Articles

Scott Yaruss Issue 25, Spring 2006
Interview by Sharon Millard, specialist speech & language therapist, The Michael Palin Centre for Stammering Children


Scott Yaruss is an Associate Professor at the University of Pittsburgh with an international reputation as a researcher in the field of stuttering. He has published many papers relating to the nature of stuttering and the evaluation of therapy outcomes. He was a key-note speaker at the Oxford Dysfluency Conference in 2005 and took time out to speak to Sharon Millard, from the Michael Palin Centre, about his work.

SM: So how did you become interested in stammering?

SY: Luck! My background is in linguistics and psychology, and initially I thought I would study historical linguistics. I really enjoy that area – it’s a very academic field. Anyway, during my undergraduate programme I realised that if I continued on that path I would never ‘see’ people, and, although I don’t know what to say to them when I do see them, I knew I wanted to have some kind of clinical contact in my work. I met a speech language pathologist and just on a whim thought, ‘oh, I’ll go into that’. So I applied to graduate programmes all around the US, and got into Syracuse. I was hooked, I’d found just what I wanted to do. As to how I picked stuttering up, it just seemed interesting. I got lucky.

SM: Tell me a bit about your post and current responsibilities.

SY: I’m at the University of Pittsburgh and I’m an Associate Professor, so I teach and do research. I have a small private practice as well, just so I can do some clinic too. I’m co-director of a clinic at a children’s hospital in Pittsburgh, which is just for kids who stammer. I run the more research-oriented side of the organisation, and my co-director, Greg Coleman, runs the clinical side. So between the two of us, we do clinical studies, I teach, and he trains students. And then I travel around and do workshops all over the US for school-based clinicians, primarily on how to treat kids who stutter.

SM: And which bit gives you the biggest buzz?

SY: Oh it depends. When I have enough time, or when I make enough time, the research. But I love to give talks, you know. It’s great fun. I get to see people from all over with all different backgrounds. A lot of them have the same concerns about stuttering as therapists in the UK – they just don’t feel comfortable treating this disorder. So, it’s gratifying to be able to go and give them some information, or to help them look at information they already have in a different light. I enjoy doing that a lot but, if left to myself, I could sit with some data and a computer for a little bit – I like that.

SM: What advice do you give to students and therapists working with people who stammer?

SY: Ok, well I guess first-off is to remember the perspective of the speaker. I think in our field we’ve been so clinical and so ‘top-down’. Not everyone, surely, but I fear the perspective of the speaker has often been lost. So, working with adults, that’s the thing I remind students and clinicians first – that we’re dealing with people who are experiencing more than just disruptions in their speech. And in fact, some of the most challenging of our clients are the ones who don’t experience disruptions in their speech because they’ve done so much to mask it. So the experience of the speaker is one of the things that I think is most important.

In working with kids, I think it’s remembering the parents. The kids are experiencing difficult times – but we have some confidence in how we can help them. The parents, meanwhile, are experiencing a lot of anxiety, and again, if we get too clinical and, too ‘top-down’, we don’t help them with their reactions. That’s what programmes like your parent-child interaction therapy really focus on: giving the parents something to do and having the change come through them. I think that in the United States clinicians are much less comfortable doing that; they feel as if they have to give a prescription. That’s why some approaches appeal to them more than others – but really they haven’t taken the parents lead, and worked with them to help them identify solutions that will help the child.

SM: And what do you think our research priorities should be as a profession?

SY: Well, treatment outcomes research is part of the work that I do. With adults, we run into problems if we want to do a broad-based approach to treatment. We don’t have appropriate measures for counting anything other than the frequency of dysfluencies. We have lots of data about that. That’s fine, we know that we can help adults speak more fluently. We also know that those kinds of approaches don’t tend to last as well over the long term. So, we turn to the cognitive and affective approaches. Now we’re treating more than just speech behaviour – which is something I advocate. But we don’t have adequate ways of measuring all of the aspects of the outcome. So, I think we need to develop an instrument to measure this more effectively – and that is part of the work that I have been doing. We then need to subject common approaches to systematic measure. I would love to see distinct programmes being measured with the same tools so that we could compare them more directly. Not with the idea that one is going to be better than the others, but more with the idea that different people are going to benefit from different things. I know from my work with the National Stuttering Association in the US that one of the primary concerns for adults who stutter is how to choose a treatment out of the many that are on offer. As adults, if they had some metric for choosing which one would be most appropriate for their needs, then that would be a great service to them. With kids, it’s the same issues in terms of treatment outcome. There’s more than one treatment approach out there, but there’s not nearly enough data about the various approaches – lot of data about some, and not much about others. So, we need to close that gap.
I’m also interested in some of the work that’s been presented in terms of factors that contribute to the development of stuttering. We understand a bit about that, but there’s a lot more that we need to know.

SM: Who would you say has influenced your work most?

SY: Certainly, I would say, Ed Conture and, in my treatment of adults, Dean Williams. Dean taught Ed, and Ed taught me. When I think about the clinical approach that I use, I am aware that I can hear, you know, where I’m borrowing things or using things that Dean taught me. Their approaches resonate with me.

SM: Do you have a motto?

SY: That’s a hard one. I guess in relation to treatment and research in stuttering it would be ‘stuttering is more than just stuttering’.
SM: It’s been a good conference, hasn’t it?

SY: Yes, it has indeed.

SM: Which papers have particularly impressed you?

SY: I thought Trudy Stewart’s talk was magnificent. I haven’t seen a formal speech delivered in a long time. I thought that she just did a beautiful job. Aside from the fact that the topic was fascinating and out of the box, it was presented with such poise. I really enjoyed her talk yesterday.

I was very impressed by Mark Onslow’s willingness to stand up in his talk yesterday and say that his treatment doesn’t work for everybody. That’s what we all know to be true about all treatments – and as I’ve said, our research should be considering which approach suits which person. Acknowledging this is the first step.

Regarding Hans Bosshardt’s talk, I have been reading a little bit in motor learning, and he presented some new literature about practice effects, so I enjoyed that as well. So, I saw several good talks.

SM: Away from the conference and your work, how do you relax?

SY: Sorry I didn’t understand the question!
I’ve got two kids aged six and nine. They love to play and I do too! So we play a lot. I have a hobby that I haven’t explored in years. I have a wonderful telescope and am interested in astronomy, but the problem with that is that you have to do it at night – and I used to stay up to all hours, but now I fall asleep much more easily!

SM: What does keep you awake at night?

SY: Oh, what doesn’t? I tend to stress about things. Not getting enough work done; the papers that are stacked up on my desk. You know, I’ve got data collected and analysed for five papers – if only I could just sit down on my computer and write … I’ve got six papers in review right now, but I could write five more. I lie awake thinking, ‘I should be working on this paper, or working on that paper’, and I don’t always make the progress that I probably should make.

SM: It sounds as if you are going to keep the rest of us in reading material for some time! Thank you very much for your time.