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| Home / For your patient / speech, language & motor services /< | ||
| Stuttering | ||
| Fluent speech is smooth, forward-moving, unhesitant
and effortless. A "dysfluency" is any break in fluent speech.
Dysfluency types range from very mild (saying "um") to more
severe (prolonging a sound, as in "sssssssnack"). "Stuttering" is
speech that has dysfluencies that are more severe and/or more frequent
than is considered average. Everyone has dysfluencies in their speech. The average person will have between 7-10% of their speech dysfluent. These dysfluencies are usually word or phrase repetitions, fillers (um, ah) or interjections. When a speaker experiences dysfluencies at a rate greater than 10% they may be stuttering. People who have more severe dysfluency types more than 3% of the time may also be classified as people who stutter. Stuttering is often accompanied by tension and anxiety. Sound or syllable repetitions, silent "blocks", prolongations (unnatural stretching out of a sound) and facial grimaces or tics can be present. Dysfluencies can generally be classified as one of two types: more typical or less typical. More typical types occur frequently in all people, and include hesitations, interjections (ummm, or ahhh), smooth phrase repetitions (I went, I went to the store), and smooth word repetitions (I, I went to the store). An average person can have up to 10% of their speech containing these types of dysfluencies and still be considered to have normal speech patterns. Less typical dysfluency types include halting phrase and word repetitions, sound repetitions (s-s-s-store), prolongations (sssssstore), and blocks (where speech feels "stuck"). In addition, any visible tension, tics, or physical signs of stuttering are considered to be less typical. People usually have very few of these types of dysfluencies in their speech. When speech has more than 3% of these types of dysfluencies, it may be classified as stuttering. What causes stuttering? Many children go through a period of normal nonfluency between the ages of 2 and 5 years. The frequency of dysfluency can be 10%, sometimes greater. These dysfluencies are usually whole word or phrase repetitions and interjections (the more typical dysfluency types). The child does not demonstrate any tension in his/her speech and is often unaware of having any difficulty. It has been suggested that the cause of this nonfluency may be a combination of simultaneous increases in language development, development of speech motor control, and environmental stresses that can occur in typical busy families. Most children outgrow these dysfluencies but some do not. There have been many theories about the cause of stuttering and many misconceptions exist. Currently, it is believed that a number of factors play a role in the development and maintenance of stuttering. These factors can be grouped and classified as constitutional, environmental and communication factors. There is some evidence that stuttering is genetic; it does run in some families. There is also evidence that stuttering is due to a disorder in the timing of movements of speech muscles, a defect in auditory feedback, and a lack of cerebral dominance for language functions. In normal, right-handed individuals, language functions are localized to the left side of the brain. Researchers have used PET scanning, which allows one to look at brain activation during different activities, to study what happens during moments of stuttering. People who stutter in general show a shift in brain activation from the left to the right side of the brain, suggesting that they process language differently. This right-side activation occurs when people who stutter are stuttering as well as speaking fluently. What can be done for stuttering? Treatment approaches generally fall into two different categories: "speak more fluently" or "stutter more easily". An integration of these two approaches is ideal for many individuals. The "speak more fluently" approach focuses on learning "targets" or fluency-enhancing skills (e.g., easy onsets, light contacts, blending). The "stutter more easily" approach helps the person to reduce tension and modify his/her stuttering so that it doesn't interfere with the ability to communicate. The Hearing, Speech & Deafness Center also offers treatment using the SpeechEasy® ear insert device. The device employs altered auditory feedback to improve fluency in many people who stutter. This device is similar to a hearing aid in design and provides the wearer with altered feedback that simulates an effect known as "choral reading." Early research shows that stuttering can be reduced for 85-90% of people who try the device. Improvement in speech is typically between 50-90%. Preliminary reports are that the effect lasts for long periods of time as long as person who stutters wears the device. When speaking with an individual who stutters it is helpful to focus on what they say rather than how they say it. Modifying your own speaking rate to one that is slightly slower and inserting pauses into your speech sets the pace. Be relaxed and attentive. Don't look away if an individual who stutters get stuck; on the other hand don't stare at them intently. Don't interrupt or finish their sentences. Advice such as "slow down", "relax", "take a breath" is NOT helpful. It often increases tension and thus stuttering. In short, acting natural, patient, and attentive is the best strategy for communicating with someone who stutters. For more information about adult stuttering or the SpeechEasy® fluency device, please contact us at:
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