|
 Avoiding
Pepperoni
National Post reporter Joseph Brean, who stutters, writes
about the latest treatment being pioneered by Toronto
researchers, how he copes with the speech impediment and the
perils of ordering pizza.
by Joseph Brean, Canadian National Post, August 12
,2003
For more articles like this
visit
https://www.bridges4kids.org.
A family legend has it that my mother made me stutter by
suppressing my natural left-handedness. I was three, we were
living in Nairobi, and my Kenyan pediatrician thought my
tendency to grab for spoons and crayons with my left hand would
doom me to a life of awkward scissor use and an inability to
share golf clubs.
To save me, he said, my parents ought to put these utensils in
my right hand and force the juvenile southpaw into the closet.
Today, I am all mixed up: I write with my right hand and throw
right, but I kick left, shoot a hockey stick and swing a
baseball bat left, and I golf very poorly with left-handed
clubs. I am also told I eat strangely, cutting with my left hand
and never switching my fork over.
This confused bi-dexterity, so the legend goes, also gave voice
to something more sinister.
Scientists who studied stutterers in the 1920s claimed to have
found that the disorder arises out of an incomplete dominance of
one side of the brain when it comes to language production. In
stutterers, they said, the hemispheres were competing and the
result was choppy speech.
Messing with my burgeoning left-handedness, then, might have
fostered this problem in me, and I might otherwise have been a
fluent speaker.
In all fairness to my mother, this story is at least apocryphal
and perhaps entirely false, but it reveals some persistent myths
about the speech impediment.
With its vague ideas of neural restructuring and unconscious
confusion, the story captures the modern intuition that
stuttering cannot just be a nervous habit, such as talking too
fast or saying "umm."
This early theory of skewed dominance, however, which held sway
when I was a child, has not stood up to further experiments. But
it did mark the beginning of a rich line of research into
stuttering's origins in the brain.
"We find that people who stutter have a harder time doing two
things at once," says researcher Sophie Lafaille, summing up her
ongoing work at Toronto's University Health Network's Human
Communication Laboratory.
Dr. Luc de Nil, who heads the lab, says that when you take an
image of a stutterer's brain in mid-sentence, what you see is a
flurry of activity in all speech-related brain regions. Compare
this to the focused, localized brain activity of a fluent
speaker and the inevitable conclusion is that stutterers are
just trying too hard to get their words out. Something,
somewhere, has to give.
This inability to multi-task -- on the most fundamental
neurological level -- is the immediate cause of stuttering, Dr.
de Nil says. Even when stutterers are reading words in their
heads, their overactive brains show increased activity in a
region responsible for preparing the body for such complex
actions as speech.
But the ultimate cause, whether it be an inherited genetic
trait, excessive pressure on a child learning language, or some
combination of the two, remains a matter of debate.
Those who argue that stutterers are born rather than made are
supported by the questions of heredity and genetics. Studies
have shown more than half of stutterers know of a family member
who also stutters (my grandfather, who stuttered most of his
life, went on to become a popular Nova Scotia radio host), more
than three-quarters of stutterers are boys, and if one twin
stutters, it is nearly a sure thing that the other will, too.
Recent genetic studies have pinpointed one key gene with strong
links to stuttering, and a project is underway at the University
of Illinois at Urbana-Champaign to collect blood samples for a
sweeping study of stuttering in families. But environmental
factors complicate the tidy explanation of an inherited cerebral
quirk.
In 1939, a misguided researcher (himself a stutterer) at the
University of Iowa tried to make orphans stutter by teasing them
mercilessly as they learned to speak, thereby proving the
disorder had environmental causes. The victims, who are now
suing the state, were given endless negative feedback to their
vocal development, and in a twisted way, the experiment was a
success; some of them stuttered.
Although the experiment has now been universally denounced, and
was kept secret until a reporter unearthed the files in 2001, it
is a reminder that stutterers can be made as well as born.
It is usually pressure on a child's growing language abilities
that does it.
William Parry, a U.S. stutterer and independent researcher,
theorizes that stuttering is a lingering neurological confusion
from childhood attempts to speak more fluently than one is able.
This stress of fearing dysfluency and trying to overcompensate
underlies the speech impediment, which mimics the body's
unconscious closing of the upper airway, he says.
An academic theory, the Demands-Capacity Model, proposed in
1990, similarly holds that stuttering arises out of an imbalance
between a child's capacities for fluent speech and the demands
placed on him or her by the environment, which usually means
parents.
"If there's too much demand placed on the system at an early
age, that could certainly backfire," says Dr. Bob Kroll, a
speech therapist.
Both Kroll and de Nil say the accepted wisdom is that stuttering
is caused by the interaction of environmental and genetic
factors. Whatever the cause, though, the scientist and the
therapist seem to have figured out how to give a stutterer's
brain a tune-up.
In a converted office building in northeastern Toronto, Kroll
offers his patients, many of them children, a simple program of
breath control that has made dozens of them fluent speakers. He
calls it "fluency shaping" for the adults, "easy speech" for the
teenagers, and "turtle talking" for the kids (because it starts
out very slowly). It is all the same idea, though: easing into
words to start them, then keeping the air flowing as you move to
the next word. "You need air to talk on," he tells them.
And when Kroll's subjects go to de Nil for brain imaging,
strapping themselves into the giant whirring doughnut of an MRI
machine to stutter for science, the results are astounding.
In the early stages of treatment, the images look just as they
would for a regular stutterer -- the brain lights up like Canada
Day. As they learn the breathing techniques, though, de Nil
points out how brain activity actually increases because the
therapy adds another complication to producing speech.
But when the techniques have become second nature, and the
stuttering is under control, the readouts look just like a
fluent speaker's.
- - -
Casey Smith is a stutterer with a story that spans the
explanations of heredity and environment.
He is a confused right-handed writer and left-handed golfer with
a mother and two other relations who also stutter.
"I've always wondered where it starts," he says of his stutter,
his words flowing without so much as a hesitation.
He is one of Kroll's success stories, a friendly 18-year-old who
says his speech impediment has "majorly" affected his social
life, but who has worked through the program and is now in the
final, or "maintenance," stage.
Over Cokes in his living room, with his buddies waiting for him
in the basement, he says he has always known that stuttering had
something to do with breath control.
"I used to always think it was in my head, but after I started
going to therapy and learned more about it, I realized the
breathing part was more of a factor to me," he says. "I'll think
too fast in my head of the words that I want to say, and then I
won't have enough breath to say it. And when I get really
excited, I'll just try to say too much and I'll stutter."
His mother, Debi Babiak-Smith, recalls the moment she heard her
son, then a talkative seven-year-old, make that unmistakable
pause in his speech, thus kicking off his speech impediment.
"My heart just jumped," she said. "I knew instinctively that it
wasn't just a stumble. I knew it was a stutter."
She stutters, too, just like her grandfather and her uncle did.
She attributes it to a traumatic experience with an elementary
school teacher.
She did not have the benefit of speech therapy and says she
avoids the telephone at work and has failed to pursue things in
her life for fear of speaking in public. She fears her son will
do the same.
It was Casey who came to her to ask for speech therapy about two
years ago, just as the project to use brain scans to evaluate
Kroll's classes was starting off. Casey had a typical teenage
social life and was doing well enough in school, but wanted to
overcome some of the embarrassment that kept him from speaking
in class.
Looking over the diagrams of stuttering brains getting less and
less cluttered over time as their owners learned Kroll's
techniques, Casey nods in agreement.
"That's exactly what I went through," he says.
Like the guy on Seinfeld who converted to Judaism because he
liked telling Jewish jokes, I feel no unease in publicly
observing that, for all the anguish it causes, stuttering can be
immensely funny.
It is an important point. For one thing, it helps to deflate
some of the wailing despair that tends to dominate discussions
of stuttering, which often focus on parental guilt and
self-imposed loneliness.
A speaker at a stuttering conference this weekend in Toronto,
for example, plans to argue the humourless point that
forgiveness of others is the first step toward overcoming the
disorder, as if stuttering were like losing a child to a drunk
driver.
She goes so far as to claim stutterers need to forgive
themselves for how they talk, which might be a useful exercise
for some, but strikes me as a flighty piece of self-indulgence.
And it is humour, not penitence, that makes fluent speakers
comfortable around a stutterer.
Take John Bray, for example, a Toronto cab driver and lifelong
stutterer. Every now and again, when he stutters on a word but
eventually gets it out, an impatient passenger will feign not
understanding him (a common nervous reaction to stutterers, I
have found) or insist on finishing his sentences.
He has a secret weapon for these reactions, a phrase that, by
some quirk of confidence, he always says clearly. "Do I stutter,
or what?" he deadpans, and the ice always breaks. "Folks laugh
at that because they know I do," he says.
Humour can also reveal some of the silly lengths to which
stutterers often go to avoid embarrassment.
Consider the man who came to Kroll for treatment, and after a
few sessions confessed he had never eaten a Big Mac because he
could only say "cheeseburger."
Pathetic though it may be, that is funny, and speaking as
someone who has developed a taste for Hawaiian pizza after
deciding several times not to take my chances with "pepperoni,"
I do not doubt this anecdote.
I have changed many sentences in mid-stutter ("That's r-r-ridicu
.. ridicu-cu-cu ... r-r-r ... crazy," for example), and spoiled
many a joke by stuttering on the punchline. The occupational
demands of daily newspaper journalism carry their own peculiar
risks, too. (It is hard to imagine a situation more rife with
untapped humour than my interview last year with Peter Kelly,
the stuttering Mayor of Halifax.)
Print journalism offers an empowering shield for the stuttering
writer that is breached only in interviews, and with the name of
a national daily as a calling card, it is easy to be
self-assured. Radio, however, is the acid test of confidence.
Why bother with radio if you stutter? It is a good question, and
worth asking the broadcaster in Gabon who was fired last year by
state censors after he stuttered on air through the name of
President Denis Sassou-Nguesso of neighbouring Republic of
Congo. And kudos to the stuttering man who, just a few weeks ago
in the United States, was denied his request to dedicate a song
to his wife on air, prompting a rash of angry responses that
ultimately got the show cancelled.
This same question troubled me once in university, when I agreed
to go on a campus radio talk show, but I knew the audience would
be so small it would hardly matter. A few days ago, though, I
recklessly agreed to go on the air, live, all across Manitoba.
The Vatican had denounced gay marriages. I wrote a story in this
paper about the history of papal intervention in politics, and a
Winnipeg radio station decided I would make an interesting
guest. Against my better judgment (and over e-mail) I agreed,
and got through my first sentence quite well. Then I fell
headlong over the name of Mary, Queen of Scots, much to the
surprise of the host, who had introduced himself not 60 seconds
earlier and had not yet heard my voice.
When I had finished the late queen's name (though I had not yet
got to my central point about the Vatican) I was summarily
disconnected with a nervous "thank you," after which the host
urged his listeners to turn to the Post for a somewhat clearer
explanation.
And this, which might have been a mortifying experience,
highlights what I think is a useful coping mechanism for
stutterers: unabashed self-confidence and a pig-headed refusal
to be embarrassed.
As coping mechanisms for people who have not yet attained
fluency go, it is one of the better ones, and is a hands-down
winner over not talking.
The others range from the quirky to the elaborate: I sometimes
say "like" to get the air going if I am stuttering, employing a
Valley Girl-ism that should be cause for more embarrassment than
stuttering. I also avoid eye contact in mid-stutter; Casey
blinks, and his mother used to record herself asking for her
friends on the phone so she would not have to talk. All
stutterers struggle to find synonyms for the words we know are
hard to say, as if we are tip-toeing through a thesaurus.
Treatments are equally varied. Just last week, it was announced
a device is available that plays one's own speech into the ear,
slightly delayed, to create the feeling of speaking along with
someone else, which, according to the makers of the US$1,500
device, is easier for stutterers. Indeed, de Nil says auditory
feedback for stutterers is one of the next things he intends to
study.
Other treatments have involved meditation, repetitive practise,
and one that I briefly toyed with had me listening to special
beeping noises in earphones to somehow reorganize how my brain
deals with speech. I don't think it did.
But for stutterers looking to make their lives easier, nothing
is more common than avoidance, and that is the real crime.
Take Wilfrid from Sudbury, who went to Kroll to say he would no
longer be attending classes because he did not believe he would
ever speak clearly. He had been offered a promotion at work that
would require speaking more, but he did not want the added
pressure or the attention he knew he would attract if he started
speaking fluently.
"I felt like strangling him," Kroll says, so he asked him to
demonstrate on the phone what was so hard about the fluency
techniques. Wilfrid did, spoke without a stumble, and turned to
Kroll to explain. "You just wait until next time," he said.
"That was just lucky."
Email
jbrean@nationalpost.com with questions or comments about
this article.
Phone
1-888-STUTTER or 416-252-8255 in Toronto for more information
about stuttering.
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