Nathan Maxfield, PhD, CCC-SLP, an associate professor in the Department of Communication Sciences and Disorders, spoke to more than 100 alumni from the St. John's University Speech-Language Pathology program at the 2024 Annual Caitlin King Case Study Event. Maxfield gave a presentation titled "Stuttering as Neurodivergence," in which he challenged the attending speech-language pathologists to approach stuttering from a neurodiversity model of disability.
The neurodiversity model of disability aims to help clients who stutter make adaptations to their communication and mindset to improve quality of life without necessarily normalizing their speech. The model also aims to create an environment in which it is easier to function as a person who stutters.
Maxfield presented evidence that the condition of stuttering has a strong genetic basis, and discussed therapeutic approaches that speech-language pathologists can use to support people who stutter from a neurodiversity perspective.
At the same time, he challenged the idea that the medical model approach to stuttering should be completely abandoned. This approach aims to normalize speech production in people who stutter. Based on research from perceptual studies of stuttering, he demonstrated that listeners have perceptual and cognitive limits on their ability to process speech containing stuttering.
Maxfield also reminded the audience that people who stutter may be interested in normalizing their speech as a therapeutic goal. He argued that it is okay for speech-language pathologists to continue to offer fluency-focused treatments, as long as they are well-equipped to offer such treatments and are honest with clients about treatment outcomes, including the high likelihood of relapse after treatment, the possible need for retreatment, and the need for life-long maintenance.
Maxfield emphasized that both neurodiversity and medical model approaches to the treatment of stuttering can be useful, depending on client values.