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Stuttering and What You Can Do About It

Wendell Johnson

Copyright © 1961 by the University of Minnesota Press (See copyright notice below)

Note: This excerpt from Stuttering and What You Can Do About It is a personal story, and a mystery story. The book was published by the University of Minnesota Press in 1961, and subsequently in a paperback edition by Doubleday. Although out of print, should you wish to read more the book should still be available either in your local library or by inter-library loan. The book draws upon, and to some extent summarizes, two prior, full-lengh reports of research at Iowa: The Onset of Stuttering: Research Findings and Implications and Stuttering in Children and Adults: Thirty Years of Research at the University of Iowa. But that is not the primary reason why these excerpts are included here -- though there are undoubtedly some scholars who would be interested in the three volumes for that reason. Although not presented as such, the first chapter contains Dad's look back on the youth of the stutterer who thirty years earlier dealt with this autobiographical material in the book Because I Stutter. It then goes on to outline the beginnings of the scientific effort to resove the mystery of stuttering at a time when there were no clues to be found. (And, as you'll see, I have also included some dust jacket blurbs, the full table of contents, and the acknowledgements.) - Nicholas Johnson


Dust Jacket

[cover]

STUTTERING

and WHAT

YOU CAN

DO ABOUT IT

BY WENDELL JOHNSON

[front flap]

$3.95

STUTTERING

AND WHAT YOU CAN DO ABOUT IT

by WENDELL JOHNSON

This is a book for parents who are

worried about their children's stut-

tering, for teachers, doctors, friends,

and relatives of those who stutter,

and for stutterers themselves. It of-

fers help, encouragement, and guid

ance in dealing with the problem of

stuttering, which troubles more than

a million persons in the United States

alone.

thority on the subject, writes in

simple language so that anyone

can readily understand and follow

his suggestions. What he says in

this book is based on many years of

laboratory research and clinical ob-

servation, and his own experience

as a stutterer. He tells of his early

years of struggle with the handicap

and his decision to devote his life to

getting at the basic causes of stut-

tering and finding ways to prevent

or alleviate it. He describes his re

see back flap


[back flap]

search experiences, likening them

to a detective story centered on a

search for the causes of stuttering

as the culprit in the case. In this ac-

count he quotes from interviews

which he conducted with parents in

an effort to pinpoint the exact con-

ditions or situations in which stut-

tering was believed to have started.

He explains how the problem de-

velops and how it becomes a frus-

trating "sad-go-round." Finally, he

tells what parents and others can

do for children who are threatened

with the handicap of stuttering and

what adult stutterers can do to help

themselves.

of speech pathology and psychology

in the world-renowned center of

speech pathology at the University

of Iowa. He has written other books

on stuttering, two of which are de-

scribed on the back of the jacket.

He is the consultant in speech path-

ology to the Walter Reed Army

Medical Center and to the national

office of the Veterans Administra-

tion and a member of the National

Advisory Council of the U.S. Office

of Vocational Rehabilitation.

UNIVERSITY OF MINNESOTA

PRESS, Minneapolis


Dedication

TO ALL THE OLDSTERS AND YOUNGSTERS
AND THEIR PARENTS
WITH, ABOUT, AND FOR WHOM THIS BOOK HAS BEEN WRITTEN

With Appreciation and Best Wishes

This book is for parents who are afraid their children are going to grow up to be stutterers, for speakers who have grown up to he stutterers, and for all who see in stuttering one of the most interesting and distinctively human of the quandaries of man.

It is a hopeful book. It is based on scientific research findings. It is designed to be helpful.

Much of this book deals with the relation of parents to the problem of stuttering. In introducing the pages that lie ahead, I want to say a few friendly words of reassurance to you who are parents. We are often told that the trouble with children is parents. I, for one, think this view is neither fair nor scientifically sound. There are many factors besides parents that affect the lives of the young in our society. There are doctors, teachers, preachers, and publishers; television, radio, and neighborhood gossip; the corner drugstore, the skating rink, the recreation center, and the city playground; to say nothing of climate, cold germs, cost of living, food fads, and books on child psychology -- and speech pathology

When all has been said and pondered, it is only fair to consider that parents have had parents too. And their parents had parents. The particular generation of mothers and fathers who are now striving to cope with the hazards and the distracting joys of bringing up their own children are not to be blamed for all the folly that has come down through the ages, any more than they are to be credited with all the wisdom abroad in the world today.

When parents are made to feel guilty and uneasy by being blamed for the mistakes and miseries of their children, matters tend to be made worse instead of better. The distress which they and their

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STUTTERING AND WHAT YOU CAN DO ABOUT IT

children share is complicated and deepened. The plain truth is that very often it is the blaming itself that is to blame when things go wrong or worsen.

It is something else again to face up to facts. This has nothing to do with blaming anybody. It is helpful, of course, to parents as well as to their youngsters, and to those who serve their special needs, to have clear descriptions of the difficulties children and parents do have with each other. It is worthwhile, therefore, to observe with care and report in detail the problems that arise in the interactions between parents and children, and to explain them in ways that suggest practical solutions.

It is in such a spirit that this book has been written for you who are parents and for its other readers as well.

You have every right to be hopeful if stuttering is your problem -- or your child's problem. Methods of dealing with stuttering, and of preventing it, have been greatly improved in recent years. With continuing research, and proper education of young parents and of the general public, we may all but eliminate the problem in the years ahead.

In the meantime, there is much information that can be helpful to you. You stand to gain particularly from knowing about the way the problem arises in specific cases -- in cases more or less like your own. The better you understand the way the problem begins -- its causes, that is -- the more you can do to prevent it in the first place, or to keep it from developing further once it has arisen, or to deal with it effectively if it is already well developed. What is known about the problem called stuttering can be put in few words or many, and both the many and the few -- detailed accounts and brief summaries -- are to be found in this book. In general, the book is made up of statements of information, of explanation, and of practical application. Since it has been written especially for the parents and the youthful and adult stutterers who have practical reasons for reading it, it is designed to contain enough factual information to make the explanations and recommendations -- and summaries -- meaningful and useful.

Readers who desire additional information are referred to the

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WITH APPRECIATION AND BEST WISHES

following books, upon which this one is largely based: Stuttering in Children and Adults: Thirty Years of Research at the University of Iowa, edited by Wendell Johnson with the assistance of Ralph Leutenegger (Minneapolis: University of Minnesota Press, 1955; 472 pp.); The Onset of Stuttering: Research Findings and Implications, by Wendell Johnson and Associates (Minneapolis: University of Minnesota Press, 1959; 519 pp.). "Toward Understanding Stuttering," which I prepared in 1959 for the National Society for Crippled Children and Adults, 2023 West Ogden Avenue, Chicago 10, Illinois, is a companion pamphlet, for parents, based on The Onset of Stuttering. "An Open Letter to the Mother of a Stuttering Child," a small pamphlet also based on the Iowa stuttering research findings, is published by the Interstate Printers and Publishers, Danville, Illinois.

Parts of this book are based on other technical publications, most important of which are relevant research and clinical reports in the Journal of Speech and Hearing Disorders and the Journal of Speech and Hearing Research, published quarterly by the American Speech and Hearing Association, 1001 Connecticut Avenue N.W., Washington 6, D.C. Of particular interest in relation to certain passages in Chapter 10 is The Problem of Stuttering in Certain North American Indian Societies, by Joseph Stewart, Monograph Supplement 6, Journal of Speech and Hearing Disorders, 1960. A considerable body of pertinent research data is to be found in Studies of Speech Fluency and Disfluency in Stutterers and Nonstutterers, by Wendell Johnson and Associates, Monograph Supplement 7, Journal of Speech and Hearing Disorders, 1961.

I should like to explain that the lovable and noble physician who played the role of Dr. Gregory in "Toward Understanding Stuttering" returns in Chapter 1 of this book bearing his real name, Dr. Hedinger. Dr. Hedinger's town in Kansas, which was named Crayton in the earlier publication, is here referred to by its official name of Canton. The town of Roxbury is identified by its real name in both accounts.

The parents who participated in the clinical studies underlying this book are deserving of the thanks of all those who may find value

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STUTTERING AND WHAT YOU CAN DO ABOUT IT

in its pages. The stutterers who have helped in the laboratory and clinic to deepen our understanding of the problem they share have also earned our gratitude. I am personally mindful of the assistance and companionship in my own research and clinical activities of a large company of friends and associates, many of whom I have mentioned in introductions to previously published books and research reports. Individual acknowledgments here beyond the few which follow are hardly feasible, but to all who know that I mean them, my warmest thanks.

I was persuaded to undertake this book by Mr. A. A. Heckman, executive director of the Louis W. and Maud Hill Family Foundation, and I was generously encouraged and ably counseled in the planning of it by Mr. John Ervin, Jr., director, and Miss Jeanne Sinnen, senior editor, of the University of Minnesota Press. The technical counsel of Miss Janet Salisbury of the publishing staff was also of great value. The services of Mr. Charles Burns, literary and publishing consultant, have been extremely helpful and I am very grateful for them. I should like to record, too, that Chapters 10 and 11 reflect the evaluative readings made of them in manuscript form by Professor Dean Williams and W. Hugh Missildine, M.D. My warm thanks reflect my conviction that this book is much the better for the influence of these friends and counselors, but my thanks by no means imply that they are to be held accountable for any of the book's shortcomings, for which I am alone responsible.

A major proportion of the research that has made the book possible was completed under a series of grants from the Louis W. and Maud Hill Family Foundation. The research program is being carried forward under additional grants from the Foundation and also from the Federal Office of Vocational Rehabilitation. Supplementary funds have been granted by the Easter Seal Foundation of the National Society for Crippled Children and Adults. Basic institutional support for the total laboratory and clinical program has long been provided by the University of Iowa. It is scarcely possible to express adequately the deep sense of appreciation with which I acknowledge the support that my associates and I have been given in carrying on our studies of stuttering.

viii


WITH APPRECIATION AND BEST WISHES

Mrs. Shirley Dunn and Miss Margaret Seemuth typed the several drafts of the manuscript, and Miss Ruth Farstrup assisted in reading proof and making the index. I am appreciative of their patience and competence.

My most perceptive and resilient literary critic is my wife, whose readings and re-readings of the book in manuscript form resulted, fortunately for its readers, in many of the major and the finely detailed revisions involved in its several redraftings.

For more than half a century the presidents and other administrative officers of the University of Iowa, representing the citizens of the state, have encouraged scientific and humanitarian work in the interests of children and adults with problems of speech and hearing. On behalf of all who share my sense of gratitude for this benevolent tradition and for the continuing enlightened interest and support of President Virgil M. Hancher and his administrative associates, I am deeply pleased to express warm appreciation.

WENDELL JOHNSON

Iowa City, Iowa

March 8, 1960

ix


Table of Contents

1 IN SEARCH OF BEGINNINGS AND ENDINGS 3

2 ALICE AND HER MOTHER 16

3 FORTY-SIX UNEXPECTED ANSWERS 38

4 LEARNING TO DOUBT AND FEAR 55

5 THE CHILDREN 69

6 THE PARENTS 86

7 HOW THE PROBLEM BEGINS 104

8 HOW THE PROBLEM DEVELOPS 115

9 THE SAD-GO-ROUND 132

10 HOW YOU CAN HELP YOUR CHILD 141

11 HOW YOU CAN HELP YOURSELF 169

INDEX 203


CHAPTER 1

In Search of Beginnings and Endings

My reasons for wanting to understand the problem called stuttering were, and are, reasons like yours, if stuttering is your own or your child's problem. It was not that I intended, when I started, to go deeply into the subject. On the contrary, I only wanted to "have my stuttering cured."

It all started when I was quite small, but even so I didn't always have the problem. I remember going when I was five with my sister to her school in Roxbury two miles from our farm in Kansas. It was a large frame building painted white and to me the door was enormous. I walked through it and seemed immediately to be standing beside the teacher's desk and I had almost to reach up a little to place my hand on top of it. The teacher seemed large to me and her face was round, and I liked looking at it. I started to speak a piece while I was still looking at the teacher with my back to the children. I heard them laughing, and the teacher told me to turn around and speak my piece to them. They seemed to fill the room as I looked at them and said:

They all sat still and listened, and though I can't remember what they did after that, my memory of the day is pleasant. My family, I've been told, and maybe others too, thought I spoke well, and so I was taken to school to speak a piece -- and apparently acquitted myself satisfactorily.

The next thing I remember about speaking was when I was six,

3


STUTTERING AND WHAT YOU CAN DO ABOUT IT

and I had started going to school. I went to school in the same big white building where I had spoken my piece about the elephant the year before, and to the same nice teacher who had said I should look at the children while I spoke. After I had been going to school for a month or two she came to our home one evening, or maybe it was a Sunday afternoon, and talked to my mother and father.

She told them she had thought some of moving me ahead to the second grade soon after I started school but, she said, I was beginning to stutter, and so she had decided to keep me in the first grade. I don't know whether she said they should do something about my speech or not. Although they had never thought there was anything the matter with my speech until the teacher talked to them about it, they must have taken her word for it that something was the matter, and I have no evidence they ever asked her what she meant by "stuttering." I don't suppose she ever wondered much herself about what she meant.



I remember vividly the astonishment with which I suddenly realized, one day about twenty-five years ago, that apparently for a month or so the teacher had been the only person who had thought I was stuttering. I had been talking during that month, and before of course, to my parents and my brothers and sisters, and the other children at school, and the man at the general store, and lots of other people -- and none of them had said, or thought, as far as I have been able to find out, that I was stuttering. Whatever the teacher was talking about, none of them had noticed it, or if they had they hadn't thought of it as stuttering.

Having taken the teacher's word for it that I was beginning to stutter, my parents did what many other parents would have done under the circumstances. They took me -- not at once but after some time had passed -- to the doctor. In our case "the doctor" was not just another physician, not to us at any rate. He was a very special son of person, and I would understand after many years that he had been in his own way the Albert Schweitzer of our little valley. I remember, as though from a world that no longer exists, that day, nearly a half-century ago, when I sat beside my father on the tufted black leather buggy seat, weaving wisps of childish wonder to the

4


IN SEARCH OF BEGINNINGS AND ENDINGS

cadence of the horses' hooves along the gently rolling ten miles to old Doctor Hedinger's office in Canton.

The French people were still talking of the possible return from exile, once again, of the Emperor Napoleon Bonaparte when Doctor Hedinger was born. He had been a contemporary of Lincoln and Lee, and he had outlived most of his contemporaries when Alexander Graham Bell invented the telephone in 1876. Doctor Hedinger's era had passed into history long before he died one day from eating too much boiled cabbage, it was said, at the age of 97. He is etched in my memory as though he were a cameo, leaning toward me slightly with his full-length black coat draped like a toga from his thin shoulders. From his narrow bronzed face his white beard extended to his waistband and he seemed to hover over me like Father Time himself as he asked me with a twinkle in his eyes to say "Philadelphia."

I cannot be certain whether I passed this first of many, many speech tests the years were to hold for me, but I was never to be tested by a wiser examiner. Doctor Hedinger was so very wise that he knew the depths of his own ignorance. I know now that no one knew very much about the problem called stuttering in those days, and that old Doctor Hedinger was probably as well -- or meagerly -- informed about it as anyone else within a thousand, or even ten thousand, miles of Canton. But what he lacked in scientific knowledge he made up in sensitivity. He understood, Doctor Hedinger did, that it is precisely at those times when nothing can be done that it is most essential that one do something, and something as nice as possible. And so he gave me a pretty little bottle of sugar pills. But, being kind as well as wise, he flavored the pills with peppermint.

One of the pictures of my mother that is clear in my memory is of her standing that evening after supper by the cupboard, holding my little bottle of peppermint pills to her nose, her brown eyes narrowed in thoughtful disbelief.

Those peppermint pills were to become for me in later years a very powerful symbol -- of love without understanding. If, in 1912, Congress had appropriated a million dollars for the stutterers, young and old, of this country, the money would have been spent, of neces-

5


STUTTERING AND WHAT YOU CAN DO ABOUT IT

sity, for sugar pills, or their equivalent -- with or without peppermint depending upon the public demands for economy. That something more effective can be done today is to be explained by the fact that in the meantime the problem of stuttering has been taken into the laboratory and subjected to scientific study.

All through my school years my father persisted in trying to find someone who could "do something about my stuttering," or some method by which he could help me or I could help myself. He read one day in the paper that stutterers could talk by holding their teeth together, and so this I tried, but my father was a man of sound practical judgment and I did not talk in this strange fashion for long. By the time I had emerged from the tenderest years of childhood our family had acquired an automobile, and I remember a day when I was ten or twelve being driven with my father to Wichita, sixty miles away, to see a college professor there "who used to stutter." In slow and measured tones, he advised me to breathe in "with the diaphragm" before speaking and to exhale slowly while I spoke. This seemed pretty much like being advised to walk across the street by putting one foot ahead of the other -- and it must not have made much difference in the way I talked, because soon after that my father took me to another man, an itinerant preacher of considerable reputation in those parts, who admonished me to have faith and to use great determination. He assured me I could do anything I thought I could.

Whether he was mistaken or I was lacking in determination I can't be sure, I suppose, but at any rate the next stop on my tour of hope and desperation was a little town in the Missouri Ozarks, to which my father was attracted while on a business trip by word that there was a healer of sorts who held forth there. The ride through the flint hills of southeastern Kansas and into the beautiful Ozarks was pleasant enough, but my memory of the alleged healer is extremely obscure. I recall dimly that he talked to us about his "electrical machines," and I suspect my father's patience gave out rather quickly. I shall never forget, though, how astonished I was a few hours later

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IN SEARCH OF BEGINNINGS AND ENDINGS

at dusk in Springfield by the bareheaded and barefooted, white-robed and white-bearded old man of the mountain who carried a long staff and prophesied in a high tremulous voice to all who cared to pause and heed that the end of the world was near, at least in Springfield, Missouri. But the end of neither the world nor my stuttering came to pass.

When my father read the story of Demosthenes, who, as a rather erroneous but inspiring legend has it, overcame a speech impediment by standing on the seashore with pebbles under his tongue and shouting above the roar of the waves, to become the greatest orator of ancient Greece, I talked for several days with pebbles, as well as BB shot and other things, under my tongue. No results were apparent, however, at least up to the time my father's will to experiment was overcome by my mother's fear that I would swallow something that would have to be removed by surgery.

A summer of adjustments by a chiropractor having failed to loosen my tongue, my father was next persuaded, against his better judgment, by my innocent faith in a newspaper advertisement which guaranteed to cure my stuttering, "or your money back," to allow me to go away to a "stuttering school." I was sixteen. It was my first train ride, my first venture east of the Mississippi, my first visit alone to a big city -- and my first profoundly unnerving disappointment. It was also perhaps my first major lesson in semantics, from which I learned far more than I could possibly comprehend at the time about the meanings of words such as "guarantee" and "cure" and"money back." After three months of speaking with a very extreme drawl, reading aloud in dirge time, and swinging dumbbells while chanting, one word to a swing, "Have more backbone and less wishbone" and "Little drops of water will wear away a rock," I returned home more hesitant and tense in speech than ever, and so thoroughly demoralized it didn't even occur to me to try to get my money back.

Some three years later when I was a sophomore in McPherson College in Kansas, I learned that a program of research on stuttering was being started at the University of Iowa in Iowa City. After an exchange of letters with Lee Edward Travis, a professor in the departments of psychology, speech, and psychiatry at the university

7


STUTTERING AND WHAT YOU CAN DO ABOUT IT

who was in charge of the program, I made my way in the fall of 1926 to Iowa City.

A few days after I arrived Dr. Travis asked me to come with him to one of his classes. He explained that he wanted the students to observe my speech. I sat in a chair beside his desk at the front of the room. There were thirty or forty students looking at me. Dr. Travis told them who I was and that I was from a small town in Kansas, and then he handed me a book and asked me to read aloud to the students. I read for five minutes -- and got out four words.

After class I went with him to his car and we got in and started for the other end of the campus. When we had gone about a block he stopped to give one of the staff members a ride, and as she got in the car he introduced us. Then he started the car again and we drove down a long curving hill and crossed a river. A couple hundred yards beyond the river we turned a corner, went a block, turned another corner and went up another hill. Altogether we had gone about a mile when all of a sudden I finally managed to blurt out, "Puhleased to meet you!" They were startled, and so was I, and I wished I hadn't said it, only I would have been even more embarrassed if I hadn't said anything at all.

That year I stretched my six feet two inches the full length of a couch in Dr. Travis' office nearly every day for an hour, talking as fast and as freely as I could about anything and everything that oozed and bubbled up out of the lower caverns of my consciousness or "my unconscious" or early childhood, or wherever it came from, while Dr. Travis sat behind a screen a few feet beyond the back of my head and made notes. I stuttered a lot. I mean I tightened up the muscles I used in talking and held my breath now and then for a long time, while trying hard to speak in spite of the things I was doing which, as I realize now, made speaking impossible or nearly so. What I remember most clearly about how I felt is that I didn't like the way I felt, and my tensions and strain in talking were almost completely mysterious to me. I didn't know why I did the things I did. They felt like something I couldn't help doing. I think I had expected Dr. Travis to tell me what caused my stuttering and how to stop it and speak normally. What he said was that I was to lie

8


IN SEARCH OF BEGINNINGS AND ENDINGS

on the couch and keep on talking about anything and everything I most wanted to talk about, and I did that all through the fall and winter and spring.

Finally I got up off the couch and started doing something else with the hope that it would help me speak better. Dr. Travis and his chief in the department of psychiatry, Dr. Samuel T. Orton, were interested in testing out the theory that stuttering is related somehow to handedness. We could find no evidence that I had ever been left-handed. In fact, my good right arm had seen me through many a victory or thrilling defeat on the baseball field and basketball court. In the interests of science, however, and with the unreasoning anticipations of a prospector, I set myself the slightly baffling objective of becoming left-handed. Ten years and countless bruises later, having become a threat to my own thumbs, I placed in storage the many ingenious braces and mittens Dr. Arthur Steindler had helped me design, put away my left-handed scissors, and with my right hand wrote "Finis" to the experiment, still stuttering splendidly.

As it turned out these were only two of the many clinical experiments I was to do on myself and others at Iowa. After two years the university awarded me a bachelor's degree -- but I was stuttering about as much as ever. So I stayed. In fact, I moved into the laboratory, no longer just a "guinea pig" but also a graduate student majoring in speech pathology. I had decided to specialize in my own ordeal.

At the end of another year, I was given a master's degree. My problem not yet solved, I continued and there came a day in 1931 when a doctoral degree was conferred upon me. With need and curiosity undiminished, for I was still stuttering, I went on, and then one day the director of the laboratory, Dr. Travis, left -- and there I was.

I am like the man who was asked, "How did you come to fall in the lake?" and he said, "I didn't. I came to fish."

It was in 1934 that I became keenly aware that although there were many different opinions about stuttering and its causes, noth-

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STUTTERING AND WHAT YOU CAN DO ABOUT IT

ing like a planned and thorough scientific study of how the problem begins had ever been made. With a resolution to put first things as nearly first as possible at such a late date, I soon found myself, with several friends and associates at the Iowa Speech Clinic, engaged in a search for the beginnings of the problem called stuttering. What started out as a spirited exercise of curiosity turned into more than a quarter-century of research. This book is the story of that research and of a comprehensive program of related efforts to discover what causes stuttering -- in order to find out how to prevent it and to treat it effectively.

How would you have gone about the job of finding out how the problem of stuttering begins? What would you have looked for? Where? What questions would you have put to whom? Why those questions? Why to those persons?

We quickly discovered that there were several decisions we had to make before we could even get our investigation under way. Some of these decisions were surprisingly difficult. Some were easy. It took no great deliberation to decide, first of all, to concentrate on cases in which the problem of stuttering had arisen very recently. The point of this, of course, was to get case histories that were as detailed and reliable as possible. But before we could determine how recently the problem had begun we had to come to grips with an incredibly knotty question: How could we tell whether or not a child had begun to stutter?

How would you have answered this question? If you are like most other people, you would probably say, "Why, anybody can tell whether or not a child is stuttering by the way he talks." And yet, how does a child talk if he is stuttering -- for the first time in his life, that is? Again, if you are like most other people, you would be likely to say that he talks with hesitations and repetitions in his speech. But even normal speakers, at all age levels, speak with hesitations and repetitions, some with few, some with many. You hesitate sometimes in speaking, stumble over sounds, repeat words, and the like. How can you tell by listening to your child, or any other child, whether he is speaking with "too many" hesitations? How many are "too many"? Would you say that a youngster who hesitates and re-

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IN SEARCH OF BEGINNINGS AND ENDINGS

peats more than the average child is a stutterer? If so, then by definition all children who repeat more than "the average child" -- and that means roughly half of all children -- are to be classified as stutterers!

If you don't use "the average" as the dividing line, where do you draw the line between children you regard as stutterers and those you regard as normal speakers? Do you pick the 5 per cent who are the most hesitant and repetitious? Or 10 per cent? Or 1 per cent? Can you make your measurements exact enough to do this? What do you do about the problem of variation? That is, your child, or any other youngster, may speak much more smoothly at one time than another, or in talking to one person than when talking to someone else. Is he, then, a stutterer part of the time but not all the time? And how are you to compare your child's speech with that of other youngsters? Should you, perhaps, compare your child's speech with that of other children only when they are speaking under the same or similar conditions? Or is it sufficient to compare your youngster's speech with that of other children on the basis of a general impression gained by listening to children wherever and whenever you happen to hear them speaking?

How, indeed, can you tell whether your child, or any child, "has begun to stutter"?

It was most impressive to discover in 1934 that there was no clearly satisfactory answer to this utterly fundamental question. It seemed to us a very serious matter that for years, for centuries in fact, men had gone ahead to spin theories about stuttering before they had made quite clear what they were spinning theories about. After all, it is hardly possible to explain the beginning of something if we are not able to tell whether or not it has begun: And how is it possible to prevent or treat something if we cannot explain very well how it begins -- what causes it, that is?

We simply had to find a better answer than had so far been thought of to the question of how to tell whether or not a child has begun to stutter. Until we could do this, it was not possible to proceed with our investigation of how stuttering begins.

After long deliberation, we finally decided that we would accept as a stutterer, for the purposes of our research, any youngster

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STUTTERING AND WHAT YOU CAN DO ABOUT IT

brought to us by his parents as a stutterer. We concluded, in other words, that the soundest way to set about finding "new stutterers" was just to let it be known that we were looking for them, and then sit back and see if any children were brought to us. If any were, then we could examine them -- and their parents -- to find out what they were like. It was no good making up our minds what they would be like before examining them.

As it turned out, we were wiser than we knew at the time, because this decision had the effect of focusing our attention in each case upon the problem called "stuttering." We did not understand then as clearly as we did later that the word "stuttering" is, indeed, whatever else it may be, a name for a problem. And, as we came to see more and more clearly, the problem called stuttering includes much more than hesitations and repetitions in speech. It also includes certain feelings and reactions of the listener. That is, the problem called stuttering involves not only a speaker and his way of speaking and his related feelings, but also his listeners and the feelings they have about his way of speaking and the reactions they make to it. It was this total problem on which our attention was focused by the practical decision we made -- for the simple reason that whenever a mother and father feel their child is stuttering, they at least have a problem. And if the parents continue to have the problem, the child is also likely to be caught up in it sooner or later.

Between 1934 and 1939, when we completed Study I, as we have come to refer to it, forty-six children, thirty-two boys and fourteen girls, were brought to us by their parents, quite soon after the parents had decided they were beginning to stutter. They ranged in age from about two to nine years, and had an average age of slightly over four years. The average interval between onset of the problem, as reported, and our first interview was only about five and one-half months. We followed the development of these children for an average period of two and a half years.

For each child who had been "diagnosed" by his parents as a stutterer, and brought to us for clinical advice and help, we also selected and studied another child of the same age, sex, and level of intelligence, who was thought by his parents to have normal speech.

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IN SEARCH OF BEGINNINGS AND ENDINGS

When we first started to investigate these two groups of children, we were not at all sure what we would find. Mainly, we were very curious. We certainly expected to find differences of some sort between the two groups of children. On the basis of theories current in the mid-thirties it was to be expected that more of the children classified as stutterers would have suffered birth injuries and diseases, and more of them would have developed slowly and been awkward or lacking in muscular coordination. It was also to be expected, on the basis of most textbooks then in use, that the children classified as stutterers would be more nervous or emotionally disturbed, insecure, shy, or socially immature than the other youngsters. True, such theories were generally vague, so that it was not clear just what details were supposed to be found, or looked for, in actual cases. The fact is that so little scientific research had been done that the theories were largely unsupported by data, but they were the theories that were then generally taken for granted and our thinking was in some measure affected by them.

As it turned out, what we actually discovered was surprisingly different from what we had expected to find.

Before getting into the details of what we found, however, there a particularly fundamental point to be made as clearly as possible. It has to do with questions and answers. When we began our investigation of how stuttering begins we supposed that the questions we were asking were fairly simple and we were hardly prepared for the great difficulty the mothers and fathers had in nearly every case in giving us a straightforward account of their child's history. If they had more than one child, they seemed not always to be sure which one they were talking about. In discussing the child's birth or medical history they could not always recall what the doctor had told them, and they sometimes seemed unsure of what he had meant by what he had said. The parents often found it difficult, indeed impossible, to pinpoint an event to the particular day, or even week or month or year, of its occurrence. They could not always remember the places where things had happened. They used expressions such as

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STUTTERING AND WHAT YOU CAN DO ABOUT IT

"about average" or "a little slow" or "very good" without appearing to know what these terms might mean so far as children generally are concerned. Usually they seemed to be comparing their child with one or two other children they happened to know, instead of using reliable norms for the general population of children of like age and sex.

After several years of clinical interviewing, I have become highly sensitive to the fact that most persons are apparently not used to speaking with accuracy and in detail about their own experiences or those of their children. Most of us become accustomed to a certain level of vagueness, and evidently it is difficult and even unpleasant for us to try very hard for any length of time to be much less vague, or more careful and clear, then we usually are. An interviewer must try, therefore, to cultivate unusual sympathy and patience, as well as a special skill in asking questions effectively. He learns to sense the difference between an answer that is a clear description and one that is a statement of judgment, or opinion, or prejudice, or sheer imagination. He must finally accept a fundamental limitation on human knowledge: it is impossible to find out everything about anything.

It is as important to know what we don't know, and especially what we can never know, as it is to be clear about what we do know or can manage somehow to find out sometime. Without a sense of the limitations of our possible knowledge (which means, in part, an awareness of our ignorance) we cannot judge very well the value of what we do know and of what we are told by others -- who so often manage somehow to sound as though they know what they are talking about.

And so in scores of intensive interviews during the course of our research program I have encouraged mothers and fathers to tell in their own words, as clearly and fully as they could, just what the facts had been in the beginning of the problem they called stuttering, so far as they could recall the facts. I wanted of course to get all the specific details I could. But I also wanted to explore the limits of obtainable information. I wanted to find out what it was that the only possible informants -- the only observers who were on hand at the

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IN SEARCH OF BEGINNINGS AND ENDINGS

moment when the problem first arose -- were unable to report. I was intent on determining as best I could what it was that they had forgotten or had not observed in the first place.

The best way I know to make the meaning of these generalities come alive on the printed page is to let you listen in, as it were, on a few clinical interviews. In the next chapter you will be able to see for yourself just what it is that parents are able -- and unable -- to say when asked to give information about their own youngsters doing specific things that the parents have called "stuttering" in particular situations at specific times. These were actual interviews, tape recorded and transcribed. All names, however, are changed and certain telltale details are disguised.

These tape-recorded materials are printed with permission of the persons concerned. I am tremendously grateful to them. They were cooperative and long-suffering in response to a kind and intensity of questioning that they could have been pardoned for resenting. Their understanding of our unusual purposes -- and so of our uncommon procedures -- was not merely helpful, it was utterly essential to the success of our research.

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