Joining the conversation is Dr. Scott Yaruss, a leading expert in the field and Professor of Communicative Sciences and Disorders at Michigan State University, also the president of Stuttering Therapy Resources. Dr. Yaruss provides a comprehensive understanding of stuttering, differentiating between childhood and adult-onset forms, and highlights effective strategies for managing stuttering. Crucially, Dr. Yaruss underscores the vital need for societal understanding and acceptance, emphasizing that every voice, regardless of speech pattern, holds immense value.
Finding Clarity in Writing: John Hendrickson’s Path to Self-Expression
Dr. Correa opens the podcast episode by acknowledging the everyday anxieties many face in public speaking or even phone conversations. He sets the stage by highlighting the added layer of complexity for individuals with speech impediments like stuttering. He emphasizes the need for society to embrace diverse speech patterns, moving away from the unrealistic expectation of “perfect diction.” This sets a powerful context for the episode, advocating for inclusivity and understanding from the outset.
John Hendrickson, a senior editor at The Atlantic, discovered his unique voice through the written word. He recounts to Dr. Correa how writing became his sanctuary, a space where he could achieve the clarity and control that often eluded him in spoken language. “Reading and writing were always my favorite parts of school growing up,” Hendrickson explains. “Writing in particular has always been a venue in which I have been able to glimpse the clarity and control that alludes me out loud. It’s a place in which I feel like I can close that distance between how things sound in my head and how they actually come out.” For Hendrickson, writing bridges the gap between his internal thoughts and external expression, offering a sense of mastery over communication that stuttering sometimes obscures in speech.
Dr. Correa draws a parallel to dyslexia, another language-based condition, to clarify the distinct nature of stuttering as a fluency disorder. Hendrickson confirms he has no reading difficulties, debunking common misconceptions that often misdiagnose or misattribute stuttering to other learning disabilities. He points out the danger of these assumptions, stating, “kids who stutter are often thought to be kids who can’t read or have any other number of disorders or that it’s purely an anxiety issue or Tourette’s.” He stresses that while co-occurring conditions are possible, it’s inaccurate to assume a causal link or generalize about individuals who stutter.
Hendrickson’s career took a pivotal turn in 2019 when he wrote an article for The Atlantic about Joe Biden’s experience with stuttering. This marked his first public foray into discussing stuttering, despite having lived with it his entire life. He reveals that while aware of Biden’s stutter, he noticed it was often framed as a childhood issue overcome, even though subtle signs persisted. Hendrickson’s article aimed to explore the reasons behind this reluctance to openly discuss stuttering and the societal weight it carries. “When I asked him about it, he did frame it as a childhood problem,” Hendrickson recalls. “And in my article, I tried to unpack why, why is this such a hard thing to talk about, why does it carry that weight for so much of our lives.”
Writing the article proved to be a transformative experience for Hendrickson. He admits to not having deeply explored his own stuttering prior to this point. The research and reporting process led him to understand stuttering as a neurological disorder, and crucially, as a condition recognized as a disability under the Americans with Disabilities Act (ADA). This newfound understanding profoundly reshaped his self-perception and identity. “Only in the process of reporting and researching that I first learn that it was a neurological disorder and that it could be considered a disability and could be protected under the ADA,” he explains. “Learning all that began to reorient my sense of self.”
Antiquated Therapies and the Pursuit of “Fluency”: A Shift in Approach
Reflecting on his early experiences with speech therapy, Hendrickson describes what he now recognizes as an outdated approach focused solely on achieving “perfectly smooth speech.” He recounts practicing techniques like slow, deliberate reading, which, while producing fluency in therapy sessions, proved impractical and unnatural in real-world situations. “And you can manufacture fluency in those environments if you say, ‘My name is John. I am five years old,’ but nobody wants to talk like that in real-world situations,” Hendrickson points out.
He critiques the limitations of these techniques, emphasizing their failure to translate to everyday communication. The artificial, monotone speech produced by these methods could be “just as embarrassing as a person who stutters,” he notes. Hendrickson contrasts this with modern therapeutic approaches that prioritize clear communication, confidence, eye contact, and reducing avoidance behaviors, while fostering acceptance of stuttering itself.
Hendrickson shares insights from Dr. Yaruss, who describes the damaging cycle of “chasing the fluency god.” This refers to intensive, often expensive programs promising fluency, only for individuals to relapse and potentially feel worse than before. Dr. Yaruss advocates for a shift in focus towards embracing communication and reducing the fear of stuttering, urging individuals to “get out there and talk” and not shy away from everyday interactions.
A turning point in Hendrickson’s journey came in high school when he found a therapist who introduced him to desensitization techniques. He illustrates this with a poignant anecdote about avoiding ordering a red Gatorade at school due to difficulty with the “R” sound, resorting to pointing instead. His therapist challenged him to confront this avoidance, pushing him to use his words. “Okay, so you’re going to go back tomorrow, but you’re not going to point. You have to only use your words,” his therapist instructed.
These “desensitization challenges” extended to other avoidance behaviors, like ordering “cheeseburgers medium” instead of “medium rare” to circumvent the “R” sound. Hendrickson emphasizes how these seemingly small adjustments, when accumulated, can significantly narrow one’s life experiences. He connects these adjustments to larger life choices, such as career paths avoided due to communication demands. He concludes that therapeutic techniques focused on desensitization and pushing comfort zones have been the most effective in his personal journey.
The Look: Navigating Societal Misunderstanding
Hendrickson vividly describes “The Look,” a complex expression of confusion, revulsion, discomfort, and fear he and other people who stutter frequently encounter when they begin to stutter in conversation. He acknowledges the pervasiveness of this reaction, stating, “any person who stutters has received The Look thousands of times, and in some cases, they may get it every day, they may get it multiple times a day.” While not blaming individuals for this reaction due to widespread misunderstanding of stuttering, he hopes that increased awareness, through platforms like the Brain & Life podcast, can foster greater understanding and empathy.
Hendrickson stresses that the most helpful response to someone stuttering is “neutrality and patience.” He clarifies what not to do: “You don’t have to baby a person who stutters. You don’t have to pat them on the head. You don’t have to interrupt them. You don’t have to finish their sentences. You don’t have to clench your fist, and just wait for it to be over, just be neutral.” This simple yet powerful message encourages listeners to react with calm acceptance, allowing individuals who stutter the time and space to express themselves.
Professional and Personal Challenges: The Broader Impact of Stuttering
Hendrickson discusses the pervasive discrimination faced by people who stutter in professional settings, sharing accounts of individuals explicitly denied jobs because of their speech. He recounts his own experience being turned down for a coffee shop job due to the manager’s concern about customer comfort. “I was told as much in as many words when I applied for a job at a coffee shop when I was in college and the manager told me, ‘Sorry, I can’t hire you because I need this cafe to be a place where customers feel comfortable,'” Hendrickson remembers. He emphasizes that this discriminatory pattern persists across various employment levels.
Beyond professional obstacles, Hendrickson highlights the impact of stuttering on romantic relationships and the increased risk of substance abuse as a maladaptive coping mechanism. He acknowledges the potential for these challenges to be depressing but underscores the importance of open conversation to combat isolation and foster a sense of community among people who stutter.
Expert Insights from Dr. Scott Yaruss: Understanding and Managing Stuttering
Dr. Correa then welcomes Dr. Scott Yaruss, a seasoned speech and language specialist, to provide expert insights into stuttering. Dr. Yaruss clarifies the terminology, noting that “stuttering” is the commonly used term, while “childhood-onset fluency disorder” is the technical diagnostic term. He addresses the historical hesitancy around using the word “stuttering” due to its associated stigma, explaining the use of euphemisms like “fluency disorder” or “fluency issue.”
Dr. Yaruss differentiates stuttering from acute speech issues like expressive aphasia resulting from stroke or brain injury. He outlines the core characteristics of stuttering: repetitions, prolongations, and blocks. He describes repetitions as the repeated sounds or parts of words (e.g., “re-re-re-repeated”), prolongations as stretched-out sounds, and blocks as moments of silence with physical tension. “With a repetition, a sound or a part of a word is re- re- re- re- repeated more than once like that as the person is experiencing a moment where they’re stuck and trying to move forward,” Dr. Yaruss explains. He clarifies that these core symptoms are consistent across childhood and adult-onset stuttering but distinct from speech disorders caused by brain injuries.
Addressing parental concerns about sudden onset stuttering in children, Dr. Yaruss reassures listeners that neuroimaging is generally unnecessary unless other neurological symptoms are present. He emphasizes that isolated stuttering, characterized by repetitions, prolongations, and blocks, is typically childhood-onset fluency disorder and not indicative of underlying neurological damage requiring imaging. “If the only behavior that you’re seeing is disrupted speech, those repetitions, those prolongations and blocks, that is in all likelihood typical childhood-onset fluency disorder, typical stuttering, where neuroimaging is not going to add anything to our clinical understanding,” Dr. Yaruss states.
Dr. Yaruss elaborates on the neurological basis of stuttering, referencing neuroimaging research demonstrating subtle brain differences in people who stutter compared to those who don’t. These differences are not indicative of brain damage but rather variations in the neural pathways coordinating speech planning and production. He emphasizes that these neurological differences are also linked to genetic factors, reinforcing that stuttering is not a learned behavior or habit but a genuine neurological condition. “We know that the brains of children who stutter are indeed different in a number of important ways from the brains of children who don’t stutter,” Dr. Yaruss confirms. “It’s not just one location, like you might look for a lesion in aphasia. It’s multiple locations that are not damaged but different.”
Crucially, Dr. Yaruss dispels any notion of intellectual deficit in people who stutter, firmly stating, “There is no difference in intellectual ability between people who stutter and people who don’t stutter.” He explains that the core challenge in stuttering lies in the feeling of being “stuck” when attempting to produce specific sounds, despite knowing exactly what they want to say. He uses the analogy of a finger momentarily failing to press the correct key while typing to illustrate this momentary disruption in motor control during speech.
Management Strategies and Societal Acceptance: Reframing the Approach to Stuttering
Dr. Yaruss shifts the focus from “fixing” stuttering to managing it and fostering societal acceptance. He argues that stuttering reflects a natural variation in speech production abilities, similar to other diverse human skills. He emphasizes that the real “problem” arises not from stuttering itself but from societal judgment and the mismatch between societal expectations of fluent speech and the experiences of individuals who stutter. “It’s not so much in the fact that they stutter. The disruption in speech itself does not have to cause a problem for people. It often does because it’s uncomfortable for them,” Dr. Yaruss explains.
He advocates for helping individuals who stutter understand that their voice and message are valuable regardless of fluency. He stresses the importance of teaching society patience and understanding, creating a more inclusive communication environment. “Teaching society that just a little bit of extra time will make it easier for people to talk. That’s the most important aspect of the communication equation for people who stutter,” Dr. Yaruss asserts.
Dr. Yaruss acknowledges the availability of techniques to improve fluency but cautions that these often require significant effort and are not “quick fixes.” He emphasizes that these techniques are most effective when coupled with self-acceptance and the understanding that “it’s okay to stutter.” He reiterates that therapy should prioritize communication over perfect fluency.
Addressing the issue of bullying, Dr. Yaruss advises openness and transparency about stuttering rather than concealment. He cites research indicating that openly acknowledging differences diminishes the power of bullies. He encourages individuals who stutter to develop self-esteem and self-confidence in their communication, stating, “when they can say, ‘Yeah, I talk differently. That’s okay,’ they become impervious to those comments over time.”
Dr. Yaruss discusses the protection afforded by the Americans with Disabilities Act (ADA), emphasizing the right of people who stutter to reasonable accommodations, primarily additional time to communicate. He encourages self-advocacy in professional and other settings, empowering individuals to request the time they need. “People who stutter are entitled by ADA and just by human decency, in my opinion, to the time that they need to talk, and they need a little bit more time to talk,” Dr. Yaruss states. He acknowledges the burden of self-advocacy but underscores its importance in navigating societal structures.
Dr. Yaruss concludes by outlining his primary goals when first meeting a child or adult who stutters: to instill hope and to reframe their understanding of therapy goals. He emphasizes that “help is available” and that therapy can significantly improve communication, even if it doesn’t eliminate stuttering entirely. He aims to shift the focus from fluency to effective communication, creating a safe space where individuals feel accepted and understood. “At least when they come into that room with me, they can truly be themselves, themselves being people who stutter,” Dr. Yaruss explains. He reinforces that the ultimate purpose of communication is to convey thoughts and ideas, and that people who stutter are fully capable of doing so, and that communication can be enjoyable even with stuttering.
A Call for Empathy and Understanding
Through the personal narrative of John Hendrickson and the expert insights of Dr. Scott Yaruss, this Brain & Life podcast episode offers a profound exploration of stuttering. It moves beyond simplistic notions of a speech impediment to reveal a complex neurological condition with significant personal and societal implications. The episode champions acceptance, understanding, and empathy, urging listeners to reconsider their perceptions of speech and communication. It underscores the importance of creating a world where every voice, including those of “Stutter John” and countless others who stutter, is heard, valued, and respected.
Additional Resources
For further information and support regarding stuttering, please refer to the following resources:
- Stuttering Therapy Resources: https://www.strtherapy.com/
- The American Academy of Neurology: https://www.aan.com/
- Brain & Life Magazine: https://www.brainandlife.org/
Connect with the Brain & Life Podcast Team:
- Email: [email protected]
- Voicemail: 612-928-6206
- Social Media: @neurodrcorrea and @brainandlifemag
Episode Transcript: See Episode Transcript
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