Without Hesitation: Speaking to the Silence and the Science of Stuttering

This article is a review of Gerald Maguire's Without Hesitation: Speaking to the Silence and the Science of Stuttering first appeared in the Spring 2011 issue of CSA Voices.

WHcover Gerald A. Maguire is an Associate Pressor of Clinical Psychiatry, and Senior Associate Dean of Educational Affairs, at the University of California, Irvine School of Medicine. He is also the director of the Kirkup Center for the Medical Treatment of Stuttering. This is the only research centre in the world dedicated exclusively to this field of study – the treatment of stuttering through medicine.

Gerald Maguire is a person who stutters, as well as being a clinician and researcher. Without Hesitation is written not for pathologists or other doctors but for people who do not have a scientific background.

During his education and career, Maguire found that even among his professional, well-educated peers there existed “a shocking lack of knowledge about stuttering.” He is extremely dedicated to educating people and to helping those who stutter. He also knows that some people are uncomfortable about the idea of taking drugs for stuttering.

Without Hesitation is about pharmacotherapy – the treatment of illness with medication – as it relates to stuttering treatment. Most people know that conditions such as bipolar disorder can be treated with drugs, often in combination with psychotherapy. Using drugs to treat stuttering, however, is a relatively new concept.

GMaguire Dr. Gerald Maguire Research, particularly of the past ten years, has started to pinpoint the neurophysiological roots of stuttering.  Maguire describes the different known causes: the neurological aspect in the basal ganglia area of the brain, and the hereditary factor. Interestingly, there is believed to be a link between streptococcal infections in early childhood and stuttering, but the theory needs more study.

Maguire intersperses personal testimonials from people who stutter at the beginning of each chapter. They tell about how prescribed medications have helped, in varying degress, to improve their speech. Nobody describes it as eliminating their stuttering entirely, rather that they experienced a small to medium level of improvement in their speech, which helped their confidence.

Maguire talks about medications that “have a proven level of success” in increasing fluency, but none of these drugs are FDA certified to be administered specifically for stuttering. Maguire believes that the best approach for treatment is a combination of medicine and therapy. To date, no medical trials have been successful enough to put a stuttering reduction drug on the market. But the author points out that traditional speech therapy, too, has mixed results.

Maguire is forward thinking and innovative, and describes his use of internet video technology to treat patients. “Telemedicine” is a growing industry among those clinicians willing to try new treatment methods.

Many people who stutter are familiar with Pagoclone, a drug tested specifically for the purposes of reducing stuttering. This book was written in the early stages of testing at the Kirkup Center, so it does not comment on the apparent failure of the latest phase of the trials.

Certainly this book gives good evidence that there are drugs that reduce stuttering in some people. Without Hesitation is very positive and empowering, although in light of the failures to put such a drug on the market despite years of study, might seem overly optimistic. Only time will tell, and we can be assured that researchers like Maguire are not about to give up.