​People who stutter are regularly interrupted. Our sentences our finished for us, we are talked over, and skirted in conversations. This can be terribly frustrating and disempowering, not the least because being regularly interrupted causes dysfluent people to internalize this oppression.  
 
Yet it is also noteworthy that Speech-Language Pathology (SLP) describes the stuttering event itself as an “interruption of speech” (e.g. Guitar 2014). At first glance this use of “interruption” seems straightforward. To interrupt someone else’s speech is (as the OED defines “interrupt”) to break the continuity of something in time, to hinder from proceeding with some action, as well as to hinder, stop, prevent, thwart. Yet there is something odd about this formulation when applied to ourselves. To follow out this line of thought, not only are we interrupted by others, but SLP discourse concludes that when we stutter we interrupt—ourselves?
 
What could this mean? Is it that they think we are interrupting language itself? If so—then whose language? Certainly not our language! I have always spoken with gaps, pauses, prolongations, and repetitions. A stutter is only an interruption of what we think language should sound like: “normally” fluent, able-bodied speech.[i] One might respond that stutterers interrupt the abstract structure of language and morphology—except that linguistics generally holds language to be both flexible and dynamic.[ii] Communication theory likewise suggests that communication is filled with redundancy and thus far more flexible than we fear.[iii] All this to say that the idea that stuttering is itself an “interruption” is actually far from self-evident, and in fact a much more political and complex statement than we’ve been taught to believe.[iv]
 
But what does it mean that we both interrupt and are interrupted? Is there a relation between these events? Do people interrupt us because our speech interrupts the script of fluency? Because we interrupt the linear and ceaseless flow of time and information? There is likely truth to the idea that interruptions are attempts to interrupt the dysfluent interruption—to get back to business as usual. But we can take this conversation in a different yet equally plausible direction: thinking about who gets interrupted leads to the question of who is interruptible.
 
Dysfluent speakers, women, queer and racialized voices don’t just happen to get interrupted; some voices are understood to be interruptible in a way that others are not. That is, the problem is not exactly that some voices are just louder or more authoritative than others and thus get heard, while other voices that break the (apparently fragile!) flow of speech or that have distinct features (such as “uptalk”) don’t demand attention. The issue, rather, is always power dynamics between marginalized and privileged peoples.     
 
For example, in November 1970, the Globe and Mail published a curious piece entitled “Stammer Becomes Fashionable: Essential Mark of the English Gentleman,” an exposé of a wildly counter-intuitive British phenomenon. The cultivation of a distinguished, yet fake, stammer is described as indicating good breeding and fashion. Speech impediments in the British Parliament were reportedly displayed commonly and unashamedly, and the article details stammering as a passport to elite circles, a means of holding a listener’s attention so one’s words are appreciated more. This strategy was developed early in certain private school traditions. “In the more extreme cases,” explains Oxford professor David Jenkins, “it’s a very visible affectation. It’s also a sign of complete self-assurance. You take your time, knowing you are master of the situation.”[v]
 
Stuttering in this case was oddly used to control conversations; the stutter that stretches time and makes others uncomfortable becomes a symbol demonstrating that social elites are masters of the situation—that they are not interruptible.
 
The irony is painful but offers an important lesson: dysfluent voices are not interrupted simply because stuttering “interrupts speech.” The issue, rather, is one’s position within relations of power. For the fashionable stammerer, stuttering became a manifestation and performance of high social status. Today, we are taught to limit our stuttering for the exact same purpose.
 
There are two broad conclusions we can draw from this reflection.
 
1) To understand interruption and dysfluency we must move past the SLP discourse of stuttering “interrupting speech” to think about power and ableism. If stuttering interrupts, it interrupts not speech nor communication but ableist norms of speech that are rooted within our social, cultural, political, and economic worlds. How can this power to interrupt be used critically to cultivate community and resistance? This question is important since the capacity to interrupt is always linked with power and is thus dangerous. For example, the French novelist and stutterer Patrick Modiano appeared on a prominent French television show; displaying his admiration for Modiano, Jacques Derrida later reflected that, “he’s managed to get people to accept that they need to be patient when he can't find his words. . . . There’s someone who has succeeded in transforming the public scene and forcing it to go at his own speed” (479). Derrida’s wording, “forcing [the audience] to go at his own speed,” is quite ambiguous. Is Modiano, like the fashionable stammerer, taking control of the conversation, interrupting fluency as a way to master conversation? Or is his interruption an invitation into a different rhythm and tempo that transforms the public scene? These are very different practices that lead towards very different politics. 
 
2) The example of the fashionable stammerer highlights the possibility that being interrupted—being interruptible—has little to do with the manner in which phonemes exit one’s mouth. It is of course true, as Chris Constantino argues in his Foucauldian work on passing-as-fluent, that fluent privilege can be emulated and used to leverage one’s social position—though as many of us know, truly passing as fluent is always precarious for the stutterer and often more stressful/dangerous than it’s worth. The fashionable stammerer is evidence that in a different social context, stuttering came to mean something else entirely, a sign of privilege rather than pity. It is evidence that fluency and normalcy are always stacked games played against marginalized peoples.
 
To conclude, we are interrupted and seen as interruptible not due to the distinct characteristics of our voices and patterns of our speech but because stuttering has been framed as an interruption. We are interrupted because the power to interrupt belongs to those with social power and is seen as grotesque in our dysfluent bodies. The “fashionable stammerer” may have been a historical oddity, but social expectations around who gets to take up time when communicating remains coupled with privilege.
 
It is difficult to know the best response. Interruption is an incredibly complex event and practise marked by as many pitfalls as possibilities. One perhaps obvious response is to refuse the idea that disabled speech is an interruption of speech and communication. This is our dysfluent mode and rhythm of communicating. We neither aspire nor pretend to be fluent so at this level there is nothing to interrupt and nothing to be interrupted. We should, if we desire, finish our sentences and block visibly while others attempt to carry on the conversation without us. This would be a start.
 
But of course dysfluency is an interruption, just of a very different kind than imagined by SLP. Dysfluency transgresses ableist norms of what language should sound like, how social time should be occupied, and the place of disabled peoples within society (i.e. if not assimilated then cheerfully working towards a cure or rehabilitation). From this perspective we might begin to imagine how to use dysfluent interruption as a critical practise. How can interruption confront and transform communicative privilege and the ableism that structures our lives? How can dysfluency help to critically interrupt political norms and structures by which some people are deemed “interruptible”? If this is a much bigger challenge than refusing the idea that stuttering “interrupts speech” it is because the political reward is likewise far greater.

-Josh
​

[i] Both normalcy and fluency are fictions that quasi-exist in the way that statistical averages exist.

[ii] That stuttering stretches language and expresses variation is obvious; or, in theoretical terms, Deleuze might say that dysfluency composes a “minor grammar.”

[iii] Some communication contexts have little to no redundancy and are thus highly susceptible to interruption and error (for example, an air traffic controller). The point is that the vast majority of communicative relations could be reconfigured to make space for dysfluency if not governed by ableist protocols. Yet admittedly, what people likely mean is more straight-forward: stuttering interrupts the spontaneous or “natural” flow of meanings exchanged between people (as one of our commentators has said, stuttering can feel like being caught in a traffic jam in rush hour). This intuitive idea highlights an additional meaning of “interrupt”: stuttering seems to thwart our intended meanings and purposes within communicative events (as, of course, they unfold in fluent time). I am apparently a self-interrupting speaker. However, not only, as Zach has previously argued, might we find that we can stutter more “spontaneously” (in Chris Constantino’s terms) from a position of dysfluency pride and activism, but we must remember that language always unfolds in time, and communication is never instantaneous. The idea of being "thwarted" is, in this context, always framed by a fiction of fluency that does not exist.

[iv] At the same time, it is important to note that nearly all of these modes of interruption (which I have cast doubt upon) are precisely what SLP, a medical-industrial complex, has in mind when it frames dysfluency as an interruption. The stuttering event interrupts speech when considered linguistically, phonetically, communicatively, socially, temporally, economically, etc. etc. The fear of interruption is ubiquitous, perfectly evidenced in how SLP thinks about speech and its powers as incredibly fragile. Not only blocks and hesitations—the obvious candidates for an interruption—but repetitions, prolongations, and modulated flow of the voice are defined as interruptions. Why? Because they apparently carry no meaning and thus pose as, at best, an irritation and, at worst, a threat. However, as all of us have discovered when we’re among listeners that truly appreciate and make time for our voices, the voice, speech, language, and communication are far more robust and resilient than SLP seems to imagine.

[v] Israel Shenker, “Stammer Becomes Fashionable: Essential Mark of the English Gentleman,” The Globe and Mail, November, 1970, 12:12, Toronto.

​​A change is clearly underway. Three years ago one would be hard pressed to find any critical literature on disability and stuttering. Today, however, more and more discussions can be found exploring stuttering as an oppressed form of communication and questioning the impulse to normalize it through rehabilitative medicine. As such articles continue to come out, we thought it could be helpful to write short and accessible reviews both to let people know what is happening and to lend a critical lens to the discussion. 

Today, I would like to talk about a recent article published by the International Journal of Speech-Language Pathology titled “To be or not to be: Stuttering and the human costs of being ‘un-disabled’.” The essay is written by Brian Paul Watermeyer (PhD), a clinical psychologist at the Department of Health and Rehabilitation Sciences at Cape Town University, and Harsha Kathard (D.Ed), an SLP professor at Cape Town University. 

The central argument of this paper is that there is a psychological cost in striving for normalcy, and that SLPs are often complicit in creating the desire to be normal within stutterers. As Watermeyer and Kathard write, “[W]e hope that these reflections may contribute to deepening reflection among rehabilitation professionals of how our work may harmonize unhelpfully with cultural imperatives towards normalcy” (p. 8). This is a bold and important question, and I hope that it continues to be asked. 

Watermeyer and Kathard explicitly offer few answers. Rather, their hope in this piece is to open up space for future research. One of the questions they return to often is why, given that many other disabilities have been claimed as a positive part of one’s identity, is it seemingly so hard to think of stuttering as a “legitimate way of being and communicating” (p. 6)? Why is it that “the idea of making space for stuttering as a legitimate human difference—like some other impairments—feels incongruous?” (p. 6) Again, this is an excellent question meant to break down obstacles to (what we would refer to as) stuttering pride.  

However, one of the peculiar things about this paper is that while explicitly written from the perspective of disability studies, it doesn’t draw very deeply upon the resources offered by the field. Besides a couple one-off references to Garland-Thomson (1997, 2009) and Davis (1996), Watermeyer and Kathard draw almost exclusively upon Watermeyer’s previous publications. This of course wouldn’t be a problem if there was a lack of relevant literature to work with and if Watermeyer offered the best theory with which to think critically about stuttering. Yet I am not convinced that this is the case. I suggest the result is that Watermeyer and Kathard 1) have difficulty drawing generative conclusions and 2) are at times forced to create problems and distinctions that don’t actually exist. 

For example, Watermeyer and Kathard argue that most disabilities can be incorporated as a positive aspect of identity because “all ‘selves’ are both normal and not, both frail and robust and subject to both hope and despair” (p. 6). Yet Watermeyer and Kathard continue by setting stuttering in a separate category: “In contrast, data on stuttering suggest a picture of discrete, competing selves jostling for prominence. Here, to stutter is to fail in the quest to embody the ‘normal’ part of the inner split” (p. 6). This is a rather arbitrary and unhelpful distinction for a host of reasons. The first one that comes to mind is that Watermeyer and Kathard tend to treat identity as a free-floating thing in the social sphere. Rather than drawing conclusions about stuttering from generalized notions of identity, we need to investigate the (historical) process of how specific arrangements of identity and subjectivity are formed around the experience of stuttering. Of course the experience of stuttering is both similar and different from other forms of disability. Yet this in itself means very little. 

The larger problem, however, is that these are not primarily academic issues. If true that it is more difficult for society in general to think of stuttering as a “legitimate way of being and communicating” (p. 6) than using a wheelchair, for example, this is only because activists in the disability rights movement have been working tirelessly for 40 years to change ableist perceptions and institutions/structures around what it means to use/require a wheelchair. Stuttering, on the other hand, does not have this history. This is an activist and social issue, not an inherent problem with “stuttering identity.”    

In conclusion, and on a related note, it is telling the way in which this article ends. Following their excellent call for greater reflection on how SLP practices may be complicit with cultural imperatives towards normalcy, Watermeyer and Kathard write: “Integrating this awareness into new theoretical approaches may create a more humanitarian balance between the drive to correct and the path towards societies more able to manage difference” (p. 8). I find it very telling that the outcome of reflecting on our culture’s drive toward normalcy is summed up in words like “balance” and “manage difference.” Understanding disability/stuttering justice as a “balance” or middle ground  between assimilating difference and making space for it will always be the problem of working within the system, of trying to produce change from within the medical-industrial complex. Similarly, difference is not described as something to embrace, celebrate, or radically include, but as something (a challenge or problem) for a bureaucracy to “manage.” Managing difference is not how a more just world is created. In this context, it is hard to take seriously their concluding belief that “social change in disability is not the sole responsibility of health professions, but our influence in shaping disability culture is beyond question” (p. 8). 

Excuse us, but we are not done with the questions.

-Josh

This is not a post about stuttering. It is a post about how we are all of us bound together in complex and complicit ways.

Due to a long and very interesting history, SLP has become the dominant way to think about and engage with communicating bodies that are different from what society now takes to be “normal.” Medical and scientific practitioners have become the experts over our bodies. The American Speech-Language-Hearing Association (ASHA) capture the overall goal of SLP well in their vision statement: “Making effective communication, a human right, accessible and achievable for all.”

I wholly support this vision statement, taken at face-value. So many people have historically and continue to be marginalized because of how they communicate. Or more accurately, they are oppressed because they communicate in ways that society has decided are deficient. People are oppressed for typing rather than speaking their thoughts. For requiring assistance to type. For stimming. For stuttering. For talking with tics. We are oppressed because we don’t speak loud enough, or quick enough, or enunciate our words according to dominant linguistic norms. We are oppressed, in short, for having disability accents.

This, of course, needs to change.

My belief, however, is that ASHA has not thought carefully enough about what this phrase actually means. The disability rights movement has a long history, but this history has often times not included speech and communication disabilities and ASHA might accordingly be missing some really central things that the disability rights/studies movement has been critiquing for a long time. Since ASHA is central within the realm of SLP and is also an example of the assumptions of the wider medical community/society as a whole, it could thus be helpful to break the sentence down into chunks and think about each piece individually to criticize and ultimately reimagine some basic assumptions about disability and communicative bodies.


Making effective communication, a human right, accessible and achievable for all.

Let’s start with the big one: communication. Before we can unpack “effective communication,” we need to understand the seemingly basic idea behind communication. Unfortunately, there is nothing simple about communication; people mean a great many things by the single word. The most frequent meaning of “communication” today—and I would venture to guess, what ASHA means—involves transmitting our thoughts to another person. The purpose of speaking or writing in this sense is to get the ideas “locked in our heads” into the heads of our interlocutor or audience. Miscommunication occurs unless what we mean by our words is properly and precisely understood.

This belief that meaning is individual and interior is in large part tied to the political theory “classic liberalism” which itself is linked to capitalism. Communication is described by John Locke in the seventeenth century as transporting ideas (using words) much like one transports wheat across the ocean: words and wheat alike must not suffer corruption as they venture into the public sphere.

What is the disabled speaker/writer here but a risk, a danger: breakdown and blockage of the flow of ideas? I am increasingly convinced that our very conception and arrangement of communication is central to our oppression. We think of communication, as ASHA indicates, as the transaction of a paper-thin meaning: I own a singular meaning wrapped in a word that I must somehow get into your head. Breakdown is of course inevitable in this impossible situation. Yet rather than admitting the impossibility of liberal-capitalist communication, we pathologize and exclude more and more communicating bodies so we can pretend the system of communication is working fine. The system is not okay. It was broken from the start.

When we construct our communication practices around “transmitting ideas,” disabled people are always the ones who carry the burden of inevitable breakdown. If someone stutters they are to blame for faltering communication; it is never the listener’s fault for not understanding. Yet if a person is somewhat d/Deaf, it is never the speaker’s fault for the misunderstanding. In every breakdown, the responsibility falls uncritically on the disabled person. The system is incapable of dealing with communicative difference. It is pitiful, ableist to its core.  

We need to rethink communication radically. Communication is, in my estimation, nothing like transmitting ideas, but is rather the act of making common (note the root word here), the activity of opening up a shared space within which meaning is created together. Meaning is public, not private. It is an activity that requires collective work, not a sterile and flimsy transaction. Communication is a thick, though often difficult, means of existing with and through others. Stuttered words are brought into common spaces and contribute to the difficult work of meaning-making just like fluent words. There is no difference save that dysfluency is more honest about the process.

If we believe that communication is a shared practice of creating meaning together, we wouldn’t have to pathologize non-normative bodies so that we could reintegrate them on ableist terms. This, of course, would make it difficult to profit off of our dysfluent yet possibly-fluent-in-the-future bodies.


Making effective communication, a human right, accessible and achievable for all.

From this perspective, “effective” communication already looks a little suspect. Effective on whose terms? Effective for what purpose? It is important to note that we are not oppressed because we don’t communicate. I’ll say it again: we are not oppressed because we don’t communicate. We are oppressed because we do not communicate on ableist terms—by their standards of fluidity, time, and transparency of meaning. We are oppressed because our forms of communication are not efficient cogs in the machinery of capitalism, where time is money and money is a fluid transaction. We are oppressed and rehabilitated, in other words, because we do not communicate “effectively.” Yet effective communication is at the same time nothing but respectability politics. How we communicate makes people uncomfortable. Our awkward pauses open up gaps in the “normal” flow of conversation. Our faces contort, so people look away. We are uncomfortable. ASHA’s mandate is thus in part meant to make our communicating bodies respectable and proper so that we can assimilate into mainstream society and their ableist ways of relating to each other.


Making effective communication, a human right, accessible and achievable for all.

There is something interesting going on here. By using the language of ‘accessible’, ASHA is speaking the language of the disability rights movement. Yet by putting ‘accessible’ together with ‘achieve’ they are using this language to change our bodies rather than make space for them. We have written about the power that ableist narratives of “overcoming disability” have within our society. The narrative of “overcoming” adversity and struggle despite the challenges of disability is one that resonates loudly. Actually making communication accessible for all would mean fighting against ableism, teaching those who can’t be bothered to listen to us to care, creating communicative space for us, and operating massive social campaigns to speak against speech discrimination. What ASHA means is quite different: extending a medicalized “apparatus” into every nook of society to fix our bodies such that we can overcome our disabilities (and our fears associated with disability) and thus be integrated into an ableist society. There is nothing resembling accessibility here, at least as meant by disability rights movement.


Making effective communication, a human right, accessible and achievable for all.

This, again, is a curious phrase nestled into ASHA’s vision statement that is more than a little misleading. Upfront, and I will return to this, it must be noted that nowhere is effective communication proclaimed to be a human right. This is a clever rhetorical move that naturalizes and legitimizes ableist practices used to normalize communicative practices. The idea that communication itself is a human right is a little more solid. Article 19 of the 1948 Universal Declaration of Human Rights proclaims the right to “freedom of opinion and expression,” a right that has been somewhat haphazardly adopted in 2003 and 2005 by the UN-convened World Summit on the Information Society (WSIS) as a right to communicate. This “right” does not directly apply to conversational communication, however, but is rather focused on global telecommunications. Yet debating whether or not communication is enshrined as a human right is likely missing ASHA’s point. Proclaiming that communication is a human right is a political statement, a statement of what AHSA believes is and should be true.

However, as I noted above, by slipping ‘effective’ into the equation, ASHA is making a vastly different claim. ASHA is asking people to take the uncritical notion of ‘effective,’ with all the ableist standards it implies, as a fundamental necessity. They are in force arguing that SLP is necessary because of a human right—or, even more strongly—that access to SLP is itself a basic human right. There is nothing benign about this statement.

Yet even if we would accept, for the sake of argument, that effective communication is or should be a human right, we need to ask why the language of “human rights” is being invoked in the first place. In other words, what is the rhetorical function of “human rights” in this vision statement? There is a large body of literature that critiques the discourse of human rights as serving those who have the most power and continuing to disenfranchise the most marginalized. At the same time, the discourse of human rights sounds good and is widely used to justify international foreign policy and capitalist interests. In a similar way, I suggest that ASHA’s use of “human rights” sets communication disability up as something to be philanthropically and humanistically pitied and tolerated as it doesn’t demand any real change in how we organize our society while propping the gate open for a medicalized industry to profit off of disabled bodies.


Making effective communication, a human right, accessible and achievable for all.

Lastly, this process requires experts and is in fact something only experts can do. Normalizing disabled bodies is a technocratic process, a techne, a “making.” It is something that requires vast amounts of statistics, training, tools, and of course, money. Notice the implied subject of this sentence. The vision statement is about us, without us. It is something we, the dysfluent, cannot hope to achieve on our own. The vision statement thus not only naturalizes SLP but secures its future.


Conclusion

Given this lengthy critique, what is the response? How might we imagine “making communication accessible and achievable for all” differently? First off, we must understand that assessable communication is never simply a matter of getting better techniques but of changing power dynamics. Paraphrasing disability theorist Rod Michalko’s words to me this summer, perhaps disabled people are not listened to not because society can’t “hear us” but simply because people don’t want to. No amount of speech tools, self-talk, and assisted technology will help people communicate with an ableist world that doesn’t give a shit about our voices. Reclaiming our voices, “making communication accessible and achievable for all,” requires that we stop pretending that disabled communicators will be included if we can just be a little more normal. It requires recognizing our oppression as oppression. It requires recognizing communication not as individual and innate capacities, but as a set of relations between people that can never be solved with technological or therapeutic intervention. The ableist and oppressive relations between speaker and listener, parents, medicalized “experts,” allies, the non-vocal, and teachers are the problem. For dysfluent liberation to be possible, for communication be “accessible for all,” social relations need to be transformed. It is here that ASHA has not only missed the point but has reintrenched our oppression.

-Josh

We were looking through the American Speech-Language-Hearing Association (ASHA)’s explanation of Speech Sound Disorders this afternoon. They spend a few paragraphs defining these (articulation and phonological) disorders—e.g. when a person continues to makes the “wrong” sound for a word past the age that children typically learn the “correct” sound. There are examples: saying “wabbit” for “rabbit,” or “poon” for “spoon.” There is information on treatment.

And in the middle of it all there is this gem:

                   Q:  What if I speak more than one language? Is my accent a speech sound disorder?

                    A:  An accent is the unique way that speech is pronounced by a group of people speaking the same                          language. Accents are a natural part of spoken languages. It is important to realize that no accent is                        better than another. Accents are NOT a speech or language disorder. An SLP can work on                                           accent  modification services if a client wishes to reduce or modify his or her accent.

“An accent is NOT a speech or language disorder,” they say. “It is important to realize no accent is better than another.”

It all gets stranger when you look at the accent modification page:

                     Q:  How do accents affect communication?

                      A:  Accents reflect the unique characteristics and background of a person. Many people take great                           pride in their accents. However, some people may have difficulty communicating because of their                           accent. These difficulties include the following:

                       - People not understanding you

                       - Avoiding social interaction with those who may not understand you

                       - Frustration from having to repeat yourself all the time

                       - People focusing on your accent more than on what you are trying to say

…Well that sounds eerily familiar.

So why is it that a regional accent is “NOT a speech disorder,” but my disability accent, although it causes the exact same “difficulties,” although it is a matter of pride and identity for me, is? Why are regional accents considered “a natural part of spoken languages,” when the disability accents, likewise used by tens of millions of people worldwide aren’t? Why is it so “important to realize that no [regional] accent is better than another,” but my disability accent should be treated and removed?

This isn’t about our voices being wrong. This is about how we treat those who do not develop the way that “typical” children do. This isn’t about communication. This is about fixing and hiding away abnormal voices, abnormal bodies. This is about our culture being attuned to racism but not disability oppression. This is about how speech experts have decided variation is good, unless it is due to disability.

Sorry ASHA. Your ableism’s showing.


- Josh and Charis

Did I Stutter is a disability and stuttering pride community. We want to reclaim our bodies and voices, taking pride in them just as they are. But this statement contains an important question that we have never clearly addressed: exactly what (or who) are we reclaiming our bodies from?

There are probably many ways of answering this question but one in particular seems especially helpful. Taking back our speech means learning to tell liberating stories (or narratives) about stuttering—stories about what stuttering is, how we should “treat” it, and relate to it. The problem is that society is already saturated with competing and ableist narratives about stuttering. Reclaiming our voices thus requires that we learn to tell “counter-narratives” that (1) reject dominant narratives about stuttering that pitch it as disorder and a source of shame, while (2) replacing these with narratives of our own. 

I believe the central narrative supporting our ableist, cultural understanding of stuttering is that when we get right down to it, stuttering is a medical and scientific condition that should be treated as such. This narrative has become so engrained in our thinking that is nearly impossible to question.

What, for example, is stuttering?

According to the dominant medical and scientific story we have all come to accept as (capital-T) Truth, stuttering is simply a communication or neurological developmental disorder or pathology. Researchers and clinicians may not agree on the specifics, but everyone believes that stuttering is at core a medical and scientific condition.   

How does one treat a medical disorder? Through medical means such as rehabilitation; psychiatric treatment; pharmaceuticals; or, in the future, gene therapy.     

I, for one, am absolutely sick of hearing my speech glibly described by medical and scientific experts as a “disorder.” Medical-scientific experts may claim to possess the truth of stuttering, but I don’t recognize their authority over my body and I call on others to reject it as well.

This is all to say that one of our goals at Did I Stutter is to offer a counter-narrative to the medical and scientific story (or what we have in the past referred to as the “medical model”). Our counter-narrative is in many ways extremely simple: the medical model seeks medical solutions for social problems. 

The medical-scientific world loves to “solve” social problems (in fact, many have argued that this is exactly what the modern institution of medicine was developed to do). Nineteenth- and twentieth-century history is rife with examples of medical and scientific institutions and practitioners diagnosing social problems as medical with often terrible consequences. Allow me to outline just a few:

• An estimated 25% of women in the mid-nineteenth-century with symptoms of nervousness, hallucinations, and “abnormal” sexual appetite were diagnosed with “female hysteria” and subsequently treated in interesting ways. Turns out hysteria was just the medicalization of sexist beliefs about women. 

• The presumed rise of poverty, criminality, and “moral degeneracy” in the early twentieth century was addressed by diagnosing, institutionalizing, and often sterilizing portions of the population deemed unfit to bear children. Between 1907 to the 1970s,  in the US alone an estimated 60 000 people were sterilized. This blight on our (near global) history is called eugenics and its legacy remains with us today. 

• Up until 1980 (with the introduction of the DSM-II), homosexuality, or “sexual orientation disturbance” was considered a psychiatric disorder. Turns out society was just homophobic. Against those who would argue that this medicalization was an unfortunate artifact of the past—just “bad science”—it is worth remembering how far we have (not) come. Transgender people are today diagnosed with Gender Identity Disorder (and require this diagnosis for treatment and in many cases legal recognition), and intersex conditions are likewise heavily medicalized with disastrous effects. Finding medical solutions to our social discomfort with gender non-conforming bodies is still big business. 
  

All of these medicalizations shift attention off the social forces that produce the so-called problem in the first place. Often, the only problem is simply that people believe there is a problem. Medicine and science rush in to ease society’s anxiety with difference not by challenging us to embrace differences that we may not understand, but by labelling ‘different’ as a disorder and thus seeking to eliminate it from our bodies. 

Stuttering is not a medical disorder. Like the other things on this list, and like other forms of disability reclaimed by disability rights movements, what we call stuttering is simply a form of human variation—in this case, a different way of speaking. It is the medical and scientific narrative that has labelled this different way of speaking “abnormal” in order to (1) claim authority over our bodies and (2) calm our anxieties about people who are different.

The social problem of stuttering is the fact that we live in an ableist world uncomfortable with disability/difference. The social problem is that stutterers have been taught to hate and be ashamed of how we speak. The social problem is that people take time to listen to long-winded speakers but not to stutterers. The social problem is that stutterers are denied access to parts of society and are not treated as full citizens simply because our speech is dysfluent.

Seeking a medical solution for these social problems is not just an epic adventure in missing the point. Rather, scientists and SLPs who try to fix the social problem with medical tools are reinforcing the harmful narrative that our bodies have a disorder and thereby make it harder for us to take ownership of our speech.

Better evidence-based research, larger sample sizes, or advancements in neurophysiology and genetics will never liberate us from our oppression as stutterers. The problem is not that the science or clinical practices aren’t yet good enough. The problem is that stuttering has never been a medical and scientific problem.

It’s like trying to put out a fire with gasoline.

Medical-scientific practitioners need to realize that for better or worse, they become complicit in our oppression through the narratives they perpetuate.

“Disorder.”

“Treatment.”

“Risk.”

However, we all need to stop parroting stories that treat stuttering as something medical and scientific. And most importantly, we as a community need to learn to tell new stories that can imagine stuttering differently. My stutter has never been a disorder—it cannot be diagnosed or fixed. My stutter is how I talk. My stutter is the particular rhythms of my voice: unpredictable, dramatic, emphatic, unique. Stuttering our own stories about our voices is how they will be reclaimed. 

-Josh

One of the purposes of Did I Stutter is to shake up ideas that we take as common sense. To use a different metaphor, over time, ideas and practices that we regularly use become packed like a well-worn path. We intend to dig up and question seemingly obvious facts about stuttering, to make the trail cumbersome so we have to pick our way with more attention and perhaps find a more exciting and inviting trail that does not beeline for pathologization and rehabilitation. To be more precise, we want to show that what seems obvious may not be so obvious after all.

The taken-for-granted idea I want to explore today is that stuttering is something that can and should be measured. How do we know if a person stutters? How do we know what treatment to prescribe? How do we gauge the success of a treatment? Well, first and foremost by measuring and categorizing dysfluent speech. This is run-of-the-mill stuff for SLPs. But when we stop and think about it, measuring stuttering is an odd and fairly recent practice that reveals a lot about our assumptions of what speech, communication, and disability are.

Like many, I have gone to speech therapy and twitched as the SLP tapped out my syllables and dysfluencies on her counter. The tap quickly became background noise and forgotten: a regular part of therapy. Yet if counting stuttering has become natural for stutterers, it is far more so for SLPs. In fact, I will argue that measuring disabled speech is a central foundation of SLP as a discipline and industry.         

What we now understand as SLP only emerged as a discipline at the beginning of the 20th century. While rhetoricians have been teaching proper elocution since Ancient Greece, and medicine—including an attention to speech “defects”—flourished during the Enlightenment, it was not until the 1920s that professional “speech correctionists” from backgrounds of education, medicine, and elocution came together to form various special interests groups such as the American Academy of Speech Correction (AASC), which eventually became the American Speech-Language-Hearing Association (Duchan 2012). From a historical perspective this timeline is fairly unsurprising. Many other social sciences, such as psychology and anthropology, were established within this period, a period defined by the rise of what is called “logical positivism.”

Positivism is the belief that for a claim to be meaningful it must be demonstrable (and verifiable) through evidence. If it can’t be measured and demonstrated, it is neither true nor false, but is rather meaningless or gibberish. Needless to say, positivism shaped the entire field of Western science. Einarsdottir and Ingham (2005) point out that “from a scientific point of view, it is necessary that the measurement, and therefore the diagnosis, of a disorder should have consistency if research on that disorder is to have progress” (260). Positivism fits fairly easily with “hard” sciences like chemistry and physics which were already firmly based in experimentation, observation, and evidence. However, how do you measure messy things like the human mind (psychology), culture (anthropology), or speech (linguistics / SLP) in a way that positivists will accept as credible? Social sciences have often responded (especially in the heyday of positivism) by contorting human activities such as emotion, politics, and communication into quantifiable data that does great violence to their complex nature. Despite or perhaps because of this effort, social or “soft” sciences have continually struggled to be recognized as “real” sciences.   

The immediate problem for SLP was thus proving that what they do is scientific—i.e. credible and legitimate. Charles Van Riper hints at the early worry about the field: “Back then we had no texts, no tools. We recorded our clients’ speech on wax phonograph cylinders. Our sound waves were scratched on a smoked kymograph drum. Using tuning forks of different frequencies, we calibrated hearing loss by marks on the office carpet. We had no standardized tests.” (Van Riper, 1989, pp. 72-73; quoted in Duchan 2012). One of the first tasks of the AACS was accordingly to find a scientific grounding for speech correction: a means of quantifying disabled speech such that results can be verified and taken seriously within medical scientific communities.

Wendell Johnson was more or less the first SLP to come up with a standardized and widely recognized system of measuring stuttering—or, as SLPs call it, a “disfluency typology.” In the late 50s, Johnson devised a measurement system that used eight categories of stuttering (interjections, sound and syllable repetitions, word repetitions, phrase repetitions, incomplete phrases, broken words, and prolonged sounds). By measuring any sort of speech he was of course making a statement about what speech is: a phenomenon that can be reduced to its linguistic structure, set of phonemes, and accompanying motor functions. Other less measurable ways of understanding communication were thereby set aside as outcomes of, or incidental to, the demonstrable facts of syllable counts. Since then, the categories have shifted slightly—the more general metric “SLD” or “stuttering like disfluencies” is often used today (Einarsdottir and Ingham 2005, 262)—but the idea and practice of using syllable counters, syllable count sheets, and word count sheets to quantify, standardize, and understand stuttering behaviors has changed very little. Finding the best way to measure stuttering is an intensely debated topic within SLP, yet almost all within the field agree that it must be done (and in fact only argue so intensely about how to do it because they see it as a matter of such great importance). The Lidcombe program is an excellent example of the compulsion to quantify stuttering today, as the program goes so far as to export these practices into the home and the family—Lidcombe explicitly relies on parents measuring and charting the dysfluencies of their child.

My first point is this: the idea that stuttering is something that can be measured and represented on a count sheet is not a simple and obvious fact, but must be understood in its historical context as a way of thinking closely connected to the legitimacy of SLP as a scientific discipline. SLPs are often quick to point out that theirs, in unmistakably positivist terms, is an “evidence based practice.” While many individual SLPs do strain against the positivist roots of their discipline, for better or for worse the discipline itself is still married to the (elusive) goal of measuring stuttering, which presents real limits on the possibility of individual SLPs deviating from this method.

However, while SLPs are of course measuring something in their typological practices (motor functioning or deviations from linguistic structures), I do not think they are actually representing a deep fact about the reality of stuttering and speech production when they count out syllables and measure dysfluencies. We are of course supposed to believe that dysfluency counts are describing something scientific, objective, and therefore deeply true about the reality of my body when they quantify my speech (e.g. that I have “a stutter,” and this is a pathological medical condition). But I reject the positivist project upon which SLP is built (note that rejecting positivism is not the same as rejecting science). I believe that when these sorts of claims are made what is really happening is a circular confirmation of what has already been assumed as true. SLP starts with the assumption that stuttering is a medical and biological pathology that can therefore be measured, and then proceeds to prove this by measuring and quantifying stuttering. This is a strong but certainly not maverick claim to make on my part. Many others have staunchly resisted the positivist conquest of human affairs: the discipline of political science is a fascinating example. Even closer to home groups like Deaf pride, the anti-psychiatry movement and c/s/x, and queer activists remain highly skeptical of modern psychiatry/medicine’s discourse around and definition of their bodies and minds (cf. Price 2011). Note, I am not saying SLP isn’t a science nor an evidence based practice. Rather, the point is that “scientific” does not mean objective nor a description of how things “really are.”

I might accordingly ask: what is SLP as a discipline really accomplishing by grounding itself in measuring and quantifying dysfluent speech? SLP (a) gets to call itself a science with the rest of them and (b) is able to use this credibility (and the ensuing funding) to pathologize and treat our bodies. Again, this has very little to do with the intentions of individual SLPs who for the most part are simply wanting to help stutterers. The issue is that there is always something happening that exceeds individual intentions.

Picking up on (b), my second point is this: measuring stuttering is deeply connected to capitalism. We have argued before--here and here—that whatever else it is, SLP, along with all rehabilitative medicine, is also an industry that makes money by pathologizing and subsequently treating our bodies. Understanding the historical relation between SLP, positivism, and scientific legitimacy, we can be a little more specific about the capitalist aspect of SLP. We must consider (i) that scientific credibility enables the capitalization of rehabilitative fields like SLP. Nikolas Rose (2007) argues that as medicine was intensely capitalized in the latter half of the 20th century, “clinical practice was reshaped by the requirements of medical insurance, and criteria for reimbursement. Basic and applied biological research – in biotech companies and in universities – become bound up with the generation of intellectual property and shareholder value” (4-5). In this way, syllable sheets providing hard data are an economic tool by which SLPs get reimbursed by third-party payers for services rendered. The need to provide quantifiable outcomes to third parties continues to be a source of frustration for some SLPs who wish to provide more holistic therapy. The measurement of stuttering is thus not simply a diagnostic tool for prescribing (and reviewing) appropriate treatment, but is a type of guarantor that legitimizes and sanctions the “exploitation” of disabled speakers—the idea that their bodies must be normalized through (often costly) therapy to have value in society. Scientific credibility greases the wheels of the medical-industrial complex.   

(ii) I believe it is also important to consider that measurement and quantification are central to capitalism itself. Capitalism works by maximizing profit margins: wringing the most value out of its workers and continually expanding its markets. Capitalism increasingly measures work to make production more efficient. Nike, for example, has the time it takes to produce the various parts of a shoe down to the hundredth of a second. On the other end of the process, companies quantify markets to increase profitability. Coca-Cola sets targets according to “Total Liquid Intake”: quantifying and then increasing their share of how much liquid humans ingest in a day worldwide. Insofar as speech and communication are increasingly central to capitalist production, quantifying speech and attempting to maximize communicative efficiency through SLP are every bit a capitalist project regardless of (and even in spite of) the intentions of individual SLPs.        

In conclusion, I would like to suggest that quantifying and measuring speech (or treating it as something that can be quantified at all) should perhaps be rethought. Speech is not a string of sounds. Communication is not the exchange of meanings ferried between two brains by phonemes. Similarly, dysfluencies—no matter how meticulously counted—do not disrupt my ability to be with another through speech in a measurable and reductive way. Spoken communication is a rich, affective, aesthetic, intersubjective, and dynamic process. To contort it into a string of sounds that can be measured, dissected, and then labelled as dysfluent and pathological is a violence not only against my body but against the very nature of speech. My stutter is too wily to be reduced to a syllable count. It refuses to be caged. I refuse to make it an assembly line.    


-Josh

As we’ve critiqued many of the ableist assumptions of Speech-Language Pathology, we've received reminders that “not all SLPs are like that.” We recognize that there are individual SLPs who work hard to resist many parts of the system from within. We are extremely grateful for this work, and recognize just how important it is to those of us who receive it.

However, when you read our critiques of SLP, you’ll notice that the majority of what we’ve discussed has been focused much less on the role of individual pathologists, and much more on the discipline, teachings, and premises of Speech-Language Pathology as a whole.

This is because while it’s true that not all SLPs do all of the things that DIS has critiqued, the much more important point is that every person who stutters still experiences the harmful effects of SLP as a whole. Our society has taken the discipline and industry of SLP as the default way of understanding and responding to stuttering, and the things it says about stuttering affect every single one of us, whether we’ve ever set foot in a SLP’s office or not.

Every day I encounter the assumption that my stutter is a problem to be treated and coped with. This assumption is reinforced by the practices, research, and very existence of the SLP industry. In diagnosing stuttering as a medical condition and looking for ways to treat and rehabilitate stutterers, SLP is creating and reinforcing the backdrop of discrimination (and assimilation) against which I live every day of my life.

Of course the vast majority of us who have been to speech therapy have experience this outright—the assumption that it is my speech (not the biases of my listeners) which causes my difficulty in communicating. The assumption that the underlying social struggles I face (anxiety, fear, shyness, low self-esteem) are best addressed by modifying me or my speech rather than ableism within society.

Moreover, these exact opinions are replicated by society as a whole. For one thing, everyone constantly assumes that if I’m not receiving speech therapy I should be. For another, everyone thinks of my stutter as a struggle to overcome—a deficiency to be disliked and minimized. These biases against my speech are backed up and made credible by SLP.

At Did I Stutter, we are instead claiming that there is quite literally nothing wrong with stuttering. We want to be proud of our stutters. We want completely to undo the assumptions we hear every day that there is something unfortunate or deficient about our speech and that our voices would be better off modified or changed. We want to go to schools and workplaces where those around us don’t wish we were fluent and don’t expect us to wish it too. We want to understand the “impediments” in our speech as having nothing to do with our physical bodies and everything to do with a society that doesn’t accommodate our voices just as they are. For better or worse, these goals stand in opposition to Speech-Language Pathology.

It is for this reason that Did I Stutter has been careful to position itself outside the field and logic of SLP. In doing so we aren’t critiquing the intentions of individual SLPs, who are by and large in the field to help people. Rather, we are resisting the industry’s entire assumption that disability should be responded to in therapeutic ways. Like many other liberation movements, we want to make room for people with speech impediments to define their voices for themselves without needing to defer to “experts.” We also recognize that SLPs face an unfortunate conflict of interest as it does not economically benefit SLPs or the industry as a whole for stutterers to embrace their voices just as they are and stop seeking therapeutic intervention. This is part of why we are grateful for the work of those SLPs who do resist the ableism of the larger industry, yet part of why we know that resistance from inside an ableist system will never be enough.

It may be true that not all speech-language pathologists reinforce the ableism of Speech-Language Pathology.

But yes, all stutterers are damaged by it. 

-Josh and Charis

“If my stutter was the most truthful and sincere part of me then what did it mean to try and change that voice?”

Stutterer and author Katherine Preston asks this intriguing question in her Huffington Post article citing Honest Speech. How do we discuss the concept of authentic voice in respect to the myriad reasons individuals choose to change the way they speak?

It is necessary to first differentiate between alterations related to identity and those related to assimilation, although the two are often intertwined.  

When we talk about stutterers in speech therapy, we are primarily talking about assimilation. This type of therapy is founded in speech pathology, which labels disabled speech as inferior, ineffective, and impeded. Individuals who pursue therapy are influenced by the socially constructed standard of fluency, and they seek to reconcile the difference in their speech. Commonly, the decision to enter therapy is made not by the individual but by parents and educators who mark dysfluent speech as different and attempt to realign it.   

Individuals who enter therapy for reasons related to identity are commonly not stutterers. Preston gives many examples of identity-affirming therapy, including trans* and non-binary individuals. In this case, aspects of a person’s speech are misaligned with their identity and they make the choice to pursue change. They seek therapy not to sound like everyone else, but to sound more like themselves.

Assimilation and identity can be conflated in many cases. The litigator who entered therapy to deepen her voice did so because a high-pitched voice was viewed as incongruent with her identity as a litigator. However, the perception of femininity as ineffective in the courtroom stems from the social construction of maleness as an unmarked trait. And the choice to align a person’s voice with their gender identity is influenced by the social construction of male and female speech traits.

Did I Stutter is not inherently opposed to speech therapy. Our intention is not to shame or judge individuals who pursue therapy for any reason but instead to illustrate the implicit and explicit forces that drive stutterers into speech therapy. The point is to empower dysfluent voices, and to advocate for stutterers to be treated with respect regardless of their choices about therapy. The point is to allow stuttering youth access to proud dysfluent role models and to affirm consent and bodily autonomy at all ages.

-Erin

Let me start off by recognizing that speech therapy is an incredibly complicated issue. We want to make space here for those who desire speech therapy while at the same time being able to stand back and question some taken-for-granted assumptions. So I have a couple of disclaimers up front. First, these are simply some thoughts on speech-language pathology, not final nor sedimented beliefs. I am very much still working through this issue. Second, as the amazing disability writer and activist Eli Clare pointed out to Zach and I a couple months ago, speech therapy enables people with “severe” communicative disabilities to access education and (thus) other social opportunities that would be denied them otherwise. Because of these complexities, it is not our intention to dismiss speech therapy outright. However, we are nevertheless concerned with the way in which speech-language pathologists, even at their best, exert subtle yet very real power over people who stutter.

As the name suggests, speech-language pathology or speech therapy “pathologizes” our voices. In other words, these practices begin with the assumption that our voices are abnormal or deviant, and then medically intervene, either to increase our fluency or to offer therapeutic and emotional supports. With this in mind, I would suggest that speech therapy has three effects:

(1) Entering into a client/therapist relationship produces a specific kind of identity for the stutterer (in academic terms, it is a form of “subjection”). I enter into a relationship where I become someone who is pathologized. This is a relationship where a therapist has the authority to speak the “truth” about my body and my disability, which includes the seemingly obvious fact of my physiological/medical condition. At the same time, entering into this relationship limits the kinds of responses and control I can have over my body. Individual speech-language pathologists seek to use this authority in positive ways, and I want to stress that the vast majority of speech pathologists I have encountered in my life have been incredibly wonderful and well-intentioned people. However, this is not about individual intentions. As I have mentioned in another blog post, I just don’t think the medical, physiological difficulty of producing sounds is the best way to understand what stuttering is and what makes it a so-called “impediment.” Because pathologization is built into the client/therapist relationship—because my stutter is defined upfront as a medical issue that the therapist is given authority to help with—the option of deciding for myself that there is nothing wrong with my voice is severely limited.

(2) The client/therapist relationship is “depoliticizing.” That is, speech pathology assumes, and convinces stutterers, that what stuttering is (when we get right down to it) is an individual and biological thing. This process of medicalization covers over the ways that the very idea of normal and abnormal speech is produced by cultural values and expectations—and of course, by speech pathology itself. Because of this depoliticization, the stutterer is left with the belief that ultimately (a) stuttering is something that only I can manage (whether it be through fluency reduction or reducing avoidance, fear, etc.), (b) being able to communicate is primarily my responsibility, and (c) these are not political and social, but individual psychological and physiological issues. Speech pathology can thus distract us from getting at the root causes of our oppression.

(3) Speech pathology is a massive industry that makes money off of our bodies. Or, more specifically, it makes money off of pathologizing our bodies and reinforcing the idea that we, rather than society, are the ones who ultimately need to change. On an individual level this isn’t such a big deal. We pay people to provide us with services all of the time. However, stepping back a little and looking at the big picture, the speech pathology industry rests entirely on the assumption that our bodies require intervention. Besides traditional speech pathology, this industry includes pharmaceuticals, technology such as Speech Easy, psychology, neuroscience, and genetics. Contemporary speech-language pathology cannot therefore be separated from capitalism—or what has been termed “late capitalism.” There is big money being made by exploiting our bodies.

In my own life, I have found speech therapy both helpful and unhelpful. Even while it treated my voice as broken and needing to be fixed, it encouraged me to speak up in ways I had previously avoided, and I am grateful for that. Whether or not to participate in speech therapy is a personal decision, and if you choose to engage in it you are very welcome here. Our hope is simply that as a community of stutterers we can begin a critical conversation about the pathologization of our voices. 

-Josh