2018 Joint World Congress: Hiroshima, Japan

Koichi MORI1

1National Rehabilitation Center for Persons with Disabilities (NRCD), Japan koichi-mori@umin.ac.jp

Abstract. Stuttering in adulthood is chronic and persistent. Its treatment typically requires many and frequent sessions, which may not be practical for some people who stutter (PWS), and also for clinicians in Japan due to their scarcity. Although the primary reason for using cognitive behavioral therapy (CBT) is to improve the success rate and overall quality of life (QOL) of PWS, it also enables to relax therapy scheduling. In this study, stuttering was theorized as an assembly of vicious cycle with subconscious conditioned responses, unhelpful cognition and maladaptive coping behaviors. Also postulated was normal speaking capability for most of PWS. The therapy goal was to enable PWS to use their innate ability to speak fluently. For this to be realized, (a) the goal of fluency should be replaced by better communication irrespective of stuttering because maladaptive coping behaviors are triggered by the intent "not to stutter," (b) attention control away from stuttering has to be learned, and (c) how to produce natural speech consciously in any given situation should be learned. Also required are (d) challenges to speak before checking for difficult words. With (a), fluency may be a byproduct of improved communication, but the latter alone should be enough for most PWS in order to participate and play a full role in the society. For (b) and (c) daily mindfulness meditation and speech shadowing should be practiced (5--10 min each). (d) is partially achieved by behavioral therapies specific to stuttering. Special care is needed for those who also clutter. The current group format comprising five 3-hour sessions over 5 weeks generated positive results. 

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