STUTTERING
Stuttering affects the fluency of speech and it begins during childhood but can last throughout life. A stuttering disorder is characterized by disruptions in the production of speech sounds, also called “disfluencies.” Most people produce brief disfluencies from time to time. For instance, some words are repeated and others are preceded by “um” or “uh.” Disfluencies are not necessarily a problem, but they can impede communication when the individual makes too many of them.
In most cases, stuttering has an impact on at least some daily activities. A stuttering disorder does have some impact on daily activities, but the specific activities that the individual finds difficult varies. For some people stuttering only happens during specific activities like speaking in front of crowds or on the phone but for most, stuttering occurs across many activities. As a result, people may limit their participation in certain activities, they may try to hide their disfluent speech, or even pretend like they forgot what they were going to say. Clearly, the impact of stuttering on daily life can be affected by how the person and others react to the disorder.
Some examples to stuttering:
•”W- W- W- Where are you going?” (Part-word repetition: The person is having difficulty moving from the “w” in “where” to the remaining sounds in the word. On the fourth attempt, he successfully completes the word.)
•”SSSS ave me a seat.” (Sound prolongation: The person is having difficulty moving from the “s” in “save” to the remaining sounds in the word. He continues to say the “s” sound until he is able to complete the word.)
•”I’ll meet you – um um you know like – around six o’clock.” (A series of interjections: The person expects to have difficulty smoothly joining the word “you” with the word “around.” In response to the anticipated difficulty, he produces several interjections until he is able to say the word “around” smoothly.)
How is stuttering diagnosed?
Identifying stuttering in an individual’s speech would seem like an easy task because disfluencies usually standing and disrupt communication. However, stuttering can affect more than just a person’s observable speech. Some characteristics of stuttered speech are not as easy for listeners to detect. As a result, diagnosing a stuttering disorder requires the skills of a certified speech-language pathologist (SLP).
During an evaluation, a speech-language pathologist will note the number and types of speech disfluencies a person produces in various situations. The SLP will also assess the ways in which the person reacts to and copes with disfluencies. The SLP may also gather information about factors such as teasing that may make the problem worse. A variety of other assessments and tests may be completed as well, depending upon the person’s age and history. Information about the person is then analyzed to determine whether a fluency disorder exists. If so, the extent to which it affects the ability to perform and participate in daily activities is determined.
For young children, it is important to predict whether the stuttering is likely to continue. An evaluation consists of a series of tests, observations, and interviews designed to estimate the child’s risk for continuing to stutter. Some things the SLP will consider are: a family history of stuttering, stuttering that has continued for 6 months or longer, presence of other speech or language disorders, and strong fears or concerns about stuttering on the part of the child or the family. There is no one single factor that can be used to predict if a child will continue to stutter but the combination of these factors can help determine if treatment for a stuttering disorder is necessary.
For older children and adults, the question of whether stuttering is likely to continue is somewhat less important, because the stuttering has continued at least long enough for it to become a problem in the person’s daily life. For these individuals, an evaluation consists of tests, observations, and interviews that are designed to assess the overall severity of the disorder. In addition, the impact the disorder has on the person’s ability to communicate and participate appropriately in daily activities is evaluated. Information from the evaluation is then used to develop a specific treatment program, one that is designed to: help the individual speak more fluently, communicate more effectively, and to participate better in life activities.
What can I do to communicate better with people who stutter?
Often, people are unsure about how to respond when talking to people who stutter. In general, people who stutter want to be treated just like anybody else and are very aware that their speech is different. Unfortunately, though, this sometimes leads the person to feel pressure to speak quickly. Under such conditions, people who stutter often have even more difficultly saying what they want to say in a smooth, timely manner. Therefore, listeners who appear impatient or annoyed may actually make it harder for people who stutter to speak. When talking with someone who stutters, the best thing to do is to give them time to say what they want to say. Also, suggestions like “slow down,” “relax”, or “take a deep breath” can make the individual feel even more uncomfortable. In general, however, it can be helpful to simply ask the person what would be the most helpful way to respond to his or her stuttering.