Pausing and Stuttering
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About the presenter: Peter Reitzes, MA, CCC-SLP, is an adult stutterer and an ASHA certified, New York State licensed speech-language pathologist working in an elementary school and in private practice in Brooklyn, NY. Mr. Reitzes is the author of 50 Great Activities for Children Who Stutter: Lessons, Insights, and Ideas for Therapy Success and co-hosts the StutterTalk.com weekly podcast. |
Pausing and Stuttering
by Peter Reitzes
from New York, NY
Introduction
Some speech-language pathologists (SLPs) promote the idea that people who stutter "should always move forward in their speech" and "should never pause, stop or hesitate when facing stuttering moments." The huge avoidance and covert aspects of stuttering make such beliefs appealing. However, SLPs do people who stutter a great disservice by adhering to such mantras because they may limit and discourage experimentation with both stuttering and speech tools.
For some, pausing before or during occurrences of stuttering is used productively as a tactical planning opportunity, as a moment for strategic regrouping or as a way to allow the stuttering moment and related tension to pass. Pausing has been discussed as a rate control speaking strategy (Reitzes, 2006a, 2006b; Schneider, 1995, 1998) to reduce the frequency of stuttering. In this short paper, pausing will be discussed as a way to modify traditional speech tools, reduce moments of stuttering and prevent moments of stuttering.
Pausing to Modify Speech Tools
Two examples of modifying speech tools using pausing are provided.
- Preparatory sets: Preparatory sets are used when the speaker anticipates a moment of stuttering and prepares to gently initiate/articulate the anticipated stutter. One way to experiment with preparatory sets is by pausing briefly before the anticipated stutter or feared word. The pause or stop is used to prepare an easy initiation, to prepare to stutter in a different manner, to let the stuttering moment pass by taking a normal breath or for other individualized purposes. Some SLPs will ask, "Isn't this just advocating avoidance?" It is a fair and important question. The speaker and the SLP need to monitor the different uses of pausing to make sure it is being used productively and not as an avoidance behavior. Stopping to take a normal breath and planning how to proceed can be a productive and powerful tool to have in a person's repertoire.
- Pull-outs: Using a traditional pull-out, the speaker says the word, stutters, and continues moving forward by reducing tension, thus reducing stuttering symptoms. During a stop pull-out (a term coined by a client during therapy), the speaker says the word and when a stutter occurs, stops briefly and then says the word with reduced tension. For example, the speaker attempts to say the word "student" and stutters on the "s" sound. The speaker stops and then gently re-initiates the "s" with reduced tension and then completes the word.
Stopping to Prevent or Reduce Moments of Stuttering
Pausing during a moment of stuttering or before an anticipated stutter may also have the effect of preventing additional stuttering moments. For example, during a therapy session one client was stuttering on approximately 75% of syllables spoken. The speaker realized that by stopping briefly when a stutter occurred, stuttering moments were reduced to about 5% of syllables spoken during the remainder of the session. The client and clinician realized that the clustering effect of stuttering (the back to back stutters) was significantly reduced as were the overall frequency and duration of stuttering moments.
Conclusion
When experimenting with pausing, the speaker and the SLP are strongly encouraged to closely monitor why and when pausing is used to make sure it is used productively and not as an avoidance or concealment behavior.
References
Reitzes, P. (2006a). 50 great activities for children who stutter: Lessons, insights, and ideas for therapy success. Austin, TX: PRO-ED.
Reitzes, P. (2006b). Pausing: Reducing the frequency of stuttering. Journal of Stuttering Therapy, Advocacy and Research, 1, 64-78. Retrieved 08/21/09 from http://www.journalofstuttering.com/1-2/Reitzes.2006.JSTAR.1.64-78.pdf
Schneider, P. (1995). A self-adjustment approach to fluency enhancement. In C.W. Starkweather & H.F.M. Peters (Eds.), Stuttering: Vol. I. Proceedings of the First World Congress on Fluency Disorders, Nijmegen, The Netherlands, 1, 334-337. International Fluency Association.
Schneider, P. (1998). Self-adjusting fluency therapy. Journal of Children's Communication Development, 19, 57-63.
August 29, 2009
