Stammering Cure Centre
Contents
- 1 Can stammering be cured completely?
- 2 Can neurologist cure stammering?
- 3 What worsens stammering?
- 4 Is having a stammer a disability?
- 5 Can you fix stuttering in adults?
- 6 Is stuttering Genetic?
- 7 Why do I still stutter at 18?
- 8 Why isn’t stuttering curable?
- 9 At what age does stuttering become permanent?
Can stammering be cured completely?
There is no ‘cure’, no pill or therapy which will make stammering go away. There are therapies and interventions which can help people manage their stammer and learn to speak more easily. This is often not a permanent fix and the struggle will still be there.
Can neurologist cure stammering?
Table 3. – Stuttering characteristics indicating possible psychogenic/neurogenic stuttering
Psychogenic stuttering | Neurogenic stuterring |
---|---|
– sudden onset | – sudden onset |
– unusual forms of fluency, such as multiple repetitions of all phonemes, followed by facial grimaces, nodding, and tremor-like movements | – repetitions, prolongation, blockade in all positions in words |
– consistency of stuttering through different speech tasks | – consistency of stuttering through different speech tasks |
– the symbolic significance of the current disorder | |
– the disfluencies occur during speech anywhere in a word or utterance | – disfluencies occur during speech anywhere in a word or utterance |
– a person can be indifferent to their speech | – a person is often unaware of the disorder but can be frustrated by their speech |
– bizzare voice quality | |
– anamnestic data indicate a history of emotional problems (personality disorder, post-traumatic stress disorder, drug addiction, anxiety, or depression) | |
– diagnosis of psychopathology is not necessary | |
– the person gives the impression of “sticking” to a certain pattern of disfluencies and continues to stutter in conditions that improve fluency and during the imitation of mimic movements; | |
– after expressing emotional information, there is a sudden improvement in fluency; | |
– after a short period of therapy rapid and satisfactory progress is noted | |
– worsening of symptoms when performing simpler tasks | |
– worsening of stuttering during re-reading the same text | |
– bizarre movements (for example head and eyes) and signs of anxiety unrelated to speech production | |
– unusual grammatical constructions | |
– the existence of an occasional episode of stuttering or stuttering in specific situations |
Table 3. Stuttering characteristics indicating possible psychogenic/neurogenic stuttering The indistinguishability between neurogenic, developmental, and psychogenic stuttering could lead to ineffective assessments and generally inappropriate interventions, which in turn would prevent adequate advances in stuttering therapy ( 38 ).
Neurogenic stuttering can be associated with other communication disorders, and the most common are aphasia, dysarthria, apraxia of speech, palilalia, anomia, and confusion ( 39, 40, 41 ). Tani and Sakai state that 35% of cases of individuals with neurogenic stuttering, which are known in the literature, are associated with aphasia or dysarthria to some degree ( 9 ).
Due to the presence of comorbid speech and language disorders, it can be difficult, and sometimes even impossible, to distinguish certain types of speech and language difficulties and stuttering ( 42 ). Diagnosis of neurogenic stuttering is a complex process and requires knowledge of other speech and language disorders.
Therefore, it is not always easy to establish clearly defined boundaries between neurogenic stuttering and other speech-language disorders of neurological origin ( 43 ). The direction of the treatment of neurogenic stuttering is determined by comorbid symptomatology. Therefore, systematic identification of symptoms or disorders present during the assessment is important in order to apply appropriate therapy ( 6 ).
ASSESSMENT OF NEUROGENIC STUTTERING Assessment of neurogenic stuttering involves anamnestic data, i.e. medical, social, and speech anamnesis ( 44 ), and neurological examination ( 39 ). Key diagnostic questions include knowledge of the intervals of neurological and psychological trauma, information on environmental factors, and the time of initiation of medical therapy, if administered ( 6 ).
- Standard assessment includes analysis of a representative speech sample, determination of disfluencies index, examination of secondary behaviors, assessment of speech rate, assessment of opinions and attitudes related to stuttering.
- Assessment of motor speech performance is indispensable to determine whether there are additional motor speech disorders that affect speech fluency ( 44 ).
Stuttering needs to be analyzed in different speech tasks. It is necessary to determine the position of disfluency in words and the occurrence of disfluency in substantive and non-substantive words ( 43 ), as well as the adaptation effect ( 9 ). An important diagnostic marker in the assessment of neurogenic stuttering is the appearance of symptoms at the same time as brain damage ( 45 ).
If the scans do not show the presence of neurological impairment, cognitive abilities may be an indicator of brain damage and they should be assessed. Afterward, cognitive testing should be performed if a neurological impairment is suspected and scans do not show that is the case ( 11 ). NEUROGENIC STUTTERING THERAPY Previous research has characterized neurogenic stuttering as persistent and time-resistant to speech therapy ( 11, 43 ).
However, individual cases and advances have been reported when it comes to the use of speech therapy, which includes counseling, and the use of fluency modification and fluency shaping techniques. The results of neurogenic stuttering therapy depend primarily on the neuropathology of neurogenic stuttering.
- If the damage can be reduced or removed, the outcome in therapy will be more successful.
- On the other hand, if cases of neurological impairment require a long recovery period, progress is rarely seen in the early stages of therapy ( 11 ).
- Considering there are multiple conditions that can cause neurogenic stuttering and affect the frequency with other communication disorders with which it coexists, it cannot be said that there is only one treatment approach that is successful in alleviating neurogenic stuttering.
Treatment usually requires a joint effort from speech therapists and doctors, most often neurologists ( 39 ). Treatment methods traditionally used in the treatment of developmental stuttering are also used in neurogenic stuttering ( 8 ). Speech therapy remains the mainstay in the treatment of stuttering.
- Multiple strategies to improve fluency can be used, including facilitation of word pronunciation, speech rate reduction, fluency modification-modeling mechanisms, choral speech, metronome speech, voice pitch change, white noise ( 8, 40 ).
- Stuttering therapy most commonly involves speech therapy using behavioral and cognitive methods ( 46 ).
Neurogenic stuttering can also be treated with medication, although it is not the first choice in the treatment of neurogenic stuttering. When it comes to medications, haloperidol is the most commonly used drug and has potential beneficial effects on the treatment of stuttering ( 46 ).
Other antipsychotic medications used in the treatment of stuttering, that have also been mentioned in the studies, include chlorpromazine, trifluoperazine, thioridazine, and atypical antipsychotics such as risperidone and olanzapine, and antiepileptic drugs such as carbamazepine, sodium valproate, and levetiracetam ( 47 ).
Although stuttering is most often treated with speech therapy and psychotherapy, research shows that several antipsychotic medications also present a possible way of treatment ( 46 ). Therapy for neurogenic stuttering may include counseling or education about the impairment if the person shows anxiety or concern about the impairment present.
Is it too late to stop stuttering?
It is never too late to begin stuttering therapy.
What worsens stammering?
Symptoms – Stuttering signs and symptoms may include:
Difficulty starting a word, phrase or sentence Prolonging a word or sounds within a word Repetition of a sound, syllable or word Brief silence for certain syllables or words, or pauses within a word (broken word) Addition of extra words such as “um” if difficulty moving to the next word is anticipated Excess tension, tightness, or movement of the face or upper body to produce a word Anxiety about talking Limited ability to effectively communicate
The speech difficulties of stuttering may be accompanied by:
Rapid eye blinks Tremors of the lips or jaw Facial tics Head jerks Clenching fists
Stuttering may be worse when the person is excited, tired or under stress, or when feeling self-conscious, hurried or pressured. Situations such as speaking in front of a group or talking on the phone can be particularly difficult for people who stutter.
Is having a stammer a disability?
Is it a disability? – The legal definition of disability in the EqA is different from welfare benefits etc. Broadly, a stammer is a disability under the EqA if it has a substantial adverse effect on one’s ability to carry out normal day-to-day activities, such as having a conversation or using the telephone This test is not difficult to meet.
“Substantial” means only “more than minor or trivial”. Stammering has a good record of being found to be a disability, though if disputed it will always depend on the facts and evidence. Hidden effects such as avoidance strategies should count towards it being a disability. However an employer normally has a defence if it did not know and could not reasonably be expected to know of the disability, so telling them can help.
There is a further test if the substantial effect began less than 12 months ago, eg. if the stammer started in adulthood.
Can you fix stuttering in adults?
Is there a cure for stuttering?
The short answer is no. There is no known cure for stuttering, and like any other speech disorder, it requires therapy and practice to treat or manage it, and while some people report that their stutter suddenly “disappears”, for most adults who stutter they will continue to do so for their entire lives. The long answer is, however, a little more complex than that.
While there is no magic pill or cure that will stop a person stuttering, there are effective tools you can use to manage your stutter. Working with a speech language therapist who specialises in stuttering can be beneficial for people who stutter, for both their communication skills and their confidence.
Is stuttering Genetic?
For the most part. We know that’s not the most clear answer, however stuttering is quite a complicated condition that experts still don’t know everything about – as a result, answers to seemingly simple questions can be quite lengthy. When people discuss genetics, they often are asking if there is one single gene that dictates whether a person stutters, is deaf, has blue eyes etc and if these genes are passed down among relatives.
- However, genetics is far more complicated than that, and often there are numerous – if not hundreds – of genes that dictate even the smallest of attributes.
- And of course, not all personal attributes are related to genetics.
- However, when it comes to stuttering, what we know is that in most? – but not all – instances, stuttering is genetic, in that it was passed down through family members.
In what situations does this happen? Anna Hearne, our Massey University -based Speech Language Therapist says ” children who stutter often have a family history of stuttering however the relationship between genetics and stuttering is far from clear. About 70% of those who stutter have a family history of stuttering, so a family history isn’t necessary for stuttering to develop.
There are even cases of identical twins, who share the same genetic material, where one twin stutters and the other doesn’t.” If you are person who stutters, then there is approximately a 70% chance that there is a person in your family who also stutters. However your stutter may not necessarily look (or sound) identical to theirs.
Simply because they are more likely to stutter with certain words, letters, or sounds, or their stutter involves prolonged sounds or repetitions, does not mean that your stutter will also resemble this. Another factor that makes the genetics of stuttering complicated, is that it seems to differ amongst men and women.
The fact that stuttering is more likely to happen to males is something well-documented, and which we’ve discussed before, however, this ratio is far different if it is an inherited stutter. If there is a relative who stutters, then the case of inherited stuttering becomes 1 female to every 1.5 males, as opposed to 1 female to every 7 or 8 males,
This only serves to complicate the matter, and there is still plenty of research to be done around this. Regardless, there is one thing we would like to make clear, which is that the fact that stuttering runs in families is due to genetics and not because stuttering is contagious or children are learning to stutter by copying a family member. Sometimes parents of children who stutter ask whether it’s possible that their child is subconsciously copying another person who stutters, but this is absolutely not true.
Is stuttering a form of PTSD?
Stuttering as A Variant of Post Traumatic Stress Disorder STUTTERING AS A VARIANT OF POST TRAUMATIC STRESS DISORDER: WHAT WE CAN LEARN* by Woody Starkweather and Janet Givens (Reproduced with permission from the authors) In our work on experiential therapy for stutterers, we have been impressed by many commonalities between the experience of stuttering (see ISAD 1999) and Post Traumatic Stress Disorder (PTSD).
In this paper we look at these commonalities – pattern of development, hyperarousal, organizing one’s life around the disorder, and dissociation – and also their implications for the treatment of stuttering. Van der Kolk, McFarlane, and Weisaeth (1996) have produced the most definitive work on the subject of PTSD – a book entitled Traumatic Stress: The Effects of Overwhelming Experience on the Mind, Body, and Society,
We like this book for a number of reasons. As they state in the preface, (1) it blends objective science with an awareness of the contexts in which the trauma is embedded, and (2) The authors look at the impact of the trauma on various aspects of the individual – psychological, biological, social – and the interrelation among them.
We believe this holistic approach is also imperative in working with stutterers. They describe PTSD as follows (p.5): After exposure to a trauma, most people become preoccupied with the event; having involuntary intrusive memories is a normal way of responding to dreadful experiences. This repeated replaying of upsetting memories serves the function of modifying the emotions associated with the trauma, and in most cases creates a tolerance for the content of the memories (Horowitz, 1978).
However, with the passage of time, some people are unable to integrate the awful experience and start developing the specific patterns of avoidance and hyperarousal that are associated with PTSD. What distinguishes people who develop PTSD from people who are merely temporarily stressed is that they start organizing their lives around the trauma.
Thus, it is the persistence of intrusive and distressing recollections, and not the direct experience of the traumatic event itself, that actually drives the biological and psychological dimensions of PTSD (McFarlane, 1992; Creamer, Burgess, and Pattison, 1992). What fails in people with PTSD lies in the replaying of the memories of the trauma.
Instead of allowing the person to heal, the memories serve only to re-arouse the person to a level that they feel they must defend against them, and the avoidance begins. Eventually the defensive avoidance behaviors become habitual, and the person’s life is fundamentally altered.
- In stuttering, the pattern of development is often the same.
- There are repeated occurrences of stuttering, which are frustrating and embarrassing.
- These early reactions typically occur in children, whose reactions to frustration are likely to include the use of considerable effort to speak without stuttering or to get past the stuttering event as quickly as possible.
Frustration, embarrassment and fear are particularly strong reactions in young children. When social circumstances similar to those of previous stuttering experiences occur, the stutterer is hyperaroused – i.e., strongly provoked to struggle in an effort not to stutter.
- The struggle naturally tends to increase muscular tension, which makes smooth, easy talking more difficult.
- So, the stuttering continues and grows, recreating itself.
- As the frustration, embarrassment, and fear continue, the stuttering “worsens,” that is, a number of new avoidance techniques are added to the existing struggles.
These additional “layers” alter the physical pattern of stuttering in a way that partially disguises it and increases the fear that stuttering has come to create. Eventually, the pattern of avoidance and whatever is left of the original struggle behavior create barriers to effective communication, and daily experiences of embarrassment, frustration, and fear continue.
- At this point, stutterers begin to organize their lives around their stuttering.
- This is the first commonality with PTSD that we noticed.
- Dissociation, an integral and well known component of PTSD, has been described in some detail, though only recently, in the psychology literature (van der Kolk, McFarlane, and Weisaeth, 1996).
Of PTSD, Van der Kolk (1996) writes (pp.191-92) that “Many traumatized children, and adults who were traumatized as children, have noted that when they are under stress they can make themselves “disappear.” That is, they can watch what is going on from a distance while having the sense that what is occurring is not really happening to them, but to someone else.” Dissociation allows the person to “experience no, or only limited, pain or distress; and to be protected from awareness of the full impact of what has happened” (van der Kolk, McFarlane, and Weisaeth, 1996).
- The characteristics of dissociation are: “altered time sense, – time may be experienced as either slowed down or accelerated – depersonalization, out-of-body experiences, bewilderment, confusion, disorientation, altered pain perception, altered body image, tunnel vision.
- Van der Kolk, van der Hart, and Marmar, 1996, p.313).
The dissociation that stutterers experience seems to be similar to that experienced by nonstutterers with PTSD. Van Riper (1982) described this dissociation in stutterers as “le petite mort,” (the little death) but gave few concrete data about it. Heite (2001), based on a survey of 108 stutterers, found that about two thirds of stutterers experience dissociation during some portion of the stuttering sequence.
- In most cases the dissociation subsided with the end of the behavior, although it could also occur before or during stuttering behaviors.
- We (Starkweather and Givens-Ackerman, 1997) have speculated that this dissociation may protect the stutterer (or nonstutterer for that matter) from the psychological pain of shame, embarrassment, fear, or anger.
This may or may not be so, although Heite’s finding that the frequency of dissociation in stutterers is correlated with the frequency of their avoidance behaviors (Heite, 2001) lends credence to this interpretation. Dissociation in stutterers may also be simply a physiological by-product of any strong feeling, and some of the symptoms, such as a distorted sense of time, tunnel vision, and a buzzing or rushing sound, suggest the possibility that the vascular changes that accompany strong emotions may create the phenomenon.
It seems evident that the development of stuttering and the development of PTSD follow parallel courses, the only difference being that in the case of stuttering the daily experiences that are so painful are a combination of current stuttering, memories of past stuttering, and anticipation of future stuttering rather than intrusive memories alone.
In PTSD, memories of the awful event are triggered by specific stimuli in the person’s surroundings related to the original event. Of course, as we all know, in stuttering the defensive behaviors, e.g., word-changing, speech avoidance, struggle, and forcing, are also triggered by specific stimuli in the person’s surroundings that are related to the original event.
With PTSD, “Because of timeless and unintegrated nature of traumatic memories, victims remain embedded in the trauma as a contemporary experience, instead of being able to accept it as something belonging to the past” (van der Kolk and McFarlane, 1996, p.9). In stuttering, the trauma actually is a “contemporary experience.” It is, in other words, not surprising that stutterers begin to see their disorder as the most important aspect of their identity, and to organize their lives around it by, for example, choosing careers in which they believe they will not need to talk as much, giving their children names that begin with sounds that are easy for them to say, holding back from various forms of socializing, not using the telephone, and so on.
What does this parallel development of stuttering and PTSD imply? First, since there is a well-developed and highly effective method for dealing with PTSD (van der Kolk, McFarlane, and Weisaeth, 1996), it behooves us to look at this method and see how it compares with our treatment of stuttering.
Furthermore, since dissociation is a common part of PTSD as well as stuttering and we have no specific treatment for dissociation in stutterers, it should be useful to look closely at those aspects of treatment for PTSD that deal with dissociation. Making a summary statement about the treatment of PTSD, van der Kolk, McFarlane, and Weisaeth (1996) write: “The overall aim of therapy with traumatized patients is to help them move from being haunted by the past and interpreting subsequent emotionally arousing stimuli as a return of the trauma, to being present in the here and now, capable of responding to current exigencies to their fullest potential” (pp.
xv-xvi). In stuttering therapy too, at least as we see it, the overall aim is to move stutterers from being haunted by their stuttering past and their accumulated interpretations of what that past may mean, to a place where they no longer interpret emotionally arousing stimuli as a necessary precursor to stuttering.
As with the therapy for PTSD, we seek to help stutterers stay present, in the here and now, capable of talking to their fullest potential. How is this done? In PTSD “. people need to place the trauma in the larger perspective of their lives (van der Kolk, McFarlane, and Weisaeth 1996, p. xv).” So too can stutterers learn to place their stuttering in the larger perspective of their lives.
Furthermore, with PTSD clients, “The therapeutic relationship. is often the cornerstone of effective treatment. It tends to be extraordinarily complex, particularly since the interpersonal aspect of the trauma, such as mistrust, betrayal, dependency.
- Tend to be replayed within the therapeutic dyad” (van der Kolk, McFarlane, and Weisaeth, p. xvi).
- Many speech therapists would feel comfortable making that statement about stutterers.
- We do not think that the evidence warrants a conclusion that dissociation is integral to the experience of stuttering.
- Only two-thirds of Heite’s respondents claimed it.
Furthermore, the verbal descriptions of Heite’s respondents did not always coincide with van der Kolk and his colleague’s description of dissociation in PTSD. Nevertheless, dissociation, exactly as described by van der Kolk and his colleagues, does occur in many stutterers during stuttering events.
At the least, the phenomenon deserves attention. The specific methods recommended by van der Kolk, van der Hart, and Marmar (1996) are “discussing these patients’ experiences in a safe setting, and encouraging them to share personal reminders of the trauma with the therapist.” Since, in stuttering, the events that can provoke dissociation are both actual stuttering and the accumulation of many memories of stuttering moments, a parallel treatment would be to allow the stutterer to stutter openly and freely in a setting that is safe.
This is a familiar technique for stuttering therapists of the nonavoidance persuasion. van der Kolk, McFarlane, and Weisaeth (1996) describe a gradual building up of the PTSD victim’s ability to remember the trauma without hyperarousal, from a very small confrontation with one aspect of the memory to a more complete narrative description of the event as something that happened to them in the past.
- SLP’s will recognize this as a hierarchical approach, starting with some small change in stuttering in the therapist’s office, then gradually building up to more complete changes of speech, feelings, and thoughts outside the office in the stutterer’s real world.
- The stutterer, meeting alone with the therapist, is encouraged to let the stuttering show, to examine it closely, to talk about it with the therapist (and even “talk to it” as our new book describes), and to feel the emotions and sensations that are a part of the experience.
Once the person can do this without hyperarousal and reaction, the stutterer might try stuttering in this new and open way with one very close friend or relative, and when this has been accomplished without hyperarousal with others, until, gradually, the stutterer begins to be free of the burden of fear, avoidance becomes less likely, struggle diminishes, and the stuttering itself diminishes, first in duration and then in frequency.
We use this technique – called “The Designated Listener” – in experiential therapy for stutterers. This technique, or one like it, can help the stutterer remain “in this world” while stuttering. It is worth noting here that the actual traumas of stuttering are more in the social realm and in many ways less devastating than the events that typically result in PTSD.
But they are repetitive and frequent, like the memories of trauma that haunt PTSD patients, occurring for most stutterers on a daily basis. Repetition can be damaging. Muscles and tendons become injured not only by sprains and wrenching but also by repetitive use, as in carpal tunnel syndrome.
So it is with stuttering. The traumas may be “small,” but they occur over and over again. It seems to us not unreasonable to conclude that stuttering is a very specific form of PTSD, in which small repeated social traumas, resulting from disfluent speech, cause social embarrassment, frustration, and fear.
Over time, the stutterer comes to anticipate these events and defends against them with struggle, avoidance, denial, and perhaps dissociation. For these stutterers, stuttering has become the most important thing in their lives. To treat it, therapists can help stutterers learn that the experience of stuttering need not include severe emotional reactions, struggle, and avoidance.
- Stutterers can come to see their experience of stuttering from a broader perspective, and therapists can help them do that.
- References Creamer, M., Burgess, P., and Pattison, P. (1992).
- Reactions to trauma: A cognitive processing model.
- Journal of Abnormal Psychology, 101, 452-459.
- Heite, L.B. (2001).
- La petite mort: Dissociation and the subjective experience of stuttering.
International Stuttering Awareness Day Interactive Congress. Stuttering Home Page, Judith Maginnis Kuster, Webmistress. Horowitz, M., (1978). Stress response syndromes. New York: Jason Aronson. McFarlane, A.C. (1992). Avoidance and intrusion in posttraumatic stress disorder.
- Journal of Nervous and Mental Disease, 1 80, 439-445.
- Starkweather, C.W., and Givens-Ackerman, J.
- 1997) Stuttering.
- In the Pro-Ed Studies in Communicative Disorders.
- Austin, TX: Pro-Ed.
- Van der Kolk, B.A. (1996).
- The complexity of adaptation to trauma: self-regulation, stimulus discrimination, and characterological development.
In van der Kolk, B.A., McFarlane, A.C., and Weisaeth, L (Eds.) (1996). Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York: The Guilford Press. van der Kolk, B.A., and McFarlane, A.C. (1996). The black hole of trauma.
In van der Kolk, B.A., McFarlane, A.C., and Weisaeth, L (Eds.) (1996). Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York: The Guilford Press. van der Kolk, B.A., McFarlane, A.C., and Weisaeth, L (Eds.) (1996). Traumatic stress: The effects of overwhelming experience on mind, body, and society.
New York: The Guilford Press. van der Kolk, B.A., van der Hart, O., and Marmar, C.R. (1996). Dissociation and information processing in posttraumatic stress disorder. In van der Kolk, B.A., McFarlane, A.C., and Weisaeth, L (Eds.) (1996). Traumatic stress: The effects of overwhelming experience on mind, body, and society.
Is stuttering a brain disorder?
Is stuttering neurological? One of the more common questions I receive from clinicians and parents is simply this: “Is stuttering neurological?” Answering this question directly and clearly is important, not only because it is valuable for people to have an accurate understanding of what stuttering is (and what it is not) but also because we want to address the underlying anxiety that the question may convey.
- When parents and others ask if stuttering is neurological, the subtext is often something like, “does that mean that there’s nothing we can do about it?” Or, even, “does my child have brain damage?” Here’s how I approach the question.
- First, I affirm that it is good that the parent/clinician is asking that question, because this means that they are open to learning more about stuttering.
Too often, people operate on old ideas or misperceptions about stuttering—and in our field, we have many old ideas and misperceptions that people have to wade through in order to get to current understandings of the condition. Thus, I take it as a great first step that they are curious.
- Second, I let them know that yes, indeed, we now know that stuttering is associated with differences in both neural function and neural structure.
- Indeed, we have known this for many years.
- The first research paper documenting differences in blood flow in the brains of those who stutter dates to 1990, and since then, there have been dozens of papers highlighting many aspects of the differing neurology in people who stutter.) Thus, we can say with some certainty that stuttering arises due to differences in the brain.
It is not a psychological disorder, though it can certainly have significant psychological consequences for those who live with the condition. And, it is not a learned behavior, though learning plays a significant role in how and when people stutter. Third, I point out that knowing about the neurological underpinnings of is important, but it still does not explain everything.
- For example, we still do not fully understand why these neurological differences lead to disruptions in speech production.
- It’s a long way from the brain to the mouth, I’m afraid, but research is ongoing.
- Finally, I emphasize that simply knowing that stuttering is neurological in origin does not negate any of the good work that speech-language pathologists can do to help those who stutter.
In fact, it underscores the importance of helping people who stutter come to terms with the fact that they are different — and that it is okay to be different. This knowledge also helps to explain the difficulties that we are likely to have with fluency-only treatments: being fluent all the time is simply not the way the brains of people who stutter work.
- It takes effort for them to speak in a different way in order to enhance their fluency — a lot of effort — and that is why we so often see high relapse rates in fluency-focused therapies.
- For this reason (and many others), therapy can and should incorporate multiple components.
- Some people will indeed work on their fluency, but many will also learn to handle moments of stuttering more effectively so that stuttering is less disruptive to their communication (i.e., they will stutter more easily).
And, most will likely need to work on acceptance and desensitization so they can cope successfully with the fact that they stutter. Understanding the neurological origin of the disorder also helps us recognize that stuttering is not the result of them doing something wrong.
It’s just the way their brains work, and it’s not their fault. So, next time someone asks you whether stuttering is neurological, take it as an opportunity to educate them about stuttering and to provide these with all important messages: there is hope for people who stutter, and stuttering is not their fault ! This knowledge can make a real difference in how they view the condition and in how they view themselves.
: Is stuttering neurological?
What vitamins help with stuttering?
The Schwartz Study – Dr. Schwartz did a double-blind study Schwartz, M. Thiamin and Stuttering; a preliminary study. http://www.stuttering.com/research.html (accessed 2013 April 24) of 38 adult male stutterers. Half received about 350 milligrams of vitamin B-1 (three 100 mg pills, one with each meal, plus a daily B-complex pill).
The others received placebos. Of the 19 men who received the vitamins, stuttering was “largely eliminated” in six of the men. For the other 13 men no effect was seen. The six men were then followed for seven months and “their speech has remained essentially free of stuttering.” Adult men typically weigh about 190 pounds so these men received more than one milligram per pound of body weight, or more or less twice the dosage that was effective for the younger children in the Hale study.
The study was rejected by Nature because it didn’t follow formal procedures for registering human subjects and because a news release with the results had been released. The study wasn’t rejected for scientific reasons. Dr. Schwartz now recommends taking magnesium with thiamin.
- A studySchleier E, Schelhorn P, Groh F.
- 1991) Biochemical studies in stuttering in children.
- Otolaryngol Pol.1991;45(2):141-4.
- Tested minerals in the blood of 53 stuttering children aged 5-12, and a control group of 22 non-stuttering children aged 6-16.
- Sodium, potassium, calcium and magnesium were tested.
The only significant difference was found in magnesium.47% of the stuttering children were low in magnesium. One of the functions of magnesium is in metabolizing B vitamins.
Is stuttering linked to ADHD?
Research suggests that there may be a link between stuttering and attention deficit hyperactivity disorder (ADHD), a neurodevelopmental disorder that affects both children and adults. About 3–7% of children in the United States live with ADHD, which affects twice as many males as females.
- The three primary symptoms of ADHD are a short attention span, impulsive behavior, and hyperactivity.
- However, individuals with ADHD may also experience stuttering, which some refer to as stammering or childhood-onset fluency disorder.
- Individuals who stutter know what they want to say but have issues with the normal flow of communication.
The condition presents as prolongation of sounds, repetition of syllables or words, and disruption or blocks in speech. Keep reading to learn more about the link between ADHD and stuttering and the treatment options. ADHD may cause stuttering due to physical differences in the brain.
- Individuals with ADHD may have smaller structures in the brain’s frontal lobe, which may mature later.
- This area helps with language, organization, planning, attention span, and decision-making.
- Some research indicates that in addition to physical differences in the brain, individuals with ADHD may have functional abnormalities in the Broca’s area.
This area of the frontal lobe contributes to speech production and processing. Therefore, any disturbances in its function could cause speech issues and communication difficulties. Learn more about the differences between an ADHD brain and a neurotypical brain.
- Experts estimate that about 45% of children with ADHD have a form of speech and language impairment.
- Approximately 3–6% of school-aged children have ADHD.
- However, the prevalence is much higher among those who stutter, with 4–26% having ADHD.
- Doctors do not know much about stuttering in children with ADHD specifically, except that the language patterns are similar to those in children who do not have ADHD.
Stuttering and ADHD may arise due to anomalies in certain parts of the brain. Various areas of the brain are involved in the production and processing of speech, including:
Broca’s area helps people articulate ideas, use words accurately, and produce speech. Wernicke’s area connects with Broca’s area and helps with comprehension and language processing.The angular gyrus helps with complex language function, number processing, memory, reasoning, and the association of words with images and ideas.
Individuals with ADHD may have a smaller Broca’s area and experience functional differences. Research has identified a correlation between reduced blood flow to this part of the brain and stuttering. Learn more about stuttering. There is no single test that doctors can use to diagnose ADHD.
- A 2017 study reviewed the potential of a new test for ADHD in adults, but there is not yet an option for children.
- Doctors assess an individual’s symptoms and follow guidelines in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to help them make a diagnosis.
They may also ask parents, teachers, and other caregivers about the child’s behavior while at home or school or during other activities. As other issues can cause similar symptoms to ADHD, doctors may also perform physical exams and other tests to rule out other health problems.
- Someone with ADHD who stutters may need to see a speech-language pathologist (SLP) who has specialist training in testing and treating people with language difficulties.
- When making a diagnosis, an SLP will consider when a person began stuttering and the circumstances.
- They will also analyze the person’s stuttering behaviors and evaluate their speech and language abilities.
There is currently no cure for stuttering, but various treatment options are available depending on an individual’s age and other factors. A person should work with an SLP to determine the best option for them. A treatment plan may include:
Stuttering therapy: During therapy, people learn ways to minimize stuttering, such as speaking slowly, controlling their breathing, and starting with single syllable responses before gradually progressing to longer words and sentences. They may also perform exercises to strengthen muscles in the face and throat. Therapy also helps with anxiety associated with stuttering. Medications: Currently, there are no approved medications for stuttering. However, medications for epilepsy, anxiety, or depression may help with the symptoms. Electronic devices: These devices may help control fluency relatively quickly. One example is a device that resembles a hearing aid and fits in the ear canal. It replays a slightly different version of the person’s voice so that it sounds as though they are speaking in unison with someone else. Support groups: Individuals with speech disorders may experience emotional difficulties. A support group helps people face their daily challenges, and it may improve their outlook.
Doctors often use stimulant medications for ADHD treatment, including methylphenidate (Ritalin), amphetamine/dextroamphetamine (Adderall), and dextroamphetamine (Dexedrine), These options are effective in up to 80% of cases but may increase stuttering.
Therefore, doctors may opt for nonstimulant options, such as atomoxetine (Strattera), if an individual with ADHD is experiencing stuttering. Research suggests that these medications may reduce stuttering if a person receives them alongside speech therapy. However, they may not be as effective as stimulant medications for other ADHD symptoms.
An individual should work with a doctor to find the best combinations of treatments for them. Children with ADHD may have articulation disorders that affect how they produce letter sounds. They may also have trouble with the fluency of speech and vocal quality.
Sometimes, doctors can detect that an individual has ADHD through their speech symptoms. Louder speech, pitch variability, and unusual speech patterns, such as an increased number of pauses, may also occur in children with ADHD. They may also use words repetitively or as fillers while organizing their thoughts, which can present as a stutter.
Research shows that some individuals with ADHD who stutter may respond to treatment and overcome their challenges. However, those with more intense ADHD symptoms may have a more severe stutter than others. As a result, these individuals may require more clinical intervention and therapy to achieve speech fluency.
It is important to note that although ADHD may present some challenges, there are also potential positives to having the condition. Learn about these benefits. ADHD awareness is also extremely important, as it could help more people seek a diagnosis and receive treatment or accommodations. It could also help create more welcoming and accessible schools for those with ADHD.
Learn more about ADHD awareness. Researchers have identified an association between ADHD and stuttering. Individuals with ADHD may have difficulty concentrating, behave impulsively, and exhibit hyperactive behavior. Some individuals with ADHD may also experience speech disorders, such as stuttering.
It is possible that changes in the brain cause both ADHD and stuttering. In individuals with ADHD, the structures in the brain’s frontal lobe may be smaller. These areas are involved in language, attention span, and decision-making. People with ADHD may also have functional abnormalities in Broca’s area in the frontal lobe, which controls speech production and processing.
Currently, there is no cure for stuttering, but many individuals overcome the challenges through a combination of stuttering therapy, medications for emotional difficulties, and electrical devices. Support groups can also help people navigate the daily difficulties of living with ADHD and stuttering.
Why do I still stutter at 18?
Acquired stuttering – Tests are likely if you begin stuttering unexpectedly as an adult. Stuttering like this can be a sign of aphasia, Conditions that can cause aphasia include traumatic brain injury (also known as TBI), strokes and brain tumors (including cancer), These include imaging, diagnostic or lab tests. Examples include:
Computed tomography (CT) scans, Magnetic resonance imaging (MRI) scans, Positron emission tomography (PET) scans,
Why isn’t stuttering curable?
The honest truth is that there is no cure to stuttering. By its very nature, stuttering is cyclical – meaning it can (and probably will) come and go. You can learn tricks that might even make it go away for a time, but these tricks take a lot of mental effort.
What is the new treatment for stuttering?
Redefining Intervention Science – “I work broadly in intervention science,” Dr. deLeyer-Tiarks explained. “How can we take existing interventions and apply them in novel ways? How can we develop new interventions to support various populations? VRSM, coupled with immersion therapy, is a new intervention that has been remarkably successful for chronic stuttering.” Dr.
- DeLeyer-Tiarks, in fact, is the first researcher to combine two established interventions to treat stuttering: video self-modeling (VSM), which has been in use since the 1970s, and virtual reality (VR) to produce an immersive, 360-degree VR self-modeling video.
- The 360-degree video is the intervention,” Dr.
deLeyer-Tiarks emphasized. When participants watch the video through a VR system headset or smartphone, it promotes positive treatment gains. Self-modeling is based on the late psychologist Albert Bandura, PhD’s theory of social modeling. “If you watch someone do something, and then perform the behavior independently, you’re not just mimicking that person,” Dr.
Why is stuttering not curable?
The honest truth is that there is no cure to stuttering. By its very nature, stuttering is cyclical – meaning it can (and probably will) come and go. You can learn tricks that might even make it go away for a time, but these tricks take a lot of mental effort.
At what age does stuttering become permanent?
Stuttering usually first appears between the ages of 18 months and 5 years. Between 75-80% of all children who begin stuttering will stop within 12 to 24 months without speech therapy. If your child has been stuttering longer than 6 months, they may be less likely to outgrow it on their own.