Reasons and Remedies
By Patricia Sims
ISBN 0-9536209-0-5

Patricia Sims has a belief that many childhood disorders are associated with, if not caused by personality traits with anxiety and tension.

She argues for a more holistic approach to paediatric disorders, with greater attention being paid to the diagnosis of childhood personality and behavioural difficulties.

After a general introduction, in which she states her position, she describes behaviours which can in her view, reflect underlying anxiety. These are wide ranging and include avoiding demands, clumsiness, chewing objects, walking abnormalities, and convulsions. Similarly she goes on to discuss autism, dyslexia and speech and language difficulties with reference to personality and behavioural problems. Stammering is included in the latter section.

She describes stammering in children as a "compulsive behaviour."

"When the child attempts to pass on to the next syllable or word, he is at the same time programmed or 'needing' to continue the compulsive repetitions - his brain is receiving conflicting messages" (p57).

The author believes these compulsive feelings are retained by some adults who stammer, and the behaviours maintained by the "addictive" feelings after tension is released post-stammering.

The author's style is easy and the sections illustrated with case studies from her clinical experience which are well drawn. She obviously believes strongly in the part played by personality traits in various disorders. It is clear that this view has helped her make sense of her clinical experiences. It would have been interesting to read more on how Ms Sims relates her view to developmental theories, including the current research on childhood stammering.

She does briefly mention intervention for children who stammer, specifically the Lidcombe programme. However, it is unclear how this or other interventions currently used within speech and language therapy would fit with the view that stammering resulted from specific personality traits.

This book is said to be aimed at "practitioners and parents". As a practitioner, I was interested in the authors sense making and it did cause me to reflect on the role of anxiety in childhood stammering. As a parent, perhaps looking for help, I wonder if the book raises more questions and perhaps more anxieties, than answers.

Reviewed By Dr T Stewart (Speech and Language Therapy Adviser) in the Spring 2001 edition of Speaking Out.

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