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Stuttering is a disorder of speech that affects the fluent
production of sounds, words, phrases, and sentences. Repetitions,
hesitations, or prolongation of speech sounds at the beginning
of words or within words are frequently heard, as are repetitions,
single or multiple, of entire words or phrases. Besides these
common characteristics of stuttered speech, the individual
who stutters may have problems producing speech at all. Speech
may be blocked, airflow halted. The individual struggles to
release the air, and with it the desired word. Other struggle
behavior
is also common in individuals who stutter. There may be excessive
movement of the muscles of the face and neck, and eye contact
with the listener is frequently broken. In addition, secondary
behaviors may co-occur. These behaviors are particular to
the individual and are used in order to help release the blocked
sound or word. For some individuals, there may be a habitual
turn of the head, for others, a snap of the fingers or protrusion
of the tongue. Secondary behaviors develop as the individual
tries to cope with his stuttering.
HOW
PREVALENT IS STUTTERING?
Approximately
3 million Americans stutter. Three times as many males as
females stutter. Stuttering is recorded in countries worldwide.
Well-known and successful people who stutter include Marilyn
Monroe, James Earl Jones, Winston Churchill, and Annie Glenn.
WHAT
CAUSES STUTTERING?
Because
stuttering occurs in families, speech researchers are inclined
to say that stuttering has genetic roots. Recent advances
in the field of human genetics allow scientists to identify
the genes that cause any disorder which shows inheritance
in families. The identification of "stuttering genes"
is the subject of The Stuttering Family Research Project at
the National Institutes of Health, a project which has identified
over 350 families who can donate cheek samples to be analyzed
for DNA. There is a small but growing pool of data which show
that the brain shows certain focal abnormalities in persons
who stutter. These abnormalities appear only when the individual
is speaking and appear within the premotor, motor, and auditory
association areas of the cerebral cortex. Neuropharmacological
attempts to control stuttering have been developed, but side
effects of such medications have been numerous and unpleasant.
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Most individuals
who stutter report that they began stuttering in their preschool
years. Research has indeed shown that there is a period of
normal dysfluency which may occur in preschoolers, simultaneous
with the acquisition of language. It is believed that the
dysfluency is a response to the child’s attempts to organize
his thoughts and convert them into the words, syntax, and
grammar which he is currently in the throes of learning. In
many cases of dysfluency, particularly the repetitive type
in which the child repeats a speech sound or word, the repetition
acts as a placeholder which tells the listener to wait while
the child formulates the language he needs in order to communicate
his concept. This early dysfluency is not considered true
stuttering, and properly handled, disappears as the child
develops greater language competency. True stuttering occurs
when a child becomes aware of his dysfluency and attempts
to manage or hide it. Struggle behaviors and secondary symptoms
may appear. The child may reveal his frustration at not being
able to "get the words out."
| It
is important to have a speech evaluation at the onset
of the dysfluency so that parents may be counseled in
the ways to manage it. |
Although
approximately eighty-five per cent of the children who begin
stuttering as preschoolers outgrow it before adolescence,
it is not prudent to wait until adolescence before seeking
the services of the clinicians at the Center for Speech, Language,
and Occupational Therapy, Inc. It is important to have a speech
evaluation at the onset of the dysfluency so that parents
may be counseled in the ways to manage it. Mismanagement of
a child who is dysfluent may cause speech anxiety which may
make the problem worse. In cases of children who have a genetic
predisposition to stuttering, or who exhibit symptoms of true
stuttering, speech therapy is recommended.
HOW
DOES SPEECH THERAPY HELP?
For adults
who stutter, speech therapists at the Center for Speech, Language, and Occupational Therapy, Inc. use an eclectic approach, tailored to suit the needs
of each individual. Therapy consists of training a new way
of talking. Rate of speech is manipulated and monitored. New
breathing patterns are established for optimal phrasing. Initiating
of speech is slow and easy, and troublesome sounds are targeted.
Continuous phonation and airflow are practiced. Relaxation
and breath control are introduced. Clients receive treatment
in individual sessions, but group treatment is also recommended.
While
a therapist at the Center for Speech, Language, and Occupational
Therapy, Inc. provides treatment to the dysfluent child, the
child’s parents may observe the therapy so that they
too may learn to model easy, relaxed and slow speech for him.
Thus, parents are given hands-on training. Additionally, parents
receive counseling regarding environmental conditions that
may increase or decrease their child’s dysfluent behaviors.
Go to Advice
to Parents of Children Who Stutter.
WHAT
OTHER RESOURCES ARE AVAILABLE?
The National
Stuttering Project is a non-profit organization which
supports individuals who stutter by encouraging participation
in self-help groups, by distributing information to them by
way of newsletters, educational material and holding an annual
convention.
The Stuttering
Foundation of America distributes affordable literature
regarding the nature of stuttering and the ways in which it
may be treated.
The National
Institutes of Deafness and other Communication Disorders has
a health information hotline which describes stuttering and
other disorders.
Brendan
O’Connor Webster, M.A., CCC
Speech
and Language Pathologist
Executive Director
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