In plain terms, stuttering is a speech disorder that prevents the smooth, fluent, continuous pronunciation of words and/or sentences. A more "scientific" definition is that stuttering is a speech disorder in which the normal speech flow is interrupted by frequent repetition or prolongation of speech, sounds, syllables or words, or the person cannot begin to speak.
Interruptions in speech may be accompanied by frequent eye blinking, lip and/or jaw tremors, or other unusual behaviors that the person who stutters engages in while trying to speak. Such movements are called tics and can vary from person to person.
Stuttering most often occurs in stressful situations such as:
- talking on the phone/mobile phone,
- speaking in front of a group of people,
- talking to a person we don’t know,
- speaking in public places (bakery, shop, etc.)
Of course, we also stutter in all other situations, but then the stuttering is not as stressful as in the earlier mentioned cases.
Who stutters and how stuttering "starts"?
Stuttering affects people of all ages, but it most commonly occurs in childhood between the ages of two and six, when speech develops drastically and children receive and absorb a lot of information, which can result in stuttering.
This type of stuttering is also called physiological or developmental stuttering. Simply put - the child gets too many new words and phrases to handle and it triggers a type of "overload". That is why developmental stuttering is usually just a passing phase associated with intensive speech development.
Children begin to combine two or three words into a sentence at the age of two. The pronunciation is irregular, the speech pace is slow, every syllable is equally stressed. These primitive sentences become longer between the ages two and three and children often pronounce polysyllabic words, words which they don’t even understand and they start to speak faster.
At this stage, they learn to pronounce unstressed syllables in words, which enables faster speaking and thus creating longer and more complex sentences. There is a strong desire to communicate and the vocabulary is getting wider every day.
Some children start repeating words or syllables, most often at the beginning of a statement/sentence. You can notice confusing thoughts in a child's speech, insecurity in what they are talking about, thinking about whether they said it correctly, properly and in the way their parents expect them to.
Fillers
Then there is hesitation in speech, and the consequence of this hesitation is the repetitions we hear in the pronunciation of syllables and words. Later, as adults, some will use fillers such as "so...", "like...", "mmm...", but at an early age they just repeat certain elements of speech.
Such repetitions in early childhood are considered normal if they do not appear too often. Children begin to speak more and have more to say so their speech mechanism is not ready for such production.
The maturity of the speech mechanisms that are needed for correct pronunciation and the depth of vocabulary needed for that age is what affects the fluency of speech. Some children start stuttering and some don't. There is no universal answer to the question why. Of course, we can always blame genetics and family heritage.
Children who stutter are sometimes introverted, shy and they don’t know how to cope with the demands of different speaking situations.
Pay attention to body language
The characteristic of physiological/developmental stuttering is speech without tension, spasms, without special tension of the facial musculature (facial muscle tension), tics, breathing is mostly normal, without heavy breathing and breath holding.
If physiological stuttering is not treated properly, it can turn into another form called secondary stuttering, where stuttering becomes a learned behavior. Parents, experts and educational workers should not declare such stuttering as stuttering.
Never warn the child nor yell at them under any circumstances!
The best advice I can give to parents is to ignore the problem they have noticed, not to talk about the stuttering in front of the child, not to correct the speech or ask to repeat what was said incorrectly. (at least at the very start, the approach for later phases differs).
What adults can do is to create a pleasant and relaxed atmosphere in their own home, find time to listen to the child say what he or she has to say without interrupting and finishing sentences for the child. Try to speak more slowly with longer pauses and also ensure some quiet time and time for rest.
The child is not ill, it is not doing it on purpose. Developmental physiological stuttering can go away without consequences for speech, so make sure to refer to a speech therapist who will guide you and advise you on what to do!
What causes stuttering?
The exact process why stuttering occurs is not known. It is considered that most forms of stuttering are developmental (as mentioned earlier) and appear in children who are in the process of language and speech development. This form of stuttering occurs when the child's speech and language do not meet its verbal requirements. Stuttering happens when the child is looking for the right word. Developmental stuttering usually stops in childhood and does not appear later in life.
Another form of stuttering is a neurogenic disorder. Neurogenic disorders are caused by signaling problems between the brain and nerves or muscles. In neurogenic stuttering, the brain cannot properly coordinate the different parts of the speech mechanism. Neurogenic stuttering can also occur as a result of a stroke or brain injury. Other forms of stuttering can be classified as psychogenic, resulting from mental brain activity such as thinking or problem solving.
Although it was previously thought that the most common cause of stuttering was psychogenic, it is now known that this cause occurs in a minority of people who stutter. Although people who stutter may develop emotional problems, such as fear of meeting strangers or talking on the phone, these problems are usually the consequence of stuttering, not the cause. Psychogenic stuttering sometimes occurs in people who suffer from certain types of mental illness or in people who have experienced extreme psychological stress or fear.
Scientists and medics have long known that stuttering runs more often in certain families and it is a high probability that it is hereditary. However, no genes that cause stuttering have been found so far. Also, stuttering can be triggered before you are even born. Doctors believe that if the mother experienced a certain amount of stress before giving birth to you, you were already experiencing trauma.
After that, it is enough for a certain situation to happen in your life in which you will be scared, and that event is called a "trigger" that makes people start stuttering, but it is not exactly the real cause of stuttering.
Psychological causes of stuttering
Psychological causes of stuttering can be classified into several types:
Stressful situations - stressful situations are the most common cause of stuttering. The biggest fear comes from talking on the phone, group presentations and talking to authorities. It is interesting that people who have to use the phone every day stutter less when using it. The reason for this is the fact that it has become their daily routine so they got used to the situation. If they were to present seminars in front of a group of people every day, the fear would disappear.
Stress word or letter - almost everyone has a special word or a letter that causes them to stutter more than other words. Some people even changed their names because they couldn't pronounce their first name anymore. But after a certain time, even the new name becomes difficult to pronounce, so that's not a very good idea either. Some people have difficulties with consonants. These consonants are: "p", "k", "g", "t", "d", and what is interesting is that all these consonants are called stops in our language. Some have difficulties with the vowels "a", "e", "i", "o", "u", etc.
- Stress from authoritative figures - some people are afraid of persons whom they consider to be "above" them. That is why it is a problem for you when you are stopped by the police and, if the policeman is not familiar with your situation, they will think that you really did something wrong. Also, there is the fear of speaking in front of a professor and even one's own father.
- Mental stress - when it comes to speaking, it often happens that a person cannot function normally when he or she wakes up. Then they feel as if all the muscles in their mouth area are contracted and it takes half an hour to an hour for them to come to their senses. Also they cannot control their speech and have difficulties when they are very tired.
- External stress – external stress comes from the environment, for example when receiving some bad news. If the person receives some shocking news (whether it's good or bad), they simply can't control their speech due to excitement.
- Pace stress - the most common mistake of all people who stutter is the speech pace.
They are trying to say everything as quickly as possible because they subconsciously think that they will be less embarrassed if they say what they have to say faster. You know how it goes - the sooner I'm done, the better. However, this is when the stuttering becomes more intense so talking too fast is not recommended.
Types of stuttering
- Type 1 – the mildest stuttering. A person stutters only at certain times, for example speaking in public, in front of a group of people or speaking on television. This type of stuttering does not disturb social aspects of life.
- Type 2 – mild stuttering. The person does not stutter, but has certain periods of silence without trying to utter words. It is not accompanied by tics such as closing the eyes or moving the limbs.
- Type 3 – moderately mild stuttering. The person stutters "here and there". This form of stuttering can be characterized as a short repetition of one voice, but in such a way that the person says the desired word in a shorter period of time. There are usually no tics.
- Type 4 – moderate stuttering. The person stutters and strains. A spasm occurs in the throat area when speaking and the vocal cords close due to the lack of voice. Breathing goes through the chest most of the time and not through the abdomen, which is incorrect. Certain tics may exist, for example closing the eyes and mild facial spasms.
- Type 5 – strong stuttering. Strong stuttering comes from a lack of air in spoken sentences. A person often has tics such as closing the eyes and sometimes tics with limb movements. This type of stuttering is accompanied by frequent repetition of the first sound/syllable in a sentence or the whole word.
- Type 6 – the strongest form of stuttering. The strongest form of stuttering is accompanied by a very strong tension of the whole body, it can also be said that it is a matter of "forcing" the word out. Very visible tics occur, such as head, arms or leg movements. Sometimes people who have this form of stuttering may even bang on the table and shout to finish the sentence.
When do we not stutter at all or stutter very little?
There are several situations in which we significantly reduce stuttering:
- talking to a pet;
- singing;
- shouting, talking very loudly;
- whispering, talking very quietly.
In addition to the above, it should be noted that stuttering also decreases when we talk to children. Why don't we stutter in such situations? Many studies have been made on the subject, but it is concluded that changing the tempo of singing and shouting significantly helps to eliminate stuttering completely. For this reason, most of the methods used in today’s therapy are built on this statement.
Changing the pace, paying attention to the speech and the way we speak gives the desired results and reduces stuttering in most people. The only question is how much a person is willing to practice and think about these techniques and the results will occur on their own (neuroplasticity or so called "brain reprogramming") depending on these things and the overall invested time, but we will talk more about that in the Therapies chapter.