Demands and Capacities model: * stuttering is the result of the interaction of intrinsic and environmental factors and occurs when the demands for fluency are greater than the capacity to produce it * None of these factors are necessarily abnormal * Clearly, even if further research establishes unequivocally that brain anomalies are present in people who stutter, such anomalies are not sufficient to cause stuttering. They do not explain why some syllables are said with struggle and tension while others are said fluently * Distinguishing between what are termed “distal cause” and “proximal cause” is misleading, because it is the case that all causal factors must be operating at every moment of stuttering * 3-factor causal model of moments of stuttering: Do therapies address the cause: * the question is: How can stuttering treatment change/improve the deficit in neural processing? Can plasticity accommodate the formation of the new networks required to support the fluency that adolescents and adults can acquire as a result of speech restructuring treatments? How can treatment primarily address triggers and modulating factors? Therapies can address triggers by: * reducing speech rate * stretching speech sounds * rhythmic speech * modifying the use of the voice * reducing variability of syllabic stress * reducing utterance length * reducing linguistic complexity * gentle onsets * light articulatory contacts Triggers: * short periods of phonation