Not a smooth talker?

Stammering or stuttering is a disorder of fluency in speech where the person requires unusual amount of muscular effort to speak. It is a speech coordination problem that is related to faulty breathing and speaking patterns. Speech needs a very specific sequence of coordinated movements of breathing and speech muscles. Any interruption in the sequence can lead to stammering. It can be compared with a hose pipe, if you constrict the pipe anywhere along its length, water flow is not smooth.

Stammering is not just repetitions of syllables as in ‘b-b-banana’ it’s also when a person uses extra sounds like ‘uh’ or ‘um’ to get a word started. The pauses in speech could last from a few seconds to even a minute.

This condition is often associated with other typical behaviours such as poor eye contact, abnormal head and hand movements, shifting the jaw to one side or flaring the nose while speaking. The person facing this concern may also have low self esteem and may avoid usage of certain words or speaking situations. Stammering generally starts in early childhood around 2 – 5 years of age, when a child is in the process of speech development and can continue in adulthood if not treated completely. Onset of stammering in adults is less common and there is no definite cause for why it happens.

Why it happens

The most common form of stammering in adults is due any injury to the brain from trauma or stroke. The other reason is due to some emotional or stressful events. The person may start stammering due to the shock of the event and may even recover on her own after the shock wears out. Some people who have had stammering in childhood and then got cured may experience a relapse of symptoms in adulthood.

The relation between stress and stammering is a vicious circle. You develop stammering due to anxiety and because of the diagnosis you get further anxious and your problem worsens.

How to treat it

If you’ve been consistently experiencing the above mentioned dysfluencies in a variety of situations/ settings you should consider visiting a Speech Language Pathologist [SLP] Your SLP will assess and diagnose the problem and rate it according to the severity. S/he will observe the number and type of speech dysfluencies present in different situations. Based on this assessment, your therapy plan will be devised. This condition is treated using specific techniques and strategies. Fluency therapy goes step by step, starting from simple tasks which gradually increase in complexity. Once, the problem reduces, it is stabilised and monitored. Unless stabilisation is done, it can always relapse; hence it’s important to be regular and complete the entire course. On an average it takes between 10 – 30 sessions to cure the stammering, based on the severity of the problem and age of the person. Along with the therapy sessions, practice at home is equally important. Few of the therapy techniques are discussed below

• Airflow management This is the first step and consists of regulated use of breathing. Our speech depends on the breath support and hence is very important.
• Soft and gentle phonatory onset This is the second step. Once correct breathing pattern is achieved, soft, easy, slow and relaxed initiation of sounds becomes the next target.
• Slow prolonged speech This consists of prolonging the vowels in the word. Practising this in various speaking situations by gradually increasing the complexity helps.

Relaxation exercises are taught to ease the tension in speech.

Counselling plays a very important role in reducing the various negative feelings associated with stammering. This is important because as the fear declines and confidence level increases, better results are achieved. Counselling is done for both, the person who stutters as well as the family members.

While speaking to a person who stammers

• Avoid interrupting the person, or completing his or her sentence.
• Be patient and maintain eye contact.
• Speak slowly with the person who has a stammering problem.
• Do not be over-empathising about the issue, it may make the person more nervous.
• Avoid giving advice to the person who is stammering, unless you are an expert and qualified to do so. Telling the person to relax, while s/he is stammering won’t help.

The positive side

There is no anatomical or structural problem in those who stammer. There is nothing wrong with stutterers’ tongue or vocal folds. That’s the reason there is no medicine to treat it. But it is not a disease, just a faulty way of speaking. It is best treated as early as possible—but it is never too late. It also has no link to a person’s intelligence or IQ.

Thus, stammering is neither a curse nor a disease, it is simply a type of disorder which could be cured by applying the directed course of action. Julia Roberts, Bruce Willis and Kishore Kumar too were stutterers at some point of time in their lives.

This was first published in the October 2012 issue of Complete Wellbeing.