The Bread and Butter of Stuttering

My name is Andrew Miceli, M.A., CCC-SLP. I am autistic and a lifelong severely

profound stutterer now fluent.

I didn’t begin stuttering until just after turning four years old. That was 50 years ago and

if there is one undeniable fact I’ve learned in all this time it’s that stuttering is one of the

most misunderstood and underappreciated speech disorders in the United States. It’s

misunderstood because the majority of the public doesn’t know what it really is, and it’s

underappreciated because instead of being taken seriously as a potentially debilitating

and even crippling speech disorder stuttering has routinely been, and continues to be,

the target of mockery and laughter in mainstream American society and culture.

This blog and open forum for responses is an opportunity to transition the mockery to

objective insight and the laughter to serious discussion. Insights and perspectives

learned from decades on both sides of the table as a 50-year stutterer and 20-year

professionally licensed speech-language pathologist (SLP) recognized by the American

Speech-Language Hearing Association (ASHA) will be presented. While I understand

that not everyone may agree with what I have to say (hence why this blog allows for

responses) the goal is to discuss stuttering seriously so that we can get to the heart of

the matter – to the bread and butter – in terms of what stuttering really is and how

potentially devastating a speech disorder it can be.

Stuttering has long been cited within the field of speech-language pathology as a

thought processing, planning and/or preparation problem. But if that’s true then the

question must be asked: is it that a stutterer has trouble formulating in their mind what

they want to say (e.g., the wording, word order, melodic infection, tone, etc.) prior to

speaking, or, is it that a stutterer has formulated in their mind precisely what they want

to say yet they cannot physically (put another way: cannot “mechanically”) say what

they want to say at the precise moment in time they wish to do so?

If it’s the latter then is stuttering really a problem of thought processing, planning and/or

preparation or a mechanical speech production problem rooted somewhere in the

speech production mechanism, e.g., at the vocal cords? What if the pathology of

stuttering was different than the actual stuttering itself?

What if people who stutterer lock their vocal cords – two tiny muscles in the larynx

which is in the throat that must vibrate hundreds of times per second in order to produce

sounds (and sounds make up words which make up sentences which make up spoken

language) – during instances of heightened emotions and thus constituting the

pathology of stuttering (as no stutterer reports to stutter when feeling calm and relaxed.)

And if this is the pathology of stuttering, what if stuttering is the subsequent attempt to

literally try and push the sound(s) out during instances of heightened emotions due to

locked vocal cords (a.k.a. when the pathology is occurring?)

This proposed framework supports the premise that a stutterer knows exactly what they

wants to say but physically/mechanically cannot say it at the precise moment in time

they want to due to heightened emotions and subsequently locking vocal cords (the

pathology) which is why they begin trying to push the sounds out (the stuttering) which

leads, over time – with time potentially meaning through adolescence, as stuttering

typically begins between the ages of two and six – then through the teenage years and

continuing into adulthood – to habitual pushing during instances in which the pathology

is occurring.

And if this is true then while there is legitimacy in labeling stuttering a “fluency disorder”

(as fluency in the field of speech-language pathology refers to the forward progression

of speech) an argument can be made that stuttering is really a voice disorder as the

pathology is rooted at the level of the vocal cords (referred to the engine or the motor of

speech) which in turn cause a disruption in the forward progression of fluent speech.

And, quite frankly, which label sounds (pun intended) like a more serious problem: a

“fluency disorder” or a “voice disorder?”

America is laughing at something it does not understand and simultaneously

underappreciates and underestimates: stuttering. Even if the laughter is due to

nervousness or uncertainty as opposed to maliciousness or cruelty the subconscious

mind still records that “laughing at stuttering is the acceptable response.” And whether

stuttering is a fluency disorder or a voice disorder, as fluent speech is the expected

norm in general society should difficulty producing it elicit laughter and mockery or

empathy and compassion, funding and research?

Whether you’re a stutterer or not, or a speech professional or not, consider sharing what

you think so that a serious discussion about stuttering can finally begin.

It’s about time™

Andrew Miceli, M.A., CCC-SLP