Sunday, July 31, 2005

Introduction to my blog

A good friend of mine, Irina Papancheva, from Bulgaria asked me to write a short introduction piece on my blog. She will do the translation into Bulgarian for her readers back home. So I might as well publish the English text here. If anyone wants to publish it, feel free to use this...

"My blog The Stuttering Brain

The Internet has truly changed the way that people communicate with each other. The world wide web, email, and messenger technology have allowed people worldwide to form on-line communities and discuss or share ideas important to them. The latest add-on to this revolution has been web diaries, in short "blogs". A blog is an on-line diary where a person or a group of people post their daily thoughts, typically on a very specific issue. Here some examples. An Iraqi school teacher regularly posts his experiences of daily life after the fall of the Saddam regime, allowing everyone from across the globe to get a first-person account of what it really means to live there. Or, the wife of the leader of the English Conservative Party wrote a blog during her husband's election campaign. Other blogs deal with specific life situations (e.g. the birth of child), political views (e.g. against abortion), or science (e.g. discussing new findings). In short, blogs have the unique capability of sharing first-person experiences with anyone across the world. In fact, they are like little broadcast channels of ideas.

Having persistent developmental stuttering (PDS), I am naturally interested in its nature. What are the causes? What are the best treatments? As I am also a scientist, I have been very interested in the actual research issues. In recent years, I have become much more involved: I initiated and chaired the research committee of the British Stammering Association, I attended several conferences, and I have been in discussion with the researchers. Our times are unique in the sense that new research tools have started to give us a better understanding of PDS. For example, brain imaging technologies now allow us to look inside the brain when stuttering occurs, and genetics studies point to genes that increase the risk of stuttering. However, meta-analysis of research or current research papers happens rarely, and mostly in published fee-charging journals. In my opinion many researchers are secretive about discussing new unpublished ideas, scared of commenting other researchers' work, communicate within smaller groups, and mostly speak about their specific areas of interest.

There is a need to comment publicly and independently on research. My strong scientific background, my own experience with PDS, and my many contacts allow me to undertake such a task. So I decided to start a blog. In a sense, not much changed, as I have always been thinking about specific research issues or current research findings. But, I never shared them so publicly. At first, I was a bit reluctant for several reasons: I was concerned to loose interest after a while; Posting takes up time; I expose myself to scrutiny by posting my ideas; No-one might be interested in my blog. These scenarios did not materialise. After three months, I am still posting at a regular pace: two to three posts a week. Posting does not take up too much time. The feedback has been overwhelmingly positive. I have around twenty to thirty readers per day. Some read the blog regularly, and the readers come from all over the world. And more interestingly, as the reader are watching me, my thinking have become better and sharper. I do not want to be proven wrong on the spot! To conclude, I am really enjoying myself. My blog survived the potentially difficult first months and I am eager to continue.

The web address of my blog is http://thestutteringbrain.blogspot.com "

Thursday, July 28, 2005

Stroke of fluency

There are some pretty puzzling and seemingly paradoxical phenomena that I regularly come across when looking at PDS, but probably the most striking effect is elimination or severe reduction in stuttering due to a brain injury, e.g. a stroke, an accident, or victim of violence! Yes, victim of violence...

Per Alm reports on a conversation with an older Swedish man who is forever grateful to "his" burglar that attacked him in his own house!! Apparently, he surprised the burglar at his home, got hit on the head, and spent several days in hospital. And afterwards, he was much more fluent, and had been ever since. So you can imagine how grateful the man was to his burglar!

If there are any burglars reading this blog, my address is 9, rue Donven, 4084 Esch-Alzette, Luxembourg. Feel free to pass by, and hit me on the head. We have a dog, but she shouldn't be of any concern to you. She is 10 years old, and cant walk well anymore. And she is highly corruptible by food.... ;-)

But seriously, I am amazed by such effects, especially about the ability of PDS sufferers to quickly go into fluency mode be it with chorus reading, or after a stroke. Of course, such case studies as the one reported by Per need to be taken with a pinch of salt. Was the man's speech really affected? Or was it just his memory of his fluency before the incident? A check with relatives of the men would certainly build up a stronger case. However, I have seen several of such reports, where older men had strokes and become much more fluent permanently. So there is probably something to this effect.

Not too high & Not too low

I am currently reading more about the brain, neurotransmitters, and all that stuff. I want to understand which effect drugs (like alcohol, Ectasy, Marijuana, etc), and clinical drugs have on the severity of stuttering. It seems to be clear that they can have a significant effect. Unfortunately, I cannot really comment from my own experiences, because I have never taken drugs (not even alcohol)!! (Of course, even if I had in the past, I wouldnt have told you so! :-)

The same drug can have the opposite effect in different people: for some it makes it worse, for others it makes it better. And some conclude that there must be two subtypes of stuttering. But I am wondering whether it is not possible that fluent speech is dependent on having the right level of certain neurotransmitters in certain brain regions, so not too much and not too little. So stuttering might result in an imbalance, but for some too low for other too high. And this might explain why a drug can make it better for some (i.e. might make a too-low level higher to the right level) or worse (i.e. might make a too-high level even higher).

Monday, July 25, 2005

Nijmengen conference

Next summer (July 7th-10th 2006), there is a conference in Nijmengen on speech motor control. The conference is not directly focused on PDS, but on ordered and disordered speech motor control. Thus PDS traditionally is a part of the discussion, but I think over the last years there has been a realization that disordered speech motor control is more of a symptom that the cause itself. Thus, people with PDS can have normal speech motor control at times, but often it breaks down. They will also talk about brain imaging and genetics.

Thus, this should be an interesting conference for the hard-core scientists. I will see... Maybe I might attend myself, if the conference fees are low or they waiver them for an hobby researcher... lets see...

Friday, July 22, 2005

Messy world of facts

Here are a few thoughts on how new knowledge is built, which is highly relevant for PDS research. Also check out my past post on myth creation, too.

Understanding PDS is really about knowing a set of facts. But what is a fact? A fact is a statement that is true. This definition is correct, but not very useful in practise. A more realistic statement would be that a fact is a statement that all (or the vast majority of) experts agree to be true. This is how it works, but is not 100% correct, as a person not considered an expert by the experts or the general public could come up with a new fact that experts disagree with, or disagree with a fact accepted to be true by the experts. The non-expert has to either convince the experts that s/he is right or the general public that the so-called experts are not experts and that s/he is an expert. This is ultimately a social process i.e. manipulating people to share one's own view. This can be done by valid arguments or by arguments that might not be valid but that are convincing. Invalid arguments can be used on purpose or believing that they are true.

Take myself, for example. Am I an expert? I am neither a researcher in PDS, nor a qualified therapist. So if a professor working on PDS comes along and says: "This is a fact and Tom is wrong. What does a PhD in physics know about PDS?". Who would you believe? The answer is that the strength of an argument should never be judged by considering the person making the argument, but by the argument itself. But it is hard to avoid this logical fallacy. For example, Freud said stuttering is due to a childhood conflict and I am saying Freud is wrong and has no clue about PDS. Who would the general public or you believe? But of course, the more expert someone is, the more likely his statement is the correct one, but it is not a seal of truth.

On the other hand, there are many people who claim to have solved the riddles of PDS and proclaim quick cures. They often say that they are getting silenced by the establishment. But of course, their theories are just wrong and riddled with logical fallacies like confusing correlation with causation (I started stuttering when my brother was born, therefore he is the cause of my stuttering. How about the millions of other people who didnt start stuttering when their brother/sister was born?), generalisation based on a small or biased sample (I stutter more when I talk to my dog and therefore all people with PDS stutter less with their dog. What is true for you, might not be true for everyone), accepting arguments based on authority (van Ripper said that, Prof XXX said that - I do not care who said it only what s/he said and which argument support their claim). Having said this, some professors certainly have their agenda and strong beliefs in their theories, so if you are a PhD student or post-doctoral researcher and disagree or work on another theory, you might not be able to find funding for more research... This is especially true if you tell the professor that the research area/theory s/he has worked on for 20 years is not relevant or wrong...

Therefore, the best way is empirical evidence to judge whether a pro-claimed fact is indeed true. But there is a big problem for PDS. It is not like physics, where you do a clear-cut experiment and you get a clear answer. Or like in engineering. If you are a bad engineer, the bridge falls down. There are no bridges in PDS research. It is science on the human being and far far more messy and complex. OK, there is one bridge: severity of dysfluency. If someone comes along that says PDS is this and I can cure it like this and it works, well s/he won. But no-one has really found this holy grail, and it might not actually exist. Short term fluency is easily achieved but long-term fluency consistently for all people is hard to achieve. So the reality is very messy. An important issue is also that the research findings should be replicated by other research groups. Facts are often formed by three driving forces "herd behaviour", "abilitity to project authority" and "strength of arguments and evidence". The ability for progress is the hope that strength of argument and evidence wins in the long term.

Monday, July 18, 2005

IFA Congress 2006

The next big research conference on PDS is the IFA congress in Dublin in July 2006. The last one was in Montreal. The deadline is 30th of September, so in a bit more than 2 months... keep this in mind.

I am a bit disappointed about its focus: "Submissions for presentations related to all aspects of fluency disorders are welcome. Submissions regarding Qualitative Issues in Stuttering Research and Practice, the Efficacy and the Effectiveness of Intervention to include Evidence Based Practice and Practice Based Evidence, and Multi-cultural and Multi-lingual issues will be of particular interest."

No mention of genetics, brain, or drug research, even though I believe that these research areas have contributed considerably more towards a better understanding of PDS in recent years. But I guess this is also a function of who is on the scientific program committee. Another interesting topic by itself. Who decides who the experts are? And when does a fact become a fact?

Saturday, July 16, 2005

Welcome Central and South America!

I am able to track the visitors to my blog. I know how many people visit the site, which IP address they have, from which country they are and how they got to my blog e.g. by referal from a link, from a favourite in their Netbrowser, or from a link included in an email.

Over the last days, I noticed that many Spanish speaking people are visiting my blog. Most came to the site via a link in an email!!! So someone must be sending an email around telling people about my blog! The addresses are from Mexico, Argentina, but also .es which might be Spain but could also be Spanish speaking somewhere else.

So WELCOME CENTRAL and SOUTH AMERICA! Qué t-ttt-tal? ;-)

Thursday, July 14, 2005

What do the genes do?

In my last post, I asked the question: "What do the genes (linked to PDS) do to predispose the brain to stuttering?"

I think this is a very important question. Finding the chromosome location or genes as such is interesting, but not directly relevant to the mechanism of PDS and not the end of the story. What is more important is to see which functions these genes or combinations of genes have. In this way, we might know more what sets the PDS brain apart.

The evidence really conclusively points towards the fact that PDS has a genetic component (at least in some people with PDS), and that these people will be far more likely to start stuttering if they have certain genes. This suggests that there is something physically wrong in the PDS brain, as genes are physical objects and they create proteins. And this defficiency often leads to PDS. But then, I would conclude that if a defficiency leads to PDS, it does not necessarily need to arise from bad genes, but could also be a developmental problem. In the sense, if you build a house, the construction plan could be wrong (the genes), or something during the construction phase went wrong (low skilled workers, too much rain, minor earthquake, illness by key worker, etc.). This would be a general principle for many diseases: if genetics predisposes to a disorder, this disorder can happen non-genetically as well.This leads me to the conclusion that if genes can predispose to PDS, there is very likely also the possibility that a developmental problem could create the same.

So, I am now more or less convinced that there are indeed subtypes. The one with genetic baggage and the one who had a problem during development. And of course, a combination might be true. This would fit with Per Alm's observation that either the people with PDS have a family history or they had developmental problems like ADHD.

Wednesday, July 13, 2005

Blame Chromosome 12!

Another interesting development in PDS research... and as always the latest news is here on TheStutteringBrain blog! :-)

Here is a new genetics article: Genomewide Significant Linkage to Stuttering on Chromosome by Riaz, Steinberg, Ahmad, Pluzhnikov, Riazuddin, Cox, and Drayna. I have been in contact with Dennis Drayna on several occasions.

He wrote in an recent email: "It was recently published in the American Journal of Human Genetics, and I encourage you to share it with anyone who's interested. This journal ranks in the top 2% in impact factor among all biomedical research journals, and thus only the strongest and most interesting findings are able to get published in this venue. We are delighted that stuttering is now getting this level of attention and respect in the biomedical research literature. An interesting aspect of this research is the use of highly inbred Pakistani families, which provided additional power to detect genetic effects. The region we have located on chromosome 12 that contains the causative gene is different than that identified in any previous studies. This supports our long standing hypothesis that the genetic causes of stuttering share some characteristics with the genetic causes of deafness, in the sense that many different genes located on many different chromosomes are likely to be involved."

I always knew that there was something wrong with my chromosome 12! :-) The article really re-affirms my belief that there is no single stuttering gene. There are likely different genes/combinations of genes that predispose to stuttering. So really the genetics is going to be very messy. But what I am really interested in is to link the genes to specific proteins/functions in the brain!

What do these genes do to the brain to predispose it to stuttering?

Monday, July 11, 2005

Largest pharmaceutical study ever

Prof. Gerald Maguire pointed me towards Indevus' website. According to him, the company "is currently engaged in the largest pharmaceutical study ever on" PDS.

Here is the extract from the website:
"Pagoclone is a novel member of the cyclopyrrolone class of compounds and acts as a gamma amino butyric acid (GABA) receptor modulator. The Company believes that pagoclone increases the action of GABA, thus reducing excess neuronal activity and alleviating symptoms of anxiety.

We are currently evaluating the clinical and regulatory pathway to study pagoclone in stuttering, as well as the commercial opportunity in the U.S and in Europe. In the course of previous clinical trials for generalized anxiety disorder and panic disorder with pagoclone, we observed three patients who entered these trials with a secondary diagnosis of stuttering. These patients were noted to have a dramatic reduction in stuttering while receiving pagoclone. On discontinuation of study drug, stuttering returned to positive levels. These patients represented a small sample of the study and additional testing is necessary to determine whether pagoclone would be effective among a larger group of patients who stutter. A new method of use patent was recently granted to the Company in the U.S. covering the use of pagoclone as a therapeutic agent for stuttering.

We are contemplating initiating a Phase II study in stuttering during 2005 pending future evaluation of clinical, regulatory and commercial factors. Given the substantial preclinical, clinical, regulatory and manufacturing database that has been generated by us, our licensor, Aventis, and our former partners, Warner-Lambert and Pfizer, we believe pagoclone is a highly leveraged commercial opportunity. Should it be demonstrated to be safe and effective in stuttering, we believe we could form a specialty sales force that could successfully introduce the product to pediatric and adult neurologists in the U.S. We expect to seek a partner to commercialize the product outside the U.S.

Stuttering is defined as a break in the flow of speech which is disrupted by repetitions, prolongations or abnormal stoppages of sounds and syllables. It can be accompanied by unusual facial and body movements. Three million Americans suffer with stuttering, the cause of which is unknown. Currently, there is no approved pharmacotherapy for stuttering. The only approved treatment is speech therapy, encompassing physical, psychological and nutritional components." (Source Indevus, taken from their website on July 11th, 2005)

New design

I have re-designed the blog. I think it is more functional and prettier now. If you dont like it, pls send me a comment!

And happy birthday to George!

Sunday, July 10, 2005

Did Neanderthals stutter?

I am currently reading about the Neanderthal people in a book on human evolution. They are a human species that died out some 20'000 years ago, and co-existed with Modern Humans. I am wondering whether they stuttered, too! :-) I am sure some of them did, too. As my old physics professor used to say: "What can happen, will happen!". If they have speech and it can break down, it will break down in some people. What I am really interested in is whether there were a higher proportion of people who stuttered? Maybe they died out, because they were all stutterers. Stuttering is not helpful while hunting. Just imagine, a Neanderthal warning others:" Thhhheerrrrreee is a bbbbbbbbear". Well then it's definitely too late!

But seriously, maybe Modern Humans in the past or other human species were stuttering more. And then they got selected out by nature. So what I mean is the following. If you have two kinds of humans with different genes, the one stutters and the other doesnt. Then the group who doesnt stutter might have more off-spring for various reasons social exclusion, greater difficulties in influencing others, etc. Even if the difference is just 0.1% per generation, after 1'000 generation the trait will be eliminated.

The question really is how did speech arise? Apes for example they make sounds but they dont speak. Sometime along human evolution, the brain must have evolved to integrate inner thinking into speech (sequence of sounds with grammatical rules). So the ability to speak must have some evolutionary advantage, and thus the inability is a disadvantage. This disadvantage is greater the more complex the society I would guess? So if we now only see 1% of the population stuttering, it might be that 100'000 years ago ist was 10% or 20%. If the selection is harsher in societies, we should expect to see a higher proportion of stuttering in Aborigenes or the people from isolated Indonesian islands. Is this true?? Does anyone have data on this?

This could lead to the conclusion that stuttering or PDS is not really a disorder as such, but the remainder of what the brain in speech areas in early human being were. I always knew that I had some deep deep animalistic roots... :-)

Saturday, July 09, 2005

Male stutterers but female therapists

Just a quick thought for today. Most people with PDS are male. But most speech and language therapists (SLTs) are female, at least in the UK. I think that in the US it is more balanced. Interestingly, the US/Canadian call themselves speech and language PATHOLOGISTS rather then the more "female" therapist.

I have always wondered whether this does not actually have a negative effect on the therapy outcome. I generally have the impression that female therapists are too soft with their male clients. (Though I know of quite though female therapists!! :-) I think men need more pushing and goal-oriented practise, and far less talking and listening. But I understand this might not apply for all men.

I am wondering how many men with PDS have actually married their/a therapist! I know of one!

Friday, July 08, 2005

Fluency shaping vs van Ripper

In a previous post, I have said that there are really two types of therapies out there that seems to be effective to some degree, at the very least on a short-term basis. Yesterday I was meeting up with Einar, who is from Island but was born in Luxembourg. He did a lot of therapy a la van Ripper. And we were discussing the pro and cons of therapies. He is rather more in favour of van Riper type therapies.

Let me just briefly summarise the two types of therapies. Pls correct me if I get it wrong. I first tried to use Wikipedia to cut and paste a definition, but its definition is so bad. It does not even mention fluency shaping, but only onetherapy del Ferro. This is mainly a breathing technique therapy based in Amsterdam. I wouldnt be surprised if someone close to them has modified the Wikipedia content to their advantage.

Fluency shaping is about working directly and mainly on your speech. The aim is to practise ways of speaking that enhance your fluency like gentle onset, slow speech, or connecting sillables. Van Riper-like therapies, also post-block modification therapies, (I hope I dont mix up things here) foccus on reducing the (overt and covert) symptoms of stuttered speech, but also reducing or easing stuttered speech. The aim is cognitive control over your (symptom) behaviour to change it, mostly post-stuttering event like avoiding eye contact, reducing fear of speaking, voluntary stuttering, stuttering easier. There are many variants of these two types and some even combine elements of both.

What is my view point? In a sense, they are concentrating on different aspects of PDS, and have "different philosphies". I guess, a van Ripperist would say: Avoiding eye contact has nothing to do with stuttering at all. It is a secondary symptom. So why dont you just keep on stuttering, but train yourself to normalise your natural eye contact. Fear and Tension is not directly related to stuttering. Why not stuttering without fear and shame rather than stuttering with fear and shame? So all these secondary symptoms are unnecessary and you really can unlearn them. And then I guess you could argue the same with stuttered speech. Why stutter hard with tension? Just try it without tension and easier. The result really is that ultimately many become very fluent as well. I guess as the secondary symptoms are considerably enhancing disfluencies, and most likely implicitly they might gain more control over their speech production processes. Fluency shaping really starts the other way round. It says, the problem is disfluent speech, which leads to all the secondary symptoms like eye avoidance, fear, shame, tension, etc. So by making people (more) fluent, you automatically eliminate all the secondary symptoms. It acts directly on speech production, the primary symptoms.

What is my experience? I personally did not benefit from van Ripper therapies much at least from a fluency point of view, but I do think that all the sessions did help me meeting other people and understanding that having PDS is just one part of your existence. Fluency shaping therapies had a much more dramatic effect on my fluency. But I know that other people experienced the opposite. There are no right or wrong in a person's experience.

I find it very difficult to change my behaviour when I am talking, i.e. take cognitive control. I remember that I did several months of post-block modification therapy (individual and group) at Indiana University (US). I even had problems identifying when I was stuttering! Then they gave me some fluency shaping therapy exercises, and within 1-2 weeks I was much more fluent. It didnt last very long. I remember being shocked at how fluent I was. It was May, and the end of my exchange year in the US, I had 5 months until the start of term in the UK. They even offered me to stay the five months and give me a job at the departement. But I declined, and went cruising through California with a friend of mine for 2-3 weeks and then back to Luxembourg. That was the most stupid decision I ever took in my life. I should have gone back after California to work on my speech. And they should have told me how stupid my decision was and done more lobbying! But they didnt. Too polite, too female. Actually, I probably would have changed my mind with more pressure. I guess the experience of being fluent and potentially more fluent was strange, uncomfortable and a bit scary tilted the balance in my decision making. I also did a fluency shaping therapy in Kassel, which produce more much long lasting effects.

To summarise, fluency shaping therapies make me much more fluent, van Ripper therapies were helpful on a psychological/social level but I could have gotten the same from well-informed self-help groups. What's funny, is that when I meet a fluency shaping person they say I think fluency shaping would help you, if I meet a van Ripper person they say I think van Ripper would help you. I think they are both right!! ;-) not being sarcastic here.

Pics from ODC 2005

Here are two pictures from the Oxford Disfluency Conference.

This is a picture of a few of us on our way to the nighclub MOOD in Oxford. We were in a good mood as we came back at around 4 o c'clock! From right to left: Katarina (SLT from Croatia, without husband and child!!), Mirjana (?) (SLT from Croatia), Oren (PhD student from Boston), Sarita (SLT from Montreal), Per (researcher from Sweden), MYSELF, George (SLT from Canterbury)




This picture shows Oren Civier, Hans-Georg Bosshardt, Katrin Neumann, and Harald Euler.

Thursday, July 07, 2005

Third and Final day of ODC

The first keynote talk of the day was given by Prof Mark Onslow: "Shock! Horror! Excitement! A 10yr retrospective on stuttering." I have heard a similar talk at the IFA congress in Montreal. I am sorry to say, but I still dont understand exactly what he wants to say. First, he only talks and rarely uses slides, except for a few pics on Star Treck! I need to see text in front of me. Second, he often speaks about more general aspects of theory building like saying that multi-factorial models are impossible to falsify. But I dont really understand what it means for PDS research, and really I should understand what he means as I have spent a lot of time thinking about more fundamental issues in theory building as a theorist... So I kind of dont know what to think about his ideas as it dont know exactly what they are. Unfortunately, I didnt have the opportunity to talk to him.

Three other talks stand out. Prof. Henry-Annie Bijleveld from Brussels's talk on basal ganglia. The basal ganglia is a brain structure that also controls timing and automatisms. She talked about how they could help to understand the intersection between psychological and physiological aspects of stammering. I also enjoyed the talk by Kate Watkins, a fellow at one of Oxford's colleges. Her talk was really the most professional one. She seems to be a very good and dilligent researcher, and her brain scan pictures looked really cool. We were having lunch together. She is new to PDS but that might actually be a good thing to be without baggage. I also enjoyed Katrin Neumann's talk. But there was much information to digest. She seems to be in disagreement with Watkins on some results like the anomalies. Kate said that she thought they were mostly consequences (for reasons I forgot), but Katrin probably thinks more about them as a cause and that they are permament and do not change after therapy. Per Alm's comment was: "This was a lot of information to take in. I will have a look at it at home!".

Overall, I really think that PDS research is moving forward. Per Alm's work, the brain research by Watkins and by Neuman, and Ingham's are good science. The signals they see are getting strong enough to constrain or rule out certain theories. I think we are now really starting to see real breakthroughs in theory building.

And you will hear about it here on the blog!!!! By the way, Per Alm agreed to be guest writer on my blog... So you will hear from him, too.

Tomorrow... GOSSIP on ODC... sex, drugs, and rock 'n roll :-)

Friday, July 01, 2005

Second day of ODC

Not too much happened today. There were only sessions in the morning. I missed the first keynote speech as I was still sleeping! :-)

I gave my talk on noon. It went OK, people's feedback was positive. I was talking about findings that I made while looking at the data of the Kassel Stuttering Therapy. I looked at different aspects of the patients' data. 1) I did not find any gender bias in the data 2) Most patients were young. I did say that I did not believe that older people would stutter less. But one or two people said that the older you are the less you stutter. But I have to look at the articles. In any case, the decrease in prevalence is relatively mild and does not explain the significant drop with age. 3) I looked at the correlation of measured stuttering, self-rated stuttering, and self-rated avoidance. avoidance and self-rated were strongly correlated, and self-rated severity and measured stuttering. 4) I found that the 1-year and the 3-year data were statistically not distinguishable on paired t-tests.

Prof Euler spoke about the actual outcome study. We only found that the severity of stuttering affects the outcome, all other variables seem not significant. He even derived an equation to predict the fluency after therapy. Interestingly he found some other variables apart from severity-before in the 3 year data. But this sample has only 50 people. So when he did if for patients with 2Y data and 1Y data. There was no effect! That just shows how slippery statistics can be. If you analyse for many factors, some factors BY CHANCE will be significant!! especially for smaller samples.

During the meal and at the pub I spoke to several people. Some of them had read my blog! :-) So I am not only writing for myself!!!!! I am trying to advertise this blog as much as possible, as you can imagine. I spoke with Per Alm whose PhD work I discussed here. I also spoke to many language therapists from all over the world. Tomorrow there will be more brain-based research talks. So I am curious to know what they have to say.

Just a last note. Unfortunately, I have to say that lots of research that was presented was a bit shaky in terms of methodology and graphical presentation...

First day of ODC

I am writing directly from the Oxford Dysfluency Conference - live coverage so to speak from St Catherine's College. I was nice to meet up again with old friends. This morning was mostly key note speeches and in the afternoon three parallel sessions. I have been speaking with many people.

First, Ruth Watkins spoke about language ability and whether it is related to stuttering/recovery or not. I am a bit suspicious about the research methodology. The language ability was computed from speech sample, so I am wondering whether it really reflect the true language abilities of the kids or whether it is distorted due to the (expected) disfluencies. For example, kids might on purpose use grammatically simpler sentences as it makes speaking easier, or kids might on purpose use grammatically more difficult sentences to avoid certain words? I believe that the language abilities should be deduced from non-speech related tests. In any case, they did not find any clear differences...

Second, Scott Yaruss gave a talk. He is a good public speaker, in fact he should have become a TV preacher!! :-) The talk's contents was OK, but very general and not very specific. So hardly a scientific talk...

Ehud Yairi talked about genetics of stuttering. It is quite exciting what they found. I was quite happy to hear some signal on chromosone 12, but then he said that there is also on chromosome 13, 2, and more.... And the genes have not been identified yet, so there might be different subtypes genetically speaking. He also admitted that he does not completely understand what the geneticists in the team did. I think he should have spent more time understanding it properly.

I also went to another genetics talk, which I found much clearer. I missed part of it, because I fell asleep!!

OK. I am off to bed.