“Stammering is an involuntary repetition, prolongation or block which interrupts the normal flow of Speech.”

Approximately one person in every hundred stammers, and stammering covers a wide range of behaviors. One person may get blocked or stuck on a certain word or sounds, another may repeat sounds, another may go back in speech and take a run at the difficult word and yet another may do all of these things and many more.

There are times when a speech is fluent, perhaps when talking to oneself or with a friend or may be junior. At the other times stammering may occur frequently especially when tired, excited or under stress. Stammering may be worse when speaking to someone in authority or while talking on the phone. Why is it that the stammering and fluency varies so often? This is because of the lack of neuro-muscular coordination.

The shame and embarrassment, the fear and tension, the loss of self confidence and the sense of frustration all adds up making the speech impossible. Despite the best efforts of not to stammer, the words do not come out smoothly, normally.

HOW DOES STAMMERING DEVELOP?

It usually starts between 3 and 5 years, it appears less often between 5 and 9 years and is quite rare after 12 or 13 years old. Five percent of all children will stammer at some time during their early years, 4 percent will recover with or without help, leaving 1 percent of adults who stammer. Interestingly, it is four times more common in boys than in girls.
Many people who stammer spend a great deal of time trying to find out why they stammer. Perhaps they believe that if they could get an answer to this question, they would be cured. Unfortunately such beliefs are not true and only lead people to focus on the past rather than on what is happening now. The one certainity is that there is no single cause, but that stammering is probably the result of many factors coming together in an individual at the same time. These factors could be physical, emotional or due to outside influences such as friends, school, parents etc.
Recent research shows that most of the stammerers have difficulty in co-ordinating the muscles for speech; they need more time to speak. This helps us to understand something which has already been discovered by the stammerer, that the slower he/she speaks the more likely they are to be fluent.

WHAT CAN YOU DO?

The main aim must be to take the mystery out of Stammering. Continued Speech Therapy is the only answer.

There is no short-cut method to cure Stammering. However, therapy will help:

(a) To learn about speech organs and their role in easy speaking.
(b) Removing the psycho-fear of Stammering by analyzing mistakes step by step and then developing normal speech habits and positive attitudes.
(c) Total behavior modification.
(d) Fluency maintenance.

ELIMINATING STEREOTYPES ABOUT STUTTERING?

• People who stutter are as intelligent and well-adjusted as non-stutterers.
• Don’t assume that people who stutter are prone to be nervous, anxious, fearful, or shy. While stuttering behaviors may sometimes resemble the behaviors of non-stutterers who experience these emotions, people who stutter exhibit the same full range of personality traits as those who do not.
• Stuttering is not the result of emotional conflict or fearfulness.
• People who stutter often have excellent communications skills. They should not be seen as deficient at verbal communication. Some people who stutter are very often qualified for and interested in positions requiring them to deal with members of the public on daily basis.
• People who stutter have the same ambitions and goals for advancement as non-stutterers. To an extent consistent with their abilities, they should be offered leadership opportunities and paths for promotion within an organization.
• Stuttering varies widely in different people and varies in the same person over different times and places. People who stutter often have “good” and “bad” days with their speech.
• For people who stutter, a job interview is perhaps the single most difficult speaking situation they will ever encounter and is not indicative of how they would speak on the job. It is important to consider the actual job requirements and conditions before ruling out a candidate for employment because of his speech impediment.
• Some people who stutter less severely may not acknowledge their condition publicly for fear of losing their jobs or being denied promotions. By feeling forced to keep their condition a secret, they place themselves under enormous stress. This can impact their own job performance as well as that of their colleagues.

WHAT IS STAMMERING AND WHAT IS NOT?

Stammering is not a disease – and medical science therefore has no “drug” to “cure” it. WHO has defined stammering as a disorder of rate or rhythm which disrupts fluency. Says Harisinghani, “The stuttering is confused about when exactly to utter the word in any A particular sentence. Even the severest stutterer does not stammer while singing. This might be because, in singing a song, he knows exactly when to say the words (of the song). There is no confusion in his mind about this since he has heard the song before and memorized its words. When speaking in other situations, however, the stammering child or adult is always unsure about the timing. He is either in a hurry to speak or in perennial doubt about his ability to be fluent.” That is why stammering has also been described as ‘an internal struggle to speak’.

The stuttering difficulty may vary from one situation to another, increasing in frequency and severity as and when he feels inferior, anxious or self-conscious. The degree of difficulty may vary from a mild problem with initial syllables or certain words, to violent contortions and a momentary inability to utter any sounds at all.

WHY DO SOME PEOPLE STUTTER/STAMMER?

No one really knows what causes a person to stutterer although theories abound. A weighty number of papers and books have been written, discussing whether the problem is psychological, physical, predispositional, neurological, environmental, imitative – or a combination of these. Tests have also shown that stutterers have no hormonal imbalance; other studies have shown that their I.Q. level is either average or above average.

One theory is the theory of delayed auditory feedback. Whatever we speak is heard by the ears and it is estimated that it takes about 17 milliseconds for a sound to reach the ear. In a stutterer, there is a delay and since he hasn’t heard his word, he waits for it. The interim is filled with hemming and hawing, repeating the same words or prolonging a particular sound – hence the stutterer. Or so the theory goes.

Sometimes, very rarely, specific brain damage after an accident or stroke can result in a stutter.

But the fact that all stutterers have periods of fluency suggests that the problem is more due to psychological factors than physiological impairment (except in cases of stuttering caused by disease such as Bell’s Palsy or a stroke).

Stuttering is found to run in families in about 6 out of 10 cases. The explanation could be familial rather than genetic – because of unconscious imitation of the speech of a parent or sibling.

It is also more frequent among males than females, in a ratio of about 5:1. Why this is so is not definitely known. Some speech pathologists believe it is a sex-linked trait. Others assign developmental reasons: that speech develops earlier in girls who are, on the whole, more vocal than boys. Still others cite an environmental factor: boys are required to conform to higher parental expectations and so are subject to greater stress.

Sudden or chronic stress can often be the trigger: child abuse, the loss of a parent, a new baby, a perfectionist father.

When left-handed children are forced to use the right hand, the fear of punishment for failure to use the more awkward hand can also start off a stutter.

Speech, says Harisinghani, is one of the most finely-tuned of human activities, involving both, physical and cerebral (intellectual) functions. “At the ‘brain’ level, thoughts are born, words are selected from the memory bank and put into appropriate grammatical form, the speaking machine is activated. The lungs begin to exhale air (most speech occurs as we breathe out) which passes between the two vocal cords causing them to vibrate and thus produce voice. This voice moves upward into the mouth where it is transformed into the spoken word through the intricate movements of the tongue, lips and teeth.”

What happens to this precisely-coordinated mechanism of speech in the case of a stutterer? American research professor and speech therapist Martin Schwartz theorizes that stutterers are born with a tendency to tense the vocal cords when stressed and so experience strong throat and larynx constrictions just before stuttering. There is a kind of locking of the vocal cords.

ARE STUTTERERS/STAMMERERS MADE NOT BORN?

A stutter typically starts between the ages of 2 and 6, while the control of the speech mechanism is still unstable. Almost every toddler goes through a stage of “normal non-fluency” when he hesitates and repeats sounds. He is eager to recount new experiences, but breaks off in a jerk because he doesn’t have the vocabulary to express them. While he gropes for words, he fills the pause by repeating or revising initial words or by using interjections. Examples: “Um-huh”. “It’s-it’s very hot”. “The cat-er-kite is in the air.” The child doesn’t even notice that anything’s wrong, unless it is specifically drawn to his attention. When he’s learned enough words to give body to his ideas, the non-fluency vanishes. So this stage should be no cause for concern.
However, any attempt to correct the child at this stage, or any kind of ridicule, instills the germ of anxiety and, very soon, he learns to speak in stutters and stutters. As speech pathologist Wendell Holmes says, “Stuttering starts not in the mouth of the child but in the mind of the parent.”
“Quite often,” says speech pathologist Ramesh K. Oza, “a child who has not reached fluency or developed a vocabulary in his mother tongue is planked into a playgroup in which the teachers not only speak only English but insist that English be spoken at home. With constant corrections at home and at school, this child is often at a loss for words, and can end up developing a stutter.

Stuttering becomes a cause for concern when it persists into the primary school stage – which happens in about one in every 100 cases. Normal non-fluency-which consists largely of whole word/phrase repetitions – has, by this time, given way increasingly to part-word repetitions (like “dad-dad-dad-daddy”) or to prolongation of the initial sound (eg.b..b..b..ball). Simultaneously, the child’s face may contort with the effort of trying to force out the sound, and changes may occur in his breathing pattern. At school, the jibes of other children tend to worsen the situation: the stuttering child becomes self-conscious, ashamed and anxious about his speech.

In the next stage of stuttering, there is an escalation of the tension and embarrassment. Instead of repeating sounds, the hapless victim cannot get the sounds out at all or, if he starts, he cannot end them. These interruptions, respectively known as “blocks” and “prolongations” in medical terms, occur in full force during important or stressful communication. They are often accompanied by blinking eyes, facial ties and jerky movements. These, on the face of it, appear to help the stutterer to force out the word. But actually, such bodily movements have nothing to do with producing the sound since that involves only the muscles of speech.

By this time, it has almost become part of the stutterer’s self-image to speak dysfluently. It has been reinforced so much that it’s almost as if he knows no other way of speaking. Says Harisinghani, “Speech is one of the body’s strongest habits. Stuttered speech is an abnormal variation of normal speech, but essentially Stuttering is also a habit.

However, Stuttering does not develop in a predictable pattern. In children, speech difficulties can disappear for weeks or months only to return suddenly in full force. Quite often, the problem vanishes in adolescence. Adults have also been known to stop Stuttering for no apparent reason. And most Stutters can speak fluently under certain conditions – when they sing, recite in a group, shout, whisper, or when they are alone in the privacy of their rooms.

In the next stage of stuttering, there is an escalation of the tension and embarrassment. Instead of repeating sounds, the hapless victim cannot get the sounds out at all or, if he starts, he cannot end them. These interruptions, respectively known as “blocks” and “prolongations” in medical terms, occur in full force during important or stressful communication. They are often accompanied by blinking eyes, facial ties and jerky movements. These, on the face of it, appear to help the stutterer to force out the word. But actually, such bodily movements have nothing to do with producing the sound since that involves only the muscles of speech.

By this time, it has almost become part of the stutterer’s self-image to speak dysfluently. It has been reinforced so much that it’s almost as if he knows no other way of speaking. Says Harisinghani, “Speech is one of the body’s strongest habits. Stuttered speech is an abnormal variation of normal speech, but essentially Stuttering is also a habit.

However, Stuttering does not develop in a predictable pattern. In children, speech difficulties can disappear for weeks or months only to return suddenly in full force. Quite often, the problem vanishes in adolescence. Adults have also been known to stop Stuttering for no apparent reason. And most Stutters can speak fluently under certain conditions – when they sing, recite in a group, shout, whisper, or when they are alone in the privacy of their rooms.