Friday, December 23, 2011

'Regulated Breathing', a.k.a. Airflow

I am excited about a discovery I recently made.

For the past few decades I have spent much time in trying to promote the Passive Airflow approach to stuttering, as in my experience this is a step in the right direction. However, what always worried me was the apparent scarceness of objective, independent research to back it up.

But recently (and better late than never!) I found out that the Airflow approach, which is a proprietary technique and has recently been patented, has its generic equivalent called the Regulated Breathing (RB) approach. RB has been known since 1974 when an article titled “A rapid method of eliminating stuttering by a regulated breathing approach” by Azrin, N.H. & Nunn, R.G. was published in Behavior Research and Therapy, 12, 279-286.

This was followed by various clinical experiments, workshops and resulting articles, the majority of them showing positive results with stuttering children as well as adults. For an online 2006 article appearing in The Journal of Speech-Language Pathology and Applied Behavior Analysis summing up the experiments up to 2006, check out THIS LINK.

An interesting feature of the RB experiments is that the proponents thereof are mostly psychologists. A probable reason for this is that RB, and the related Airflow approach, form part of the behaviorist branch of psychology. Behaviorism, in plain English, is that section of psychology in which HABIT plays a major part. 

If anybody is interested in trying out RB, do check out the above academic article, or else google ‘Regulated Breathing Stuttering’ for more details. Apart from the Airflow therapy offered by the National Center for Stuttering (NCS) in New York I don’t know of any institution where this therapy is offered, but the following institutions have done work in this respect and may provide courses: in the US: North Dakota State University (dept of psychology), Southern Illinois University, Oregon Health & Science University, Western Michigan University and the University of Wisconsin-Milwaukee. Outside of the US: Laval University, Quebec, Canada and Leiden University, the Netherlands. Work has also been done in Norway. 

In Nigeria, Africa, an academic book on RB was published this year which can be bought via Amazon – check out the link HERE

The Airflow self-help program offered by the NCS at at this stage seems to be the most organized and advanced RB facility. The program (consisting of a range of CDs, videos, a book, a manual etc.) is not cheap, however – for orders outside the US the cost is $120-90.

A word of caution – for adult PWSs, RB is NOT a miracle method and may require perseverance and daily practicing. It also may not work for everybody. This is for the PWS who is really serious about improving his fluency. For children and teens it should be much easier, however.  When my stuttering son was about ten years of age I taught him the airflow, and it did wonders for him. I hope that the above information will be of help. Check out my own online book on the Airflow approach which can be read HERE.


  1. Hello Sir,
    I enjoy reading your blog immensely. I would like to ask you a small question regarding the Passive airflow technique. While you are in a middle of a sentence and you experience a block, do you breathe and flutter or do you only flutter?
    For example, would it be (Flutter) My mobile is (flutter)lost somewhere or would it rather be.. (Flutter) My mobile is (Breathe in and Flutter) lost somewhere? I'd appreciate it very much if you cleared it out for me. Thank You.

  2. A good question! I would say that it would depend on whether you have enough air in your lungs. A good flutter requires only a very little bit of air slipping out of your mouth - the less air, the better the flutter. But when you are at the end of your breath, it will become very hard to produce a passive, correct flutter. So I would rather say that you first have to breathe in (but not too deeply) before starting to speak, and then you: "(flutter) My mobile is lost somewhere." (Remember to also slow down the first syllable "My", and maybe if needed also the second word "mobile".) If you have managed to start the sentence without stuttering, then go on and don't stop! But at some stage, of course, you need to breathe in again, and then you flutter and speak. When you do have a block mid-sentence, try to flutter without a new breath, and remember to slow those first syllable(s) after the flutter. But, as I said, it will depend on whether you have enough air in the lungs at that stage. I hope that my advice will be of help. Best of luck and kind regards!

  3. Thank you for the reply, Mr. Louw. I really appreciate it. While we're at it, I'd like to bother you with another similar question. I hope you don't mind.
    Often times, when I'm having a conversation and I know that a feared word is coming along the way, I simply can't get it out! I apply all the technique, think rest, check to see if I'm pre-forming the word and remain calm but still the word wont come out. Maybe it's like a mental pre-forming of some sort rather than a physical one? This often happens when I'm starting a sentence. For example, the word "Computer" gives me a really hard time. I've practiced saying the word thousands of times using the technique but when I'm in a real world situation, I block almost 50% of the times. Maybe I'm doing something wrong or maybe I just need to practice more? I hope you'll help me out on this one. Best wishes!

  4. Before you can swim in deep water, you first have to learn to swim in shallow water. It's a big step from practising or using the technique in the privacy of your own home, to actually applying it in circumstances of stress. If the technique is not yet established as a habit, your stuttering responses will simply take over when in stress - and it's very difficult to apply fluency techniques when you are in high stress. It's like learning a sport, or any other type of skill - it has to be practised before you can play well in front of many people. So yes, I would suggest that you first focus on using the technique correctly in LOW stress situations, where it should work. Then gradually start using it in more difficult situations of stress. A major part of this approach is stress desensitisation, where you gradually de-stress yourself, beginning with low-stress situations and working upward to higher-stress situations. Check out again the chapter in my book on applying the technique in real life. Best of luck!

  5. For a debate on this particular post regarding the 'Regulated Breathing' approach, check out the Stuttering Community thread discussion at Nemo is my username in the Stuttering Community.