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Barbara
Dahm: Dynamic Stuttering Therapy Most Effective For People Who
Stutter
By
Joel Leyden Tel
Aviv ---- May 8, 2009 ...... Barbara Dahm is responsible for providing
survival skills. Survival skills for people who stutter. “Stuttering affects everyone,” says Dahm CCC-SLP who is a Board Recognized Specialist in Fluency Disorders. It cuts across nations, borders, race and gender. It affects people with all levels of intelligence and many with Downs Syndrome. But the good news is that there is a new therapy that is an effective treatment.” Dahm states that there are genetic markers common in members in a family that stutter. Environment also plays a role. “People usually begin to stutter as they develop language as a child and it can continue into adolescents. Puberty may even play a factor with hormone and voice factors having an affect. Barbara Dahm is a Board Recognized Specialist in Fluency Disorders. Most people describe stuttering as a disorder where the flow of speech is interrupted. But Dahm, the director of the Communication Therapy Institute Ltd., and an online Internet clinic that specializes in the treatment of stuttering, says that stuttering is a condition in which the brain produces speech with too many processes of control. Dahm has extensive experience working with children and adults who stutter in both group and individual settings. Since 1987, she has been involved with the treatment of nearly 2000 people who stutter. Today there are branches of CTI in Israel and New Jersey. She is a member of the Association of Israeli Communication Clinicians, a founding member of the International Fluency Association, a member of ASHA Special Interest Division in Fluency and Fluency Disorders and a member of several self-help groups for people who stutter. She received her degrees – both Bachlor and Masters from Boston University and has over 35 years of experience as a speech pathologist. While treating people who stutter, she discovered the benefits of the speech processing approach to therapy. She authored Generating Fluent Speech: A Comprehensive Speech Processing Approach (1997) and Dynamic Stuttering Therapy ( 2007). She has presented
her approach to professionals and people who stutter in The Netherlands,
England, Germany, Denmark, Canada, Israel and the USA. “Dynamic Stuttering Therapy is the therapeutic answer to the latest research that shows variations in the brain activity between people who do and do not stutter,” says Dahm. “Participants in Dynamic Stuttering Therapy learn to give up speech controls and make the cognitive changes necessary for developing the same automatic brain processes found in fluent speakers. The result is natural flowing speech that is generated with ease and comfort.” When asked what motivated her to go into the field of stuttering therapy, Dahm replied: “As a speech pathologist I wanted to help people who have problems communicating. I was intrigued about stuttering because it is a condition that can devastate the lives of many people who have great potential. Stuttering can have a highly negative impact on one personally, commercially and academically.” Dahm states that people become more open, more free and their ability to speak fluently is greatly improved, by understanding the problem. They then know how to help themselves with more self-confidence. Dahm was asked if different cultures create different problems? Dahm replied, “No, stuttering affects everyone. She says that therapy usually takes between 20 to 30 hours. “Some people who have gone through years of conventional therapy, accomplish more in these 20 hours of Dynamic Stuttering Therapy ,” says Dahm. Dahm provides some interesting facts saying that most people begin stuttering as children from the ages of 2-5. And that four times as many males stutter than females. “I am working with the speech production system from the inside as opposed to conventional therapy that tries to control the speech, says Dahm. “I help clients to speak automatically and normally. And to give up control which is a very big paradox.” Dahm says that anyone who opens most Speech Pathology journals, will see that the focus has been on the speech itself and not as a system. In Stuttering research and practice by Nan Bernstein Ratner and E. Charles Healey, Ann Smith talks about looking for a unified strategy that will aid our attempts to understand and treat stuttering. “Up until now the myriad approaches to stuttering have created a fragmented and confusing literature on the disorder.” Stuttering is not a series of “stuttered events”, says Smith. “We need a major paradigm shift. We have to look at stuttering through a multifactorial and dynamic model. ” Dahm responds
that Dynamic Stuttering Therapy is the only therapy that looks
at stuttering through the perspective of a dynamic model. Stuttering
is the result of a speech production system that does not function
in the normal way. “All of the processes that are necessary for the production of speech and language as described by a psycholinguistic model such as Levelt’s work in parallel,” says Dahm. “Dynamic Stuttering Therapy teaches people who stutter to use all of the speech production process in parallel.” Brain imaging studies have shown that different brain areas are involved in stuttered speech than in fluent speech. Motor areas are over-activated in stuttering. This provides the basis for a stuttering system model that is testable and should help to advance the understanding and treatment of this disorder. Dahm states that Dynamic Stuttering Therapy is the first therapy for stuttering that is based on a system model that includes developing normal neurological processes. “Although
brain imaging studies have not yet been made of our clients to
determine the differences before and after therapy, clients report
that they are producing speech internally in a different way,
much more automatic way and the result is flowing speech,”
says Dahm. “We have found that one of the differences between fluent and stuttering speakers is that fluent speakers develop speech in the brain while at the same time the brain sends a neurological signal to the vocal folds. Research in sub vocal speech has shown how this happens.” “People who stutter on the other hand, try to get their words out by exerting effort either by pushing out air or exerting energy to make sounds with their mouth. During therapy we show our clients how to develop sub vocal speech while sending the neurological signal to the vocal folds so that the speaker can produce a normal voice that is heard by the listener.” Dahm adds: “Most stuttering therapies require the person who stutters to speak slowly and monitor their speech or pay attention to their stuttering. In Dynamic Stuttering Therapy we help our clients to develop automatic processes that they use in non-threatening situations and in practice so much so that they are able to let go of controls when under pressure.” “Dynamic Stuttering Therapy is unlike any other treatment approach for stuttering, because instead of working from the outside as in focusing on the speech and trying to somehow get it to be fluent, it works from the inside out using the internal speech production in the normal automatic way so that the speech produced is automatically fluent. Dynamic Stuttering Therapy requires a paradigm shift. In spite of the knowledge we now have about differences in neurological function and motor programs between fluent and stuttering speakers, treatment approaches still focus on speech rate, speech control, and the moment of stuttering.” Dahm says that regardless of age or how one stutters, the treatment involves the same principles. Clients achieve the same goals, using the natural processes for speaking. Each person sets in motion a new dynamic between the brain and the organs involved in the execution of speech. It involves the easiest, most efficient and healthiest use of the speech production system. “Dynamic Stuttering Therapy is not complicated at all, but initially it is hard to internalize because it contradicts the seemingly logical inclination to speak better by exerting more control,” says Dahm. “While the new way of speaking is quite easy, it is difficult to learn without the guidance of a qualified clinician. Dynamic Stuttering Therapy involves concentrating on ideas instead of words and talking without thinking about speaking while the voice carries all the energy for speech. Speaking becomes an automatic uncontrolled process. The new pattern of speaking is kept going, not via physical or mental effort, but by nothing more and nothing less than developing language without thought while producing a natural voice that contains normal patterns of intonation.”
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