Stuttering - Causes, Types and Treatment

Introduction

We see a few have interludes and gaps while speaking with peers. This is because they seem to repeat the phrase's consonants or syllables. For instance, the person utters ‘goo goo goo-d morning’ for a good morning. And they are usually stated as stammering. Yes, Stammering is common among little ones and adults, affecting more than seventy million people worldwide. And to the fact, one percent of the planet stutters.

What Is Stuttering?

Stuttering, commonly known as stammering, is a speech disorder in which the speech flow and fluency are disrupted or blocked. As a result, the person presents involuntary repetitions and lengthening of letters, sounds, vowels, syllables, words, or idioms. Stuttering is considered a condition of “selection, initiation, and execution of motor sequences required for speech production,” as per Watkins et al.

What Causes Stuttering?

Though the precise cause of stuttering is still unknown, specific attributes play a role in stuttering, and thus they have stated the types accordingly.

Types of Stuttering.

Developmental: The children begin to stutter at their developmental stage. Developmental stuttering is typically seen from two to six years of age.

Neurogenic: The distraction of signals and altering chemical messengers causing brain damage would lead to stuttering. The factors driving such are given below.

• Trauma.

• Brain injury.

• Stroke.

• Meningitis (an inflammation disorder).

• Parkinson’s disease (a degenerative disease).

Psychological: Cognitive impairments like stress, anxiety, depression, and embarrassment worsen the condition. In contrast, they may evolve as a result of stuttering.

Who Is at Risk of Stuttering?

In addition to the causative factors, these people are at risk of stuttering.

• The children with a family history of stuttering with a prevalence of two in three people.

• Boys are more likely to develop long-span stuttering than girls.

• The earlier the condition begins, the sooner it will cease without persisting in future life.

What Are the Signs and Symptoms of Stuttering?

Though involuntary repetitiveness of constants or words and obstruction of speech are the prominent features of stuttering, the person has certain feelings of concern. They encounter blockage, posture imbalance, and sound alterations. The succeeding presents the overall characteristics of stuttering.

Common Signs:

The person needs help with the fluency of speech, primarily composed with great effort and strain.

Repetition:

• Syllables: The person repeats either a syllable piece of a word or a whole syllable word. For example, ‘Wa wa wa’ for water and ‘in in in’ for in the book.

• Incomplete Syllables: An incomplete syllable is meant for a consonant without a vowel. So, here a repetition of that becomes habitual. For example, ‘b b b’ for a bag.

• Multi-Syllables: In this theme, more than one syllable or word is repeated. For example, ‘Can I Can I’ for Can I borrow a pencil?

Postures:

• Audible: A sound is being lengthened like ‘rrrrrrrrrrrrrrrrrrrrrrrr.’

• Inaudible: An effort is taken, but the speech leads to a block or no sound.

Superfluous Deeds:

• Verbal: The person takes surplus care to go back to the phrase and amend it. He utilizes ‘um.’

• Non-verbal: The throat is cleared, or the head is stabbed to rectify their flaws and evade the blocks.

Feelings: 

As stuttering has an adverse impact on themselves and their peers, the person finds it emotionally distorted to commence a speech. Emotional disturbances incorporate shame, guilt, fear, embarrassment, sadness, anger, and frustration. As a result, a few dare say that stuttering is less intelligent. Eventually, sooner or later, stuttering with these feelings paves the way for low self-esteem and self-image. Thus it interferes with daily functioning, career, and relationships.

Disfluency: 

The person who chronically stutters endures diverse disfluencies. They struggle with linguistic planning, the prominent factor triggering and accompanying speech disfluency.

Comorbid Conditions: 

Comorbid conditions are known for the state that co-occurs with the disorder. In this manner, stuttering might be seen with language disorders, as demonstrated.

• Attention Deficit Hyperactivity Disorder (ADHD): It is a chronic neurodevelopmental condition characterized by attention deficits, hyperactivity, or impulsive behavior. It is evident that about 4 to 50 percent of children with ADHD stutter.
• Dyslexia: Dyslexia is a disorder in which the person has impaired reading and writing. Thirty to fifty percent of dyslexic adults stutter.

How Is Stuttering Diagnosed?

Not every stuttering disorder is presumed, as some require a proper diagnosis. A speech-language pathologist, a medical care professional, closely and extensively identifies the condition. The therapist considers the following appropriate analysis, tests, and interviews.

• Firstly, the therapist will analyze the case history reviewing the onset, severity, frequency, and duration of stuttering.

• In children, he contemplates the parent’s speech and parent-child interaction while considering the age and speech impediments.

• The therapist will apprehend the various aspects of speech and conduct to approach adults. Then, he utilizes the disfluency type index (DTI) test to rule out the disfluency in detail.

• Subsequently, the therapist may employ the naturalness rating scale(NRS) and childhood stuttering (TCOS) test to witness the naturalness and transparency.

• The syllables or word repetition, prolongations, and frequency rate per time are also looked for.

• Finally, the person is supervised for their emotions and behavior as the stuttering would broadly accompany psychological issues.

What Are the Treatment Options for Stuttering?

After the certified speech-language therapist precisely diagnosed the condition, ruling out the severity and chronicity, treatment can proceed with sound care. There is no such complete recovery for stuttering, though, instead, the symptoms and speech problems.

• Speech Therapy: Speech therapy is considered the best treatment as it directs one to speak more distinctly. The speech therapist will provide guidance on slowing the speech and coping with situations that worsen the stuttering.

• Fluency Shaping Therapy: The therapy works on breathing, articulation, pronunciation, and stretching the consonants to pave the way for more fluency which advances the person to converse speedily with reduced blocks and interruptions.

• Stuttering Modification Therapy: The therapy contributes to coping with the stuttering conditions by recognizing and working on them. Modification therapy does not work to eliminate the stuttering itself. Instead, it modifies the stuttering to make it less effort and easier.

• Electronic Fluency Device: Also known as assistive or altered auditory feedback devices, which are meant to delay the voice or alter the frequency. In addition, this earpiece device would play noise, creating an echo for the person.

• Psychological Intervention: Cognitive Behavioral Therapy (CBT) is used for the management of stuttering as it relies upon identifying and altering thought patterns. Sociological approaches can also help in sorting stuttering.

Pharmacological Drugs: Doctors prescribe certain medications for stuttering.

1. Antipsychotic drugs such as Olanzapine, risperidone, and haloperidol.

2. Antidepressants like Citalopram and Clomipramine.

3. Alprazolam (an anti-anxiety medication).

Conclusion

The person stuttering will quest words for substitution and rearrange them to hide such conditions. In addition, it bears the theme of loss of control, so it requires early concern. Speech and fluency allied therapies will function well over stuttering, alleviating the symptoms. And the secondary approaches include cognitive therapies with medication. As a direct consequence, stuttering can be managed effectively.