Friday, September 19, 2014

Stuttering

Stuttering


The Basics 
     Stuttering is a fluency disorder marked by repetitions (ba-ba-ball), prolongations (baaaaaall), and blocks ([pause] ball).  This disorder is increased by stress and can cause significant emotional trauma.  Some people who stutter (PWS) are made fun of, others feel like they can’t communicate appropriately, and others are just embarrassed by the way they sound.
     Stuttering therapy has two basic branches, “stuttering modification” and “fluency-shaping”.  Stuttering modification focuses on the stutter and how the PWS can get out of the stutter. This technique places the stutter at the forefront.  Fluency shaping focuses on building fluency and almost ignores the stutter- focusing instead on good, steady speech. This handout will focus on fluency-shaping.

What is it?
Stuttering is a communication disorder involving disruptions, or “disfluencies,” in a person’s speech. In addition to producing disfluencies, people who stutter often experience physical tension and struggle in their speech muscles, as well as embarrassment, anxiety, and fear about speaking

Definitions
“Stuttering” is made up different patterns and severities of three different kinds of disfluencies: repetitions, prolongations, and blocks.
Repetitions: Consist of a repeated word or syllable. “ba-ba-ball” is an example.
Prolongations: words consisting of an elongated sound. “baaaaat” is an example. 
Blocks: a space of time in which the person is trying to speak, but cannot “get the word out.” Ex: [pause while opening and closing mouth to make the /b/ sound] “ball.”

Causes
There are no known causes for stuttering.  There have been some links to family history and some genetic studies done, however no strong association has been found.  Stuttering is not a “nervous” or anxiety-related disorder and cannot be caused by family relationships.

Cures/Solutions
There is no known cure for stuttering.  However, that being said, many young children who stutter developmentally (start stuttering young) will naturally recover (stop stuttering as they grow older).  Speech therapy can help stutterers grow more confident in their speech, learn to control their symptoms (e.g., repetitions, prolongations, and blocks) and to deal with the emotional and social side effects of the stutter.

 Stuttering Facts
Most teenage PWS will never be fully fluent.  However, many learn to manage their stutter and the accompanying emotions in such a way that they can continue to live their life normally and achieve near-fluent speech. 
PWS  are normally fluent when whispering, speaking in a group, and singing
Stuttering is universally found in all languages
PWS tend to stutter less when they are relaxed and rested versus when they are stressed , excited, or fatigued.
80% of stutterers are male
Some famous people who stuttered include: James Earl Jones (Darth Vader), King George VI of England (The Kings Speech), Winston Churchill (Prime minister during WWII), an d Lewis Carroll (Author of Alice in Wonderland) 
  
Ways you can help
1. Don’t tell the child “slow down” or “ just relax.”
2. Don’t complete words for the child or talk for him or her.
3. Help all members of the class learn to take turns talking and listening. All children — and especially those who stutter — find it much easier to talk when there are few interruptions and they have the listener’s attention.
4. Expect the same quality and quantity of work from the student who stutters as the one who doesn’t.
5. Speak with the student in an unhurried way, pausing frequently.
6. Convey that you are listening to the content of the message, not how it is said.
7. Have a one-on-one conversation with the student who stutters about needed accommodations in the classroom. Respect the student’s needs, but do not be enabling.
8. Don’t make stuttering something to be ashamed of. Talk about stuttering just like any other matter
9. Speak with your child in an unhurried way, pausing frequently. Wait a few seconds after your child finishes speaking before you begin to speak.
10. Reduce the number of questions you ask your child.  Children respond better to you listening to their concerns, not answering questions.
11. Use your facial expressions and other body language to convey to your child that you are listening to the content of her message and not to how she's talking.
12. Observe the way you interact with your child.  Show the child that you are listening and decrease criticisms, rapid speech patterns, interruptions, and questions.
13. Above all, convey that you accept your child as he is. The most powerful force will be your support of him, whether he stutters or not.
Techniques
Use slow, steady speech- some therapists will have the PWS speak to the rhythm of a slow metronome and slowly increase the speed as they increase fluency.  In many situations, asking the PWS to slow down or speak slowly can help the stutter to achieve fluency.
Easy phrase initiation- the PWS should use easy phrase initiation (or a softer start to a phrase) to help relax and release tension in the mouth and throat.
Breath management- the PWS should manage his breaths to speak easily on one breath. In other words, he should speak without running out of air or straining his air supply taking frequent breaths.  This may require a verbal cue such as, “take a deep breath and continue”.
Deliberate flow between words- another technique is to continue to “speak” between words.  So instead of saying “The dog sat” a PWS using this approach might say “The—dog—zat” continuing to use voicing so as not to interupt the breath and muscle flow.

Other suggestions
The PWS should be listened to patiently, not be hurried and not interrupted
NEVER finish a PWS word unless asked to by the PWS
Don’t fill in words or supply answers
Don’t look pained, pitying or impatient
Do not withdraw eye contact, glance nervously at the PWS or stare vacantly into space
Speak naturally
Maintain an unhurried, calm and interested manner
Try to help the PWS maintain a calm and relaxed environment
Help the child avoid bullying by maintaining a kind classroom atmosphere. If bullying becomes a problem it can be beneficial to educate the class about stuttering, what it is, how the PWS controls it, and how the classmates can help him achieve better fluency
Some reactive methods to bullying are: avoid, ignore, inform, confront, and to make light of stuttering in general.

 
Information collected and compiled from
The National  Stuttering Association www.nsastutter.org
The Stuttering Foundation www.stutteringhelp.org

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