I am currently working on a paper for ODC 2005, and it's about analysing patient and outcome data of a fluency shaping therapy, the Kassel Stuttering Therapy (KST)
Historically, there has been no constructive approach to developing better therapies. No-one is really to blame, as no-one really knows what causes people to stutter. The constructive way is: 1) understand PDS completely 2) devise new treatment or improve therapies based on 1)
But unfortunatly, we are stuck at 1). But hopefully new understanding of PDS will help.
Over the centuries, everyone had his own theory, and there were many innovative therapies: cutting a part of the tongue out, putting pebbles in your mouth, wearing a special braces, solving childhood traumas, swinging your right hand, and probably the most radical and effective one: not speaking for 3 weeks!!
Why did they never do these things for a broken bone?? Well, because everyone understands what has happened, a fatal blow to human creativity.
The therapy approaches we have now have mostly emerged from trial and error. Two stand out: fluency shaping and post-block modification. Fluency shaping is about modifying your speech like gentle onset or slower. Post-block modification is about learning to deal with blocks when they occur, using techniques like mental focus, repeating a stuttered word until fluent and relaxed, and dissensitisation. There is of course more to it, but just so you get the idea.
I could go on for hours... Isnt therapy not more about unlearning bad habits? How about dealing with the social and psychological effects? Why do so many relapse? What is the best outcome measure? How about drugs? Gene therapy? Why are you not fluent Tom? Were all the speakers who claim to have been cured only very mildly stuttering????
I'll come back to these issues at a later time. I have a deadline for the paper for beginning of June, so I better talk about these issues...