Agreed! I attended speech therapy for my stuttering, where they emphasized acceptance and desensitization, both of which heavily rely on conditioning principles. For instance, someone with anticipatory anxiety might gradually be exposed to a fear-inducing stimulus (conditioned stimulus, CS) while practicing relaxation (unconditioned stimulus, US) that elicit calmness (unconditioned response, UR). Over time, this process reduces the fear response, as the individual learns to associate the previously anxiety-provoking stimulus with neutrality or calmness. This could help explain the effectiveness of [mindfulness ](https://www.google.com/search?q=%22mindfulness%22+%22stuttering%22+%22research%22)in many people who stutter. Similarly, modern speech therapies like the Lidcombe Program—based on operant conditioning—show excellent outcomes in young children. However, their efficacy diminishes significantly after age 12, leading to poorer results. This raises critical questions, which I aim to explore collaboratively: why do these poor outcomes occur after the age of 12, and how can speech therapy approaches be improved to address this gap? Furthermore, conditioning theories introduce terms like "extinction" and "extinction failure", which I believe are crucial for framing our investigation. I have explained these terms in my [Google drive document](https://docs.google.com/document/d/15SG11YKBvQy88cVpejWpMNYzLdV9lsTr409Y7E2iFMc/edit?usp=sharing), I urge you to take a read. By adopting these terms, we can better understand the underlying mechanisms and refine our research approach to advance speech therapy techniques, I argue. However, my message in the main post was more directed towards: Nobody speaks all of the time, including non-stutterers and PWS. Sometimes we remain silent despite having planned words or phrases that we could potentially have said. So there must be a mechanism inside our brains that regulates when we speak and when we remain silent. For example anticipating stuttering or negative judgements can lead to poorly fine-tuning this release threshold. 1. **Conditioned Stimulus (CS):** The act of speaking in social situations or any context where the individual anticipates stuttering or negative judgments becomes the conditioned stimulus. 2. **Unconditioned Stimulus (US):** Experiences of negative feedback, stuttering, or fear of judgment trigger anxiety or discomfort, which is the unconditioned stimulus. This leads to a natural reaction of avoidance or hesitation (unconditioned response, UR). 3. **Unconditioned Response (UR):** Anxiety, tension, or avoidance behaviors occur in response to the fear-inducing stimulus (e.g., anticipating stuttering or judgment). 4. **Maladaptive Learned Response:** Over time, the brain associates the anticipation of speaking (CS) with fear and avoidance (CR), increasing the threshold for initiating speech. This results in maladaptive regulation of when to speak or remain silent, contributing to hesitation or disfluencies even when one has words prepared to say. Your thoughts?