Stuttering: Innate or learned?
SYNOPSIS In 1939, stuttering was widely considered genetic in origin, and untreatable. Wendell Johnson, a stutter himself, theorized that stuttering was not an inborn condition but something children learned from parents who seized on minor speech imperfections. As children became acutely aware of their speech, he said, they could not help but stutter.
At the Iowa Soldiers' Orphans' Home in Davenport, Iowa, 22 orphans were divided into two groups. One group was labeled normal speakers and given positive speech therapy (what was this?). The other group was criticized for any mistakes in speech and induced to think of themselves as stutterers.
Eight of the 11 orphans in the second group became chronic stutterers. (and in the norm group? zero?)
Apparently a (formal) counter-learning treatment was never applied to induce unlearning of stuttering for these children, though this became the strategy Johnson used in treating other cases.
Johnson never publicized this experiment himself, but did go on to fame from the position that speech problems were not genetic. He died in 1965, and the Wendell Johnson Speech and Hearing Center at the University of Iowa was completed in 1967.
COMMENT This one is interesting because it is both medical and behavioral. At the time, a medical reviewer would likely have said "it's genetic in origin and this labeling is just a waste of time." In other words, that reviewer would have seen no risk, because conventional wisdom said the manipulation would be futile, and I think it would have likely been approved by a medical review. (Maybe it was?)
But what if a psychologist, a cognitive behavior therapist or the like, had reviewed it? The logic Johnson used is a basic tenet of behavioral therapy, the idea that problems are learned, but because bad learning produced the problem good learning or counter-conditioning can fix it. This possibility is far down the list for medical researchers though, and thus no risk nor ethical issue would have been expected.
Hindsight, it's wonderful, everyone can be an expert. This is a case where the risk/benefit ratio decision rule applies, but that would not have been obvious a priori to reviewers. That is, given that popular wisdom was not supported, the long-term gain of finding an effective treatment is tremendous. But pre-screening couldn't make an appropriate cost/benefit judgment, you have to do the research and learn that conventional wisdom is wrong.
This one does not seem, to me, to involve ethical issues in its conception, but the failure to follow-up with treatment to counter the inducement is baffling.
IF IT IS TRUE that Johnson did not try to rectify the induced stuttering. I raise this possibility because this was not published, and Johnson is dead, so there is a good bit of hearsay here about what was done and what happened. What if Johnson did try to reverse the results but failed? This would temper greatly the idea that learning/labeling is the cause (and solution), and perhaps explain why he didn't, or couldn't, publish the research. Consistent with this is that the research assistant did try somewhat and failed. But then how could years of effective treatments by reconditioning have followed for other patients?John Watson's classic (1920) research with Little Albert comes to mind, showing the conditioning of emotions. Watson also failed to try to decondition Little Albert.
Given that intent to publish is one of the criteria used to determine whether an ethics review is needed, would Johnson get cleared here because it wasn't published?