Tips to improve stuttering according to the research study: "A perspective on stuttering: feeling a loss of control" (apply socratic questioning; build tolerance for sensing a loss of control during a feared word; work on the struggle of coping with a loss of control of the speech mechanism)

Tips to improve stuttering according to the research study: "A perspective on stuttering: feeling a loss of control" (apply socratic questioning; build tolerance for sensing a loss of control during a feared word; work on the struggle of coping with a loss of control of the speech mechanism) This is my attempt to extract tips from [this](https://pubs.asha.org/doi/pdf/10.1044/cicsd_26_S_5) research study which discusses that the sensation of loss of control leads to struggle or avoidance responses. **Theory:** * The main experience in stuttering is a sense of **loss of control** of the speech mechanism that leaves individuals feeling helpless to override it and finish their utterance * PWS have routinely agreed that when stuttering, they consistently experience a sense of loss of control that they feel incapable of inhibiting so that they can promptly resume the forward flow of speech * It's difficult to know for certain whether young children experience this sense of loss of control or not - as they comment with: "Mommy, the word won't come out, I can't say it or I don't talk right" * The sense of involuntary loss of control is likely experienced by individuals with long-standing histories of stuttering, and thus likely applies to adults and adolescents * A sense of loss of control can lead PWS to apply accessory behaviors to escape or avoid this sensation \[aka negative reinforcement\] * Accessory behaviors could be secondary characteristics, slowing down, speeding up, interjections (adding 'ehm'), monotoning, and eye blinking * Associated features are for example tension, but there is no certainty over the nature of tension and stuttering * Causative stimuli in the form of demands can come from the environment (an external source) and/or be self-imposed demands (an internal source) **Tips:** * According to Yaruss (2022), people who stutter simply have a lack of tolerance for this sensation of a loss of control. **Clinical intervention**: So, build tolerance for this sensation of loss of control whenever we experience a trigger or feared word. Distraction/avoidance does not lead to building tolerance, rather mindful acceptance of the trigger does. Reducing cognitive, emotional and linguistic conflict or demands does not lead to building tolerance for this conflict or demand * Each person has a different sensation of loss of control. **Clinical intervention**: So, detect and analyze all the sensations that you perceive as a loss of control of the speech mechanism (aka this sensation of inability to initiate articulation) * Work on the struggle of coping with a loss of control * Apply [**socratic questioning**](https://www.google.com/search?sca_esv=575515247&sxsrf=AM9HkKnYZSzinkrJnikRzubGCZl29eiwKA:1697936562251&q=socratic+questioning&tbm=isch&source=lnms&sa=X&ved=2ahUKEwicnJPNuoiCAxXIhf0HHTa0Dq8Q0pQJegQIDBAB&biw=1745&bih=846&dpr=1.1): This basically means, keep asking yourself questions that seek to explore complex ideas, concepts, and beliefs that challenge assumptions, clarify meaning, and reveal underlying principles. Such as, "Why do I feel this sensation of loss of control?". If you simply answer 'Because a feared word triggered me', then this answer is not good enough. So basically, I want you to continue posing follow-up questions to eventually reach the bottom most core layer. "Yes, a feared word triggered me just now. So, why exactly does this lead to a sensation of a loss of control?" "How did I learn or develop this sensation exactly?" "Why does this sensation lead to a speech block exactly?" If you simply answer: "Because it's neurological", then you completely missed the point of this homework exercise. Because, why do we sometimes stutter, and other times we don't stutter - whenever we sense a loss of control (while it's neurological)? Why do we rely on the sensation of loss of control - in order to execute speech movements? What made us link this sensation of loss of control to speech performance - years after we first started stuttering? **My opinion:** * *"If we stutter on the /P/ (for example: P..p..p..), then the issue is not the /P/ but the next sound"* \--> **In my opinion**: Yes and no. If my feared letter is the /P/ and I would stutter on P..p..p**R**agmatic, P..p..p**A**le, P..p..p**L**ease. Then just because I stuttered on the /P/, doesn't make the following sounds also a feared sound. **Conclusion**: So, the /R/, /A/, or /L/ don't suddenly become feared letters as well * **In my opinion**: the "learned" behavior: 'slow voice onset time' could attribute to neural differences * **In my opinion**: the sensation of loss of control is a "learned" ability that PWS gradually develop. For example, research states that PWS never start out with stuttering anticipation at early onset. I argue that stuttering anticipation contributes greatly towards the sensation of a loss of control, as well as the anticipatory **pressure** in the throat (alarming us 'as if' we are about to stutter) is a formed association between the body sensation (in this case, the throat) and speech performance (or rather, the ability to initiate articulation)