New Narratives and Dysfluency ‘Banks’?

In our zeal to resist medical conceptions of stuttering do we just substitute one normalizing litmus test for another?

By rejecting fluency in and of itself or by asking whether forms of knowledge are consistent with our favorite model of disability, what ways of being do we disqualify?

I’m not comfortable telling another stutterer how to think/feel about their stuttering.

Stutterers are always already resisting how they are constituted.

How are they currently resisting societal demands for fluency?

How are they currently resisting their body’s demands for effortful speech?

Rather than see therapy as a means to liberate the self (be it fluent or stuttered) I suggest we see it as an exploration of the stutterer’s resistance and agency.

We explore how the stutterer has been constituted not to determine who they must be but to determine who they do not have to be.

We explore how they got here but leave where they’re going up to them.

In my clinical experience, most stutterers value both an increase in their ability to resist societal pressures to speak fluently and an increase in fluency, or at least easier stuttering.

Mind your Ps and Qs is an English language expression meaning "mind your manners", "mind your language", "be on your best behaviour", "watch what you're doing".

• To our self.
• To others.
• How we talk about children who stutter.
• How children who stutter hear us talk about stuttering generally.

Action: helpful self talk to counter stereotypes.

• Gather evidence in real-life situations will lead to generating more balanced thoughts on the basis of their findings.
• People can identify helpful self-talk that will positively influence their emotional reaction and behaviour in a situation.
• Helpful self-talk can also be generated by reflecting on previous experiences that have gone well and what the person was saying to himself or herself at the time.

<hr>

For the Speech and Language Therapist

• Be aware of own thoughts, feelings and expectations around stuttering and our role as an SLT.
• Communication trumps fluency.

Action: helpful self talk.

• Handouts for teachers.
• Powerpoint for school presentation.
• Advice leaflet for parents (Generate discussion about what works in therapy  and helpful versus unhelpful advice).

The Questions we need to ask

Who needs to change? What do they/we need to change?

Acknowledging the natural variation, the unique skills, experiences and traits of neurodivergent children.

— Constantino (2018)

<hr>

Client who stutters

What do they understand about stuttering? And their stuttering in particular?

Cons for the Client

• Exposure: "I stutter".
• Risk of failure.
• Lack of acceptance by self and others .

<hr>

The Speech and Language Therapist

What do we understand about stuttering? Turn the tables on the process of normalising judgement As therapists we need to enquire into what a person thinks of the judgement they have been assigned. What if stuttering was the norm? If stuttering was cool…

Cons for the Therapist

• Exposing beliefs contrary to the medical model.
• Perceived risk of ‘failure’.
• Lack of acceptance by peers, clients and client's families.

<hr>

Who needs to change?

How do we do this? Is this our responsibility alone?

• Ourselves as SLTs
• Families.
• Parents.
• Teachers.
• Employers.
• School systems.
• Health services.
• Shop keepers.

• ‍The blurt. Stutterers pepper their language with so-called “fillers” that ostensibly sit outside of, and even detract from, the message. We sometimes grimace and groan in the act of speech. In addition, we sometimes find ourselves in the midst of speaking sounds, words, or phrases we didn’t fully intend.‍
• The misfire. The phenomenon of stuttering includes both prolongation and repetition. Stuttering can extend the opening sounds of a message (e.g. ---aaaaaaaagree or bo-bo-bo-book), which an ableist grammar recodes as misfires that communicative parties can tacitly agree to ignore.‍
• The stall. A repetition can be a redundant redundancy (one that serves no discernable purpose), like repeating most of a sentence multiple times to get a “running start” on the difficult finish that was long ago anticipated by our impatient interlocutor. Or, in a hard block, the voice suddenly and unexpectedly runs dry. A word stops in your throat, and you must wait for infra-bodily traffic to clear while the absence of meaning gapes wide and dangerous in the social world.‍
• Crossed wires. A regular experience for stutterers, crossed wires describes the state of “talking past each other” that might begin when one party “mishears” the other and then feedbacks error into the conversation.‍
• The swerve. Clinicians prefer the term “avoidance” to describe the strategy stutterers employ when we sense an oncoming phoneme over which we expect to trip. I might, for example, begin to say “I agree” but change course, swerving around a potential misfire to substitute on the fly: “I don’t know.”‍
• The cut-off. This accident is one of attempted repair, caused when interlocutors or bystanders rush to the scene of an accident, interrupt, and reimpose order by attempting to predict and finish the stalled (or otherwise damaged) message according to a dominant grammar.‍
• The gridlock. Stuttering ferociously at the front of a queue, for example, halts the flow of information, people, and capital; it stalls a lane of traffic and tempts impatient honks in the form of tapped toes and glances, as everyone waits for an undetermined time until information and thus bodies will once again flow free.

My dilemma as an SLT

How best to support speech and language therapists who are working with children and adults who stutter so that they work as allies in the context of evidence which shows that stuttering therapy has an overall positive effect.  No one treatment approach for stuttering demonstrates significantly greater effects over another treatment approach. Herder, Howard, Nye, & Vanryckeghem (2006).

• Need to validate professional identities that support.
• Learning from people who stutter.
• Therapy which focuses on positive outcomes in terms of children and adults living the lives they want  to live and the development of therapy that focuses on education and resistance to normalising discourses.
• Resists focus on fluency and cure in therapy.
• Focus on confidence, fun and delight in finding and validating identities which fit with our dreams, hopes and ambitions.

What is the fluent gaze? Can we see it in cinema? Is the gaze the right conception due to the auditory nature of stammering? Is there an oppositional gaze: a stammered/dysfluent gaze?

<hr>

‘The scene for the portrait is designed by a stammerer; photographed and painted by a stammerer; of a stammerer stammering. The stammered gaze.’ — Patrick Campbell

<hr>

Close-up of Dysfluent mono typeface, in use in Dysfluent magazine issue 1.

‍

You have to see yourself in society to be a part of that society

Visual activism to confront and challenge societal preconceptions:

Look → Think → Act

Simi Linton (1998) in Claiming Disability: Knowledge and Identity quoted by Rosemarie Garland-Thomson:
 "We wield that white cane, or ride that wheelchair or limp that limp” … luxuriate in that stammer?

<hr>

The portrait invites us to stare, engrossed perhaps less with the “strangeness” of this woman’s disability and more with the strangeness of witnessing such dignity in a face that marks a life we have learned to imagine as unliveable and unworthy, as the kind of person we routinely detect in advance through medical technology and eliminate from our human community.

— Garland-Thomson (2009)

Flaunt the visible marks of disability. The relish with which disabled people can live their identity and present themselves to the starees.

• Facilitating cultural competence and awareness
• Understanding the dynamics of stigma, self-stigma and masking and the psychological consequences of living with a concealable stigmatised identity
  
• Exploring the lived experience and feelings associated with stammering in an ableist world that privileges fluency
  
• Understanding minority stress and ableist trauma
  
• Supporting the development of new affirming narratives around stammering
  
• Finding own unique stammering aesthetic
  
• Disclosure and self-advocacy
  
• Community

• Public information and education programmes
• Reducing barriers – creating a stammer-friendly environment and culture
• Campaigning
• Lobbying
• Representation
• Cultural change
• Celebration of stammering and difference