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Stuttering Blocks
A Self-Help Strategy for Defeating
Stuttering Blocks by Valsalva Control
By William D. Parry, CF-SLP
Copyright © 2009 by William D. Parry
My Background
A formerly severe stutterer who became a successful trial
lawyer, thru the use of Valsalva Control;
Published the Valsalva Hypothesis in J. Fluency Dis. (1985);
Founded the Philadelphia Area Chapter of the NSA in 1985;
Led local NSA support group meetings for 15 years;
Member of the NSA's Board of Directors for 6 years;
Presented national and international workshops on Valsalva
Control for stuttering;
Wrote Understanding & Controlling Stuttering: A
Comprehensive New Approach based on the Valsalva
Hypothesis;
Received M.A. in Speech, Language & Hearing Science from
Temple University.
Now doing Clinical Fellowship in Speech-Language Pathology.
The Kind of Stuttering This
Workshop Is About
The most common variety of stuttering, in which the
flow of speech is involuntarily disrupted by:
Forceful closures of the mouth or larynx,
1. Anticipation of Difficulty
Expectation that speaking will be difficult, or that a
particular word or sound will be hard to say.
Concern over importance of good speech.
Fear, emotional conflict, or ambivalence about
talking.
Fear of stuttering.
Feeling of impaired speaking ability due to fatigue,
illness, inexperience, neurological deficits, etc.
Self-image as a stutterer.
The Valsalva-Stuttering Cycle (cont’d)
3. Valsalva Tuning
The brain responds by neurologically
preparing the larynx and other parts of the
body's Valsalva mechanism to perform a
Valsalva maneuver (in which air pressure is
built up by forcefully closing the larynx or
mouth while the chest and abdominal
muscles squeeze the chest cavity), in the
mistaken belief that this may help to force
the words out.
The Valsalva-Stuttering Cycle (cont’d)
5. Avoidance Behaviors
Attempts to overcome, avoid, postpone, or
hide the blockage of speech.
May involve a wide variety of behaviors, such
as hesitations, repetitions, use of starters,
fillers, and other unnecessary words and
sounds, word substitutions, grunting,
breathing irregularities, facial contortions,
teeth gnashing, etc.
The Valsalva-Stuttering Cycle (cont’d)
6. Mental Reaction
Confirmation of belief that speaking is difficult, or
that a particular word or sound is hard to say.
False impression that force or other stuttering
behavior helped to get the words out.
Reinforcement of Valsalva tuning, the use of force,
and stuttering behavior as ways of overcoming
obstacles.
Feelings of guilt, shame, and embarrassment. Loss
of confidence and self-esteem.
The Valsalva Trap
For the person who stutters, attempting to
use effort to force words out may feel like the
right thing, the safe thing, the only thing to
do.
But in reality, force and effort make fluent
speech impossible.
The harder one tries to be fluent, the more
likely the Valsalva mechanism will be
activated and interfere with speech.
Creation of Nerve Pathways
Constant repetition of the Valsalva-Stuttering Cycle
creates strong nerve pathways in the brain, linking
speech to the Valsalva mechanism.
Meanwhile, the nerve pathways for fluent speech –
normally concentrated in the left hemisphere – are
used less, and therefore aren’t as strong.
This may explain why a PWS’s areas of brain activity differs
from that of normal speakers.
Consequently, Valsalva-stuttering becomes a
habitual, neurologically-based behavior that is very
hard to eradicate.
Relevance to Stuttering Therapy
Virtually all fluency-enhancing conditions and
stuttering therapies can be explained in terms of their
incidental effect on some aspect of the Valsalva-
Stuttering Cycle. For example:
Light contacts, easy vocal onset, and passive air-flow may
help to avoid the build up of air pressure.
Emphasizing phonation (singing, stretching syllables,
metronome) neurologically programs the larynx for
phonation rather than effort closure.
Devices that alter auditory feedback (masking, DAF, FAF)
may force us to process words as sequences of movement
rather than as “things” to be forced out.
Psychological approaches may help reduce our anticipation
of difficulty.
A Reason for Relapses?
increased to 2.4 10
syllables/second. 0
Longest
Block -
Sec.
Always remember . . .
Fluency is not the meaning of our existence
and should never be the basis of our self-
esteem.
The quest for perfect speech is unrealistic,
unnecessary, and ultimately self-defeating.
We may never reach the point where we are
absolutely fluent all the time. And that’s
okay.
Always remember (cont’d) . . .
There’s no purely mechanical formula for fluency.
You must understand the reason for each
strategy, if you are to learn from it.
Learn from your experiences, both fluent and
disfluent.
Instead of chasing fluency for its own sake, more
productive goals would be:
To have fun communicating with others, and
by William D. Parry,
CF-SLP
Websites:
The Valsalva-Stuttering Network: www.valsalva.org
E-mail: valsalvastutter@aol.com