Ehud Yairi: Reflections on a Career.

This is the second in a series of papers that provides an historical record in this journal of contributions made by the most influential researchers in the field of fluency disorders. The present paper reflects on the long and productive career of Ehud Yairi, outlining his many contributions to the field of stuttering, and his outstanding achievements and accomplishments. The paper is based on interviews with him during 2020, after the conclusion of his research career. His visionary, lifetime work has advanced our understanding of the nature, origins, and epidemiology of this disorder.

[A Multi-arm Placebo-controlled Study with Glutamic Acid Conducted in Rostock in 1953/1954]. / Eine Rostocker Placebo-kontrollierte mehrarmige Studie mit Glutaminsäure bei Kindern und Jugendlichen 1953/54.

A Multi-arm Placebo-controlled Study with Glutamic Acid Conducted in Rostock in 1953/1954 Glutamic acid was commonly used in the treatment of intellectually disabled children in the 50s. Koch reported first results of an observation of 140 children treated with glutamic acid in 1952. In this line is the multi-arm placebo-controlled study reported here. The original study protocols were available. 58 children with speech problems who attending a school of special needs received glutamic acid, or vitamin B, or St.-John's-wort. The effect of glutamic acid was in few cases an improvement of attention. On the other hand restlessness and stutter increased. The majority of all reported a weight loss. The treatment with vitamin B showed a positive effect concerning concentration. The treatment with St.-John's wort was stopped caused by headache and vomiting in eight of nine cases. The results of the study reported here are unpublished. The reason may be that until the 60s the effects of glutamic acid in the treatment of intellectually disabled children were in generally overestimated.

Nature and nurture in stuttering: a systematic review on the case of Moses.

Stuttering is a disturbance of normal fluency of speech whose pathophysiology is still not well understood. We investigated one of the most ancient speech disorders in the biblical person Moses who lived in approximately 1300 BC. To get the most complete medical and non-medical information on Moses, we did systematic searches in the Holy Bible using the Bible-Discovery v2.3© software ( http://www.bible-discovery.com ) looking for verses containing the terms "Moses", "Stuttering" and "Stutter"; and in PubMed/Medline database for manuscripts having the terms "Moses", "Bible" and "Stuttering". From the Bible search, 742 verses were found, of which 23 were relevant; three additional verses were found by hand search. Six papers discussing Moses's pathology were found in the PubMed search. The analysis of ancient descriptions in the light of current research suggests that stuttering is the most likely pathology Moses had, with clear evidence for both genetic origin and environmental triggers. Further, it was found that Moses practiced some "sensory tricks" that could be used to relieve his speech disorder which are, to our knowledge, the first "tricks" that successfully modulated a movement disorder described in the medical literature.

Historical and cultural influences on establishing professional legitimacy: a case example from Lionel Logue.

PURPOSE: In the film The King's Speech, the credibility of the king's speech clinician, Lionel Logue, is challenged. This article examines Logue's credentials in light of the credentialing standards and attitudes of Logue's time as well as those affecting today's practices. The aim is to show how standards of legitimacy change with the times. METHOD: Documents related to clinical qualifications and clinical practices are analyzed for the period in the early 20th century, when Logue practiced. They are then compared with how clinicians of today attain professional legitimacy. CONCLUSION: Early 20th century clinicians drew their credibility from their home disciplines such as medicine, phonetics, elocution, and education. Some of their therapies originated in the home discipline. Other therapies were commonly used, regardless of one's disciplinary background. Lionel Logue's background and methods would not have been suspect in his time. He may have been faulted by some for his lack of scientific perspective, but another likely source for the challenges to his credibility were early 20th century British social biases against Australians and against those using Australian dialects. The comparative analysis revealed that early 20th century clinicians and clinicians of today have certain clinical practices in common, but they differ considerably in how they establish their legitimacy. This indicates that judgments about a clinician's legitimacy are both historically and culturally determined.

Retraining left-handers and the aetiology of stuttering: the rise and fall of an intriguing theory.

Many twentieth-century British and American educators, psychologists, and psychiatrists advocated forcing left-handed children to write with their right hands. These experts asserted that a child's decision to rely on his or her left hand was a reflection of a defiant personality that could best be corrected by forcible switching. The methods used to retrain left-handers were often tortuous, including restraining a resistant child's left hand. In contrast, those who saw left-handedness as inherited, but natural, not only disapproved of forced switching, but also often warned of its putative negative consequences, especially stuttering. These claims were given credence in the 1930s by influential University of Iowa researchers, including psychiatrist S. T. Orton, psychologist L. E. Travis, and their students. From the late 1920s until the 1950s, the Iowa researchers published articles and books connecting the etiology of stuttering to forcing natural left-handers to write and perform other tasks with their right hand. Based on their clinical studies these practitioners concluded that stutterers displayed weak laterality. The Iowa group also published detailed case studies of patients whose stuttering was putatively cured by the restoration of their left-handedness. By the late-1940s, the connection between stuttering and retraining evaporated, due in large part to the growing dominance of psychoanalytic psychiatry. Despite robust statistical and clinical evidence, the connection between forced hand switching and stuttering has largely been forgotten. Recent imaging studies of stutterers, however, have suggested that stuttering is tied to disturbed signal transmission between the hemispheres. Similar to the Iowa researchers of the 1930s, current investigators have found connections between stuttering and weak laterality.

The "Iowa Way" revisited.

UNLABELLED: This paper attempts to bridge the gap between past and present stuttering therapy approaches. Specifically, the ideas and methods of Wendell Johnson and Dean Williams are compared to current approaches used in treating mental illness and communication disorders in which there is an emphasis on focusing on what is "right" with the individual and spending less time focusing on the "disorder". There is particular emphasis on tying Johnson's and Williams' overall philosophy to modern psychological approaches rooted in "Positive Psychology", to highlight how these early ideas in stuttering therapy may help us to discover the common factors that underlie the success of several different stuttering therapy approaches, independent of the specific techniques employed. It is proposed that future research on clinical efficacy in stuttering should use focused hypotheses techniques to investigate common factors that make therapy effective across individuals and therapy approaches. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) summarize the basic philosophy of the "Iowa" approach to stuttering as laid out by Wendell Johnson and Dean Williams; (2) describe current therapeutic techniques that incorporate "positive psychology"; (3) discuss possible common factors that influence therapy outcome that are independent of the therapeutic technique employed.

A dialogue among various cultures and its manifestation in stuttering therapy.

UNLABELLED: This paper presents a historical retrospective of the evolution of the clinical aspects of stuttering, and refers to social, cultural, political, and economic variables that might have exerted an influence on this evolution, particularly in relation to the authors' experience in Israel. The retrospective commences in the early decades of the 20th century, when speech and language pathology did not exist as a profession, and presents the major approaches to therapy in children and adults employed by clinicians throughout the century. We focused on the impact of the change that occurred in religious society vis-à-vis stuttering on the various aspects of stuttering therapy and research. The Israeli Stuttering Organization - AMBI - is discussed in order to explore the possible influence of social, cultural, and political variables. In addition, we devoted special attention to the changes that occurred in the therapist-client relationship since they are indicative of the change in the nature of the treatment. We elaborated on the need for dialogue as a major component in the therapy and as an important contributor to a successful outcome. The dialogue is also discussed in terms of Eastern philosophy. Future developments in the understanding of stuttering and its implications for therapy are presented and discussed. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) summarize the history of the clinical development of stuttering and explore the possible influence of social, cultural, political, and economic variables particularly in relation to Israel; (2) provide a new definition of stuttering; and (3) contrast the model of a dialogue as opposed to a monologue and explain its use in the therapist-client relationship.

[Hinko Lehner--the first Croatian logoped]. / Hinko Lehner--prvi hrvatski logoped.

In his career, somewhat longer than 22 years, Lehner was frequently transferred from place to place. Beside working as municipal and county physician he worked also as a spa doctor. Very much interested in the stuttering treatment, his own problem that he had solved during his student period in Vienna, he kept trying to sensitize his fellow-doctors, teachers, but also the Croatian authorities for this problem. He lectured and published on this topic in the professional medical journal, but also in the newspapers. About stuttering he published, at his own expenses, first a booklet (1895) and then a book (1912). Therefore it is justified to consider him a pioneer of logopedy in Croatia albeit, regrettably, forgotten. In order to improve the health situation in Croatia as well as the social status of his profession, he wrote about the health system and the position of doctor in the society.

Evidence-based treatment and stuttering--historical perspective.

PURPOSE: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based. METHOD: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking evidence of a different kind: FS seeks evidence concerning treatment outcome, and SM seeks evidence concerning the nature of the stutter event. CONCLUSION: Although outcome evidence provides the principal support for FS, support for SM comes principally from a cognitive learning model of defensive behavior as applied to the nature of the stutter event. Neither approach can claim anything like uniform success with adults who stutter. However, self-management and modeling are strategies common to both approaches and have shown consistently positive effects on outcome. It is argued that both strategies merit additional treatment efficacy study. Cognitive behavior theory may provide a useful framework for this research.

Oliver Bloodstein: reflections on a career. Interview by Mark Onslow.

UNLABELLED: Oliver Bloodstein arrived at the University of Iowa in 1941 to study under Wendell Johnson. There he began an influential career that included a seminal documentation of the development of stuttering, the development of the continuity hypothesis and the anticipatory struggle hypothesis, and the writing of five editions of the influential text "A Handbook on Stuttering." In this interview Dr. Bloodstein reflects on his remarkable and inspiring career, which continues today with his involvement in the preparation of a sixth edition of this text. EDUCATIONAL OBJECTIVES: The reader will: (1) describe the contribution to the field of stuttering made by Dr. Bloodstein; (2) discuss the career influences that led to his achievements; (3) know Dr. Bloodstein's current views on the cause of stuttering; and (4) identify the locations at which he worked during his career.

Changing perspectives for practice in stuttering: echoes from a Celtic past, when wordlessness was entitled to time.

Changing perspectives for practice in stuttering therapy are informed by the changes in knowledge, social values, and belief systems of a society. The International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001) has a sociological emphasis with a focus on the ability and functioning of the person, and it is currently fostering changes in perspectives for working with those who stutter. These perspectives are reflected in Irish social mores in the 7th and 8th centuries, when social and legal codes enshrined the rights of people with speech disabilities in law and recognized the dignity and integrity of people with such disabilities. The society of the time showed awareness and acceptance of people with disabilities, and it provided the supports to enable their participation in society. To a large extent, these principles contrast with the predominantly impairment-based focus that has been the heritage of the speech-language pathology profession in the 20th century. In order to review changing emphases in stuttering therapy and to consider applications of a sociological approach to stuttering, an outline of historical perspectives of the profession of speech-language pathology is presented. The evolution of the ICF is also outlined, moving from an impairment-based focus to a more sociological perspective. Both perspectives provide a historical context for consideration of approaches to working with stuttering, reflecting the ICF and echoing principles that were practiced in an ancient Celtic society.