Notes from Antwerp

Norbert Lieckfeldt and Margaret Leahy report from the European Symposium on Fluency Disorders held in Antwerp last April.

The lovely city of Antwerp was once again the setting for this event, organised by Kurt Eggers of Lessius University College. Despite initial fears that volcanic ash would disrupt the best laid plans, this 2nd symposium attracted 280 participants, who succeeded in arriving from 25 different countries (with some setbacks). In total there were 50 presentations, covering developmental stammering, neurogenic stammering and also cluttering.

The seven keynote presentations all went ahead, albeit some only with the aid of videoconferencing, and there were 22 posters to keep us engaged during lunch and coffee breaks and beyond. We had two long, busy, information-packed days, with loads of opportunity to meet people, and raise a glass or two along the way. What follows is merely a short insight into the numerous presentations given - presentations are on the Symposium's website at http://tinyurl.com/26jtxqm

Ken St Louis (who made it through the ash all the way from West Virginia) updated us on progress in his wide-ranging international survey that measures public opinions about stammering, and other issues such as mental illness and obesity. In his ever-optimistic way, he looked forward to a world that will be 'enlightened' about stammering, one that will 'understand' and 'accommodate' and 'be accepting' of people who stammer. He also mentioned the provision of 'assistance and sympathy', with which some may argue.

Henny Bijleveld from Brussels provided a comprehensive review of sub-cortical implications of stammering and movement disorders, including Tourette's syndrome and chorea. The limbic system and amygdala affect the timing of impulses in the brain's supplementary motor area, providing insight into how stammering comes about.

Dennis Drayna (via videolink) outlined his research published earlier this year - see First genes found for stammering - in which his team located particular gene mutations which may help to explain a proportion of stammering. He made a complex matter easy to understand.

Recovery in children

Professor Peter Howell from University College London reported on his latest research findings on predicted recovery from stammering in childhood. It is notoriously difficult to distinguish which children who start to stammer would recover naturally, without intervention from a therapist, and which are less likely to recover unless they receive such intervention. In 2007, he identified that the pattern of stammering might give a clue: children who increase the relative number of whole-word repetitions (singly or as parts of phrases - called stallings) are more likely to recover. Children whose stammering persists do not increase the relative number of whole-word repetitions but instead increase part-word repetitions, prolongations and broken words (called advancings). The higher rate of whole-word repetitions in recovered cases and the lack of change in persistent speakers suggests whole-word repetitions may have a role in promoting fluent speech. Regular readers of Speaking Out will hear more about this - his new book 'Recovery from Stuttering' due out in October 2010, will be reviewed in a future edition.

There were two papers on treatment of neurogenic stammering: one by K. Konig, a survey of therapists in Germany; and the other, by Theys et al., an in-depth study of stammering associated with speech disorders following stroke. In both instances, high levels of recovery with therapy were reported. Those who improved achieved amongst other things a "good state of health; high motivation; and ability to spontaneously use techniques" in everyday situations. Easy onset, rhythmic speech and slower rate of speech were the most widely used techniques.

Edinburgh's Paul Brocklehurst presented his research on self-reported errors in 'inner speech' - the kind of speech we all use when we talk to ourselves. He investigated the impact of what is called the Covert Repair Hypothesis - when we prepare to speak, we constantly monitor what we are going to say and 'repair' any perceived errors before the actual speaking. The theory states that, in people who stammer, there would be more errors in internal speech, so more problems would be identified that need correcting. However, the 'repair' function itself is not as efficient as that of a fluent person so that a loop of error/repair brings speaking to a halt. Paul's research demonstrated that people who stammer are significantly more likely than fluent people to make and identify errors in their inner speech.

A poster that drew interest was on the impact of fluent and dysfluent speech on telephone preference - conventional or mobile? This small study by Helen Jenkins and Rachel Smith from Birmingham questioned people about their preferences. Results indicated that mobiles may be "less anxiety provoking and more accessible" for people who stammer than the conventional phone.

From Speaking Out Summer 2010, page 13