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  • Title: Valsalva Stuttering Network Home Page
    Descriptive info: .. The Valsalva Stuttering Network.. Home Page.. Click here for.. Free Stuttering.. Information.. from William D.. Parry,.. an ASHA-Certified Speech- Language Pathologist.. If you are a person who.. stutters.. (stammers), do words sometimes feel like brick walls, even before you try to say them? Do you repeat, prolong, or force on initial consonants?.. Do you sometimes choke on words that start with vowels?.. Do your blocks get stronger the harder you try to break through them?.. This website will propose new explanations and solutions to these common stuttering behaviors, based on the author’s recent clinical research on.. Valsalva Control Therapy.. It will show that the problem is.. not.. in saying the consonant, but rather the.. neurological substitution of effort in place of phonation of the word’s vowel sound.. This reaction may be triggered by the anticipation of difficulty or the urge to use effort to reduce anxiety.. Stuttering.. (or stammering), in its most common form, may involve the stutterer's instinctive activation of the body's.. Valsalva mechanism.. in an attempt to force out words when he or she anticipates difficulty or feels the need to use extra effort to speak properly.. This possibility has been generally ignored by speech therapists and is rarely addressed by current stuttering therapy.. Because persons who stutter aren't taught to control their Valsalva mechanism, many continue to have difficulty controlling their stuttering blocks and often relapse after therapy, without understanding why they are unable to stop stuttering.. The purpose of the.. Valsalva.. -S.. tuttering Network.. is to promote research and education about stuttering and the Valsalva mechanism and to develop effective stuttering therapies and techniques to reduce the Valsalva mechanism's interference with speech.. The Valsalva-Stuttering Network welcomes everyone who has an interest in stuttering and/or the Valsalva mechanism, including persons who stutter, speech-language pathologists (SLPs) and other professionals, and researchers.. In addition to its possible involvement  ...   Valsalva Stuttering Therapy is now available worldwide through video conferencing over the Internet.. Research.. -.. Results of the first clinical study of Valsalva Control Therapy - plus.. video showing dramatic initial results of Phase 2 intensive therapy study.. - presented at the National Stuttering Association annual conference in Ft.. Worth, Texas, July 7, 2011.. (NOTE: No additional volunteers are needed for the study, because there is already sufficient evidence as to the effectiveness of Valsalva Control.. ).. Links.. - Links to external websites regarding stuttering.. , stuttering therapy, the Valsalva maneuver, stuttering.. support organizations.. , and other information resources.. Copyright © 2011-2013 by William D.. Parry.. Now Available:.. The new.. Revised and Expanded Third Edition.. of.. Understanding Controlling Stuttering.. (2013).. ,.. containing new insights and self-help exercises based on.. Valsalva Stuttering Therapy.. Contact Information:.. William D.. Parry, CCC-SLP.. A licensed speech-language pathologist, offering Valsalva Stuttering Therapy and counseling in person in Philadelphia and by video conferencing over the Internet (subject to applicable law).. Office:.. 1608 Walnut Street, Suite 900, Philadelphia, PA 19103.. Phone:.. 215-620-6792.. E-mail:.. stutteringtherap@aol.. com.. Websites:.. Stuttering Therapy and Counseling:.. www.. stutteringtherapist.. The Valsalva-Stuttering Network:.. valsalva.. org.. E-mail:.. contact@valsalva.. Beating Stuttering Blocks:.. stutterblock.. Stuttering and the Law:.. stutterlaw.. Valsalva Stuttering Therapy is a new approach to improving fluency by controlling the physiological mechanism that may be causing stuttering blocks.. For further information on Valsalva Stuttering Therapy, visit.. Stuttering Therapy and Counseling.. at.. The Revised and Expanded Third Edition of.. Understanding and Controlling Stuttering.. (2013) may be ordered from the.. National Stuttering Association.. or from.. Amazon.. Buy it on Amazon for 20% off regular price.. For information concerning stuttering self-help and support, please contact:.. 119 West 40th Street, 14th Floor, New York, NY 10018.. Telephone: (800) 364-1677 or (800) WE STUTTER.. Fax: (212) 944-8244.. e-mail:.. info@WeStutter.. Updated 5/13/2013.. Return to Stutteringtherapist.. com Home Page.. Return to Stutterblock.. Last revised: 9/26/2013..

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  • Title: Free Stuttering Help
    Descriptive info: Information About Controlling the Physiological Mechanism That May Cause Stuttering Blocks.. By William D.. J.. D.. , M.. A.. , CCC-SLP.. A licensed speech-language pathologist and trial lawyer, with 25 years experience in stuttering support and advocacy and author of.. Understanding Controlling Stuttering: A Comprehensive New Approach Based on the Valsalva Hypothesis.. This page is intended to provide information for persons wishing to explore the Valsalva Control approach to reducing their stuttering blocks.. It is not a substitute for individual diagnosis, stuttering therapy, and counseling by a qualified speech-language pathologist or other appropriate health-care professional.. Information about William Parry's book.. NEW!.. - The Revised and Expanded Third Edition (2013).. Dismantling the 'Brick Wall' of Stuttering,.. by William D.. Parry, CCC-SLP.. William Parry's paper presented as part of the International Stuttering Association's 2013 International Stuttering Awareness Day On-Line Conference.. Stuttering Unblocked: Freeing Your Speech from the Neurological Brick Wall.. Video excerpts from William Parry's presentation at the.. National Stuttering Association annual conference in Scottsdale, Arizona, July 5, 2013.. Part One: Understanding the Brick Wall.. Part Two: Valsalva Stuttering Therapy.. Introduction to the Worldwide Valsalva Stuttering Therapy Program (VIDEOS).. Three videos discussing the neurological, physiological, and psychological factors in stuttering blocks, and the fundamental principles of Valsalva Stuttering Therapy.. If you stutter, do words sometimes feel like brick walls ? Do you repeat, prolong, or force on initial consonants? Do your blocks get stronger the harder you try to break through them? In this video, William  ...   World Congress for People Who Stutter.. , in Buenos Aires, Argentina, May 2011.. Introduction to Stuttering, Valsalva Stuttering and Valsalva Control,.. Stuttering and the Valsalva Mechanism: A Key To Understanding and Controlling Stuttering Blocks.. Why is stuttering usually worst when the words are most important? This article shows how a natural bodily function - the Valsalva mechanism - may turn our efforts to speak into the very blocks we are trying so hard to avoid.. It explains why it is so hard for people who stutter to stop stuttering, and suggests a new approach to stuttering therapy.. This introductory article is based on Bill Parry's presentation to the.. 1995 World Congress for People Who Stutter.. in Linköping, Sweden.. Phonation and Valsalva-Stuttering Blocks.. Detrimental Self-Talk and Stuttering - A Flow Chart.. ,.. William Parry's workshop presentation at the NSA conference in July 2009:.. Video excerpts from the Beating Stuttering Blocks workshop.. Beating Stuttering Blocks (PowerPoint).. Beating Stuttering Blocks (PDF).. Diagnosing Valsalva Stuttering: Suggested Criteria.. Beating Stuttering Blocks: Some Basic Suggestions for Valsalva Control Stuttering Therapyl.. For those interested in William Parry's book:.. Understanding and Controlling Stuttering: A Comprehensive New Approach Based on the Valsalva Hypothesis.. - Information about William Parry's book, available from the National Stuttering Association and Amazon.. Other Sources of Information and Support:.. The National Stuttering Association.. The Philadelphia Area Chapter of the National Stuttering Association.. American Speech-Language-Hearing Association.. Stuttering Foundation of America.. Stuttering Home Page.. Return to VSN Home Page.. Last revised: 11/10/2013..

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  • Title: Valsalva Stuttering Network - Introduction
    Descriptive info: Parry, J.. Stuttering and Valsalva Stuttering.. |.. The Valsalva Mechanism.. The Valsalva Hypothesis.. Stuttering Therapy.. Electronic Devices.. Stuttering Research.. NOTE:.. The following article was written prior to my recent clinical trials of.. , which produced important refinements to the Valsalva Hypothesis and improved therapy techniques.. Therefore, please see my new articles:.. Valsalva Stuttering Therapy: A Brief Introduction.. and.. based on my presentation at the National Stuttering Association conference in Ft.. Worth, Texas, on July 7, 2011, including.. the results of my first clinical study of Valsalva Control Therapy and.. videos from my current trial of intensive Valsalva Control Therapy.. Stuttering and Valsalva Stuttering.. Stuttering.. (sometimes called stammering ) is a specific kind of disfluency, in which the flow of speech is involuntarily disrupted by forceful closures of the mouth or larynx, by repetitions or prolongations of sounds and syllables, or by hesitations or delays in making voiced sounds.. Stuttering generally involves an excessive amount of effort, force, and struggle in the attempt to speak.. It also may be accompanied by a variety of secondary behaviors intended to avoid, postpone, or hide the blocks.. Most people who stutter are able to speak fluently some of the time, but on other occasions their speech is blocked.. Stuttering is a complex and multi-faceted condition which, depending on the individual, may involve a combination of learned behavior and various neurological, physiological, and psychological factors.. Some people who stutter become adept at.. covert stuttering.. , by substituting words and avoiding situations in which they fear they will stutter.. (For additional information about stuttering in general, see.. The Stuttering Experience.. , on this website.. Valsalva stuttering.. is this author's term for describing what appears to be an extremely common type of stuttering behavior.. In Valsalva stuttering, the stutterer instinctively activates the body's.. in an attempt to force out words, particularly when he or she anticipates that speaking will be difficult or that extra effort is needed.. The symptoms of Valsalva stuttering include:.. Excessively.. forceful closures of the mouth or larynx.. , either of a sustained or repetitive nature, accompanied by tightness in the abdominal muscles and increased air pressure in the lungs; and.. Delays in phonation.. (the production of voiced sounds in the larynx).. Repetitions or prolongations.. of initial consonant sounds.. In some instances, Valsalva stuttering might be masked by covert stuttering or secondary avoidance behaviors (.. e.. g.. ,.. hesitations, repetitions, interjections, starters, circumlocutions, etc.. ).. In those cases, one should focus on the underlying stuttering behavior that the person is trying to avoid.. While not all stutterers may exhibit Valsalva-stuttering behaviors, it is likely that a large majority do.. (The author's observation of hundreds of stutterers over the past 24 years indicates this to be the case.. ) However, speech-language pathologists are almost never taught about the Valsalva mechanism, are generally unaware of its possible involvement in stuttering, and are not prepared either to diagnose or to treat it.. While therapists may encourage stutterers to relax the lips, tongue, and larynx, these are only the tip of the iceberg.. Control of the mouth and larynx will be difficult as long as therapists ignore the physiological mechanism providing the force behind the blocks.. Back to top.. The.. Valsalva mechanism.. consists of neurologically coordinated muscles in the mouth, larynx, chest, and abdomen.. It is designed to perform a.. Valsalva maneuver.. to increase air pressure in the lungs by forcefully closing the upper airway while the chest and abdominal muscles contract.. This assists us in many types of physical effort and in forcing things out of the body.. The ordinary.. Valsalva maneuver.. involves tight closure of the vocal and vestibular folds of the larynx (called.. effort closure.. ) for the purpose of sealing off the respiratory tract, accompanied by contraction of muscles of the abdomen and chest.. The various elements of the Valsalva mechanism appear to be linked neurologically so that they tend to contract simultaneously.. The force of the closure is in proportion to the amount of pulmonary air pressure being resisted.. Ordinarily the Valsalva maneuver (with its accompanying effort closure of the larynx) is done instinctively, without conscious thought.. This occurs in normal, healthy persons during lifting, pushing, pulling, defecation, natural childbirth, and other strenuous tasks.. (During activities such as lifting, the rectal muscles also contract, to prevent accidental evacuation of the bowels, but during defecation they do not.. ) However, a person can also either perform a Valsalva maneuver on purpose, or consciously refrain from doing one.. The forceful closures associated with a Valsalva maneuver need not be limited to the usual effort closure of the larynx, but may instead involve tight closure of the lips or tongue, depending on which structure initiates blockage of the airway.. Consequently, forceful closure of the lips and tongue may occur during the articulation of certain consonants, while forceful closure of the larynx may occur during the initial articulation vowel sounds (known as.. coup de glotte.. or "glottal attack" and sometimes referred to as "hard onset").. The Valsalva maneuver is also known to interfere with the playing of.. trombones.. and other.. Valsalva Hypothesis.. postulates that.. excessively forceful closures of the mouth or larynx.. associated with certain types of stuttering, as well as.. difficulty in phonation.. , may involve a.. neurological confusion between speech and the human body's Valsalva mechanism.. Persons who stutter may have learned to activate the Valsalva mechanism in an effort to produce words, as if they were.. things.. to be forced out of the body.. Such activation is most likely to occur when the stutterer anticipates difficulty or feels the need to use extra effort to speak properly.. While this might instinctively.. feel.. like the right thing to do, it actually makes fluent speech impossible.. When a person who stutters prepares to exert effort in speaking, excessive neuromotor tuning  ...   altered feedback ( FAF ).. have been known in the laboratory for many years, although the reasons are not thoroughly understood.. The author of.. Understanding Controlling Stuttering.. suggests ways in which DAF and FAF might promote fluency by affecting the Valsalva-stuttering cycle.. Therefore, the principle behind the recently publicized.. is not new.. What's new is the miniaturization of the device so it can be worn in the ear canal.. While many stutterers report benefits from the SpeechEasy while wearing it, it is expensive, the results are not perfect, and background noise often causes a problem.. None of these devices should be regarded as a cure for stuttering.. They only reduce stuttering while they are being worn, and their long-term effectiveness has yet to be proved.. Because they work by changing the way you hear your own voice, you must begin talking before they kick in.. Therefore, they won't help you get through a silent block.. You must you start vocalizing first, for example, by beginning your speech with an ahh sound.. Furthermore, these devices do little or nothing to increase a your understanding of stuttering or ability to control stuttering on your own.. While no one doubts the importance of basic research on stuttering, there is also a need for research to provide immediate relief for people who stutter.. Much of the current research is focused on new.. imaging techniques.. , such as PET scans and fMRI scans, which produce colorful computer-generated pictures showing differences in the way stutterers' brains function compared to non-stutterers.. This is exciting stuff, but we have yet to see anyone overcome stuttering simply by looking at brain scans.. Genetic research.. has shown that susceptibility to stuttering may be inherited in many cases, but it's not likely that we will see gene therapy for stuttering during our lifetime.. Other research has focused on pharmacological ways to reduce stuttering, including various.. drugs that block dopamine receptors.. in the brain.. Clinical trials are now underway on.. pagoclone.. , an anti-anxiety drug that acts as a gamma amino butyric acid (GABA) selective receptor modulator.. Although such drugs seem to produce a modest reduction in stuttering, the question remains whether taking drugs is worth the long-term risk of side effects, if an equal or greater increase in fluency might be achieved by non-pharmaceutical means.. Meanwhile, stuttering research.. has almost completely ignored the possible involvement of the Valsalva mechanism in stuttering behavior - which, if properly understood, could bring immediate, practical benefits to many people who stutter, for no additional cost and with no harmful side effects.. While the Valsalva mechanism is well known to medical science and even trombone players, it is rare to find it mentioned anywhere in the speech pathology literature.. Consequently, information about the Valsalva mechanism is not conveyed to speech therapists or to their clients.. is a comprehensive new approach to reducing the frequency and severity of stuttering blocks by teaching the person who stutters to relax his or her Valsalva mechanism while speaking and focusing on the phonation of vowel sounds.. Rather than teaching a new way to speak, Valsalva Control is aimed at recognizing and controlling the physiological forces that interfere with speech.. Its goal is not artificial fluency, but freeing the stutterer's natural speaking ability and making speech easier and more enjoyable.. No individual Valsalva Control exercise or technique is claimed to be a panacea or an instant ticket to fluency.. Valsalva Control is holistic in nature, including a variety of exercises as well as changes in attitudes toward speech and stuttering.. Rather than offering a quick fix, it seeks to provide tools for lasting improvement.. Valsalva Control should be seriously considered as a supplement to stuttering therapy because it is:.. The only approach that directly deals with Valsalva-stuttering behavior,.. Simple, natural sounding, and consistent with normal speech,.. Not based on artificial speaking techniques that sound unnatural and are difficult to monitor and maintain,.. Harmless and non-invasive,.. Without adverse side effects,.. Without additional cost,.. Easy to utilize by any SLP without the need for special equipment, and.. Compatible with many existing stuttering therapy programs.. Valsalva Control is especially intended for those persons who show the symptoms of Valsalva stuttering mentioned above.. (Persons wondering whether they might be good candidates for Valsalva Control should look at.. ) Although this approach may prove to be more suitable for some stutterers than others, the same is true for all other therapies as well.. In any event, Valsalva Control would give speech therapists a potentially valuable option to help their clients understand and control stuttering blocks.. Although there are not yet any scientific studies of Valsalva Control, anecdotal reports indicate that numerous persons have found Valsalva Control exercises to be helpful, even on a self-help basis.. However, for Valsalva Control to be most effective, one will probably need the help of a speech therapist who is familiar with this approach.. This author has personally observed dramatic results in a clinical setting.. For further descriptions of Valsalva Control, see.. The Principles of Valsalva Control.. Beating Stuttering Blocks: Some Basics Suggestions for Valsalva Control.. The Valsalva Hypothesis and Valsalva Control can radically change the way in which we view stuttering.. See.. A New Outlook on Stuttering.. , also on this website.. Copyright © 2002, 2004, 2009, 2010, 2011 by William D.. Parry, Esquire, CCC-SLP.. A licensed speech-language pathologist and trial lawyer, offering stuttering therapy and counseling (including Valsalva Control stuttering therapy) in person in Philadelphia and over the Internet via webcam (subject to applicable law).. Valsalva Control Stuttering Therapy is a new approach to improving fluency by controlling the physiological mechanism that may be causing stuttering blocks.. For further information on Valsalva Control Therapy, visit.. Researchers and speech-language pathologists seeking further information about the Valsalva Hypothesis may e-mail me at:.. Valsalvastutter@aol.. Last revised: 5/13/13..

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  • Title: Stuttering Blocks Explained-Video
    Descriptive info: Copyright © 2011 by William D.. Mobile phone:.. Office phone:.. 215-735-3500.. Last revised: 5/1/2013..

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  • Title: Valsalva Stuttering Network - Articles
    Descriptive info: Understanding Controlling Stuttering: A Comprehensive New Approach Based on the Valsalva Hypothesis - The Revised and Expanded Third Edition (2013).. Stuttering and the Valsalva Mechanism: Introduction.. , by William D.. Results of Bill Parry's first clinical study of Valsalva Control Therapy, presented at the International Stuttering Association.. Stuttering and the Valsalva Mechanism: A Hypothesis in Need of Investigation.. Parry  ...   Best Advocate.. Parry, Esq.. based on a pamphlet previously published by the National Stuttering Association while Bill Parry was a member of its Board of Directors and Chair of its Advocacy Committee.. Stuttering as a Disability under the Americans with Disabilities Act.. MORE TO COME.. Copyright © 2002, 2004, 2005, 2009,2010, 2011, 2012, 2013 by William D.. Last revised: 11/10/13..

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  • Title: The Worldwide Valsalva Control Program for Stuttering
    Descriptive info: the worldwide.. valsalva stuttering therapy.. program 2013.. william d.. Parry, CCc-slp.. Valsalva Stuttering Therapy is available worldwide, through video-conferencing over the Internet.. (Subject to applicable law.. A webcam and high-speed Internet connection are required, plus a Skype account and the ability to open and print PDF documents.. Participants must have competency in written and spoken English.. is a comprehensive new approach.. to stuttering therapy, which seeks to improve fluency by controlling the.. physiological mechanism.. –.. the.. – that may be involved in stuttering blocks.. Rather than teaching fluency shaping or focusing on controlling one's speech, Valsalva Stuttering Therapy is aimed at addressing the physiological, neurological, and psychological factors that.. interfere.. with  ...   by Skype.. ™.. (subject to applicable law) or in my Philadelphia office.. In addition to therapy sessions, participants must also do at least one hour of practice every day, plus other assignments.. The Basic Program can be followed up with optional additional sessions on an hourly basis.. Another option is the.. Regular Valsalva Stuttering Therapy Program.. , which includes.. 25 hours of therapy.. The minimum amount of therapy offered is 10 hours.. Links to further information.. E-mail William Parry at.. for further information.. For persons interested in therapy, a.. free.. consultation may be arranged.. Copyright © 2010 - 2013 by William D.. Return to Valsalva Stuttering Network Home Page.. Return to StutteringTherapist..

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  • Title: New Insights and Tools To Beat Stuttering Blocks
    Descriptive info: Based on the Author's Presentation at the National Stuttering Association's.. Annual Conference, Ft.. Worth, Texas - July 7, 2011.. My name is William Parry.. I am a speech-language pathologist from Philadelphia and leader of the Philadelphia Area Chapter of the National Stuttering Association (NSA).. For most of my life I myself struggled with stuttering.. I began stuttering at age four.. After decades of failed therapies, I found my own way to understand and overcome my stuttering in the early 1980’s, using an approach that I call “Valsalva Control.. ” It enabled me to pursue a successful career as a trial lawyer.. Since then, I have been active in the National Stuttering Association, founded the Philadelphia Area Chapter, led its stuttering support group meetings for more than 15 years, served on the NSA’s Board of Directors, shared my ideas at numerous workshops, and wrote a popular book on stuttering –.. Understanding Controlling Stuttering –.. which is sold by the NSA.. I am now pursuing my second career – that of a professional speech-language pathologist – in the hope of furthering the understanding and treatment of stuttering.. Over the past year I have been conducting clinical research on the effectiveness of Valsalva Control Therapy in reducing stuttering blocks in adults with persistent developmental stuttering.. Last month I began a new trial of a more intensive therapy program.. This has already produced dramatic results, as you will see in the video recordings I will present later in this workshop.. In addition to research results, I am going to share with you some new insights and techniques that you might find helpful.. I will begin by outlining my present beliefs regarding the nature of stuttering and stuttering blocks.. Persistent Developmental Stuttering.. First, I want to be clear as to what I mean by.. “persistent developmental stuttering.. ”.. “Developmental stuttering” usually begins in childhood and is.. associated with brain damage.. It is “persistent” if it continues into adulthood.. It is basically a.. speech.. problem rather than a language problem.. The person knows exactly what he or she wants to say, but is sometimes blocked when trying to say the words.. The person is able to talk fluently.. some.. of the time, and stuttering severity may vary depending on the speaking situation.. The Puzzle of Stuttering.. Stuttering has confounded people throughout history.. It is a multi-faceted disorder, involving the interaction of many factors, which may vary for each individual.. Many different theories have been proposed as to its cause and a wide variety of treatments have been tried.. However, none of the theories or therapies adequately explained or relieved my stuttering.. Furthermore, I did not want to replace my natural speaking voice with an artificial-sounding “fluency technique.. My Quest.. My speech mechanism seemed basically all right, because I had learned to act out roles in front of an audience with perfect fluency.. However, in other situations, it seemed as if a powerful force clamped down on my speech like a vise, causing me to block.. My problem wasn’t any lack of ability to speak, but rather an.. interference.. with that ability.. I suspected that the interference was.. physiological.. in nature, but that it might be activated by.. psychological.. factors.. Around 1983, I quit therapy, began doing my own research into stuttering, and developed my own approach to therapy.. I am now continuing that research clinically as a speech-language pathologist.. Stuttering and Effort.. My personal experience, my observation of others who stutter, and my clinical research have all led me to the conclusion that.. the best way to understand and treat stuttering behavior is to view it not in terms of “fluency” but rather in terms of.. effort.. As I will demonstrate, stuttering is the result of.. misplaced effort.. in the attempt to speak.. Therefore, the key to fluency is.. understanding and treating the motivations and mechanisms behind the use of effort.. The Mechanism of Stuttering Blocks.. I believe that the underlying mechanism for stuttering blocks boils down to the following:.. a neurological confusion in the motor programming of the larynx, in which effort is substituted for phonation of the vowel sound in specific syllables.. The Real Problem Is the Vowel.. Most people assume that stutterers have trouble saying initial consonants.. However, these sounds are not the real problem.. For example, a person repeating /p/ in “puh-puh-puh-Peter” or prolonging the /s/ in “S-s-s-s-s-sam” or the /m/ in “M-m-m-mary” is actually saying the /p/, the /s/, and the /m/ perfectly well.. In each case, the real problem is the speaker’s difficulty in producing the.. vowel sound.. that follows.. Stuttering and Phonation.. There is ample evidence that stuttering blocks may involve interference with phonation.. Consider the following:.. Persons who stutter have no trouble.. silently mouthing their words.. or.. whispering.. Therefore, stutterers’ articulation does not seem to be impaired.. Stuttering does not occur until the person adds.. phonation.. The problem is not phonation in general, because the stutterer phonates when prolonging or repeating voiced consonants like /m/, /n/, /r/ and /l/.. However, when he gets to the vowel sound –.. He hits a “brick wall.. ”.. Therefore, the problem must be specific to phonation of the.. vowel sound.. of the particular word or syllable in question.. Motor Programming.. This phenomenon can be understood in terms of.. motor programming.. Before any bodily movement can occur, the brain must create a.. motor program.. for the muscles involved.. The same is true for speech.. A process called.. prephonatory tuning.. must prepare the laryngeal muscles to bring the vocal folds together properly before phonation can occur.. However, phonation is not the only function of the larynx.. The larynx is also involved in the exertion of.. physical effort.. as part of the body’s Valsalva mechanism.. The Valsalva mechanism consists of the larynx and other muscles throughout the body, including the abdominal and chest muscles.. These muscles are neurologically programmed to build up air pressure in the lungs by means of a.. During a Valsalva maneuver,.. both the vocal folds and false vocal folds close tightly to block the airway.. This laryngeal function is called.. Meanwhile, the abdominal and chest muscles contract in order to increase the air pressure in the lungs.. The.. more they squeeze to increase air pressure, the more tightly the larynx closes to hold the air in.. Instances of Valsalva Maneuvers.. The purpose of the Valsalva maneuver is to stiffen the trunk of the body so that physical effort can be exerted more efficiently.. We instinctively perform these maneuvers every day – usually when lifting, pushing, or pulling heavy objects and when bearing down to make bowel movements.. The Valsalva maneuver may also be activated as part of the “fight or flight” response to fearful situations.. Valsalva and Speech.. But what might happen if the Valsalva mechanism becomes involved in the effort to speak – either in response to the anticipation of difficulty or as a reaction to fearful speaking situations?.. Activating the Valsalva mechanism might instinctively.. feel.. like the right thing to do, but it could interfere with speech in at least two ways:.. By promoting forceful closures of the mouth or larynx to build up air pressure; and.. By programming the larynx for.. rather than preparing it to phonate the vowel sound.. Effort Inserted at Vowel Position.. The vowel is the natural place to insert the motor program for effort, because it’s the heart of the syllable and has the most energy.. Possible Effects of Weakness in Motor Programming.. N.. umerous studies have suggested that persons who stutter may have weaknesses in parts of the brain that put together the neurological programs for speech and other fine motor skills.. These weaknesses may contribute to a person’s.. feeling that speech is difficult and requires effort.. They might also make a person’s motor programming for speech.. susceptible to interference.. Such interference could be precipitated by stress, anxiety, and other emotional triggers, which would account for the variability of stuttering.. There are many other factors that may contribute to the feeling that speech is difficult or that promote the the urge to exert effort -.. developmental delays, psychological factors,  ...   situations are analyzed in terms of the.. urge to exert effort.. Speaking situation hierarchies are utilized, based on difficulty and importance to client.. Negative attitudes and self-talk are analyzed and replaced with more helpful ones.. Transition Exercises.. Transition exercises include:.. Role playing exercises based on actual speaking situations.. Time-pressure exercises.. The client is encouraged to focus on his or her.. role.. or.. purpose.. in speaking, rather than trying to make a “good impression” by trying not to stutter.. Handling Anticipated Blocks.. Among other things, clients are taught.. to force through anticipated blocks.. Instead they should stop, take a breath, relax their abdomen as they exhale, and focus on phonating the vowel sound.. We have found that pulling on clasped fingers (later reduced to pinching the thumb and forefinger together) may help to focus on vowel production and to displace the urge to exert effort.. However, I must caution you that this advice is.. a substitute for therapy.. It is only effective.. after.. a person has become skilled in the fundamentals of Valsalva Control.. Clinical Trial – Phase 1.. In July 2010, I began the first phase of my clinical trial on the effectiveness of Valsalva Control Therapy.. The participants were five English-speaking males, ages 21-31, with moderate-to-severe developmental stuttering.. Appropriate consents and authorizations were obtained.. Therapy was administered in 25 weekly one-hour sessions, plus daily 30-minute exercise routines and other homework assignments.. All sessions were conducted by video conferencing using Skype™ and video recorded.. During the course of the study, the therapy evolved as new materials and exercises were added.. Average Results for All 5 Participants.. The following are the average results for all five participants in the study.. % Syllables Stuttered in Oral Reading.. The first graph shows the reduction in percentage of syllables stuttered in oral reading for all five participants.. The black line shows a beginning average of 8.. 86 per cent stuttered syllables, reduced to an average of 1.. 26 per cent after 24 weeks – a reduction of about 86 per cent.. Stuttering Severity Scores (SSI-4).. The next graph shows the Stuttering Severity Scores for the five participants, based on the Stuttering Severity Instrument-4.. As shown by the black line, the average score was reduced by 61 per cent, dropping from “Moderate” to “Very Mild.. OASES Scores at 0, 8, 16 24 Weeks.. The next graph shows the overall impact of stuttering as measured by the OASES questionnaire – the “Overall Assessment of the Speaker’s Experience of Stuttering.. ” This test has a minimum score of 1.. 00 and a maximum score of 5.. 00.. As shown by the black line, the average impact was reduced from “Moderate-Severe,” to “Mild-Moderate” – an average reduction of 50.. 63 per cent.. “Easy and Effortless” Self-Reporting.. Each week the participants were asked to report how.. easy and effortless.. their speech had.. felt.. to them in various speaking situations.. Participants ranked the amount of effort on a scale of 1 to 9, with 1 being “Very easy and effortless” and 9 being “Very difficult.. The next graph shows the average progress in “easy and effortless speech.. ” The red line represents the average “most difficult” experience, the green line represents the average “easiest” experience, and the blue line represents the average rating of speech in general.. As you will see, the average effort in general was cut approximately in half, from around 5 down to about 2.. 6.. Participants’ Evaluation of Program.. At the end of 24 weeks, the participants were given a questionnaire to evaluate the therapy they had received.. They were asked to rate how strongly they agreed or disagreed with the following statements.. 5 out of 5 participants “.. Strongly Agreed.. ” with these statements:.. o.. The explanations about Valsalva-Stuttering.. accurately described my own experience.. of stuttering.. The program helped me to.. understand.. my stuttering better.. I will.. continue to use.. Valsalva Control in the future.. I learned skills and insights that.. will help me to continue to improve.. my speech on my own.. I would.. recommend Valsalva Control.. to other people who stutter.. 4 out of 5 participants “.. ” and one “Somewhat Agreed” that:.. The program made.. speaking more enjoyable.. for me.. Overall, I was.. satisfied.. with the Valsalva Control program.. 3 out of 5 participants “.. ” and two “Somewhat Agreed” that:.. The program made my speech.. easier and less effortful.. The program.. reduced the frequency.. of my stuttering blocks.. helped to reduce my anxiety.. about speaking.. I find it.. easy to use.. Valsalva Control in everyday speaking situations.. My speech.. sounds and feels natural.. when I use Valsalva Control.. All participants.. who had previous therapy “.. ” that:.. helped me more than any other therapy.. I have had.. Conclusions - Phase 1.. Based on the Phase 1 trial, Valsalva Control appears to be a valid approach to understanding and treating stuttering, while pre serving the individuals’ own natural-sounding speech.. Furthermore, Valsalva Control provides practical insights and tools for persons to make further progress on their own.. This is important, because deeply entrenched nerve pathways for any kind of behavior, including stuttering, often take a very long time to change.. Three of the five participants showed dramatically reduced stuttering both in and outside of therapy sessions.. The two other participants reported less success in transferring Valsalva Control to outside speaking situations, possibly due to anxiety issues.. They may have needed more intensive therapy than weekly Skype sessions.. Furthermore, it appeared that the standard one-hour weekly sessions were not intensive enough to establish sufficient changes in the habitual behavior of some participants.. Consequently, the results were not as rapid or as consistent as I would have liked.. Clinical Trial – Phase 2.. A few weeks ago I began a m.. ore intensive Phase 2 clinical trial of Valsalva Control Therapy.. The new therapy sessions will be longer, more frequent, and more structured than in Phase 1.. They will include new therapy materials, exercises, and techniques that were developed during Phase 1.. The new trial will determine whether these modifications will help to reduce stuttering more quickly and effectively.. In the new, intensive format, therapy begins with at least two 3-hour sessions per week for the first three weeks, then tapering off.. Participants must also do at least 30 minutes of practice every morning, plus an additional 30 minutes during the day.. Participants must actually practice their speaking exercises (including “Adronian”) outside of therapy sessions (.. with a friend or family).. This format has already produced dramatic results within the first two weeks, as you will see in the video.. Individual Case Study: RP.. The first participant in Phase 2 is.. RP,.. a 22-year-old male college student and part-time cook.. He began stuttering around age 5.. His mother and one of her brothers stuttered as children.. RP’s stuttering is extremely severe, especially in conversational speech, with approximately 25 percent stuttered syllables and blocks that often last 25 seconds or more.. His total score on the Stuttering Severity Instrument-4 was 41 – Very Severe.. His overall score on the OASES questionnaire, which measures the impact of stuttering, was 4.. 07 –Severe.. RP’s prior therapy included a 12-day precision fluency shaping program last summer, similar to the program at Hollins.. The techniques were helpful for about a month, but then trying to make the targets became too stressful and his stuttering returned as severe as ever.. RP recently completed four 3-hour Valsalva Control Therapy sessions on Skype during a 10-day period.. As you are about to see, his stuttering was dramatically reduced.. Videos of RP Before and After 2 Weeks of Therapy.. Now let’s hear from RP himself.. Here are video recordings made before therapy began and ten days later, after four 3-hour sessions of Valsalva Control Therapy.. (Time: 8:48).. Further Information.. If you would like further information about Valsalva Control Therapy, I invite you to visit my website, “The Valsalva-Stuttering Network,” at.. Valsalva.. A licensed speech-language pathologist and trial lawyer, offering Valsalva Stuttering Therapy and counseling in person in Philadelphia and over the Internet via webcam (subject to applicable law).. Last revised: 5/1/13..

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  • Title: Valsalva-Stuttering Network - Links
    Descriptive info: Articles and Videos about Stuttering and Valsalva-Stuttering Therapy.. William Parry's new stuttering therapy website:.. StutteringTherapist.. com - Stuttering Therapy and Counseling.. William Parry's article on.. Stuttering and the.. Valsalva Mechanism: A Key To Understanding and Controlling Stuttering Blocks.. Information about William Parry's book.. Articles and Chapters from William Parry's book..  ...   Stuttering and the Law.. StutterTherapy.. org - Stuttering Therapy: A Comprehensive Guide.. The Worldwide Valsalva Control Program for Stuttering.. (More to come.. A licensed speech-language pathologist and trial lawyer, offering Valsalva Stuttering Therapy in person in Philadelphia and over the Internet via webcam (subject to applicable law).. Last revised: 4/30/2012..

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  • Title: An Introduction to
    Descriptive info: An Introduction to.. The Worldwide.. Valsalva Stuttering.. Therapy Program.. Copyright © 2012 by William D.. All rights reserved.. These videos are intended for persons who are participating in a supervised Valsalva Stuttering Therapy program.. They are for informational purposes only and are not a substitute for diagnosis and treatment by a qualified speech-language pathologist.. The discussions apply only to the most common type of stuttering in adults, known  ...   Part 1: The Nature of Stuttering Blocks.. This video discusses the neurological and physiological factors involved in stuttering blocks.. Part 2: The Psychology of Stuttering Blocks.. This video discusses some of the psychological factors involved in stuttering blocks.. Part 3: Fundamentals of Valsalva Stuttering Therapy.. This video discusses some of the fundamental principles of a promising new treatment of stuttering, called Valsalva Stuttering Therapy.. Last revised: 8.. /6/2012..

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  • Title: Detrimental Self-Talk and Stuttering
    Descriptive info: The Valsalva-Stuttering System:.. Beliefs, Intentions and Effort.. NOTE: THIS ARTICLE IS NO LONGER CURRENT.. FOR THE LATEST INFORMATION ABOUT THE VALSALVA HYPOTHESIS, VALSALVA STUTTERING THERAPY, AND THE NEW SELF-HELP EXERCISES, SEE THE REVISED AND EXPANDED THIRD EDITION OF.. UNDERSTANDING CONTROLLING STUTTERING.. (2013), NOW AVAILABLE FROM THE NATIONAL STUTTERING ASSOCIATION.. Stuttering blocks can be viewed as neurological motor programs that manifest the.. intention to exert effort in trying to say a word.. in response to anxiety and/or the anticipation of difficulty.. The motor program for effort is influenced by our.. beliefs, expectations..  ...   stuttering requires that the larynx be neurologically prepared to phonate vowel sounds rather than to exert effort.. The elimination of the motor program for effort requires that the speaker's.. intention.. in speaking be changed to something.. other.. than trying to say the word.. It also involves a change in the.. expectations.. and ultimately in the underlying.. beliefs.. These changes will gradually have the effect of reducing the speaker's.. Valsalva Stuttering Therapy.. is specifically designed to address all these aspects of the Valsalva-Stuttering System, using both.. physical.. approaches.. Mobile phone:.. Last revised:.. 5/1/13..

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  • Title: Phonation and Valsalva-Stuttering Blocks
    Descriptive info: Stuttering Blocks.. and the “Speech Alarm System”.. Valsalva-Stuttering Blocks Revisited.. In persistent developmental stuttering (the most common form of stuttering in adults and teenagers), the actual “block” occurs in the brain before the person who stutters even tries to say the word.. The block is an error in the.. neurological motor programming of the larynx.. to phonate the.. of a specific word or syllable.. Before any bodily movement can occur, the brain must first create a.. to determine when and how muscles are to be activated.. A neurological process called.. must prepare the appropriate muscles in the larynx to bring the vocal folds together at the proper time to vibrate as airflow passes between them.. The vibrating vocal folds create a buzzing noise.. The buzz is turned into specific vowel sounds by the shape of the oral cavity, as determined by the position of the lips and tongue.. When the person who stutters comes to the word or syllable in question, the brain does not program the larynx to phonate the vowel sound.. Instead, the larynx is programmed for.. – the function that it performs during a.. For that reason, we will call these blocks.. “Valsalva-stuttering blocks.. The vowel sound is the natural place for motor programming for effort to occur, because it is the part of the syllable that is loudest and therefore has the most energy.. In effort closure, the entire larynx closes tightly – including both the vocal folds and the false vocal folds above them – to keep air from escaping.. The purpose is to build up air pressure in the lungs to stiffen the trunk of the body, so that physical effort can be exerted more efficiently.. Often the person who stutters will feel tightness in the throat as well as the abdominal muscles.. Even if the larynx does not actually close, it still is.. ready to play its part in saying the vowel.. The rest of the speech mechanism – the lips and tongue – must now wait until the larynx is ready to phonate the vowel sound.. The person’s speech gets stuck on the consonant or glottal stop that.. precedes.. the vowel, resulting in repetitions, prolongations, hesitations, and/or forceful closures of the mouth or larynx.. This creates a false impression that the initial sound is causing the problem.. It should be noted that a stutterer’s lips and tongue usually have no trouble articulating words on their own, when they don’t have to wait for the larynx to phonate.. For example, a person who stutters is almost always fluent when there is no phonation, as in.. whispering,.. or when phonation is continuous, as in the “Humdronian Speech Exercise” or.. singing.. The person who stutters may feel as if the feared word contains an insurmountable obstacle – often described as a “brick wall” – that requires force to overcome.. The PWS may be overwhelmed by a seemingly uncontrollable urge to use physical effort to force the word out – as in a Valsalva maneuver.. This may instinctively.. like the right thing – the.. only.. thing – to do.. But the more the speaker builds up air pressure to break through the perceived block, the stronger the block becomes.. The Block Is an Illusion.. In reality, there is no obstacle or “brick wall.. ” It is an illusion, with no substance or power of its own.. Its only power comes from.. you.. You yourself create the obstacle by exerting effort in trying to force through it.. That is the essence of a Valsalva maneuver.. The blockage of the upper airway automatically becomes stronger to resist the air pressure that you build up in your lungs.. The purpose is to stiffen the trunk of the body to help you exert physical effort more efficiently.. This maneuver is totally inappropriate for speech.. You  ...   to walk through a crime-infested neighborhood at night, your amygdalae would probably be on high alert for muggers.. Any movement in the shadows might cause them to send an alarm – triggering the release of stress hormones through your brain and body.. Likewise, the triggering of stuttering blocks may vary greatly, depending on the speaking situation.. We might better understand this variance if we view it in terms of a “.. Speech Alarm System.. We will visualize the Speech Alarm System as having the following color-coded “Alert Levels”:.. RED = Extreme;.. ORANGE = High;.. YELLOW = Moderate;.. BLUE = Low; and.. GREEN = Clear.. As you enter speaking situations, you may habitually set the sensitivity of your “Speech Alarm System” based on your memories, thoughts, expectations, attitudes, and beliefs about the difficulty or danger of the speaking situation and/or the words you anticipate saying.. The following is a hypothetical example of how the Speech Alarm System might work.. This process may be conscious, unconscious, or semi-conscious.. It may seem to you as being so necessary, automatic, and inevitable that you feel you have no choice in the matter.. You approach a speaking situation thinking,.. “I am a stutterer.. Therefore, speech is difficult for me.. Already your Alert Level starts at BLUE.. Then you think,.. “In the past I have usually stuttered in this type of speaking situation, or when speaking to this person.. Therefore, I will probably stutter this time also.. This moves your Alert Level up to YELLOW.. Next you think,.. “It is very important that I make a good impression.. Therefore, I must try hard not to stutter.. Your Alert Level is now at ORANGE.. On top of all this, you think,.. “I have blocked a lot on words that start with ‘p’ (or any other type of word on which you have had trouble).. Therefore, I must try especially hard not to stutter on p-words.. At this point, your Alert Level has shot all the way up to RED.. Your amygdalae are now on Extreme Alert for the dreaded “p-words” (or whatever other type of word you might fear).. As you come to a “p-word,” your amygdalae send out an alarm: “Danger! Danger!” This triggers your.. sympathetic nervous system.. to initiate the fight-flight-freeze response, which floods your brain and body with stress hormones.. These hormones cause your larynx to be neurologically programmed to do.. instead of phonating the vowel sound of the specific word or syllable.. (Doing effort closure as part of a Valsalva maneuver is an instinctive way to prepare your body for physical action.. ) The stress hormones also shut down the thinking part of your brain, causing you to forget everything you may have learned in speech therapy.. You instinctively revert back to your old, established struggle or avoidance behaviors – as if no other choices are possible.. All the while, the stress hormones are urging you to “Force! Force!” – as if you were in real danger and needed to fight off a mugger.. But there is no mugger.. It is only a word.. You are safe.. Your Speech Alarm System has given you a.. false alarm.. Because speaking situations present no real dangers,.. all.. of its alarms are.. false.. alarms.. The Speech Alarm System is actually unnecessary and counter-productive.. Nevertheless, you keep using it because, on some psychological level, it helps you feel.. safe.. You might feel naked and exposed – and perhaps even terrified – without it.. Exerting effort in response to the alarms set off by your amygdalae has the immediate short-term effect of reducing your anxiety.. Over the long term, however, responding to these false alarms perpetuates your fears and stuttering behaviors.. Mobile Phone:.. The Second Edition (2000) (5th Printing updated in.. 2009.. ) of.. Understanding and Controlling Stuttering.. may be ordered from the.. 1/16/2012..

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