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Problems with person-first language

5/4/2015

3 Comments

 
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As a dysfluency pride project, Did I Stutter adamantly supports the right of individuals to incorporate stuttering as an element of identity formation. To this end, we are aware of the highly politicized language used by others to categorize our bodies and voices. We consciously refer to ourselves as stutterers instead of people who stutter, which is the language preferred and perpetuated by the field of speech-language pathology.

Person-first language was originally introduced by disability advocacy groups in the 1980s to fight the dehumanization of disabled people and has evolved into a tool of ableism used to oppress stutterers and inhibit the formation of self-advocacy networks. It employs awkward phrasing that marks stuttering as an undesirable trait and reinforces non-disabled speech as normative. The person-first label ‘person who stutters’ is often abbreviated to PWS. Using acronyms to refer to an individual or group of stigmatized people accentuates the marginalization of that group.

These linguistic standards are imposed upon disabled people, although many disability groups are very explicit in their rejection of person-first language (the Deaf, Blind, and Autistic communities, for example). The strongest support for person-first language comes from non-disabled parents of disabled children and clinicians working with the disabled, individuals who are not using the language to refer to themselves. Person-first language is codified in policy by many social work, therapy, and academic organizations, which may require their employees to use it.

Many stuttering self-help organizations model person-first language, referring to individuals as people who stutter. These organizations may support stuttering pride and view their members positively, but insisting on person-first language reinforces the message that stuttering is a defect. The tone of these groups is commonly one of minimizing or ‘overcoming’ stuttering, and members are discouraged from adopting dysfluency as an element of identity.

Person-first language, with its emphasis on the person and not the disability, is effective in separating disabled people from each other and lessening the strength of community formation. To form communities of political significance, we need to be seen as stutterers (and Autistic people, and wheelchair users, etc.) instead of people who stutter, people with autism, people who use wheelchairs.

The distinctions between person-first and identity-first language can seem insignificant to non-disabled people, to whom these labels aren’t applied. While proponents claim that referring to us as people first is more respectful, they dismiss the fact that only stigmatized identities are given person-first labels. We are not expected to call ourselves ‘people with whiteness’ and no one seems worried that our identities will be reduced to our shoe size or eye color. Similarly, non-disabled people are not expected to refer to themselves as ‘people who are not people who stutter’.

Some people prefer to be called people who stutter, or people with disabilities. It is their right to choose the language of their identity, and their choice should be respected. That right should be respected among all disabled people. There is no linguistic standard that can be applied so broadly. No person should be burdened with the duty of asserting their humanity as a means of introduction. We are people. To ensure that this fact is not overlooked in discourse about our bodies is not our responsibility.

 -Erin

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Accents and AbleismĀ 

4/8/2015

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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
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Stories from the Brainreels Podcast

4/3/2015

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We are very excited about this podcast with the fabulous Cheryl Green at "Stories from the Brainreels!" We discuss everything from identity-first language to community building. The link includes access to a full typed transcript. Check it out here!




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On being inconvenient

3/23/2015

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They tell me time is precious.

We have 1 life (not to botch), roughly 3 decades to reproduce (the family structure), 40 hours a week to make money, 24 hours in a day, 16 waking hours.

There’s no time to waste.

In those 16 hours we have to shower, eat, shave, shit, laugh, dress, buy, love, drive, drink, clean, mourn, write, and stress. We have to brownnose our bosses, save for the future, impress our colleagues, grow up, stay youthful, buy a house while interest is low, stay fit, keep in touch, pay off debts, invest, floss our teeth, and watch loved ones die.

So I’m told, life is short.

My response: to stutter whenever and wherever I can.

I like to be inconvenient.

See, the thing about time is that some people are allowed to take up more of it than others. Some people’s time (read: fancy businessmen and other good, privileged capitalists) is worth more than mine. Some people are rewarded for yammering on and lounging in time since their time is what makes the world spin. Disabled people, on the other hand, are taught from an early age to cram ourselves inside time, to take up as little space as possible, to not be a burden.

Part of our oppression as dysfluent speakers comes from being caught in this contradiction: our time is not valuable and yet we continue to www w.-ww-aaaaa—wwwww….  …           to Wwwwwaa.   WWW---waaaaaaste it, spending an extravagant amount of time sputtering consonants and screeching out vowels: far more than we have been allotted. We don’t just stutter away our lives, but (more tragically) the lives of colleagues, families, corporations, and governments.

I take a mischievous delight in being inconvenient.
I steal time that shouldn’t belong to me
from right underneath the businessman’s nose.                          

This doesn’t always work of course. Our ableist world is well-practised at depriving disabled people of time, dignity, and life.       

Yet wherever and whenever possible—precisely when most inconvenient—we must stammer ourselves into the world, in protest and hope that we can reclaim what has always been ours.   

Time was never a commodity--
       It cannot be owned.

It must be squandered
together.


-Josh

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Reflections from a teacher who stutters

3/16/2015

5 Comments

 
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When I tell people I teach elementary school math, I can't help but notice the surprised looks I get. In general, people are too polite to ask how someone who stutters as much as I do can get up in front of kids and teach anything. Truthfully, I'd love it if someone actually did ask me this question. Foremost, because it has been a lot of work. As I did my Masters in education I felt like I had to constantly prove myself in ways people with average fluency did not. I am proud of my accomplishments and what I do as a teacher, but also I'd like to break down the perception that there are jobs inaccessible to people who stutter or who have other disabilities.

Reflecting back on the past two years as a classroom teacher, I've made a lot of personal growth. When I first started teaching I used a lot of speech tools and techniques that hindered what I wanted to say. I spent more energy on attempting fluency than on actually teaching. With the help of the Did I Stutter Project and a very supportive administration, I no longer view my stutter as an obstacle but as an asset. The only speech tool I use regularly now is advertising. And I prefer to call it advocating. Self advocacy is something I try to instill in all my learners, whether they have a disability or not.  

I can't deny that I face challenges daily. I have difficulty with /s/, /p/, /m/ and /r/ sounds and math vocabulary abounds with them: symmetry, multiply, parallel, remainder, to name just a few. There is no using circumlocution to avoid these as they are crucial words for my students to hear, use, and understand. This doesn't even account for all the other communication that needs to happen throughout the day to ensure an organized, peaceful, and welcoming learning environment. In addition to regular classroom duties I, am responsible for calling parents, speaking up in meetings, and even addressing assembly.

At the beginning of this school year I sat down with my new students and talked about the things that make us unique. I spoke honestly about stuttering and why some people speak this way. I made sure they understood that I'm not uncomfortable and they can always ask me to repeat myself if they don't understand what I've said. We talked about the etiquette of conversation and how you should never finish anyone's sentences for them even if you think it's helpful. I also talked to them about being gay and from New Jersey because these too make me unique. I encourage my students to find the things about themselves that make them unique and to have pride in those things.

As I said before, I truly believe my stutter makes me a better communicator. Because I speak slowly and with a lot of blocks and repetitions, students are able to process what I say more easily. I can't bolt through a long set of instructions for example. I also employ an economy of words. My students aren't used to me talking at length so I think they listen more carefully when I do speak. I believe I have become a much more creative and careful thinker as well, because my mental energy is no longer spent on attempting fluency. Additionally, I've become a better advocate for myself and for my students in terms of accommodations.

My classes are a mix of learners with various needs--from students with identified high incidence disabilities (specific learning disabilities, ADHD and Autism) to those identified as needing enrichment through the gifted and talented program. Some of my students fit in both exceptionalities as well. I am a strong believer in Howard Gardner’s theory of Multiple Intelligences. Rather than lecture, I use hands-on discovery, games, songs (I play guitar and sing math songs at least once a week), kinesthetic movement activities, projects, and practical applications like cooking and building, to deliver and reinforce new concepts. This can take hours of preparation and careful planning, but I think it makes for a much more varied, child-centered learning environment.

Of course I do occasionally have to introduce a new concept in the more traditional ‘teacher in front of the classroom’ model. In these instances I often use videos (I’m a huge fan of Learnzillion), text reading apps, animation apps (Tellagami is my favorite) and other technology to help me effectively communicate in the most efficient way possible. These tools are often referred to as assistive technology: any item, piece of equipment or product that is used to increase, maintain, or improve the functional capabilities of people with disabilities. You'll notice that I don't include AT specifically designed for people who stutter like those that provide delayed auditory feedback, because fluency is not my mission, but rather effective, comfortable communication.

My hope is that when I use AT in the classroom it eliminates any stigma for students who chose to use it as well. Many of my students use Virtual Manipulatives and I have several students who are not strong readers or writers who benefit from such apps as Dragon dictation, Announcify, and Google read/write. As I learn about new tools and apps, I introduce them to all my students as something they might be interested in trying. I have been criticized by some colleagues for this, but I remind them that autocorrect and calculators are types of AT and ask if they are willing to give those up. I offer alternative formats for all exams and presentations as well. Because there is no stigma, I have many non-disabled students who prefer to use AT or alternative exams/presentations because of the novelty.

What makes me the most satisfied as a teacher is not when I find out all my students have passed their standardized tests, but rather when they tell me they love coming to my class. And truthfully, this happens a lot. I think having a teacher who both shows pride in his stuttering and who models the use of assistive technology can only help to confirm that people with disabilities can perform as well or even better than non-disabled people in their jobs.

-Eli



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Medical Solutions for Social Problems

3/9/2015

1 Comment

 
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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


1 Comment

Stuttering and Sexism

2/19/2015

2 Comments

 
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The conceptualization of dysfluent speech as ugly or unpleasant is an effective tool in the marginalization of stutterers. It is particularly salient for women, who face intersecting and compounding marginalization in patriarchal society. The appearance, behavior, and speech of women are much more heavily policed. Norms of emphasized femininity dictate that appropriate roles for women are submissive, docile, and aligned with specific standards of physical appearance. Understanding gender-based oppression is critical to discussing the ways that women experience speech discrimination and their role in activism.

Patriarchal society praises women for behaving and appearing in ways that accentuate their vulnerability and diminish their confidence. The misconception that stuttering is caused by shyness, anxiety, or low self-esteem is used to reinforce the belief that women are intellectually, emotionally, and psychologically frail in relation to men. A woman’s response to her own stuttering is more positively sanctioned if she expresses shame, and women much more than men are encouraged to suppress stuttering, even at the expense of communication and expression.

The gendered differences in perception of confidence among stutterers illustrate an important facet of patriarchy, that the perpetuation of a binary system necessitates the treatment of masculinity and femininity as mutually exclusive categories. Vulnerability and low self-esteem are positively sanctioned in adherence to standards of emphasized femininity, while dysfluent men are negatively sanctioned for expressing shame, as it is a deviant performance of hegemonic masculinity. This type of binary-based double standard is visible in speech and behavior more broadly. For example: similar actions by leaders are labeled as assertive when performed by men and abrasive when performed by women.

Emphasized femininity as an embodied practice involves adherence to specific norms regarding physical appearance and self-image. Embodied practices of vulnerability encourage low self-image and the persistent focus on improvement of physical appearance rather than acceptance or pride. It is far more widely accepted for women to participate in and support crash diets and weight loss regimens than campaigns for body positivity or health at every size. Women’s public engagement with stuttering is similarly influenced. Medical-model self-help groups that focus on avoiding stuttering and improving self-acceptance are much more accessible than radical activism, which rejects the notion of stutterers as flawed and demands institutional change. For women, rejecting patriarchal standards of body image and body presentation is itself a radical act. To give up the work of therapy, assimilation, and internalized shame and instead be proud of a dysfluent voice is a highly deviant act. It is much more difficult for women than men to obtain legitimacy when they do not view stuttering as a defect.

It is important to account for the effect of gender-based oppression on dysfluent women when considering the experience of stutterers more broadly. It is also important to consider that the experience of trans and non-binary people is different from that of cisgender women. Intersectional analyses must also account for privilege and oppression based on race, class, age, sexuality, and other disabilities. When we talk about ableism and speech discrimination general, abstract terms, the nuance of intersecting oppressions can often be masked. Too often, we talk about pride and activism in ways that do not account for ways we experience privilege, and the ways in which others are oppressed.   

-Erin

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Dis-Counted Speech: Why are we still measuring stuttering?

2/9/2015

2 Comments

 
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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

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#Not All Speech-Language Pathologists

1/6/2015

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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


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Did I Stutter on StutterTalk!

12/31/2014

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Erin and Josh are featured on this week's StutterTalk podcast: Honest Speech and Stuttering Hospitably (Ep. 488). Lots of great questions that we need to keep discussing as a community. 

(Transcripts of the podcast are being posted here.)

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