by Sujata Deane

I have had a stuttering problem since the age of six when I was sent to a residential school. It started due, probably to feelings of neglect as I went from a home of doting grand parents.

I never got any real help in terms of therapy till I started to work – except as a child when my mother took me to a child specialist who told mummy to remove from the hostel but due to financial reasons (both were working) could not do so. When I was in college I went to AIIMS but only for a single session as the therapist there only made me read and I wasn’t very happy going there.

My first actual therapy was the Precision Fluency Shaping Program (PFSP) at the Clark Institute, Toronto. It was a 3-week therapy program. It is a well-integrated program in that it is a series of steps working up to a new way of speech.

After the course I felt I had control over my speech for the first time and had at last acquired something I for longed for my whole life…Fluency. We had to practice “Shaping Program” every morning. (20 mins. of the four classes of sounds lessening the duration of each syllable till you reach actual continuous speech).

When I came home to work, I realized how difficult it was as it was very slow, monotonous and unnatural. Also the speech sound production had to be very precise (the name suggests it) so was difficult to maintain over a period of time. Also I started having strange effects like saliva in the mouth, my voice becoming very tiny, pain in the jaws (maybe because I was doing something wrong or exerting too much) and there was no one to guide me.

I went to Amsterdam in 1990 for speech therapy at the Del Feuo Institute. This therapy was based entirely on breath control for 10 days at the clinic. We had to speak only when we had 100% control on our breath. Initially it seemed good but practically it was again like another strange form of speech. I started exerting too much (mostly in frustration) to get control to speak but would start running out of breath because after speaking we had to exhale vigorously all the breath. Sometimes I would also take in too much of air; all of this because we couldn’t ask any questions out there and then the eventual question of maintenance being the most important and difficult to implement.

I started speech therapy at Adlakha Speech Clinic from November 16, 1992. I had realized by now that crash courses will not cure my speech, it is only continuous and regular effort and therapy.

We started on the exercises and then the Abdominal and Thoracic Breathing and phonation exercises. I began R.O.S. Reading (Hindi) gradually, increasing the time. Since reading the language is difficult for me, it took me a while to stabilize my rate but eventually we did. I found reading for a longer period quite tiring initially but I slowly got used to it, as they assured me I would. My abdominal breathing was stabilized at 16 seconds and I continue to practice it at that. Because of all the exercises and R.O.S. my speech stabilized a lot. Then I got a bad cold and sore throat and was unable to practice for almost 4 days. I couldn’t do my exercises or go for therapy sessions. I felt my progress seemed to drop. (I think because when I do not speak with some kind of control for sometime or days I start losing confidence and feeling unable to cope).

One other problem (which might be associated with the above problem) is that sometimes (usually in the morning) I speak (phonate) with great difficulty, as if no words are coming out and the longer I pause the longer the block. At this time if I speak immediately and fast it might come out or I might block. But I lose complete control at this time. E.g. If someone says good morning, I might manage a meek hello or a very stiff smile. I become totally stiff and disoriented at this time and just cannot concentrate on anything. It is a most frustrating feeling and I came to the clinic and explained the situations. The speech therapist told me that it could be that you are holding your breath and obviously you can’t phonate then. He says that is a very frequent problem with stutterers.

I remembered that and tried not to do it (let out my breath the way he told me). But I felt scared that I might overdo something or do it wrong or at the wrong moment. This feeling of confusion is there with me so much that sometimes I am speaking fine but suddenly I start feeling that now something will go wrong and I start to panic.

January 16, 1993.
My speech during the last 48 hours.

At the start of the day, i.e. when I wake up in the morning, one takes some time getting prepared to actually speak. I have over the years, due to some reasons, developed a sense of dread of beginning to speak in the morning and do not have any confidence of doing so. If it comes out well then probably the whole day it goes well too but if I don’t speak for a period then I have the same feelings of insecurity in my speech with the result that my speech would either tremor or my mouth wouldn’t open and I wouldn’t be able to articulate or have any kind of loudness. I felt I had NO CONTROL.

During the last 24 hours that feeling has improved considerably. Earlier when I spoke I felt my breath would just give in and I would have no breath to continue the rest of the sentence and would resultantly be breathless. I now decided that when I get up and speak and have the feeling that my breath is giving in, I would just increase my loudness on those words and automatically rate also would drop and the feeling of breath not going with my words wasn’t there. My rate of speech (ROS) also automatically stabilizes as the day goes and in spite of others speaking at a fast rate I have no difficulty maintaining my R.O.S. because there is definite clarity of speech and it sounds better. I, though, feel that I need to work more on R.O.S. to maintain that stability and every morning think of the loudness pattern I need to maintain when in trouble to stabilize my speech slowly.

During the last 48 hours I can say that I have had CONTROL of my speech.