Stuttering, sometimes referred to as stammering, is a speech disorder that is characterized by disruptions in the flow of speech sounds, also called “disfluencies.” Approximately 3 million Americans stutter. Stuttering can make communication with other people difficult, and can affect a person’s quality of life.
Early Diagnosis And Treatment Can Help Prevent Long-Term Effects
By Rebecca Rochat
Stuttering typically involves repeating a word; drawing out or prolonging a word, syllable or phrase; or speech that may become completely blocked with no sound forthcoming. The speech disruptions may be accompanied by struggling behaviors, such as rapid eye movements or lip tremors, or the person may appear very tense or out of breath when talking.
Most people experience brief disfluencies from time to time, which is not necessarily a problem unless they impede communication when a person produces too many of them.
“Disfluency is common to the human experience; that is, everyone has experienced it at one time or another and it’s usually fleeting,” says Rob Burroughs, president and CEO of the Speech Language Reading Center in Chattanooga. “When interruptions in the speech flow persist and attract attention, we typically call it stuttering.”
Children & Stuttering
Stuttering affects people of all ages. The first signs of stuttering in children tend to appear around 18 to 24 months when a child starts to put words together to form sentences, which is natural at that stage of life. Approximately 5 percent of all children will stutter for some period of time, lasting from a few weeks to a few years; however, most children will outgrow stuttering. Boys are twice as likely to stutter as girls.
“Research indicates that about one in five children will go through a period in which they stutter,” says Burroughs. “Sometimes linked with rapid vocabulary expansion, this period typically lasts from three to six months. However, if it lasts longer, is severe or causes them anxiety or low self-esteem, parents should not wait, but seek an immediate evaluation by a speechlanguage pathologist.”
There are three types of stuttering. Developmental stuttering is the most common type, occurring in children 2.5 to 6 years of age when children are still learning speech and language skills. At this age, stuttering is believed to be triggered when speech and language abilities are unable to meet the child’s verbal demands. Developmental stuttering tends to run in families. Recent studies have pointed to the existence of “stuttering genes” that predispose a person to stutter.
Neurogenic stuttering is the second most common type of stuttering, which may occur after a stroke, head trauma or other type of brain injury. Generally, individuals experiencing neurogenic stuttering have had a history of normal speech prior to an injury or disease. The stuttering is caused when the brain has difficulty coordinating different speaking components because of signaling problems between the brain and nerves of muscles.
Psychogenic stuttering, which is rare and accounts for only a minority of the people who stutter, was once thought to be the cause of all stuttering. This type of stuttering may occur in people with mental illness or who have experienced mental stress or anguish. Adult psychogenic stuttering begins suddenly after an event causing extreme psychological stress.
Diagnosing stuttering may seem like an easy thing to do; however, some characteristics of stuttering are not easy to detect, and stuttering can affect more than just a person’s speech.
Stuttering is usually diagnosed by a speech-language pathologist (SLP). Results are then compared to the speech characteristics of fluent speakers. During an evaluation, the SLP will note the number and types of speech disfluencies and the impact on the person’s life. The SLP may also gather information about other factors, such as teasing, that make the problem worse. Assessments of speech rate and language skills may be performed, as well.
When evaluating a child, the SLP will try to predict if the stuttering is likely to continue or if the child will outgrow it. Factors to consider include: a family history of stuttering, if the child’s stuttering has lasted six months or longer, and if the child has other speech or language problems. No one factor is a prediction that the stuttering will continue. A combination of all factors will determine whether treatment is necessary.
Research is being conducted to help speech-language pathologists determine if a child is likely to outgrow stuttering or if a child is at risk for stuttering into adulthood.
For older children and adults, the question of continued stuttering is not considered as it has already become a problem. A series of tests, observations and interviews can assess the overall severity of the stuttering. Information is then used to help the individual speak more fluently, communicate more effectively, and participate more fully in life activities.
Once stuttering has been correctly diagnosed, there are many treatment options available today. Most treatment options fall into the category of “behavioral,” which teach specific skills and behaviors that improve oral communication.
For very young children, early treatment is critical to prevent developmental stuttering from becoming a lifelong problem. The treatment often focuses on teaching parents how to support a child’s fluent speech.
“Any time a parent has a concern about their child’s fluency, they should contact a speech-language pathologist,” says Carla Wiksell, the senior speech-language pathologist at The Speech & Hearing Center in Chattanooga. “We offer screenings that are free to children 5 years and younger. During this screening we can determine if the child’s fluency is age-appropriate and should be monitored for continued progress or if red flags are present indicating further assessment is needed.”
The Speech Language Reading Center also provides comprehensive assessment and treatment of speech and language disorders.
The U.S. Food and Drug Administration (FDA) has not approved any drug for the treatment of stuttering. However, some drugs that are used to treat other health issues have been used to treat stuttering.
Some people who stutter use electronic devices to help control fluency. One device fits into the ear canal and digitally replays a slightly altered version of the wearer’s voice so that it sounds as if he or she is speaking in unison with another person.
Many people find success in facing the challenges of stuttering through a combination of therapy and self-help groups, which can provide support and resources.
While there is currently no cure for stuttering, an SLP can help determine the best treatment options based on a person’s age, communication goals and other factors. “The primary treatment objective for my patients is to lead them to discover how to stutter easier and less noticeably,” says Burroughs. “Treatment techniques vary greatly depending on the person’s age and stuttering profile.”
There are many national organizations that provide support and information about stuttering, including The Stuttering Foundation (www.stutteringhelp.org), the American Speech-Language-Hearing Association (www.asha.org), and The National Stuttering Association (www. nsastutter.org).
In Chattanooga, contact The Speech & Hearing Center at (423) 622-6900 and the Speech Language Reading Center at (423) 877-5042 for diagnostic and treatment services for speech problems.
Rebecca Rochat is a resident of Chattanooga. She attended the University of Tennessee where she earned a B.S. in child development and M.S. in textiles, merchandising and design. In addition to freelance writing, Rebecca serves as an adjunct instructor at the University of Tennessee at Chattanooga.
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