Understanding and Controlling
Stuttering.
Table of Contents.
WE LIVE IN A WORLD dominated by the spoken word. Almost everywhere
- at home, school, work, social gatherings - speech is the way people get
to know one another and share ideas, information, and feelings. By means
of speech, we tell who we are, what we want, and why we are important. Through
the give and take of spoken conversation, we develop friendships and become
skilled in dealing with others. Speech is like a magic thread by which we
weave ourselves into the fabric of society.
It is easy for the average person to take speech for granted. When an idea
springs into his mind, he simply opens his mouth. Automatically, his brain
comes up with the right words and sends them off through the organs of speech.
Almost instantly - without any conscious effort - he hears himself talking.
He gives no thought to the complex interaction of brain cells, nerves, muscles,
and other parts of the body that make his speech possible. The words just
seem to flow, like the clear water of a mountain stream.
To be sure, the average person may find some speaking situations more difficult.
Answering a question in class, asking the boss for a raise, delivering a
speech to a large audience, for example. The person may be unsure of what
to say, afraid of angering someone, or worried about making a fool of himself.
Rarely, however, will he doubt his ability to speak. Frightened and hesitant
though he may be, he will nevertheless open his mouth, and the magic of speech
will take over.
But this is not true for the person who stutters.
For the person who stutters, speaking is an entirely different experience.
Speech doesn't flow smoothly, like the babbling mountain brook. Speech is
more like the poor salmon, struggling to jump over waterfalls as it fights
its way upstream to the spawning ground.
If you are a stutterer, you have no assurance that the words will spring
from your lips on command. True, there are times when your speech may come
easily. But in other situations, the flow of speech is blocked.
Sometimes, when you try to say a word, your speech is so totally blocked
that nothing comes out at all. The blocking may occur in the mouth, with
your lips or teeth pressing tightly together like a vise. Or your tongue
may feel like it's trying to push its way through the roof of your mouth.
Sometimes the air gets strangled down in your throat, and you feel as if
you had swallowed a cork. Other times your vocal cords seem frozen, unable
to make a sound. You may grope desperately for words, but all you get are
uh's and ah's and other embarrassing noises.
Sometimes the block is partial or intermittent. You may get stuck on a certain
sound and keep prolonging it. For example, your pronunciation of
"s-s-s-s-s-s-s-snake" may hiss like the serpent it describes. Or you may
keep repeating the first part of a word over and over, before being able
to move onto the rest. When you say "buh-buh-buh-buh-basketball," you may
give the impression that you're actually dribbling the ball down the court.
But stuttering is not simply the repetition of sounds we see in the written
depictions of stuttered speech. The hallmark of real stuttering is the tremendous
amount of physical effort a stutterer uses in trying to force out
the words. Instead of touching lightly and briefly during speech, the lips
and tongue press harder and longer than necessary, or the larynx itself may
clamp shut. While this is happening, the air pressure in the stutterer's
body may increase to the point that he feels he is about to explode.
In addition to the blocks, stuttering is often complicated by other kinds
of physical and verbal behavior. In the struggle to force the words out,
a stutterer might twist and contort his face, jerk his head, blink his eyes,
grind his teeth, bite the inside of his mouth, swing his arms, etc. He may
insert unnecessary words, phrases, or sounds as "starters" before trying
to say a difficult word. He may go back and repeat the previous few words
over and over and over, as he tries again and again to leap over the hurdle.
If possible, he may try to substitute a different word that is easier to
say.
Persons who stutter are generally able to sense that a particular word is
going to be trouble, even before they try to say it. Therefore, some stutterers
become adept at covert stuttering - struggling silently through the
blocks before speaking, changing and censoring words in advance, and saying
only the things they feel will not give them trouble. Their entire conversation
is dictated by the effort to conceal their stuttering. Other stutterers go
to equally great lengths to avoid talking altogether.
The Definition of Stuttering
The precise definition of "stuttering" is a matter on which speech pathologists
often disagree. Therefore, it may be helpful to explain exactly what is meant
by the term when used in this book.
Stuttering refers to a particular speech disorder in which the flow
of speech tends to be involuntarily disrupted by forceful closures of the
mouth or larynx, by repetitions or prolongations of sounds and syllables,
or by hesitations or delays in making voiced sounds. Stuttering generally
involves an excessive amount of effort, force, and struggle in the attempt
to speak. It also may be accompanied by a variety of behaviors intended to
avoid, postpone, or hide the blocks.
Stuttering is sometimes called "stammering," especially in Great Britain.
For our purposes, the two words are synonymous and both refer to the same
disorder.
Stuttering must be distinguished from disfluency, which refers broadly
to any interruption in the natural flow and rhythm of speech. Stuttering
is a very specific kind of disfluency. Many people are disfluent from time
to time, for a variety of reasons, but that doesn't necessarily make them
stutterers. Stuttering also differs from language disabilities such as aphasia,
in which the ability to think of the appropriate words is impaired. A stutterer's
problem is not in finding the words, but rather in saying them.
We must also differentiate stuttering from a relatively rare kind of disfluency,
sometimes called acquired stuttering, which may occur at any age following
certain kinds of brain damage. Although it may involve stuttering-like symptoms,
acquired stuttering is actually a very different disorder, as will be explained
in a subsequent chapter. This book will be devoted exclusively to the usual,
garden variety of stuttering - sometimes called developmental stuttering
- which seems to develop of its own accord during childhood. Therefore, the
discussions in this book may have little or no application to a brain-damaged
person with acquired stuttering.
Developmental stutterers, as distinguished from acquired stutterers, are
generally capable of fluent speech in at least some instances. Most have
no trouble when singing or when reading in unison with someone else, and
they are usually much more fluent when talking to themselves or to animals
or small children. The severity of developmental stuttering often depends
on the speaking situation. For example, many individuals have a particularly
hard time saying their name, talking on the telephone, or addressing authority
figures.
Those are some of the basic characteristics of stuttering. The severity,
frequency, and situations in which stuttering occurs will vary according
to each individual. We will examine all of these aspects of stuttering in
greater detail as we go along.
The Prevalence of Stuttering
If you stutter, you have probably experienced the feeling of being alone
and out of place in our glib and garrulous world. But you are not the only
one. It has been estimated that nearly one percent of the general population
stutters. This would amount to more than two million stutterers in the United
States alone. For some reason, stuttering is about four times more common
in males than females.
There is truth to the statement, "If you stutter you are in good company."
Throughout history, there have been many notable people who stuttered. These
include Moses, Aristotle, Virgil, Sir Isaac Newton, Joseph Priestley, Charles
Darwin, Lewis Carroll, Charles Lamb, Clara Barton, Sir Winston Churchill,
King George VI of England, W. Somerset Maugham, James Earl Jones, and many
others.
Stuttering usually starts in childhood, most often between ages two and eight
(although in rare cases it may begin much later). Roughly 4 to 5 per cent
of people experience stuttering at some time during their childhood. Fortunately,
the majority become fluent by the time they reach adulthood, even without
speech therapy. But the rest are not so lucky. Many go on to become adult
stutterers, for whom stuttering is likely to be a chronic, persistent problem
for the rest of their lives.
The Impact of Stuttering
If you stutter, you know that the experience of stuttering is far more than
just the blocks themselves. It can affect one's entire life.
The experience of stuttering is the constant fear of speaking situations,
the fear of ridicule and rejection. It is the uncertainty of not knowing
whether the words will come out when you need them, or whether you will suddenly
find yourself abandoned by speech in an awkward situation. It is the frustration
of not being able to say what you want, of having important words bottled
up inside you while other people babble nonsense with no trouble at all.
Stuttering is the embarrassment of not being able to say your name when meeting
someone. It is the exhausting struggle to tell people even the most routine
information, such as your address and telephone number. It is the isolation
of not being able to participate fully in everyday conversations.
Stuttering is the inconvenience of walking or driving from store to store
in search of an item, because you can't use the telephone to call ahead to
see who has it. It is the disappointment of not being able to order the food
you want in a restaurant, and selecting an alternative that is easier to
say.
Stuttering is the disillusionment of seeing a job or promotion go to a less
qualified but more fluent person. It is the resignation of settling for a
job or career that is less rewarding than the one you really wanted, simply
because it doesn't require you to talk as much.
The experience of stuttering is the pervasive feeling of shame and guilt,
and nagging doubts about your competence and worthiness as a person. It is
the sense of forever being a little child, while other people are self-confident
adults. And it is the indignity of constantly having to put up with people
who tell you to "relax," who try to fill in words for you, or who keep giving
you useless advice on how to stop stuttering.
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