# Stuttering

*This page is about speech problems, the album can be found at Hands All Over*

| Stuttering |
| --- |
| Other names | Stammering, alalia syllabaris, alalia literalis, anarthria literalis, dysphemia. |
| Pronunciation | * Stuttering (/ˈstʌtərɪŋ/), stammering (/ˈstæmərɪŋ/
 |
| Medical specialty | Speech-language pathology |
| Symptoms | Unwanted sound repetition and disruption or blocking of speech |
| Complications | Shame, bullying, social anxiety, fear of public speaking |
| Usual onset | 2–5 years |
| Duration | Long term |
| Causes | Unknown |
| Differential diagnosis | dysphonia |
| Treatment | Speech therapy |
| Medication | Dopamine antagonists |
| Prognosis | Usually resolves by late childhood; 20% of cases last into adulthood |
| Frequency | About 1% |

**Stuttering** or **stammering** is a problem of speech. It is a speech disorder some people have. Five to six percent of children have a stammer while one percent of adults have a stammer. Men are four times more likely to have a stammer than women. Stammers normally start at 2-6 years and run in families.

The person knows what they want to say but the flow of their speech is ‘bumpy’ and may have some of the following features:

* Repetitions (of sounds, parts of words or phrases)
* Blocks (stops before words)
* Prolongations (making a sound longer, e.g. 'hhhhhhham' instead of 'ham')
* Pauses
* Rephrasing (saying something else instead)
* Hesitations (struggling to say words)
* Fillers (using key phrases such as ‘you know what I mean’ to hide their difficulties)
* Tension (the muscles in their face and neck look tight)
* Facial or body movements

## Feelings and attitudes

Stammering can be very upsetting, and knock a person's confidence. Joseph Sheehan compared stuttering to an iceberg, with the bumpy parts you can hear (overt parts) of stuttering above the waterline, and the larger block of how the person feels (covert parts) invisible below the surface. These people may feel embarrassment, shame, frustration, fear, anger, and guilt. These feelings may increase stress and effort making the person stammer more. Such negative feelings may be an important part of a treatment program.
Stammers affect peoples lives. They may lack confidence to apply for job interviews or make friends.

## Treatment

Stuttering therapy

### Fluency shaping therapy

This therapy is also known as "speak more fluently", "prolonged speech" or "connected speech." It trains stutterers to speak fluently (without the ‘bumpy bits’) by controlling their breathing and how they move their lips, jaw, and tongue.
Stutterers are trained to slow down their speaking rate by stretching vowels and consonants. Other methods include soft speech contacts. This helps to make very slow but non bumpy speech used only in the speech clinic. To make more normal sounding speech for daily life speed of speech is increased. Many people find their speech does not sound natural at the end of therapy. Fluency shaping approaches are normally taught in groups therapy programs, which may take two to three weeks to complete. More recently the Camperdown program, using a much shorter schedule, has been shown to work well.

### Stuttering modification therapy

The goal of stuttering modification therapy is not to get rid of stuttering but to change it so that stuttering is easier and less stressful. As fear and worry make people stutter by getting rid of these feelings stuttering will decrease. The most widely known approach was made by Charles Van Riper in 1973 and is also known as block modification therapy. Stuttering modification therapy has four stages:

* In the first stage, called identification, the stutterer and speech and language therapist work out the core behaviours, secondary behaviors, and feelings that make the stuttering
* In the second stage, called desensitization, the stutterer works to reduce fear and anxiety. This is done by freezing stuttering behaviors, confronting difficult sounds, words and situations, and stuttering on purpose ("voluntary stuttering")
* In the third stage, called modification, the stutterer learns "easy stuttering." This is done by "cancellations" (stopping in a stammer, waiting a few moments, and saying the word again); "pull-outs," or pulling out of a stammer into ‘normal’ speech; and "preparatory sets," or looking ahead for words they may stutter on, and using "easy stuttering" on those words
* In the fourth stage, called stabilization, the stutterer prepares practice assignments, makes preparatory sets and pull-outs automatic, and changes how they feel about themselves from being a person who stutters to being a person who speaks fluently but who sometimes stutters mildly

### Famous stutterers

There were many famous *stutterers*:

* Moses, a revered prophet in Islam, Judaism, and Christianity
* Muhammad, the final prophet and messenger in Islam
* Uthman bin Affan, a Caliph of Islam
* Ubayd Allah ibn Ziyad, an Arab Umayyad governor
* Aristotle, a Greek philosopher and one of the tutors of Alexander the Great
* Demosthenes, a well-known Greek statesman and orator from ancient Athens
* Quintus Caecilius Metellus Pius, a Roman politician and general who won victories during the Sertorian War
* Ptolemy XV Caesar
* Claudius, the fourth Roman emperor
* Isaac Newton, an English physicist, mathematician and astronomer
* Gareth Gates, a British pop singer-songwriter and musical theatre actor
* Notker Balbulus, a Benedictine monk at the Abbey of Saint Gall active as a poet, scholar and (probably) composer
* Scatman John, an American jazz musician and singer
* Winston Churchill, an English politician
* King George VI
* Bruce Willis, an American actor
* Ozzy Osbourne, an English heavy metal singer
* Tiger Woods, an American professional golfer
* Mel Tillis, an American country music singer and songwriter
* Ed Sheeran, a British singer-songwriter and guitarist

## Evolutionary note

Features developed later in evolution are usually more variable than features developed earlier. The classic example of this principle is the difficulties of many human births compared to the reliability of ape births. Languages in hominids is certainly one of their later accomplishments.

* Guitar, Barry (2005). *Stuttering: An Integrated Approach to Its Nature and Treatment*. San Diego: Lippincott Williams & Wilkins. ISBN 978-0-7817-3920-7.
* Ward, David (2006). *Stuttering and Cluttering: Frameworks for understanding treatment*. Hove and New York City: Psychology Press. ISBN 978-1-84169-334-7.
* Fraser, Jane (2005). *If Your Child Stutters: A Guide for Parents*. Stuttering Foundation of America. ISBN 978-0-933388-44-4.