Stuttering: Causes and treatment

A blog by Nirmal Sugathan

Research Scholar in Speech Language Pathology

AIISH, Mysore

As a Speech Language Pathologist I get to see a lot of people in my clinical practice who visit me with the problem of stuttering. The clients range from children who are brought by parents to adults who seek help by themselves. Children shared with me how awful they feel when their peers make fun of them. Working adults were worried about stuttering difficulty interfering with their work, especially when the job demands direct communication with clients. I am glad that I could help a lot of them to cope with the issue. For some others the task was to equip them with the confidence to speak with stuttering. There are moments that give me joy when I look back.

I thought I should share some of the information regarding stuttering to create and spread awareness.

What causes stuttering?

            Several reasons, including certain variations in the brain, have been identified as the cause of stuttering but we are unable to clearly understand the exact reason for it. However, genetics is found to be a major cause. Speech/language development happens in a child between 2 – 2 ½ years. The fact that in most cases stuttering occurs within this age group proves that stuttering and speech/language development are inter-related. Besides this, it is reported that, in some cases, stuttering occurs in relation to a shift in the place of residence or on a sudden disappearance of a member in the family. A child is born with the possibility of it developing stutter later. The circumstances under which the child lives may also become a reason for the occurrence of stuttering.

 Does Stutter cure itself?

            The causes of stutter in a child depends on various aspects:

Genetic: If a member of the child’s/individual’s family is having chronic stuttering, the possibility of cure will be remote.

Gender Difference: The chances of curing stutter in girls is high.

Age at which Stuttering Begins: Stuttering that occurs at a later stage is difficult to cure without treatment. Stuttering that occurs after 35 years of age should be treated immediately.

Intensity of Shuttering: It is difficult to cure stuttering without treatment if its intensity does not decrease within one year.

Nature of Stuttering: If the stutter cannot utter a word or if there is prolongation of certain letters while speaking, the possibility of stuttering subsiding without treatment is remote. If unclear speech along with stuttering and inadequate speech level in accordance with the age are detected, a speech therapist should be consulted without delay.

            There is difference between boys and girls in curing stutter naturally without undergoing treatment. Stuttering is commonly experienced in boys and girls alike up to the age of five. But by the time they reach 1st standard, stuttering in girls seems to be diminishing. When they reach 5th Standard, the ratio between boys and girls is reduced to 5: 1. From this it is evident that girls are relieved of from stuttering rather quickly.

Repetition in Speech

            At the initial stage the child is not aware of the obstructions in its speech. Therefore the child does not show any reluctance in speech or try to avoid speech. But at this stage the repetition experienced in the child’s speech attracts the attention of the parents. When they try to make him speak without obstruction, the child becomes aware of his stuttering and it becomes more evident.

            At the next stage, in order to overcome the obstruction the child tries to give emphasis in pronouncing words while speaking. This makes the facial muscles tense. In his attempts to be free from stuttering, the child shows rapid eye blinks, head jerks, tremors of the lips and jaw and clenching of fists. When these are repeated, these actions become part of stuttering. Witnessing these actions, people feel that the stuttering is severe.

            When stuttering continues after the age of six, it is not limited to stuttering alone. His inability to speak and the sympathetic look of the listener begins to frighten the child. As a result the child loses confidence in talking and consequently he tries to avoid talking. This may aggravate stuttering.

Teenage and Afterwards

            Stutter occupies psychological depth in teenagers and elder people. More than the obstacles, loss of confidence in talking, fear, anxiety and inferiority complex are other problems faced by the elders who suffer from stuttering. Due to stuttering some people cannot speak and express their talents in the class rooms/work places. As they become introverts, they fail to develop new acquaintances. Absenting themselves from attending the class on the fear that they would be required to read aloud in the class, the failure due to the above, and failure being faced in interviews are also problems being faced by them.

Speech Therapy and Treatment

            Children, especially children below five years, react positively to speech therapy within the first year of stuttering. They could be completely cured. In these children stuttering is a problem of speech alone and therefore speech therapy will have a positive impact.

            Though stuttering in elder people cannot be completely cured by speech therapy, its severity could be reduced and the muscular tension being experienced when trying to speak, voice ceased at the vocal cord and suffocation etc. could be changed.

            In addition to stuttering, feelings and emotions like inferiority complex also require treatment for which the assistance of a psychologist could be sought for. 

When Stuttering Occurs in Children

            Parents should act in line with the following when stuttering is identified in children:

            Consult a speech therapist immediately on identifying stuttering in children. If a speech therapist is consulted within the initial months, stuttering could be completely cured by following the actions prescribed by him.

            Do not try to correct children when stuttering is experienced while speaking. Attempting correction by others will make the child aware of his draw back which will persuade him not to speak. This will aggravate the problem.

            Avoid talking to children in a quick pace and instead talk to them slowly. When the child also tries to speak to the parents with the same speed, its stuttering becomes worse.

            Give importance to what the child talks about rather than thinking about the way in which he speaks.