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Thursday, November 27, 2008

STUTTERING

We all get a kick out of watching Porky Pig's animated arsenal of sputters, misfires and f-f-f-false starts. But if you, your spouse or your child is among the millions of Americans whose speech is laden with hesitations, prolongations, repetitions and blockages, then you know firsthand that stuttering is not as amusing as a Looney Tunes cartoon.

About 4 percent of all children between the ages of two and seven will develop a stutter--but there will be far more boys than girls. Although most of the children who stutter will outgrow the problem by puberty, a small percentage (less than 1 percent) carry it into adulthood.

As yet, no one knows what causes stuttering, and there is no cure. "Our best guess is that it is due to a combination of psychological, neurological and genetic factors," says Barry Guitar, Ph.D., professor of communication science and disorders at the University of Vermont in Burlington. But they do know that it is habit forming and is usually related to stress, according to Martin F. Schwartz, Ph.D., executive director of the National Center for Stuttering in New York City.

When a child is learning, to speak, or when an adult has to speak in stressful situations (before a large audience, for instance), that stress focuses tension on the vocal cords, closing and locking them. The person struggles to speak but can't do so easily: The struggle becomes a stutter. "If the vocal cords can be kept open and relaxed, however, the stuttering can be stopped immediately, " says Dr. Schwartz.

If you or your child does stutter, try these techniques.


Pause a second.

If you're stuttering, maybe it's because you're trying to speak as fast as or faster than others--and you just don't need to. "Slow down to a normal rate and set your own relaxed pace," says Edward G. Conture, Ph.D., chairman of the Program of Communication Sciences and Disorders at Syracuse University in Syracuse, New York. "When someone asks you a question, pause one to two seconds before responding, then answer at a rate that is comfortable for you."

Nip stutter starters in the bud.


The moment before a stutter begins, you may grimace, twist your face or purse your lips without being conscious of these movements. R. Gregory Nunn, Ph.D., a clinical psychologist and president of R. G. Nunn and Associates, a private clinic in San Diego, suggests using competing behaviors when you feel these stuttering precursors come on.

When muscles tense up, for instance, let your arms, shoulders, chest and stomach slump and relax. If your lips are pursed, open them slightly. Or loosen your tight throat by letting out a little air through your mouth before saying just one word per breath, gradually increasing the number until you feel comfortable.


Record your stuttering.

Keep a personal log of all your stuttering episodes, noting what takes place prior to and during the stutter, says Dr. Nunn. "When you become aware of situations and behaviors that contribute to your stuttering, you can catch them in advance and prevent stuttering before it starts." If you always stutter on the phone, for instance, be prepared to use some competing behavior techniques even before you dial.


Practice natural breathing.

"A stutterer tries to superimpose speech over short, rapid, uneven breaths or speak while holding his breath," explains Dr. Nunn. "We want him to get used to natural speech breathing." Take a relaxed breath through the mouth, filling your lungs with a comfortable amount of air, and let it out slowly and easily, producing a deep, hollow sound. Practice this breathing pattern daily. Then try to maintain the deep breathing while you speak, letting the words come out easily as the smooth, even breath is being exhaled.


Synchronize your airflow.

Dr. Schwartz recommends the following method to take tension off the vocal cords. First relax. Take a short, easy breath through your mouth. just before speaking, let the air flow passively through your mouth, opening up the locked cords. Slow the first word a bit, easing into the first syllable, gliding to the next. Then proceed at a comfortable pace. Do this with each sentence, stopping and starting at natural pause points. Stuttering should stop right away. Practice this technique for 15 minutes three times a day, and try to integrate it into all your conversation. Four months of daily practice should make this behavior a habit.

Nix cola and coffee.

Caffeine, sugar and other stimulants encourage muscle and vocal tension, says Dr. Schwartz. They should be eliminated or greatly reduced.

When to See the Doctor


How do you know whether to help a stuttering child at home or to see a speech specialist? Martin F. Schwartz, Ph.D., executive director of the National Center for Stuttering in New York City, provides these guidelines.

If you are the parent of a child who stutters and someone in the immediate family also stutters, there's a chance your child's habit may continue into adulthood. Note whether there's a lot of struggling with words or at midsentence and also whether the stutter occurs every day and the child reacts by acting unhappy or refusing to speak. When stuttering is this persistent, you should definitely go to a speech specialist.

By adulthood, the habit is ingrained, and a good bit of one-on-one counseling may be needed to overcome it. The help of a licensed speech therapist may be necessary before you can change the habit.

Also, if stuttering should develop for the first time in adulthood or very suddenly in an older, normally fluent child, it may be the result of a neurological condition, a head injury or an event that has been very upsetting. See a doctor immediately.


Skip the sweets.

Sugar reduction alone has completely eliminated stuttering in some children, says Dr. Schwartz. You may observe rapid improvement in your child's speech simply by decreasing his consumption of cakes, cookies, candy and soda.

Set the pace.

"When kids try to speak as fast as or faster than adults, they often stutter," says Dr. Conture. "If you speak slowly and evenly to your child, he'll soon get the picture and slow down naturally." Other pacemaking tips from Dr. Conture: Pause one to two seconds before responding to your child's questions. Try not to finish the child's sentences, talk over him or interrupt. And don't tell him to speak slowly while you proceed rapidly.

Take a listening break.

A fast-paced, hectic environment where it is difficult to speak and be heard may increase stuttering in children, says Dr. Conture. When talking with a child who stutters, turn off the TV and radio as often as possible, or keep the volume low, so the child doesn't have to verbally compete with background talking. It's ideal if you can set aside time for family discussions and then give everyone a chance to speak in turn without undue interruption. And if your child talks to you while you are doing things that require your concentration, take a time-out. "Assure him you are listening and then do listen," says Dr. Conture.

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This service is provided as general information only, and should not be treated as a substitute for the medical advice of your own doctor..