ABSTRACT
For most clinicians the words ‘block modification’ are immediately associated with the name Van Riper (1973, 1982). These techniques come from his work of 20 years, investigating the speech of very severe stammerers and experimenting with a variety of therapeutic approaches. The aim of block modification was not to train people to be fluent, but rather to stutter ‘fluently’. Van Riper’s premise was that the core of stammering is probably what he refers to as ‘lags and mistimings’, which are neuromuscular in origin. He saw the associated struggle and avoidance, however, as learned behaviours which can be unlearned (Van Riper, 1990). These behaviours are what perpetuate the stammer as a disabling disorder and, if they can be modified, Van Riper proposes that most of the problem will no longer exist. From his studies, Van Riper came to believe that as a person anticipates stammering, they ‘prepare’ themselves to stammer. He called this preparation an abnormal ‘preparatory set’, which, having been initiated, virtually ensures that the person will go on to stammer (Van Riper, 1973). The goal of block modification is therefore for the person to learn a new motor preparatory set to use in place of the abnormal one. Ward (2006) refers to modification as ‘the phase of therapy where “abnormal” stuttering is changed into a less effortful version’ (p249).
