Traditional speech-language therapy for people who stutter has largely operated under a medical model focused on eliminating dysfluency - breaks in the normal rhythm of speech. But for Rodney Gabel, a professor of speech-language pathology at Binghamton University, and Ladan Khoshbin, a doctoral student in Binghamton's Community Research and Action program, true progress in stuttering research begins with listening to people's stories.
Khoshbin, an international student and licensed speech-language pathologist (SLP) from Iran, moved to Binghamton in 2023 to work with Gabel, a prominent figure in the stuttering field and a person who stutters. Their collaboration recently culminated in a study published in the Journal of Fluency Disorders that examined archival personal narratives of recovery to highlight what individuals who stutter need from clinical care. The study challenges standard fluency-centered models by placing personal stories at the core of therapy.
Gabel and Khoshbin's study used a dataset from the Voices Past and Present collection of recovery-focused personal narratives by SLPs who stutter, presented at American Speech-Language-Hearing Association (ASHA) convention panels and professional forums dating back to 1957.
Gabel, one of the ASHA panelists featured in 2003, had been using the dataset as an educational tool for years.
"I'd have students go through the narratives and pick out what they thought was most important," he said. "It's a good way for students to learn and become familiar with what it's like to be a person who stutters."
When Khoshbin was assigned this qualitative content analysis in her first year as a doctoral student under Gabel, she thought it was "exactly what I had been looking for, for many years."
She and Gabel became interested in what they could learn about change, growth, and the experience of stuttering by using this source material.
For their study, they used narrative inquiry and thematic analysis, an approach Gabel described as "the perfect combination of an art and a science," to evaluate 30 narratives presented at ASHA panels from 1996-2019, each reflecting on the person's lived experience with stuttering and ongoing journey toward living effectively with it.
"I started with thematic analysis ... but this was not telling the story, and I'm interested in the story part," said Khoshbin, who led the data review. "I wanted to see the bigger picture: how people started, how they got to their turning point, how they felt during ups and downs, and how they try to continue and advocate for acceptance."
Through this process, Gabel and Khoshbin uncovered six core themes that are central to growth and recovery:
- The emotional and cognitive work of acceptance
- Claiming voice through disclosure of one's stuttering and voluntary stuttering
- The lifelong and nonlinear nature of living with stuttering
- Challenging dominant fluency-centered paradigms
- The healing power of relationships
- Therapy as a co-narrative process
A central contribution of the study is its assessment of traditional definitions of recovery. While medical models frame recovery as symptom elimination, stuttering is typically a lifelong condition. Instead, Gabel and Khoshbin advocate for a paradigm shift toward living effectively.
"Recovery means you've recovered from an illness - and that doesn't happen, because stuttering doesn't just stop," Gabel said. "Is there actually anything wrong with stuttering? There isn't. It's just a different way of talking. Living effectively is an extension of what all of us see as living effectively: Are you successful? Are you attaining your goals? Are you happy? Are you getting what you need? Are you able to communicate how you want, when you want, and say exactly what you want, stuttering or not?"
For this population, effectively living with stuttering is defined not by achieving fluency, but by empowerment, authenticity, and connection.
"We were trying to eliminate stuttering," Khoshbin said of her early clinical years. "But I could see this was not what people were asking for. I had a client tell me, 'I want to be able to find friends.' It's not just about stuttering; it's about belonging and participation."
When another client pointed out that focusing on fluency techniques robbed him of the pleasure of communication, Khoshbin realized the field needed a fundamental shift: "He told me, 'When I'm talking with people, I'm focused on my techniques to be fluent. I cannot listen to them, so I'm losing the joy of communication. I don't need to be fluent. I want to be me.'"
Rather than abandoning fluency techniques entirely, Gabel and Khoshbin advocate for a balanced, client-centered approach that honors personal goals.
I tell my clients to give themselves the right to be as they are. That's how they talk, and it's beautiful. It's verbal diversity, and it's all okay. Be yourself and feel the joy of communication.
"I need to be there, listen to their story, and make a safe place for them to share their emotions, their fears, their feelings of guilt, everything," Khoshbin said. "The clinician needs to be there for the clients and believe that [the clients] know better than anyone else about their life experiences and needs."
The study's insights are directly informing both Binghamton's Master of Science in Speech-Language Pathology curriculum and clinical operations for the University's new Stutter Forward program, offered by the Stuttering Education and Research Lab led by Gabel and Binghamton Assistant Professor Cody Dew.
"In many therapy programs, you're only considered to be doing really well if you don't stutter. In our program, we don't do that," Gabel explained. "We work on things that help people communicate more easily, but we don't really talk about not stuttering. That's not our thing, because it's very limiting."
Gabel and Khoshbin plan to expand the project by transcribing and analyzing archives dating back to 1958, to determine whether the six themes they identified transcend generations.
Gabel is also interested in comparing the stories in the dataset with existing literature, including psychological research on "redemption" stories. He described these as "stories of people who were living a certain way, things went badly, then they made a change, and things turned around."
He noted that across different groups, redemption stories tend to follow a similar arc.
"We can look at whether stories about living effectively with stuttering fit this pattern," Gabel said. "If people who manage their stuttering more effectively tell stories that follow a redemption arc, that could support the counseling approach we're using."
Khoshbin, who said these personal narratives were what she had long been seeking, plans to build her researcher identity around natural qualitative data and lived experiences.
"One of my papers explores women's experiences with stuttering, through studying a podcast hosted by a woman who stutters and featuring conversations with other women who stutter," she said. "Rather than conducting formal interviews, I analyze stories shared in naturally occurring sources, including these podcasts, written narratives, and any platform people use to share their stories. I hope to make this approach my research signature by interpreting these accounts and sharing insights with academic, research, and clinical communities."
Gabel and Khoshbin noted that considering lived experience and discussing people's narratives are not new concepts, but they are gaining popularity across fields, a development both researchers are thrilled about.
"We need to understand and listen to our clients' lived experiences in any healthcare field," Khoshbin said. "Listening to people's lived experiences and stories can help us adopt a more client-centered approach in any field where we work with people."
