Stuttering

What is stuttering?

Stuttering is a speech disorder, which disrupts the smooth flow of speech. Individuals who stutter have no control over the difficulty they experience saying a word. Sometimes involuntary body movements such as excessive eye blinking accompany a stutter.

 

What is stammering?

Stammering is the term used in the United Kingdom for stuttering.

 

Stuttering

Stuttering usually begins before a child is 3 years of age and can often stop without any treatment. It is not unusual that children who are developing speech normally will sound like they are stuttering when they are excited, or when excitement combines with competition to be heard.

                  

Causes

The underlying cause of stuttering is unknown however current research suggests that there is a speech-motor programming difficulty. Despite many attempts by researchers, to date there is no one specific cause for stuttering. It is known that stuttering is most probably due to a problem with the neural processing that underlies speech production. It is also known that in some cases stuttering is genetic; however the exact nature of the inheritance is unknown.

 

Types of stuttering

Below are a few examples of the types of stuttering that exist.

  • Blocks: occur either at the beginning or during a word. The speaker stops and is unable to voice or produce sound.
  • Sound Repetitions: the first sound of a word is repeated, e.g. p p p pink
  • Prolongations: the sound in a word is stretched out, e.g. b...ase
  • Word Repetitions: words are repeated, e.g. I...I... like ice-cream
  • Phrase Repetitions: phrases are repeated, e.g. I like... I like... ice-cream

 

Interesting Facts

  • Approximately 1% of the population stutters
  • Many children grow out of stuttering
  • In childhood, stuttering affects five in every one hundred children
  • Males have a higher risk than females of developing a stutter (the ratio is approximately 3:1)
  • There are high recovery rates among females
  • 75% of the associated risk of stuttering occurs by 3.5 years of age
  • Individuals who stutter are found in every country, language and race around the world. Stuttering has no boundaries, thus it does not take wealth, poverty, or education into consideration.
  • Stuttering is not an emotional disorder, though anxiety does present itself as a response to the stutter.
  • Stuttering is principally inherited, as approximately 60% of people who stutter have a family history.
  • Genetics are thought to be two times more influential than environmental factors.
  • Feelings commonly associated with stuttering include frustration, anxiety, embarrassment, excitement or tension.

 

Fluency inducers 

The following may be fluency inducers:

 

  • speaking alone
  • speaking in unison
  • speaking to an infant
  • speaking to an animal
  • singing
  • swearing
  • speaking to rhythm
  • simultaneously writing
  • speaking using an accent

 

Fluency disruptors may occur:

  • with conjunctions
  • when asking “wh” questions
  • when learning new syntax
  • during fast turn taking
  • when interrupted
  • if not self monitoring
  • when not concentrating on production of speech
  • when forming responses
  • when choosing vocabulary
  • when put on the spot
  • when there is a high demand on speech
  • when uncertain of what to say
  • if rushing or disorganised

 

Secondary behaviours appear as a response and/or reaction to the stuttering and are beyond the individual’s control. Examples of this include:

  • Excessive eye blinking
  • Facial grimaces
  • Thrusting head backwards
  • Hitting self

 

Treatment

The Lidcombe Program is used to treat stuttering in young children. This treatment has been scientifically researched and is evidenced based best practice. The Lidcombe Program is heavily reliant on parents, as they administer the treatment under speech pathology supervision. Parents are trained to administer the treatment and are taught how to make daily measures of their child’s stuttering. It is the responsibility of the speech pathologist to teach the parent, adjust the treatment and ensure that it is an enjoyable and positive experience for the child. The Lidcombe Program has greatest success with children aged up to 6 or 7 years in age. The treatment can be administered with older children, but it is generally more difficult for the child to generalise smooth speech outside of the clinic.

 

The Camperdown Program is a treatment for stuttering in teenagers and adults. The aim of the program is to provide a way to speak without stuttering. The Camperdown Program is used to help train participants who stutter to use prolonged speech at a very slow rate. Participants increase their speech rate systematically through programmed instruction. The use of prolonged speech stops stuttering in the clinic, and then the participant attempts to use the technique to stop stuttering outside the clinic.

 

Other treatments are also available; however before beginning therapy, participants should enquire whether or not the treatment is evidence based best practise, as this means that the therapy has been researched and scientifically proven to be successful.

 

References:

-Bloodstein, O. (1995) A handbook on stuttering. (5th Edition). San Diego: Singular Publishing Group.

-Bourke, J., Fraser, S., Josevski, S., Sedgey, L., Streatfeld, B., & Tuke, M. (2005). iStutter. --Retrieved April 1, 2009 from http://www.latrobe.edu.au/istutter/

-Guitar, B. (1998). Stuttering. An integrated approach to its nature and treatment. (2nd Edition). Baltimore: Williams & Wilkins.

-O’Brian, S., Onslow, M., Cream, A., Packman, A. (2003). The Camperdown Program: Outcomes of a new prolonged speech treatment model. Journal of Speech, Language and Hearing Research, 46, 933-946.

-Rousseau, I., Packman, A., Onslow, M., & Harrison E. (2003). Treatment time with the Lidcombe Program of early stuttering intervention: is language a factor? In C. Williams, & S. Leitao, (Eds). (2003). Nature nurture knowledge: Proceedings of the 2003 Speech Pathology Australia national conference. (pp. 157-162) Melbourne: Speech Pathology Australia.

-Wingate, M.E. (1964). A standard definition of stuttering. Journal of Speech and Hearing Disorders, 20, 484-489.

-Yari, E., & Ambrose, A. (1992). Onset of stuttering in preschool children: selected factors. Journal of Speech and Hearing Research, 32, 783-788.