A Picture Is Worth One Thousand Words

This paper is available in UzbekSwedishFrench and Hungarian

About the authors: Judy Kuster, M.S. in speech-language pathology and M.S. in counseling, is an associate professor in Communication Disorders at Minnesota State University, Mankato. She is well-published in Internet resources and has presented at state, national and international conferences. She is the webmaster for Net Connections for Communication Disorders and Sciences and the Stuttering Home Page as well as the coordinator of this online conference. Currently she is a member of the Division #4 Task Force on continuing education and Task Force on membership.

Anders Lundberg, M.S., is a Clinical Psychologist at the Department of Logopedics and Phoniatrics, Sahlgren's University Hospital, Göteborg, Sweden. Interested and experienced in stuttering first on a personal level, then later also on a professional one.

Adriana DiGrande, M.S., CCC has been treating children and adults who stutter exclusively since 1982. Adriana is a clinical instructor at Boston University and Emerson College where she trains graduate students in the area of stuttering and has presented at state and national conferences on the topic of stuttering.

Lori Andrews, M.A., is a Marital and Family Therapist Intern, Registered Art Therapist, and the current vice-president of the San Diego Art Therapy Association. She enjoys integrating creativity and life issues in her therapeutic approach for individuals of all ages. She has facilitated art as an expression of children and adolescents who stutter at the National Stuttering Project Symposium and has been a presenter on Art and the Child who Stutters at the International Fluency Association Conference. Lori is currently in a group private practice in San Diego, California.

A Picture Is Worth One Thousand Words

by Judy Kuster from Minnesota, USA and Lori Andrews from California, USA

Many years ago an advertising executive for Royal baking powder developed an ad he hoped would sell their product. Instead he accomplished coining a phrase that has become familiar everywhere - "A Picture Is Worth One Thousand Words." The ad he developed was a boy's smiling face with a Chinese saying underneath. The advertising executive apparently thought that his company would sell more baking powder if the wisdom of Chinese philosophy supported his claims. He could have made an even stronger claim if he had known the Chinese language. The executive wrongly translated the phrase. It literally says "A Picture's Meaning Can Express Ten Thousand Words." (commfaculty.fullerton.edu/lester/writings/1000_words.html)

Centuries ago, in perhaps the very first drawings of "stuttering," the Egyptians drew hieroglyphic symbols it is believed represented stuttering. As you can see, the picture shows a person trying to speak but the speaking gets blocked by what looks like walls.

(From Faulkner (1991) A Concise Dictionary of Middle Egyptian)

The first figure of this hieroglyphic symbol said to represent stuttering shows a person seated, pointing to his mouth and to the ground. "Perhaps what this hieroglyph depicts is a tremor -- an earthquake -- being conducted from the ground to the mouth: If this is so, then the Egyptians used the earthquake as a metaphor for the moment of stuttering." (Silverman, p. 8).

iceberg.gifSome people, including professionals have used artwork/pictures to help others understand stuttering. Joseph Sheehan's famous "Iceberg of Stuttering" (pictured left, from a Sheehan Stuttering Clinic brochure) depicts how much of stuttering is really under the surface.

Charles Van Riper also used a picture to demonstrate how stuttering develops. His description of the picture is equally as vivid. "Stuttering has three sources; The major one represented by the largest, Lake Learning, into which the stream from Constitutional Reservoir flows. Neurosis Pond is also one of the sources of stuttering, but it is smaller. Its contribution to the flow also occurs further down the river's course. Stuttering can come from any of these three sources.

As the stream leaves Lake Learning, it flows slowly and many a child caught in its current may make it to shore by himself or with a bit of parental or therapeutic help.river.jpg Some of them are cast up on Precarious Island and become fluent for a time, only to be swept away again by the swift-moving emotional currents from Neurosis Pond. The second stage in the development of stuttering is represented by Surprise Rapids, and the stutterer begins to know that he is in trouble. It isn't hard to rescue him, however, if you know how to do it.

Once he is swept over Frustration Falls, however, he takes a beating from the many rocks that churn the stream. Despite their random struggling, a few make it to shore even at this stage, the third, but they usually need an understanding therapist and cooperative parents to help them. The river flows even faster here, and soon it enters the Gorge of Fear. This is the worst stretch of the whole stream of stuttering, for below it lies the Whirlpool of Self-reinforcement. Once the child is caught in its constant circling, there is little hope that he will ever make it to shore by himself. Only an able and stout swimmer who knows not only this part, but all of the river of stuttering, can hope to save him."(Van Riper, p. 280-1).

conture.gifEdward Conture uses a picture analogy to help children understand the difference between forward moving and disrupted speech. He explains, "For a frog to hop across a pond or stream on lily pads he would have to smoothly, easily, and sequentially hop from one pad to another. However, if he landed on one and repeatedly hopped up and down (repetition) or landed on one in a physically tense, fixed manner (stoppage) he would disrupt his forward movement across the pond. Likewise, speech requires physically easy, smooth, sequential behavior to make forward movement from beginning to the end of a sound, syllable, or word." (Conture, p. 138).

Not only can drawings help explain the nature of stuttering, artwork can also help individuals express their experience with or feelings about stuttering when they aren't able to find the words, or when words themselves are inadequate. Recently, a good friend sent me a computer-generated picture of "stuttering."

copyright, Louise Heite

stanislov.gifVarious art media besides drawings have been used, including sculpture. Two examples of interesting sculpture were found. Stanislav Szukalski was an "artist, anthropologist, self-proclaimed genius. Hailed at one time as Poland's greatest living artist and a member of Chicago's cultural elite during the 1920s, Szukalski spent his last years living in undeserved obscurity in suburban Los Angeles until his death at age 93 in 1987." (http://www.protong.org/szukalski/) One of his sculptures is entitled A Stuttering Philosopher (1915).

woodys.jpgC. Woodruff Starkweather made a sculpture for his friend, Charles Van Riper, to depict stuttering. The sculpture is entitled, "The Author as a Young Man." Van Riper used a picture of the sculpture as an illustration in his book, The Treatment of Stuttering.

These are examples of art being used to express symbolic communication. The profession of Art Therapy uses this form of communication in working with children and adults. The profession is regulated by The American Art Therapy Association, Inc. Professional art therapists have a master's degree in art therapy or at least 21 semester credits in art therapy if they have a master's degree in a related field. The roots of art therapy came from both the mental health and educational sectors. Psychiatrists began to study the artwork of patients to see if there was a link between their art and their illness. About the same time, educators were discovering that "the free and spontaneous art expression of children represented both emotional and symbolic communications." (www.arttherapy.org)

Anders Lundberg, a clinical psychologist and one of the authors of this paper, has had considerable professional experience using artwork with children who stutter. His interesting contribution to this paper, which includes several pictures, is separated from this page to save downloading time.

Several speech-language pathologists have also used art to draw out the feelings their clients have about stuttering. Clients are instructed, "Draw a picture of what it feels like to stutter." Adriana DiGrande, MS, CCC-SLP and Diane Parris, MS, CCC-SLP presented a poster session at the 1993 ASHA convention in Anaheim, California, entitled, "Monsters, Chains and Cages: Images of Stuttering." In an article about their work (Trace, 1994) DiGrande and Parris explain how they use art to help draw out the covert aspects of stuttering. An additional advantage is that when a person who stutters sees the artwork of others who stutter, they realize they aren't alone in their feelings about stuttering. "They may not have drawn their picture the same way, but they can understand what the other person is trying to say. They feel there is a common bond in what each other is communicating, and they become very supportive of each other," reports DiGrande (Trace, 1994). Not only can the pictures develop a "common bond" among children who stutter, they can also open avenues of communication between parents and their children. In many families the topic of stuttering is often a "taboo" subject and a wall of silence develops around stuttering. These drawings have opened the door for the parent and child to discuss stuttering in a less threatening manner and they have provided parents with a better understanding of their child's experience.

Kristin Chmela, MS, CCC-SLP uses drawing as an activity during treatment. Chmela shares that the drawings further help the clinician understand the child's current perceptions of stuttering. This often includes looking for signs of changes in the perceptions over time, and indication of progress as well as current concerns. Chmela shared several drawings for this conference (in the art gallery) and the Stuttering Foundation of America also uses some of these pictures in their book, The School Age Child Who Stutters: Working Effectively with Attitudes and Emotions. The drawings are part of the handout which comes with Tape #85 of the same name. (personal correspondence with Kristin Chmela and Jane Fraser, SFA).

Whether art is used to help others learn about stuttering or help individuals express their feelings when they aren't able to find the words, these pictures can send messages that are worth thousands of words.

This paper provides an opportunity for the reader to learn about stuttering through the art work of children by visiting the Art Gallery of Stuttering. Pictures have been submitted by several speech-language pathologists. This paper also provides an opportunity for children to draw their own pictures of stuttering which may be added to the art gallery. Pictures should be scanned and saved as gifs or jpegs and emailed to Judy Kuster or original pictures can be mailed to:

Judy Kuster
1018 S. Payne St.
New Ulm, MN


  • Conture, E.G. (1990) Stuttering, Englewood Cliffs, NJ: Prentice Hall
  • Faulkner (1991) A Concise Dictionary of Middle Egyptian Oakville, CT: David Brown Book Co
  • Lundberg, A.: Stammande barn - En bok till dig med ett stammande barn i din n�rhet (Stuttering Children - a book for you with a stuttering child near you). Liber Utbildning AB, Stockholm, Sweden (1995). Available only in Swedish.
  • Lundberg A.: STAMNING - grundbok f�r behandlare. (STUTTERING - A fundamental book for clinicians). Lianen Konsult, G�teborg, Sweden (1999). Available only in Swedish.
  • Silverman, F.H. (1996) Stuttering and other Fluency Disorders, Needham Heights, MA: Allyn and Bacon
  • Trace, Robert (May 2, 1994), Images of Stuttering: Intensive Therapy Program Draws Out Feelings, ADVANCE for Speech-Language Pathologists and Audiologists, p. 12-13
  • Van Riper, C (1973) The Treatment of Stuttering, Englewood Cliffs, NJ: Prentice Hall.
  • Van Riper, C. and Emerick, L (1984) Speech Correction: An Introduction to Speech Pathology and Audiology Englewood Cliffs, NJ: Prentice Hall

August 15, 2019