Stuttering

It is the most common speech disorder. It is a condition in which there is a disorder in the flow, rhythm, treble, emphasis, extraction and understanding of phonemes of speech.

It can be in the form of silent pauses, inability to produce a sound, unnecessary sound repetitions, lengthening of sounds, syllables or words. The natural flow of speech and communication are disrupted. Psychological problems can also be seen due to the deterioration of communication.

It is more of a childhood issue. The incidence in preschool children is about 5%. It is much more common in boys than girls. Its incidence in adults is about 1%.

Stuttering can be of varying severity among people. There may also be periods when someone who stutters is speaking fluently.

In addition to speech disorder, secondary behaviors such as hand clapping, nodding, and eye blinking may develop in stuttering. Avoidance of words or sounds that cannot be extracted, distance from speech environments can be seen.

In cases where adequate medical and family support is not received, stuttering can cause loss of self-confidence, alienation from friends, work, school, failures in working life, and decrease in quality of life.

Types of stuttering: 

Stuttering is evaluated in two different types in terms of its onset time.

• Acquired stuttering: It may occur due to head trauma, occlusions in cerebral vessels, diseases such as Parkinson’s, brain damage, some medications or after psychological trauma, extreme stress and anxiety. It is a less common type of stuttering. It is more common in adults.
• Developmental stuttering: It is the more common type of stuttering. It usually begins between the ages of 2-4, when tongue movements develop rapidly. While most of them recover spontaneously in early childhood, they need more support in later ages.

Risk groups for stuttering: 

• Boys,
• Stuttering history in first degree relatives in the family
• Anxious, sensitive, self-blaming children with attention problems,
• Presence of additional disease such as attention deficit hyperactivity syndrome.

Reasons:

Stuttering often does not develop due to a single cause. It is a disease in which more than one cause plays a role.

• Genetic predisposition; The incidence of the disease increases in those whose first-degree relatives have a history of stuttering,
• Imaging studies have identified problems in the brain structure of some patients.
• There may be problems with cognitive activities such as attention, planning, and maintaining a task.
• There may be problems in the language development period,
• More perfectionist, anxious, sensitive personality structure may cause.

Diagnosis:

Stuttering Diagnostic Criteria:

• Disturbance in the usual fluency and timing pattern of speech as defined by one or more of the following (appropriateness required for the person’s age):
• Sound and syllable repetitions (e.g. “Ggg-I saw”)
• Sustain sounds (e.g. “I saw ggg”)
• Padding words (e.g. “um, ah”)
• Fragmentation of words (eg, breaks within a word) (eg “I saw–I saw”)
• Audible or silent blocks (filled or unfilled pauses in speech) (e.g. “I saw”),
• Speaking in a roundabout way (substituting words to avoid problem words)
• Words produced by excessive physical tension,
• Repetition of monosyllabic words (e.g. “I-I-I-I saw it”)
• Speech fluency disorder impairs school success, professional success or social communication.
• Speech-related – speech difficulties are often greater than those associated with problems, even if there is a motor or sensory impairment or environmental deprivation.

Stuttering can become even more pronounced in public, in the classroom, in front of authorized persons such as teachers, and in conversations on the phone. Also, the person tends to avert their eyes when struggling with sounds or words.

When should medical help be sought?

Stuttering that starts at a young age can be easily corrected with early intervention. During this period, some stutterers may spontaneously switch to fluent speech. Medical assistance accelerates recovery.



Stuttering in later ages or adolescence may require slightly different treatment methods.

Therefore, when stuttering is noticed, medical help should be sought as soon as possible. A specialist support or speech/language therapist will assist in the treatment of the disease.

Stuttering treatment:

The treatment process for stuttering varies according to the age of the person and the severity of the disease. Factors affecting the treatment process are:

• Age at onset of treatment,
• The person’s willingness and belief in treatment,
• The chosen treatment method
• Family involvement in treatment
• Relationship between patient and therapist, trust,
• Personal characteristics of the patient,
• Presence of additional disease,
• The extent to which stuttering affects one’s social and professional life.

Stuttering treatment aims to make the person feel more comfortable while speaking, to speak more fluently, to improve communication skills, and to learn to cope with fears and worries.

The speech and language therapist will make necessary recommendations about treatment options. Possible treatment options include:

• Indirect therapy: It is usually applied in children under the age of five. With the support of the family, changes are made in the child’s home environment, communication methods are taught indirectly. The aim is to prepare a speaking environment where the child will feel less pressure. It can be tried not to interrupt the child, not to be criticized, to provide a slow and calm speaking environment, to speak-listening sessions within the family in turn, etc. However, if the disease is thought to get worse, direct treatments should be started.
• Direct therapy: There are some standard treatment programs according to the age of the child. The appropriate treatment protocol is selected by the speech and language therapist. It is implemented with family support. As the child’s age progresses, treatment becomes more difficult and the duration of treatment becomes longer. The aim is for the child to understand stuttering better, to provide fluent speech, to share experience, and to reduce the pressure on the child.
• Cognitive behavioral therapy : It is useful for combating psychological problems that develop mostly due to stuttering.
• Using a device: There are different device options that give a one-second delay to the person’s voice and shift the frequency. It is worn in the ear like a hearing aid.