Stuttering

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Stuttering and Its Diagnosis

Stuttering or stammering is a complicated multidimensional communication problem. The overt or visible side of which is marked by hesitant speech which has abnormal interruptions like repetitions, prolongations, pauses and blocks. These disruptions in fluency are sometimes accompanied by secondary features like eye blinking, head jerking, facial grimaces or heavy breathing. Some people who stutter show a great deal of muscular tension and forcing while they try to speak.

The covert side of the problem revolves around what the person actually feels. Shame, embarrassment, frustration and avoidance are just a few feelings that a person with stuttering experiences.  While talking the PWS  ( People who stutter) may substitute words, talk indirectly around a topic, or reply with incorrect information to avoid certain struggle words. The problem of stammering can impact the person’s life severely.

Phenomena associated with stuttering:

There are several conditions or speaking where in stammering is absent or reduced

  1. Singing
  2. Speaking to a rhythmic beat
  3. Reading in chorus or unison with another person
  4. Speaking at a whisper
  5. Communicating with Young Children
  6. When you’re under the impact of a loud masking noise, you’re speaking in hushed tones.
  7. While Speaking at a higher or lower pitch than normal
  8. Speaking in monotone
  9. Speaking under the influence of delayed auditory feedback

All of the aforementioned fluency enhancing conditions facilitate a physical change in the way of speaking. Speaking slowly gives more time for the complex processes of respiration, vocalization and articulation. Other conditions generate an increase or decrease in loudness and pitch. Such a physical change which is consciously brought about by the speaker overrides the stuttering trigger, otherwise evident in normal speaking conditions.

Stuttering occurs more in males than females

  • Ratio is 3-5 males to every one female who stutters
  • This could be due to an inherited genetic predisposition
  • Or due to high environmental expectations on males than females
  • Or maybe because males have more language and articulation problems than females.

Stuttering occurs more in children who are twins

  • Identical twins show higher chances of stuttering in children
  • Fraternal twins show more of a tendency for only one child to stutter
  • This can be attributed to either genetic preponderance of stammering or due to slowness in maturation in early development

Onset of stuttering is in early childhood when the child is learning to string words together into phrases and sentences.

  • When a child starts stringing words into sentences there is increased stress on the child’s cognitive and motor systems.
  • The cause of stuttering or stuttering trigger may already be present but is not pulled until the stress is introduced during the complex stage of speech development.
  • Another possibility can be the child’s negative reaction to otherwise more common mistakes  he makes while attempting complex speech strings.
  • The child’s stress reactions to normal non fluencies may further tense the complex muscles of respiration, phonation and articulation. This results in even more tension, frustration, and subsequent stammering. It’s like a viscous circle

Stuttering tends to run in families

  • 40%-60% of cases have either maternal of paternal positive family history
  • This can be either due to genetic pre disposition or due to parent’s awareness and their negative reaction to normal non fluency. Stuttering may develop from parental over-concern and subsequent reaction

Situations in which stuttering increases

  • Speaking on telephone
  • Speaking in front of large audiences or to authority figures
  • Telling jokes
  • Saying one’s name
  • Speaking in a situation when speaking fluently is of utmost importance to the person who stutters
  • Such situations increase stress and muscular tension which exacerbates and maintains stuttering.
  • Situations in which the person anticipates and fears stuttering lead to more stammering, creating a viscous cycle of continued tension, anticipation and consequent stuttering

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