In the movie The King’s Speech, the son of King George (mother of Queen Elizabeth) cannot speak without stuttering significantly. It results in his inability to function with the respect and admiration of those with whom he must engage in conversation. In fact, he is ridiculed, mocked, and often ignored, as people consider him weak-minded due to the handicap. People who suffer from speech disorders such as stuttering and stuttering are clearly misunderstood, so let’s review what stuttering is, the signs and symptoms of stuttering, diagnosis, and what can be done to reduce or eliminate it from speech patterns.

What is stuttering? (Also known as stutter):

Stuttering is a speech impediment that often occurs when there are too many interruptions in the production of speech sounds. For example, I’m sure you’ve heard people use an overabundance of “uh’s, um’s, and oh” when they speak. These are called disfluencies (specifically interjections) in speech production and are quite common, even in people who are not considered to have a speech production disorder. The problem exists when there are too many lacks of fluency that impede an individual’s ability to communicate effectively.

Stuttering usually becomes noticeable during childhood and will often last a lifetime. Parents usually don’t notice speech production difficulties until their children begin to speak in sentences of more than a few words at a time. Stuttering often pervades many activities in a person’s life, whether it’s when talking on the phone, in front of large groups, or perhaps when in an environment that brings with it some level of discomfort or stress for the individual. In some cases, it is a generalized problem, meaning they struggle with communication at home, school, work, and/or social situations.

As a result, many of these people will limit their participation in basic activities to avoid having to communicate with others. Why? They are often embarrassed or afraid of the reactions of other people with whom they are trying to communicate. Some stutterers may try to camouflage their speech difficulties by stopping in the middle of a sentence and pretending to have forgotten their train of thought; others will rearrange the words in a sentence so that the words come out in perhaps an unusual order, while still others may refuse to speak. Either way, it is truly a tragedy for those who have disassociated themselves from others to eliminate the need for communication.

Here are some statistics that go along with stuttering:

– Stuttering usually appears between 2 1/2 and 4 years of age. Although rare, stuttering can develop during elementary school.

– Stuttering is more common in men than in women and, in fact, it is estimated that children are three to four times more likely to stutter.

– Approximately 75% of preschool children who may develop a stutter will also stop stuttering.

Signs and symptoms of stuttering:

As described below, stammering or stuttering is a speech interruption that often makes it difficult for others to follow the pattern of speech and the information being conveyed. But there is more to stuttering than one might realize. Stuttered speech also includes increased repetition of words or parts of words, as when a person might say, “I, I, I, I want a cookie ccc” or as in prolongations of speech sounds, as in example cccc -cookie.

Finally, you may notice the repetition of part of the word, which would be something like “QQQ-What time is it?”

People who stutter can appear breathless and incredibly tense when trying to communicate with others. There are many reasons for these gestures and understanding them will help us to be more compassionate towards the individual. Some stutterers seem to have the words “stuck” on the tongue without being able to pronounce any sounds. Many stutterers describe this as words getting stuck in the throat. They know “what” they want to say, it just won’t come out without some sort of delay in their speech pattern.

An interjection can often be used to help “produce” the sounds the individual is trying to make and is often in the form of “um,” “like,” or some other word or sound used to allow speech flows freely. Again, everyone struggles to get the words out from time to time, stutterers find it difficult ALL the time.

Diagnosis of a stutter:

It’s not always about identifying all the signs and symptoms of a stutter. Repetitive sounds, speech prolongations, and interjections are readily observed by those listening to the individual struggling to pronounce words, but there are also unobserved difficulties. As a result, consulting with a certified speech-language pathologist (SLP) is the best course of action to take.

During the assessment, the SLP will observe and record the following:

– The number and type of interruptions/slurs in speech that a person produces in a specific period of time and in various situations as well.

– How the individual reacts and copes with the disfluencies produced.

– Conversation level.

– Language skills.

– Severity of the identified symptoms and how it impacts their daily life.

Information will also be obtained about particular circumstances or factors that may cause or cause stuttering to worsen, for example teasing, teasing or perhaps being tired etc. the age when symptoms were first discovered, the current age of the patient, and information about family members who may also have stuttering.

After evaluating, reviewing, and analyzing all of the information, the SLP will be able to determine if a fluency disorder exists and to what extent it has affected the individual’s ability to communicate with others and participate in daily activities.

Although the diagnosis is fairly consistent between adults and children, there are additional factors to consider when diagnosing young children. First, the SLP will want to assess to determine if the stuttering is likely to continue throughout the child’s life or if it is likely to reduce over time. The evaluation will include multiple tests, observations, and interviews that will be used to determine the risk of continued stuttering.

Included in these additional tests will be:

– Family history: did the child’s father, grandmother or mother have problems with stuttering as a child, adult, etc.?

– Chronology: when the stuttering began and how long it has occurred to date; 13 months; 4 – 6 months; 6 months or more.

– Other speech and/or language disorders;

– Anxiety/Fear expressed by the child or his family regarding stuttering.

Unfortunately, there is no single factor or single predictor that determines or helps an SLP identify the likelihood that the child will continue to stutter. Combining all of the information obtained will help determine the best treatment and course of action to take at this time to help reduce, eliminate, or provide successful intervention(s) for the child and /or adult.

Treatments to calm stuttering:

Stuttering treatment focuses more on behavioral triggers than medical reasons, as there is no medication that will reduce or eliminate stuttering. Treatment will focus on skills and techniques to help the person control their disorder and improve their ability to communicate orally. For example, the SLP can teach the individual to control her breathing. Calming breaths will help the individual provide a sense of relaxation by reducing the anxiety that often manifests itself when speaking. They will also learn to monitor and control the speed at which they speak. By reducing the speed and patterns of speech, they will often be able to speak with less fluency in their sentences. In addition, they will be coached and watched as they learn to put fewer words together, allowing them to produce a smoother flow of the words they are trying to get. The treatment will take time and patience. It may be necessary for the individual to seek treatment daily, weekly, or monthly, and follow-up will be critical to continued success.

It is important to realize that people who stutter are already very aware of their inability to express themselves to others without feelings of tension or anxiety. But did you know that there are things that people who listen to people who stutter often do that make them more painfully aware of their problem than ever? For example, completing sentences or filling in the blanks causes the speech to become more dissolved as they become aware of one’s impatience to complete their statement; Interrupting their train of thought is also something to be avoided as it is quite difficult for them to complete a sentence when they can focus on what they want to say. People who stutter want to be treated like everyone else, with the same level of respect and consideration. Give them time to generate what they want to communicate, and then listen patiently. Avoid making affirmations such as “take a deep breath”, “calm down” or “take your time” as this also makes it harder for them to focus and concentrate as it leads to more frustration and anxiety often resulting in their inability to complete their affirmation without more stutters.

People who stutter will develop their own strategies alongside those learned from SLP to allow themselves to communicate at a level where they feel most comfortable and confident doing so. It is helpful, if you need to communicate regularly with a person struggling with stuttering, to simply ask the person how they would like you (the listener) to respond when communicating. Letting the person know that you are interested in “WHAT” they have to say and not “HOW” they say it will certainly reduce their level of anxiety, tension, and discomfort. For example, “I notice you stutter.” “I don’t want you to feel awkward interacting with me, so tell me how you’d like me to respond when you stutter.” This statement should be made in a non-condescending manner, giving the person the confidence and sincerity to engage in conversation with you, given that they will stumble over certain words.

Although the exact cause of stuttering is unknown, studies suggest that an individual’s genetics may play a role. Perhaps it is individual inherited traits that have resulted in a stutter due to an impairment in the ability to produce sentences fluently in part due to an inability to control various required muscle movements. Whatever the underlying reason, it is something that makes communication difficult for many people affected by the disorder. With this in mind, recognize how we can help vs. how it hurts is something each of us can do to reduce the frustration, embarrassment, and anxiety that go along with speech production problems.

I encourage you, if you haven’t already, to watch the movie, The King’s Speech. It is truly a moving film and allows viewers to acknowledge the emotional, social and interpersonal difficulties experienced by people who suffer from stuttering/stuttering. Although it is a movie, it provides an excellent description of stuttering and how people have suffered for many years.

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