Royal Victoria Infirmary, Newcastle-upon-TyneDuring the ten years 1960-1969, at the Royal Victoria Infirmary, Newcastle-upon-Tyne, working one session weekly with adults, 87 stammerers were referred to me. All patients referred are accepted for treatment; there is no screening of any description so therapy is available to all, regardless of intelligence, motivation and so on. Those patients were all offered easy-stammering therapy.Therapy for the Stammerer I think it is impossible to describe therapy on paper. Every stammerer I have worked with, over twenty years, has been different from every other stammerer, and treatment is always different in detail, if not in essence, for each individual. With clinical experience one gets a "feeling" for stammerers, which guides details of treatment. Some patients need to discuss their problems and attitudes in great detail whereas others have visually nothing to say about themselves. I am, therefore, keenly aware that much has to be left unsaid, and that what is said can only be an outline of the therapy involved.Let it first be stated that a high percentage of stammerers talk rather rapidly, as if to indicate that the only matter of import is to reach the end of the sentence. If speech is fast, then it must be slowed down in order to employ the easy-stammer. No purpose can be served by stating that a given number of words per minute is right or wrong; clinical experience is the best guide. 240 w.p.m. is not uncommon among stammerers, and any clinician would rightly judge four words per second too fast for any person concentrating not only on what he is saying but also on how he is saying it. On the other hand, he may find that slowing down to say 180 w.p.m. is quite adequate, whereas a different person who talks at 180 w.p.m. may also need to slow down before he can learn to control his stammer.Whenever a true stammer occurs there is always muscular tension; it may be tension of the lips, tongue, jaw, soft palate, pharynx or larynx, or a mixture of these. To gain control of the stammer, one must gain control of the tension, and replace it with muscular ease. It is usually possible to modify the stammer; to learn to produce a type of stammer, but one that is free of tension. This I think of as a "half-way house" in treatment, and I call it easy-stammering". Once this has been achieved and the stammerer can stammer most of the time without tension, then it is comparatively easy to further modify the easy-stammer, so that it approximates more and more to normal speech.At the outset of therapy I give the patient a brief outline of treatment, and having taught him what easy-stammering is, he needs to teach himselfwhat it iswhat it sounds like and what it feels like. Absolute concentration is required to convert a stammered word to an easy-stammered word. I also always make it known that there is no magic formula in controlling stammering; it is extremely hard work and requires motivation as well as concentration.