Children who stutter have historically been met with impatience, derision or disregard when they can’t quickly express their thoughts and emotions. That’s the case for Maggie, the protagonist of author C.C. Harrington’s book WILDOAK, which urges us to listen to and support those with communication challenges. Mayo Clinic’s Dr. Heather Clark joins us to share her clinical expertise as a speech language pathologist.
Children who stutter have historically been met with impatience, derision or disregard when they can’t quickly express their thoughts and emotions. That’s the case for Maggie, the protagonist of author C.C. Harrington’s book WILDOAK, which urges us to listen to and support those with communication challenges. Mayo Clinic’s Dr. Heather Clark joins us to share her clinical expertise as a speech language pathologist.
This episode was made possible by the generous support of Ken Stevens.
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Dr. Denise Millstine: Welcome to the “Read. Talk. Grow.” podcast, where we explore health topics through books. Our topic is the speech disorder stuttering and our book is “Wildoak” by C.C. Harrington. I'm your host, Dr. Denise Millstine. I'm an assistant professor of medicine at Mayo Clinic, where I practice women's health, internal medicine, and integrative medicine.
My guests today are C.C. Harrington, who grew up in the English countryside, mostly barefoot. She loves the natural world and believes that stories, much like the roots of an ancient forest, connect readers and listeners in essential ways. She graduated from Oxford University with a degree in English literature and has since worked for a national newspaper, studied printmaking, and taught literacy to children with learning differences. She now lives in Maryland with her family, including her dog, who loves to eat manuscripts. “Wildoak” is her first book. Christina, welcome to the show.
Christina (C.C.) Harrington: Thank you so much, Denise. It's an absolute honor to be here. Thank you.
Dr. Denise Millstine: Our expert guest is Dr. Heather Clark, who's a professor and the division chair of speech pathology at Mayo Clinic in Rochester, Minnesota. She serves children and adults with communication, cognitive, and/or swallowing difficulties. Hetty, welcome to the show.
Dr. Heather Clark: Thank you for having me. It was a pleasure reading this book, and I'm so excited to talk to Christina directly.
Dr. Denise Millstine: It's going to be a fun conversation. For our listeners, “Wildoak” is an award-winning middle-grade novel about Maggie. Maggie is a young girl who struggles at school because of her stutter. After what her parents consider the last straw, she is sent to live with her grandfather, who she barely knows, in the English countryside, where she encounters a remarkable landscape and an abandoned snow leopard. When the landscape and the leopard are threatened by the villagers, Maggie has to decide whether she can find her voice to speak on their behalf.
So you both know how “Read. Talk. Grow.” works; we discuss books that portray health conditions and health topics in an effort to better understand health experiences through story. In this case, we're going to talk about stuttering.
Christina, this book is so much about voice. Even your dedication reads, “To all children who stutter, to all who speak for the animals and all who speak for the trees.” It's so beautiful. Tell us about your inspiration for writing this book.
Christina (C.C.) Harrington: Oh, thank you. Just quickly, thank you so much for having me. And Hetty, it's such an honor and delight to meet you and I'm so excited to talk with you, too. So the inspiration for this book really comes from lots of different places. I mean, there are three sort of central threads to the story. The main one is Maggie, and then obviously there's Rumpus, the snow leopard, and then Wildoak forest itself.
So for Maggie, I'm part of the book club and a dear friend of mine a long time ago shared the transcript of a speech that Dr. Alan Rabinowitz gave at a Moth event in New York. And in this transcript, Dr. Rabinowitz talks about his childhood as a young boy growing up in New York City with a very strong stutter and for him, he was able to talk to his pets in his apartment fluently. But he really struggled to talk to other human beings. In this speech that he shares, he talks about a particular moment when he went to the Bronx Zoo, he was about six years old, with his dad. And he actually has written a beautiful children's picture book about his childhood. And then he talks about this moment, this particular moment at the Bronx Zoo where he comes across the cat enclosure, the big cat enclosure, and there's this old female jaguar behind the bars, and he gets up close and has this moment of really profound connection with this cat. And the thought occurs to him, “You are just like me, full of emotion and intelligence and sensitivity, but you can't get your words out.” In that moment, he makes a promise to the cat and he says, if I ever find my voice, I will speak for you and that's exactly what he does. He grows up to become this absolutely phenomenal international conservationist. He found this fantastic organization called Panthera, which if you haven't heard about, I strongly recommend you look it up.
You know, as a writer, it's hard to pinpoint exactly when and where the kernel of inspiration sort of comes from. But that particular speech that he shared, that touched my heart in a really profound way. I'm not a person who has speech differences. I do have family members and friends who either stutter now or had stuttered as a child. But that moment was really profound in terms of the inspiration for Maggie.
I mean, I could talk for a very long time about the inspiration and listen to the forest where I grew up going to Cornwall and my love for Dr. Jane Goodall, and then the inspiration for the snow leopard. That was a real thing. I came across a photograph online. I don't know if you know, (if) many people know this. It's important to remember the book is set in 1963, so attitude towards speech differences were very different to what they are today. But in 1963, you could walk into Harrods and buy, quite literally buy a leopard cub or a cheetah cub. And that moment of inspiration came from a particular photograph that I saw online.
Dr. Denise Millstine: Thank you so much for that. And thank you for highlighting for our listeners that the book is set in the 1960s, and it's going to be interesting in this conversation how much we feel attitudes and how people with speech differences are treated differently today, whether that's true or not. But first, Hetty, tell us your reaction to the book and also share with the audience what it's like to be a speech pathologist.
Dr. Heather Clark: Sure, thank you. And you know, I want to quickly respond to just the fact that you have included communication as a health issue. So not everyone thinks about the ability to communicate as something that is a driver of wellness and a driver of overall health. And of course, communication is not only a health issue, it's an educational issue. It's a social issue. It's an interpersonal issue and an emotional issue. Just the opportunity to put communication in the forefront in this setting, I think, is so important.
I loved the book and I loved that it was set in the early ‘60s. That was immediately obvious to me from just that opening paragraph, where she's waiting to, for her turn to read aloud, and she knows she's going to stutter, and that she is in fact punished because she is unable to activate her voice for this role. And so I know we'll talk about how attitudes have changed. I think the overt punishment, yeah, I think that's the right word,for speech difficulties is no longer the norm. But I think there are still partner reactions that the person who stutters can anticipate and even just that anticipation, you know, kind of further influences how easy it's going to be for them to talk.
You asked me what it's like being a speech language pathologist and it's wonderful. I really get the opportunity to help people with something that is very central to their identity, that impacts their wellbeing, their family's wellbeing. And aside from those very lofty goals and ambitions, the fact is that communication is fascinating and there are so many different aspects that can be impacted and we have a lot of tools for optimizing communication when one or more components is giving us trouble.
Dr. Denise Millstine: Hopefully we'll talk about some of those tools. We see Maggie use them in the book. Christina, Hetty just mentioned that difficult moment where we meet Maggie. She's in class. She's being called on to read. She's been to several schools in a very short period of time, and at each has struggled because of her stuttering. At this moment, she becomes incredibly anxious because she's afraid she will block, when she tries to read. What does that mean, this idea of blocking?
Christina (C.C.) Harrington: Yeah, I mean, Hetty might do a better job of explaining technically what's happening but I think effectively the air isn't passing where it needs to, and she's not able to get any sound to come out. It's not voluntary. She's not choosing that. I mean I researched so many aspects of Maggie as a character, particularly her voice. And I think although it's a speech difference that's shared obviously by millions of people, the experience can be very, it is unique and different for each person.
So Hetty, I'd love your views on this. So for Maggie, she is a person who experiences all three sort of aspects; she struggles with repetition, she struggles with blocks and she struggles with prolongations. You know not everybody experiences, their voice won’t necessarily sound the same. So for Maggie, she finds it particularly hard when she experiences a block.
And I think at the time the practice of reading aloud was, you know, that was something that was much more, we didn't tend to do that today. But Hetty, I’d love your thoughts and to what extent you feel things have changed because the sort of quite shocking to me that in the research that I did. One thing, for example, if someone is experiencing a block , it's quite sort of common for a person to think, oh, let me just finish that word for you, let me finish that sentence for you. And that's not helpful. It really isn't. And it sort of shocked me how prevalent that response today is.
Dr. Heather Clark: It's an interesting phenomenon because if you're speaking with someone who does not have communication difficulty and they seem to be tripping over a word, or they're going, “Oh, you know, that place or what.” And you know what they're going for, it's very appropriate to jump in with the right word. And then they say, “Oh yeah, that's what I meant.” And on the conversation goes on.
So we have the situation where communication behavior that's really quite normal in other contexts is just so unhelpful in a context with someone, I would say especially who stutters, but also people with certain language disorders, you know, where it's hard for them to put words together. So I think as a culture, I think we're more aware that that behavior isn't helpful for people who stutter. And I think books like yours, TV shows and movies that feature people who stutter or have other communication disorders do a nice job of kind of revealing things that are helpful and not helpful. But I would say, especially for someone whose fluency difficulties are not severe or not obvious all the time, would be very natural for someone to jump in with a word that has the person with the disfluency now feeling an extra level of failure rather than feeling like, oh, we've just moved the conversation along.
Dr. Denise Millstine: And maybe we can piggyback on that, jumping a little further in the book and we'll come back. But jumping a little further in the book to Maggie's grandfather, who she calls Fred, and Fred is someone who is very patient and also very insightful with Maggie's speech challenges.
So maybe Hetty, you could talk about, at least what I see as a non-speech pathologist, as some of the strategies that Christina created for Fred to help Maggie. Which were things like, of course, giving time, being patient, realizing that Maggie would block when he would ask her a direct question, trying to find a way around those types of communication styles, and then also providing her with the ability to write some of the messages that she was trying to express and was struggling with. Would you say those are some good strategies, or are there further strategies you could suggest?
Dr. Heather Clark: Yeah, absolutely. And I think you kind of listed most of the behaviors that I had highlighted in my copy of the book. So first, your comment about comfort with silence, that there's a way of creating a communicative atmosphere that doesn't have a communicative pressure. So if there's a time where there isn't a voice and that's kind of perceived as a normal setting or a normal context, I think that's very facilitating.
Christina, you wrote that so eloquently. He wasn't forcing her to make conversation. He seemed more comfortable with the quiet, too, which was good. And then later that same page, you say Fred was looking at her directly. His eyes were bright and full of curiosity as if it genuinely mattered to him how she was feeling, what she was thinking.
I get goosebumps or my heart breaks or something when you realize that some people have the experience that because they can't express themselves smoothly, that people lose interest in their thoughts and feelings. That our own impatience outweighs our curiosity. And so I think this was just captured so eloquently.
The opportunity to communicate using all modalities, and writing is certainly helpful, especially in preparation for something that you know you need to say later. So that would be a nice tool to use both in anticipation but also in the moment. We probably can all flashback, although I guess it depends on the age of our listener, to the scene in “A Fish Called Wanda,” where the gentleman who stuttered ultimately just in frustration, wrote the word he was having trouble saying. But let's not underestimate the value of facial expressions, pointing, body language. We're all multimodality communicators. We just might need to be kind of more open to that. We can know in different contexts.
Christina (C.C.) Harrington: I just want to jump in on the writing piece. I think for Maggie that was very much a kind of last resort. And I think one of the pieces of feedback when I was doing early stages of research into this particular aspect of Maggie the character, it was something I really took to heart. Was that the goal I think for me as a writer is to create this character as fully as possible and to make her as rounded and as comprehensive a character on the page.
So her voice is one aspect of who she is. I never wanted it to define the whole of her. And so my goal for Maggie was that she would get to a place where she was able to accept her voice as it was, as it is. I mean, she's kind of, I know it sounds weird to talk to her, right, but she's very much alive and real to me. I wanted to get to a place where she speaks and accepts her voice wholeheartedly.
And so the idea of writing, that was I think, that's kind of a last resort for her. For her, that was one of the pieces at the, towards the end of the book and how she grows up and what happens to her and how her life unfolds and how she ultimately uses her voice to say exactly what she wants to say. And it's never easy. It never becomes easy for her. It's not like she has this kind of sudden, oh, well, everything's fine, you know? She struggles. Absolutely. She struggles.
There's a scene at the end where Fred says to her, where she says she still struggles with a voice she doesn't like. She doesn't like it. She does. You know, it's hard. She finds it difficult. I don't want to take longer than everybody else. Everybody has something about themselves they want to change, Maggie. Whether it's the way they look, the way they sound, where there from, what they own or what they don't. He paused. Some of us feel it more than others, but the truth is, and I believe this with all my heart. There's room in this beautiful, complicated world of ours for all of us, just as we are in fact, there is a need for it.
So I do. Yeah, I do feel like that was a big part of Maggie's personal story and bringing in these sort of strategies and the hope is that people around her, you know, and Fred does and, you know, bringing in some of those sorts of strategies. But ultimately, my hope was that she would get to a place where she is able to use her voice and say exactly what she wants to say without her voice changing.
Dr. Denise Millstine: Hey listeners, we hope you're enjoying this episode of “Read. Talk. Grow.” If you find our discussions helpful and insightful, please take a moment to subscribe to and rate “Read. Talk. Grow.” on your preferred podcast platform and don't forget to tell your friends to listen. Your support will help us reach more readers and those eager to learn about health through books. As always, feel free to drop us a line at readtalkgrow@mayo.edu with suggestions for books, topics or any comments. Thanks for listening.
Dr. Heather Clark: I was going to just simply read another section of the book that describes the behaviors that Fred employs to be such a good conversation partner. And so if you'll indulge me. “He did not once interrupt her, rush her, or finish any of her sentences. He did not wince when she stuttered, and she did many, many times. He did not turn away or lose focus. He listened fully and wholeheartedly until she had nothing left to say and the light in the kitchen windows had begun to fade.”
And that really describes, you know, in a nutshell, how to be a good conversation partner for someone who stutters. But to the point you were making most recently, Christina. Just this idea of communicating even though, if that's the right phrase, I think many people would love for people to accept their communication differences as a strength. I don't know that most people get there. But just recognizing that I can communicate even if I don't communicate in the exact same way as someone else. Which is kind of the heart of the treatment philosophy of, and I'm doing air quotes here, but stuttering fluently, and that is just allowing the stutters to happen and communicate anyway.
Christina (C.C.) Harrington: Would you say, Hetty, that has become the predominant approach in terms of speech pathology now? Or because something, in 1963 that was not the case? Would you say that that's one of the shifts that has happened over time? Or do you feel that there are still many different kinds of approaches?
Dr. Denise Millstine: Well, and I want to piggyback on that question too, because we hear the father in the story say we're going to do this, so we fix you. And so I think that would be a joint question if you can approach, if you can elaborate on the modern approach.
Dr. Heather Clark: Wonderful questions. So I think the world of stuttering has maybe preceded or been ahead of the curve, in terms of focusing on a difference acceptance approach. As you know, right now, there is a huge movement for neurodiversity inclusivity. And so the stuttering foundations and other groups that are designed, developed, I'm not sure what word I'm looking for. The stuttering foundations that were founded by people who stutter, really were huge advocates for this approach of really accepting this speech difference and how to move forward and be an effective communicator, in spite of that. And we certainly know many public figures who stutter, who stutter infrequently, but partly because they accepted, this is something that's part of their communication, but that doesn't limit their communication.
There are still what we would call fluency enhancing techniques that people can learn to reduce the severity of their stutter, or to try to expand their moments of fluency so that stuttering is less frequent and less severe. I think I'm speaking for most people who help people who stutter in that those approaches are always couched within this idea of, this may not be something that is ever fixed, nor does it need to be.
Christina (C.C.) Harrington: Nor should it be, yes.
Dr. Heather Clark: But to communicate through the stutters.
Christina (C.C.) Harrington: I mean, Hetty, can I give a quick shout out? Are you familiar with “The Stuttering Association for the Young” as an organization?
Dr. Heather Clark: I know there are so many, but yeah.
Christina (C.C.) Harrington: Just for anyone listening, particularly parents of young people who stutter, if you're interested in that approach, it's a wonderful organization. And I worked with Taro Alexander. He was kind enough to be one of the expert readers towards the end of the drafting process, and they run a camp for children. He started and I think there's something really powerful about being in a place where you are not the only person, with this speech difference. And that I think that can be a really, really powerful way of moving towards that idea of, this is mindfulness, this is how it sounds. And I can say what I need to say, it might take more time.
I'm very mindful of not, you know, I, I feel like I can speak to the character in the book, but I'm very mindful of not wanting. I think these things are really profoundly personal. And you know, whatever approach families and individuals decide to take, you know is absolutely unique and up to them. And so I'm just sort of mindful of not coming across as saying there is one right or wrong approach. But I will say that I think all the organizations that I talk to and work with, I think they do an amazing job. The “Stuttering Foundation of America,” the “American Institute for Stuttering” and “SAY,” particularly for young people.
Dr. Denise Millstine: And you mentioned the importance of being around other people who have perhaps similar speech challenges in this example, but also, Hetty, what you were saying about seeing public figures who speak and communicate with some speech differences.
We interviewed an author in “Read. Talk. Grow.” episode number 39, Chana Porter, about disordered eating and her book called “The Thick and the Lean.” And Chana is a person with a stutter, and she mentions this at the beginning of the episode to say to listeners, if you think there's an issue with your podcast platform or your connection, please just be patient, I will have some stuttering from time to time. And I thought it was quite lovely how she gave people this awareness and also responded in the way that people had previously reacted.
I want to talk about that reaction. And again, we're really hoping that the world has changed and has become more accepting. And it's really wonderful, Hetty, to hear that from your professional viewpoint, the area of stuttering is ahead of some of the other curves in terms of equity and acceptance. But in the story, we see many characters really short change Maggie; cut her off, tell her spit it out, become impatient with her, make fun of her, declare there's something wrong with her.
I'd really love to hear from both of you some perspective on why we do this with people with different ability that we often equate it to a cognitive impact, or not being as smart, or maybe acting out, and how we can raise awareness for employing some of the strategies we've already talked about. And that's a question for both of you.
Christina (C.C.) Harrington: I mean, it's such an important question to me. I wish I had a better, I wish I had an answer at all really well as to why people can respond in that way. I have a neurodiverse child, and also the connection between neurodiversity and perceived intelligence, it’s in the way that that can be so cruelly handled. I don't know why other people at times will do that and respond in that way.
I am a believer that story can foster greater understanding, and understanding fosters empathy. And I do believe that we need an even more understanding and empathetic world, because it's only when you put yourself in the shoes and you're able to really catch a glimpse. And of course, I will never truly understand what it would be like to live in this world the way Maggie lived. But even just by picking up a story. When you catch a glimpse of another person's perspective, you're able to…My hope is gain some of foster some of that empathy and understanding. That, in turn will perhaps nudge your awareness into a different direction. So that's always my hope for story and the power of story and what it's capable of doing that can bring about more change.
Dr. Denise Millstine: You're speaking our language, our “Read. Talk. Grow.” language. That's exactly why we do what we do. Thank you, that was beautifully said.
Dr. Heather Clark: I think you summed it up perfectly. And it's why books like yours are so important, and that characters on TV shows and movies are, that the stories are about them. They are part of the story, but their communication difference isn't the story, it's just them. And I think there's more awareness of those issues and can see more characters in our media that have differences. Whereas as a humanity very intolerant of differences of any kind, so any opportunity we have to see that different is not scary or evil is wonderful.
Christina (C.C.) Harrington: You know I'm curious Hetty, if you have thoughts on, I struggle with the word disorder and but I also I'm aware it's such a difficult the language that we use. I find the language that we use might have something to do with the way people respond. Difference, disorder, there are lots of contexts, sort of, it depends on the context within which you are discussing something that, you know, that can determine which of those words is appropriate. And of course, it's incredibly personal as well. So I wonder if you do you have any thoughts on, on so that the language that we use to try to label some of these, some of these things.
Dr. Heather Clark: I very much do. So you might not be aware, but the name of my profession in the United States is speech language pathology. So we have it right there. And the name of our science is communication disorders and sciences. So communication disorders is our field. And that's very understandable on the surface in that that is describing who we are trying to help. And when I was in training we used those terms differences and disorders very specifically, to recognize that someone who communicates with sign language, for example, communicates differently but doesn't necessarily have a disorder. At the same time, they could very well have a disorder. The difference does not preclude a disorder. Same with you know, foreign accents. So we're very mindful of that.
My own discipline, our trade magazines. There is so much loud conversation at the moment about inclusivity in our own discipline and acknowledgment of neurodiversity. And I think there's great potential for a paradigm shift within my own profession.
Christina (C.C.) Harrington: Right, it's really interesting. Right, you know, I think it's complicated, yeah.
Dr. Denise Millstine: I'm so glad you asked that question, Christina, because when I was preparing for this conversation and I was actually trying to look at preferred terms because the term disorder also didn't feel quite right. But we wanted to, of course, be recognizable. So I think ongoing conversation about this will be helpful.
There are two things I want to make sure that our listeners know about the book before we close. And I do have a last question for both of you. One is that somehow we've talked for more than half an hour without talking about the other main character, who is Rumpus, the snow leopard, who is so powerful. And the listeners are going to have to read the book to spend time with Rumpus and see how he and Maggie and the worlds get along.
The other mention I want to make is that the book is simply gorgeous. The prints within it are incredible and remarkable. For those of you who read with young children, this is a great book to physically put in hand. It is just absolutely stunning. Well done Christina.
Christina (C.C.) Harrington: Thank you. Denise. Diana Sudyka is the name of the artist who did the beautiful prints. And yeah, she really did a remarkable job of the prints inside and the cover, yeah.
Dr. Denise Millstine: So the final comments I want you to make, are regarding the phrases that we see actually on the cover of the book. And also that Maggie hears as she's acclimating to Cornwall and the countryside and Wildoak, which is the name of the forest. She finds an ancient oak tree that she literally hears speak to her and she hears the tree say, “Be gentle with yourself. It is hard to be human.” Can you both comment on that and its beauty and then we'll wrap up.
Dr. Heather Clark: I don't know if there's anything to be added to that. I think it says it perfectly.
Christina (C.C.) Harrington: Yeah Denise, thank you so much for your kind words. The scene where Maggie interacts with the old oak tree, I think in many ways it strikes in the heart of this book and the heart of this story. And it is about the nature of communication and understanding, and not just to us as humans, not just for us as unique individuals and the way we communicate with other humans and how we speak to ourselves, how we how we talk to ourselves and treat ourselves, but also how we interact with all sentient beings. With, you know, Rumpus is a snow leopard, with animals.
And then, of course, Wildoak forest itself and the whole of the natural world. You know, forests with all of this science that's unfolding about the way trees communicate with one another. So it strikes to the heart of the book in terms of communication, but it's also it's true.
And all of the pain that Maggie experiences as a young person. It may be that you as a reader, you don't have a speech difference and that's not the pain you encounter. But it is hard to be a human being and we feel deeply. And so for Maggie that scene, you know, she finds and draws real comfort in that natural world. There's an understanding, a reciprocity, which I think is so powerful. And this is something that I feel myself. So that's a really important scene and I believe that there's real truth in it.
Dr. Denise Millstine: What a beautiful way to end this discussion about stuttering and about the book “Wildoak” by C.C. Harrington. Thank you both for being on the show.
Christina (C.C.) Harrington: Thank you so much for having us. And for me, I so appreciate it. It's such an honor.
Dr. Heather Clark: Thank you for your time.
Dr. Denise Millstine: “Read. Talk. Grow.” is a product of the Women's Health Center at Mayo Clinic. This episode was made possible by the generous support of Ken Stevens. Our producer is Lisa Speckhard-Pasque and our recording engineer is Rick Andresen.
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