Stammering or Stuttering is a speech problem which affects approximately 1 in 100 adults, it is frequently suffered in childhood and is four times more likely to effect men than women. About 17,500 people in Northern Ireland suffer from stammering. This article will focus on the different types of stuttering, why it occurs, and how to seek help if you or someone you know is impacted by this condition.
The NHS identifies two main forms of stammering:
– Developmental Stammering – the most common type of stammering; it occurs in early childhood when speech and language skills are developing rapidly
– Acquired or Late-Onset Stammering – is relatively rare and occurs in older children and adults as a result of a head injury, stroke or a progressive neurological condition; it can also be caused by certain drugs or medication, or psychological or emotional trauma
Stammering can manifest itself in different ways, for example;
- Elongating words
- Repeating sounds or syllables
- Not being able to say certain words at all
The severity of an individuals stammer can vary from situation to situation, for example it could worsen in high pressure situations, when on the telephone, or when speaking to strangers for the first time. An individual who stammers knows what they would like to say but has trouble producing a normal flow of speech. Speech disruptions may also be accompanied by other ‘struggle behaviours’ such as rapid eye blinks or tremors of the lips.
Around 2/3 people who stammer have a family history of stammering. If you have a family member who stammers, you are more likely to stammer. However, if you have a family member who stammers severely, his or her severity does not put you at additional risk for stammering nor does it relate to the severity of your own stammering.
Stammering in Children
Approximately 5% of all children go through a period of stuttering that lasts six months or more. Three-quarters of those will recover by late childhood, leaving about 1% with a long-term problem.
Why is it more common in childhood?
Speech development in children involves the communication between different areas of the brain and the muscles responsible for breathing and speaking. Ideally, if each part of this system works together speech will come out in the right order, with the correct rhythm, pauses, and timing.
Sometimes, as a child is learning the process of creating simple sentences the communication between the brain and the muscles controlling breathing and speaking aren’t co-ordinating very well. This can cause repetitions and stoppages, particularly when the child is excited or feeling under pressure. Differences in brain development between the boys and girls has been identified as to why boys are more vulnerable to speech and language difficulties. Often, as the brain develops and this co-ordination improves children ‘grow out’ of stammering.
Speech and language therapy is widely available on the NHS for people who stammer. The therapist will listen to you talk and test your speech, they will talk to you about how stuttering impacts your life and devise ways to work with you in managing your stuttering. Therapists will work on helping you feel less tense and help you face speaking situations that make you fearful or anxious for example speaking on the phone or ordering food at a restaurant.
The British Stammering Associate lists some of the wide range of approaches available to help adults who stammer.
- Fluency techniques: you’ll learn a new way of speaking which you’ll apply to the whole of your speech. An example of this type of approach is called the Camperdown Program.
- Stammering modification, aka block modification: you’ll learn to speak with less effort and tension and change the way you feel and think about your stammer.
- Work on your breathing: you’ll learn a new way of breathing which can help you become more fluent. This might include Diaphragmatic breathing aka costal breathing.
- Psychological ways of working: these help address the thoughts and feelings linked with stammering and include cognitive behaviour therapy (CBT), mindfulness and acceptance and commitment therapy (ACT). These therapies do not treat stammering directly, but can be helpful if you experience negative feelings as a result of your stammering.
There is no ‘one’ solution which fits everyone but this is a clear picture of the main sources of help available. For many it’s a journey, which often includes trying different approaches along the way.
If you are aged 18 or older and cannot get therapy in your area, the British Stammering Association offers a teletherapy service
Feedback devices alter the way you hear your own voice. They include:
– delayed auditory feedback (DAF) – these play your voice back to you a fraction of a second after speaking
– frequency-shifted auditory feedback (FSAF) – these play your voice back to you at a lower or higher frequency
– combined DAF/FSAF devices – these use a combination of both methods mentioned above
These devices are often fitted inside or around the ear, similar to a hearing aid, and can help improve the fluency of some people’s speech. There are also apps for smartphones and computers that work in a similar way.
If you are speaking with someone who stutters it is important to be patient and considerate. You should not rush them, interrupt them, finish their sentences, or ask them to change the pace at which they are speaking. Often the reactions of other people can impact how much/little a person stutters – showing frustration, awkwardness, or impatience can put unnecessary pressure on the conversation and worsen the stuttering.
There has been a support group in Belfast proposed to start in November 2019. This group would meet once a month at Belfast City Hospital. If you’re interested in going along, email Pearse on firstname.lastname@example.org or for more information visit https://stamma.org/connect/belfast-group
You can also visit the British Stammering Association website here for more information.