.

4) Breathy voice.  This is a soft or breathy speaking style.  (Marilyn 
Monroe did this to overcome stuttering.)

5) Blending.  You maintain a continuous airflow from the beginning of 
each phrase to the end.  You blend each syllable into the next.

The last fluency shaping speech motor skill improves your prosody, or 
rhythm.  The slow-motion speech produces a monotonous, droning speaking 
style.  Now you work on adding inflections, intonations, and emotions to 
make your slow speech sound more normal.

When you master these fluency shaping speech motor skills at the 
extremely slow speaking rate, you then work on increasing your speaking 
rate, while continuing to use your fluent speech skills.  

At this point, your speech in the speech clinic should sound normal, and 
you should talk fluently.  You are now ready to transfer this fluent 
speech to conversations outside the clinic.  

Martin Schwartz practices a different version of fluency shaping 
therapy.  He focuses on reducing vocal fold tension before you speak.
He is not concerned with how you talk.  Rather, he changes what you do 
before talking.

Schwartz calls this "intent therapy" because you intend to rest, instead 
of speak; and you intend to start speaking slowly.

The main physical technique dilates and relaxes the vocal cords.

This stuttering therapy trains you "exhale just before speaking as if 
one were not going to speak at all but were simply quietly breathing."  
In other words, Dr. Schwartz trains you to speak with relaxed breathing 
instead of speech breathing.  He adds, "The passive airflow kept the 
vocal folds apart and relaxed prior to speech." 

You say the first word slowly.  You don't say it abnormally slow.  You 
use normal emotional inflection and intonation.

Then you pause.  During the pause, whether you continue exhalation or 
not doesn't matter.  Then you say the rest of the phrase as fast as you 
want.  

If the first word has two or more syllables, pretend you are speaking in 
time with a metronome.  Say each syllable slowly, with equal time for 
each syllable.  You can then go on to the rest of the sentence.  You 
don't have to pause after the second syllable.


------------------------------

Subject: Effectiveness Of Stuttering Therapies

Einer Boberg and Deborah Kully followed 42 stutterers over two years 
after a three-week intensive fluency shaping program. 

The therapy program reduced stuttering from about 15-20% stuttered 
syllables to 1-2% stuttered syllables.  

12-24 months after therapy, about 70% of the stutterers had satisfactory 
fluency.  About 5% were marginally successful.  About 25% had 
unsatisfactory fluency.


------------------------------

Subject: Computers And Electronic Devices For Stuttering

AUDITORY FEEDBACK FOR IMMEDIATE FLUENCY

The three main types of auditory feedback are:

- Delayed auditory feedback (DAF) delays your voice to your headphones a 
small fraction of a second (typically 50 milliseconds).  

- Frequency-altered auditory feedback (FAF) shifts the pitch of your 
voice in your headphones, typically one-half octave.

- Masking auditory feedback (MAF) provides a synthesized tone which 
sounds like your vocal fold vibration.  

The devices reduce stuttering on average 75-80%.  The devices require no 
training or mental effort.  Your speech sounds normal.  You can talk as 
fast as you want.  Different stutterers prefer different devices.

Auditory feedback devices alone do not train you to no longer stutter.  
In conjunction with stuttering therapy, the devices can help you use 
therapy techniques in stressful situations.  If you use therapy 
techniques with your device, over time you should find you need the 
device less and less.

Casa Futura Technologies makes DAF, FAF, and MAF anti-stuttering 
telephones and pocket-sized devices.  $300-$500, P.O. Box 7551, Boulder, 
CO 80306-7551; (303) 417-9752; www.casafuturatech.com.

A free DAF application for Macintosh computers is available at: 
http://www.concentric.net/~tmorrow/stuttering.html


DAF FOR RATE CONTROL

A longer DAF delay (90-220 milliseconds) forces you to slow your 
speaking rate.  You stretch vowels and talk fluently.  DAF is widely-
used in stuttering therapy programs for this purpose.


BIOFEEDBACK DEVICES

Biofeedback is the measurement of a physical activity, and display to 
you in real time so that you can alter the physical process.  Speech 
biofeedback devices train you to use your speech-production muscles for 
fluent speech and no longer stutter. 

The two most popular stuttering biofeedback devices are:

- The Computer-Aided Fluency Establishment and Trainer (CAFET) monitors 
your breathing and your voice.  The computer trains you to inhale 
gently, let out a little air, begin voicing quietly, and gently increase 
your vocal volume (gentle onset).  About $4,000; CAFET, Inc.; 4208 
Evergreen Lane, Suite 213; Annandale, VA  22003; (703) 941-8903; Fax: 
(703) 658-4529

- The Desktop Fluency System, made by Casa Futura Technologies, provides 
DAF, FAF, MAF; vocal volume biofeedback for training gentle onsets; and 
vocal pitch biofeedback for training relaxed breathing and vocal folds.  
An electromyographic biofeedback option can train you to relax specific 
muscles.  $500, P.O. Box 7551, Boulder, CO 80306-7551; (303) 417-9752; 
www.casafuturatech.com.


------------------------------

Subject: United States Organizations For Stuttering

- The National Stuttering Project has a monthly newsletter, about 80 
local support groups, weekend workshops in various cities, and an annual 
convention.  $35; (800) 364-1677; 5100 E. La Palma, Suite 208; Anaheim 
Hills, CA 92807; NSPmail@aol.com.  

- The Stuttering Foundation of America is a non-profit publisher of 
books and videos about stuttering.  The SFA also maintains a list of 
speech pathologists who treat stuttering.  (800) 992-9392, P.O. Box 
11749, Memphis, TN 38111-0749.

- The American Speech-Language Hearing Association is the professional 
organization for speech pathologists and audiologists.  (301) 897-5700; 
10801 Rockville Pike, Rockville, MD  20852.  

- ASHA has a Special Interest Division on Fluency Disorders.  Dues are 
$25.  The newsletter covers professional issues for speech pathologists. 

- The Stuttering Resource Foundation maintains a list of speech 
pathologists who treat stuttering, available free on the Stuttering 
Homepage.  (800) 232-4773; 123 Oxford Road, New Rochelle, NY 10804. 

- SpeakEasy is a non-profit organization with support groups in the New 
Jersey area.  (201) 262-0895; 233 Concord Drive, Paramus, NJ 07652.  

- National Council on Stuttering hosts an annual convention in Chicago.  
(815) 756-6986, 558 Russell Road, DeKalb, IL 60115.


------------------------------

Subject: International Organizations For Stuttering

When traveling abroad, contact the stuttering organization in the 
country you plan to visit.  They'll invite you to a support group 
meeting, and maybe someone will want to show you around their city.

- The International Fluency Association publishes the Journal of Fluency 
Disorders.  $60; (205) 348-7131; Box 870242, Tuscaloosa, AL 35487-0242.  

- The International Stuttering Association (ISA) is an umbrella 
Association of 25 national stuttering associations.  The ISA is on the 
Internet at http://www.xs4all.nl/~edorlow/isa.html

There are organizations for stutterers in the following countries: 
Argentina, Australia, Austria, Belgium, Bulgaria, Canada, Denmark, 
Estonia, Finland, France, Germany, Greece, Hungary, Iceland, India, 
Ireland, Italy, Japan, Lithuania, Luxemburg, The Netherlands, New 
Zealand, Norway, Poland, South Africa, Spain, Sweden, Switzerland, 
United Kingdom


------------------------------

Subject: Internet Resources For Stuttering

There are two World Wide Web sites with a broad range of information 
about stuttering:

- The Stuttering Homepage, maintained by Judith Kuster & John Harrison.
www.mankato.msus.edu/dept/comdis/kuster/stutter.html

- The Stuttering Science & Therapy Website
www.casafuturatech.com

The Stuttering Science & Therapy Website includes a "Penpals Page" of 
people looking for someone to share experiences with.

There are about 25 other websites related to stuttering.  The above two 
websites have links to the other websites.

- Alt.support.stuttering is the Usenet interest group.  

- There are four e-mail mailing lists.  To subscribe, e-mail the 
subscription command to the subscription address.

Mailing list name: STUTT-X
Language: English
Subscription command: subscribe stutt-x
Send subscription command to: listserv@asuvm.inre.asu.edu
Send articles to: stutt-x@asuvm.inre.asu.edu  
List owner: Don Mowrer

Mailing list name: STUTT-L
Language: English
Subscription command: subscribe stutt-l
Send subscription command to: listserv@vm.temple.edu
Send articles to: stutt-l@vm.temple.edu
List owner: Woody Starkweather, V5002E@VM.TEMPLE.EDU

Mailing list name: STUT-HLP
Language: English
Subscription command: subscribe stut-hlp
Send subscription command to: listproc2@bgu.edu
Send articles to: stut-hlp@bgu.edu
List owner: Robert Quesal, (309) 298-2049

Mailing list name: STOT-ML
Language: German
Subscription command: subscribe stot-ml
Send subscription command to: majordomo@uni-duesseldorf.de
Send articles to: stot-ml@uni-duesseldorf.de
List owner: Andreas Czarnecki, czarnecki@uni-duesseldorf.de


------------------------------

Subject: Books And Journals About Stuttering

BOOKS

- Stuttering: Science, Therapy & Practice, by Thomas David Kehoe, is the 
most complete book on stuttering.  Available free at 
www.casafuturatech.com, or for $25 from Casa Futura Technologies, P.O. 
Box 7551, Boulder, Colorado 80306-7551; (303) 417-9752.

- Stuttering: An Integrated Approach To Its Nature And Treatment , by 
Theodore Peters, Ph.D. and Barry Guitar ($45, 1991, Baltimore: Williams 
& Wilkins, 800/638-0672).  This is my favorite textbook on stuttering.  

- Knotted Tongues, by Benson Bobrick ($22, Simon & Schuster, 1995).  
This is my favorite non-professional book about stuttering.  The book 
has a thirty-page, easy-to-read overview of stuttering science, a 
twenty-page overview of stuttering therapies, and then 110 pages about 
historical and literary persons who stuttered. 

- A Handbook On Stuttering, by Oliver Bloodstein, Ph.D. ($45, 1995, San 
Diego: Singular Publishing) covers all published research on stuttering.  
Bloodstein also wrote Stuttering: The Search for a Cause and Cure (Allyn 
& Bacon, 1995, about $40).  This book covers the same material as his 
Handbook, but is written for non-professional readers. 

- Self-Therapy For The Stutterer, by Malcolm Fraser (1993, Stuttering 
Foundation of America, $3).  This book is a stuttering modification 
therapy program that you can do without a speech therapist.  P.O. Box 
11749, Memphis, TN 38111-0749, 800/992-9392

- Stutter No More, by Martin Schwartz, Ph.D. ($9, Simon & Schuster, 
1991).  Dr.Schwartz has offered to give away this book for the cost of 
postage.  Send $1 to National Center for Stuttering, 200 East 33rd St., 
New York, NY, 10016, or call (800) 221-2483.

- The Stutterer's Survival Guide, by Nicholas Tunbridge (about $15, 
Addison-Wesley, 1994, 416/447-5101), offers simple fluency techniques, 
and suggestions for stressful situations.


JOURNALS & NEWSLETTERS

- All of the non-profit organizations have newsletters.  SpeakEasy 
Canada has an especially good newsletter.

- ADVANCE For Speech-Language Pathologists is a free weekly newspaper 
for speech pathologists and audiologists.  They devote the second issue 
in May to stuttering.  Merion Publications, 650 Park Ave. West, King of 
Prussia, PA, 19406, (800) 355-5627. 

- The Journal of Fluency Disorders is exclusively about stuttering.  It 
is written by and for Ph.D. speech pathologists.  Published by the 
International Fluency Association.  About $60/year for four issues.

- The American Speech-Language Hearing Association (ASHA) publishes 
three quarterly journals with stuttering research, plus a stuttering 
newsletter.  All are written for speech pathologists.


------------------------------

Subject: Famous People Who Stutter

IN THE PAST

Moses -- Hebrew prophet, whose brother Aaron spoke for him.

Demosthenes -- the greatest orator of ancient Greece, who practiced 
speaking with pebbles in his mouth to improve articulation, shouted 
above the ocean waves to improve his volume, and worked with a actor in 
reciting Sophocles and Euripedes to coordinate his voice and gestures. 

Aesop -- Greek author of fables.  

Vergil -- Roman poet.

Claudius -- Roman emperor.  Robert Graves' novel I, Claudius suggests 
that Claudius overplayed his disabilities as a young man, to avoid being 
murdered by enemies seeking his place in line to the throne.  But when 
he became emperor, Claudius was powerful and successful.   

Dekanawida -- Great leader who invented democratic government and united 
the Iroquois nation, sixteenth century. 

Isaac Newton -- Scientist, developed law of gravity, invented calculus.

Charles I -- King of England, 1625-1649, during the English Civil War.  
His inability to speak to Parliament "had an unfavorable influence on 
his affairs."  Charles lost the war and was hanged.  

Robert Boyle -- British chemist, known for his experiments on the 
properties of gases.

Erasmus Darwin -- Physician, scientist, and grandfather of Charles 
Darwin. 

Charles Darwin -- Naturalist and author of The Origin of Species.  

Joseph Priestley (1733-1804) -- Discovered oxygen, ammonia, carbon 
monoxide.  Wrote U.S. Constitution's statements on personal freedom.  

Charles Lamb -- Nineteenth-century British writer.  He was not allowed 
to pursue a scholarly education because of his stuttering, but worked as 
an accountant and wrote on the side.  

Leigh Hunt -- Nineteenth-century British writer, founded the liberal 
Examiner newspaper.

Charles Canon Kingsley -- Nineteenth-century English orator, writer, and 
chaplain to Queen Victoria.  

Arnold Bennett -- British novelist and playwright (1867-1931).

Clara Barton -- Founded the American Red Cross in 1881. 

Cotton Mather -- Puritan leader, medical scientist, prosecuted Salem 
witch trials.  Fasting and prayers failed to affect his speech, but 
speaking in a "drawling...little short of Singing" enabled him to become 
a preacher.  

Lewis Carroll -- Author of Alice in Wonderland.  Carroll wasn't allowed 
to become a priest because of his stuttering. 

Henry James -- American novelist.  

Marilyn Monroe -- Actress, who used a breathy way of speaking to avoid 
stuttering.

Kim Philby -- British spy.  Stuttering once saved his life, by 
confounding a fast-paced interrogator.

Winston Churchill -- Prime minister of Great Britain in World War Two.  
Churchill hummed discreetly to himself to get his vocal folds vibrating, 
and prepared his remarks in advance.  Churchill wrote: "I wrote out my 
arguments with the greatest care, and than learned them backwards and 
forwards...Not many people guessed how little spontaneity of conception, 
fullness of knowledge, or flow of language there was behind this fairly 
imposing facade."  Churchill tried to anticipate issues weeks in advance 
to prepare his remarks. 

Aneurin Bevan -- British Labor Party leader in the 1930s.  Bevan was 
Churchill's opponent in Parliament.  To overcome stuttering, Bevan 
forced himself to do public speaking as often as possible, and did so 
with his passions aroused.   Bevan developed an extraordinary vocabulary 
by substituting words to avoid stuttering.  He was regarded as the best 
orator in the Parliament except for Churchill.

Nevil Shute -- English novelist and aeronautical engineer.  

Elizabeth Bowen -- Anglo-Irish novelist.

W. Somerset Maugham -- British writer. 

Edward Hoagland -- American writer.

Henry Luce -- Founder of Time magazine and Sports Illustrated.

Field Marshall Lord Carver -- British military leader.

Patrick Campbell -- British humorist.

George VI -- King of England, 1937-52, father of Queen Elizabeth II, and 
much-loved by his subjects.  

Kenneth Tynan -- British drama critic.

Raymond Massey -- Actor.

Lord David Cecil -- Professor of English literature at Oxford.

John Slaughter -- Elected Cochise County, Arizona sheriff in 1886 with a 
mandate to clean up Tombstone, after Wyatt Earp's 1881 shoot-out.  


CONTEMPORARY FIGURES

James Earl Jones -- Actor, voice of Darth Vader and CNN, most in-demand 
voice in Hollywood.  Jones discusses his stuttering at length in his 
autobiography.

Ben Johnson -- Runner.

Bob Love -- Basketball star with Chicago Bulls in 1960s and 1970s.  

Ron Harper -- Current star with the Chicago Bulls.

Paul Johnson -- Detective novelist, author of Killing The Blues.

Margaret Drabble -- British novelist.

Tommy John -- Former Yankee pitcher.

Dave Taylor -- Former hockey star with L.A. Kings.

Lester Hayes -- Former All-Pro defensive back with the Oakland/ Los 
Angeles Raiders.

Ken Venturi -- Golfer, won U.S. Open in 1961.

Butch Baird -- Golfer.

John Updike -- Novelist.  Until recent years he avoided interviews.

Annie Glenn -- Wife of astronaut and Senator John Glenn.  

Carly Simon -- Singer.

Mel Tillis -- Country-western singer.  

Richard Condon -- Novelist.

Jake Eberts -- Movie producer ("Gandhi").

Frank Wolf -- Congressman from Virginia.

Joseph Biden -- Senator from Delaware.

Jack Welch -- President of General Electric.

Thad Spencer -- Boxer.

Henry Rogers -- Public relations pioneer.

Bo Jackson -- Football and baseball star.

John Stossel -- Television reporter, ABC's "20/20". 

Chris Zorich -- Football player, Chicago Bears.

Robert Heinlein -- Science fiction novelist.

Pat Leahy -- Football player, New York Jets.

Sam Neill -- Actor.

Peggy Lipton -- Actress.

Robert Merrill -- Opera singer.  

John Melendez -- Rock singer, and Howard Stern radio show personality.  

Howard Bingham -- Muhammed Ali's best friend and photographer, was in 
the O.J. Simpson trial.

John Larkin -- "Scatman John", American jazz musician.


------------------------------

Subject: Employment Rights

The Americans with Disabilities Act of 1990 (ADA) prohibits employment 
discrimination against qualified individuals with disabilities. 

Many employers say they want to hire someone with "good communication 
skills."  Some interviewers mistakingly presume that all stutterers have 
poor communication skills.  

For example, a job may require making presentations to clients.  A 
stutterer may have completed a public speaking course, and be 
informative, interesting, and persuasive.  If an interviewer assumes 
that stutteresr can't make presentations, he is illegally 
discriminating.


THE PRINCIPLE OF REASONABLE ACCOMMODATION

An individual with a disability may request a reasonable accomodation 
from an employer or potential employer.  This could be a change in the 
job description, for example, having someone else make telephone calls.  
Or the stutterer could request an anti-stuttering telephone, or ask that 
the employer pay for a speech therapy program.

ADA requires the employer to make a reasonable accommodation if the 
employee requests one.  

Employers are not "...obligated to provide personal use items, such as 
glasses or hearing aids..."  The employer only has to pay for an anti-
stuttering device or speech therapy if the employee can prove that he 
doesn't need it outside of work.

A reasonable accommodation need not be the best accommodation available, 
as long as it is effective for the purpose.  If the $500 electronic 
fluency aid enables Mark to talk fluently, his employer does not have to 
pay for the $2500 speech therapy. 


FINANCIAL ASSISTANCE

The Tax Credit for Small Business (Section 44 of the Internal Revenue 
Code) credits smaller employers for half the cost of "eligible access 
expenditures."

The Targeted Jobs Tax Credit Program gives tax credits to employers who 
hire individuals with disabilities.  The IRS will give your employer up 
to $2400 for hiring you.

Details are available in the Americans With Disabilities Act Resource 
Directory and in the Pocket Guide to Federal Help for Individuals with 
Disabilities (available from the U.S. Government Printing Office, 
Pueblo, CO 81009).


WHO CAN YOU CALL?

If you feel you have been discriminated against,  call your local office 
of the Equal Employment Opportunity Commission and file a complaint.  
You can also call the EEOC at (800) 669-4000.

After you file a charge of discrimination, the EEOC notifies the charged 
entity.  The EEOC then investigates, and attempts to resolve the charge 
through conciliation.  If conciliation fails, the EEOC files suit or 
issues a "right to sue" letter.

For publications about ADA, call the EEOC ADA Helpline at (800) 669-
EEOC.  Request the publication A Technical Assistance Manual on the 
Employment Provisions (Title I) of the Americans with Disabilities Act.  


A STUDY OF EMPLOYMENT AND STUTTERING

Recent research by Martin Schwartz found that stutterers earn approxi-
mately $7200 less per year than nonstutterers.  Two groups of 25 persons 
were examined.  The groups were matched for age, sex, IQ, race, 
education, and socioeconomic background.  The subjects were contacted 10 
years after graduating from college.  They were asked a number of 
questions relating to levels of achievement.  The difference did not 
appear to be the result of employer discrimination.  Rather, the 
stutterers were reluctant to accept promotions that involved making 
presentations to groups of people.


HOW TO HANDLE JOB INTERVIEWS

Talk about stuttering first.  Your first impression on the interviewer 
will be that you stutter -- and many people feel uncomfortable talking 
to a person who stutters.  Educate them about stuttering to make them 
feel comfortable.  Explain what you are doing to overcome stuttering.

Explain that you have excellent communication skills, and give specific 
examples.

Employers may not make any pre-employment inquiries regarding 
disability, but may ask questions about the ability to perform specific 
job functions.  In other words, an interviewer may not ask you about 
your stuttering.  An interviewer may ask if you have experience making 
telephone calls to customers, or about your experiences in public 
speaking, if these are essential job functions.


------------------------------

Subject: The Last Word

"Stuttering is frustrating and can feel demeaning, but if understood, 
and confronted, it need not change the quality of one's life.  I would 
even say, that it can enhance one's life experience.  You know the 
expression, 'What doesn't kill us makes us stronger'?  Stuttering is a 
chronic problem, but it is also a chronic challenge which calls on us to 
be more than we might normally be." -- John Ahlbach, former Executive 
Director of the National Stuttering Project

END OF STUTTERING FAQ -- This document is provided as is without any 
express or implied warranties.  While every effort has been taken to 
ensure the accuracy of the information contained in this article, the 
author and contributors assume no responsibility for errors or 
omissions, or for damages resulting from the use of the information 
contained herein.  The Stuttering FAQ is not copyrighted and may be 
reproduced as you wish.


-- 
                   Ask me for the STUTTERING FAQ.                     
Stuttering Science & Therapy Website: http://www.casafuturatech.com
Thomas David Kehoe    kehoe@netcom.com     Casa Futura Technologies