The Neuropsychology of Developmental Stuttering
by Bernard-thomas Hartman

Hartman hopes this approach will shed light on stuttering. He reveals his theory of a dual-tract motor programme for stuttering. A non-speech motor programme disrupts the production of fluent speech, and is triggered by environmental factors. He briefly examines dyslexia as he says it also stems from disturbed motor process.

Hartman advocates full diagnostic assessment and a therapy approach which considers the overall pattern of stuttering which fosters negative self-perceptions and emotions.

He proceeds to criticise the majority of therapy programmes. He says they are well intentioned but is very critical of the use of fluency techniques in a clinic setting. He is also critical of Self-therapy for the Adult Stutterer which he claims is a 'one size for all eclectic design'. The approach of that book is that stuttering is a behaviour that can be modified. It provides ideas for modifying your feelings and attitudes and the stutter itself. Harman most strongly dislikes the idea of the stutterer taking responsibility for his therapy.

In contrast Hartman's 'psychosocial' approach is to present the stutterer with fluency via and Edinburgh Masker or DAF machine enabling the stutterer to experience fluent speech rather than modifying the stutter. This results in positive feedback in speech situations and so, according to Hartman, does not trigger the disruptive non-speech programme which is responsible for stuttering. He also argues that there is a reduction in avoidance and anxiety which are psychosocial reactions. He illustrates this with three case study examples but provides no real evidence to support the lasting value of this therapy approach. Indeed he argues that the masker is like glasses or a hearing aid which suggests it will be an essential and permanent aid.

Hartman describes stuttering as an 'enigma wrapped within a mystery' which is rather like his book. There are some very interesting and readily accessible sections, but on the whole the concepts are difficult to grasp and his use of jargon in overwhelming. Finally, like stuttering this book is, in Hartman's words 'subject to considerable speculation and controversy'.

Reviewed in the Autumn 1995 issue of 'Speaking Out' by Anne Ayre, specialist speech and language therapist

See also
Straight Talk about Stuttering - article by Bernard-thomas Hartman

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