You can't do everything but it's good fun trying
By Jan Logan and Carolyn Cheasman

New Orleans has long been fuelling jazz clubs like this one devoted to 'trad' jazz.

We thought that readers of Speaking Out might be interested in hearing about some of the papers we attended at the American Speech Hearing Association (ASHA) conference. There were 82 presentations on stuttering so we had to be selective in what we chose to go to. Here we offer a taste of just a few of those we attended.

The first morning began with a symposium focussing on influential research outcomes during the past century and their implications for the future. Speakers included well known names such as Curlee, Gregory and Yairi. Hugo Gregory said how important it is that people who stammer are given information about stammering during therapy, describing how this can reduce feelings of guilt. Ehud Yairi summarised research which challenges the notion of stammering being a unitary disorder and described a variety of subgrouping models. He also outlined a major new United States project which is attracting significant government funding. It aims to identify stuttering subtypes and associated risk factors in children.

Another interesting presentation drawing a large audience was by Richard Culatta. who outlined forty procedures for improving fluency treatment. One example here would be that change that is likely to be most permanent occurs slowly and in small steps. Also, when someone is learning a new behaviour, the more involved the person is in giving themselves detailed feedback the more progress they will make. He referred to the variability of fluency treatment outcomes and went on to describe six research based principles of change which have been shown to positively effect the outcome of treatment.

For us the most interesting symposium was entitled 'Treatment of Adults who Stutter: A Spectrum of Approaches'. Three teams from New York, Washington State (USA) and Edmonton in Canada described their intensive therapy programmes. We were particularly interested in 'The Comprehensive Stuttering Programme' which Deborah Kully and Marilyn Langevin introduced. It is indeed a comprehensive programme drawing as it does on cognitive-behavioural skills, self therapy skills, social and communication abilities as well as speech modification work. We were struck by the way they are integrating fluency technique work with stammering modification skills, thus linking speak more fluently and stammer more fluently approaches. These two schools have traditionally been seen by some as mutually exclusive. Kully and Langevin include an explanatory model of stammering in their course which reinforced Hugo Gregory's comments about the importance of people who stammer having information. Family involvement is also viewed as important in the therapy process. Their programme includes a model of the change process, an understanding of which they view as central to the client's progress.

We were impressed by the third presentation which was given by Catherine Montgomery and Adriana DiGrande. Similarly, they combine fluency shaping and stammering modification approaches. They also stress the importance of desensitisation, attitude modification and maintenance and follow-up work. One of the central features of the programme is helping clients identify and challenge their beliefs about stuttering so they can become more comfortable communicators. It was interesting that they also draw on complementary therapies such as meditation and visualisation.

One very different presentation explored the ways in which Hollywood has represented people with communication impairments. With clips from numerous films the presenter raised some thought provoking issues about the ways in which the media can contribute to stereotypes. This had particular interest for us in relation to our own exploration of media images of stammering.

We learnt a great deal from attending this conference. Some of what we heard reinforced our current beliefs about stammering and ways of working but we have also taken away lots of fresh and challenging ideas. We are always seeking to develop our work at The City Lit and going to New Orleans has certainly stimulated this process.

Editor's note: Deborah Kully and Marilyn Langevin are based at the Institute for Stuttering Treatment and Research, University of Alberta, Canada.