>"What do you mean by primary symptom?" The traditional view of the primary symptom of stuttering is blocks, repetitions and prolongations. (which I don't agree with) Brocklehurst (PhD) views the primary symptom of stuttering as: * The inabiity to initiate articulation, see scientific [diagram](https://youtu.be/LftpTGx0xhs?t=551) (YT video, at 9:00 minutes) * He formulates it as: inhibition to execute the speech motor plan (motor program) My viewpoint is the same as Brocklehurst, except that I don't agree with the "inability" element. Argument: Because during a feared word, yes indeed, we may experience that we are stuck or unable to execute speech movements. But that is all it is, in my viewpoint: "an experience" (that we perceive) (and that we reinforce e.g., convincing ourselves of that belief, which we then "rely upon" \[aka **overreliance** on demands/conflicts (e.g., see [Evan Usler](https://alliedhealth.ceconnection.com/ovidfiles/00011363-202201000-00004.pdf), phd) to decide whether to instruct execution of speech movements\]), so I hypothesize that PWS are not actually stuck during even the worst stutters in one's lifetime, and that we were actually always able to continue executing the articulation if we simply reduced overreliance on conflicts/demands to initiate articulation. (it's an oversimplified explanation, [here](https://drive.google.com/file/d/1_-toBZWtPEOZmfGKVY6I7WM9Bbe9CRoQ/view?usp=sharing) is a more detailed explanation) Conclusion: So, my hypothesis posits that the primary symptom of stuttering is: * inhibition to execute the speech motor plan (resulting in not continuing articulation) (which you would probably call "Basal Ganglia dysfunction" \[left side\]) Secondary symptoms I hypothesize, are: * avoidance, struggle and coping behaviors. * Note, my definition of avoidance response is any behavior that avoids: "executing the speech program". For example, applying "fluency shaping techniques" or "speaking slower" specifically to attempt execution of the speech plan, I consider an avoidance-response. Argument: because the initial (or desired) speech plan is changed. I mean, if we speak slower than our initial speech plan had in mind, then we changed HOW we wanted to speak, so we changed the speech plan, and therefore "**avoiding** the speech plan" (by applying techniques) I consider an avoidance-behavior * repetitions I consider avoidance-behaviors e.g., if they (subconsciously) re-attempt a block. Argument: because "applying repetitions" **avoids** executing the initial speech plan Personal experience: The most underlying (root) disruption of initiating articulation, I hypothesize, is: * head and neck pain that can lead to passing out (or entering a coma), if I execute articulation while relaxing (or untensing) my muscles (see the triggers in the last provided link)