What is stuttering/stammering?

It is a pattern of speech: prolongations of sounds, repetitions of syllables, silent blocks. The struggle to speak can be internal or external, noisy or silent. All this can make oral communication difficult or even impossible.

Stuttering can also include secondary symptoms such as stamping a foot or other unnatural body of facial movements. The stutterer does this in order to ‘break’ his speech blocks so that he can have his say.

As time goes by the stutter tends to become a deep-seated habit. In addition the defect may – also due to the stigma attached to stuttering – undermine self-confidence and self-image. Speech-related fears may also develop.

What causes stuttering?

Experts disagree about the cause or causes of stuttering. It would appear that a major part of stuttering behaviour is learned through the years. Stress does play a role.

An interesting theory is that stuttering is learned struggle behaviour resulting from excessive contractions of the vocal cords due to stress.

Latest brain research also suggests an organic malfunction of some part of the brain involved in speaking. For instance, the basal ganglia in the brain are responsible for vocal-cord coordination. It has been hypothesised that the vocal-cord blocking (which results in stuttering) is the result of defective vocal-cord coordination due to the basal ganglia malfunctioning (which in turn could be the result of neurotransmitter imbalances within the b. ganglia). Check out THIS POST for more information.

Is it caused by psychological abnormalities?

All the indications are that, as a group, people who stutter are not more abnormal than fluent people.

Currently most experts maintain that any psychological problems such as frustration, aggression, depression, neuroses, a poor self-image and speech fears are the RESULT of the disorder and not the PRIMARY CAUSE (though they may be CONTRIBUTING CAUSES that aggravate the problem).

Is stuttering hereditary?

There are strong indications that the POTENTIAL to start stuttering can in fact be genetically transmitted and that this potential may in conditions of stress be activated and lead to stuttering, eg when the child learns to speak (a process which can put lots of pressure on a child’s speech system), or when subjected to other forms of stress. Stuttering is usually activated during the pre-school years; but can also arise later – in times of war, some soldiers begin to stutter due to battle stress.

Can a child begin to stutter by imitation, eg if he plays with a friend who stutters?

This is an outdated view with which few experts will agree these days.

Can a child begin to stutter if he was originally left-handed and is forced to become right-handed?

Once again this is an outdated view. Many children have been forced to become right-handed without beginning to stutter as a result. If a left-handed child does stutter after becoming right-handed, it may be because the additional stress caused by the change has activated an inherited tendency to stutter.

Can a child begin to stutter after a traumatic experience?

Some children do begin to stutter after a traumatic experience, eg. after a car accident.

How many people stutter?

Approximately three per cent of pre-school children stutter, whereas in adults it varies between one and two per cent.

Can one outgrow stuttering?

Approximately three quarters of children spontaneously outgrow stuttering, usually before or during their primary school years. Those who don’t outgrow it usually become chronic stutterers.

Do stuttering boys/men outnumber stuttering girls/women?

Yes. The ratio is approximately five to one.

What are the problems faced by people who stutter?

Stuttering can cause many problems. A child who stutters is often ridiculed at school. He may develop a fear of certain words and situations, or of telephones, or of speech in general. He will tend to avoid these things. This may undermine his self-confidence and self-image.

Often stutterers develop a variety of mannerisms to help them say difficult words. Some people can only speak after stamping a foot or making other body movements. These mannerisms help the stutterer by momentarily distracting his attention from the difficult word. This sometimes helps him to get the word out.

Many stutterers experience facial contortions in their efforts to speak. Because of this there is a stigma attached to stuttering. This in turn contributes to (unnecessary) feelings of guilt and shame as well as uncertainty, poor self-confidence and a poor self-image. In severe cases the disorder may amount to partial mutism.

Due to the stigma many people try to hide their defect. They often use other words (synonyms) instead of feared words. These avoidances, however, make life more difficult in the long term. When feared words are avoided, the fear increases.

The adult stutterer’s life can be hard. It can severely limit you at university or in your career or social life. The fact is that stuttering can be a serious communication disability. Fluent people tend to underestimate the problem.

What can be done about stuttering?

Speech therapy is more successful with children than with older, chronic stutterers. There are exceptions to the rule, but generally speaking it is very difficult to cure the adult stutterer or to cure himself by self-help. Much can be done, however, to control, alleviate and manage the disorder. Usually this management requires hard work, adequate guidance and a dedicated effort.

Speech therapy and / or self-therapy can help you gain your desired level of fluency management and confidence. The therapy may involve practising speech control techniques, modifying your attitude towards speaking, stress control, improving your self-image etc.

Does alcohol affect stuttering?

People react to alcohol in different ways. A few drinks may have a relaxing effect on some people and consequently reduce their stuttering, whereas the same amount may excite others and increase their tension level or speaking tempo, which will have a detrimental effect on their speech.

Does smoking affect stuttering?

As far as I know this has not yet been researched, but it has been found that the nicotine in tobacco does tend to increase stress levels. And as stuttering is affected by stress, it makes sense that many people who stutter will stutter more if they are also smokers. There are exceptions, however; some smokers feel that smoking relaxes them, for instance when taking a smoke break which is relaxing in itself - and these people may actually experience less stuttering after such a break. Check out my post where this is discussed HERE as well as the poll results.

My pre-school son recently began to stutter. What should I do? Should I point out to him that he is speaking incorrectly?

First establish if he is really stuttering. Many pre-school non stuttering children are not completely fluent – this is quite normal and part of the way in which language is acquired. Consult a speech therapist to determine if it really is a stutter.

If it is, you should refrain from pointing out to him that he is doing something abnormal. This will only increase his tension levels and cause more stuttering. Rather try to protect him from all forms of stress – he may then outgrow it himself. Speak slowly in his presence and use simple sentences and words. He will tend to follow your example and also speak slower.

If the child is aware of the problem, encourage him to speak slowly and softly. Give him time to speak, so that there is no pressure on him to get a word in quickly. Read the chapter on ‘The Stuttering Child’ in this book.

What should you do when you’re talking to a person who stutters? Should you help him with his words?

* Speak slowly when you are in conversation with a stutterer – if you speak quickly, you put pressure on him to do the same. This could impact negatively on his speech.

* Don’t speak too loudly. This puts pressure on him to also raise his voice, which will put pressure on his speech system.

* Don’t look away when he speaks – this may create the perception that you disapprove of his speech. Look at his eyes, not his mouth. Concentrate on WHAT he is saying, not HOW he is saying it.

* Be patient. If you can show you are not worried about the stutter he will feel more at ease and his speech will tend to improve.

* Try to avoid direct questions, especially specific questions requiring exact answers such as his name (ie answers which cannot be phrased in another way).

* Some people long to be helped with a difficult word or sentence, but many – perhaps the majority of people who stutter – prefer to complete the sentence themselves. This issue depends on the individual and the situation. In certain circumstances it may be an act of human kindness to help the stutterer out, for instance where it becomes obvious that a child is completely unable to say a word, where the whole class is laughing and where the child himself is acutely embarrassed because of the block.

* Give him a turn to speak if he wants to say something in the course of a conversation where many people are present.

* If he stutters, and you know that he should be using a specific speech technique on which he is working, remind him to use it.

Is there a difference between stuttering and stammering?

No. Stammering is the term used in the UK; in the USA and South Africa the disorder is known as stuttering.



Anonymous said...

what is the direct link to download this book?

Anonymous said...

Thank you so much! I found your book very useful.I am considering practicing passive airflow at home.

Peter Louw said...

The book can now also be downloaded FOR FREE at Google Books - use the link on the right-hand side of the blog.

delekhan said...

Thank you for your explanations of the technique, I have
even watch your Youtube video where you demonstrated it, but I still have a question regarding the flutter: is there a case when the passive airflow is too passive? I am afraid that my airflow is too passive because I tried to record it on my mic and it didn't record anything. I know there is extremely slight flow, like a soft sigh, but since I can't record it, maybe it is too soft?

Peter Louw said...

Dear Delekhan, there are two possibilities: either your microphone is not suitable for picking up the flutter, or your flutter is absent. Not all microphones pick up the flutter. Cheap mikes actually work best for this, because the expensive mikes have filters that neutralise noises such as flutters. The old analogue mikes worked well for flutter purposes, but the digital mikes which are part of cell phones may be problematic for our purposes, though my cell phone does pick up the flutter. Another way to test your flutter is to use a small rubber or soft plastic tube - in my book you will find more detail. You can even try placing a finger so that it nearly touches your lips - if you feel hot air coming out of your mouth you will know that there is airflow. But it should be very slight, and not a loud, "pushed" flow. If you're unsure whether you are producing flutters, first exaggerate the flow by actually blowing air out before speaking. Then try to soften and minimise those blows. Best of luck and let me know if you are getting results. Kind regards.

Delekhan said...

Hello, thank you for your answer. Now I have tried to record the flutter on my microphone again and although I still didn't get any sound (yes, if I force it a little it will be heard, but if I am subtle as I want to be I don't get any sound), I have seen that during recording my input bar (I am using Audacity) is rising when I release the flow. So there is the air vibrating, microphone got it, but I guess it is too soft to produce any sound/noise. I have put a hand in front of my mouth and yes, there is a warm air coming out of it when the air flows out, but it doesn't produce any noise. I have also connected 2 plastic straws (put one into the other) to act as an evaluation tube you mentioned and yes I can hear the noise, but I really need to put it into my ear to be able hear it. So I am producing air flow, but can it be too slight?

Why am I concerned if the flow is too slight – because few days ago when I started researching this technique I have found out that I actually do produce that very slight flow of air naturally when I begin a sentence. So could it be that I have developed it subconsciously during my stuttering years? Or people who do not stutter produce that extremely slight flow of air too, so I need to force it a little bit, to pronounce it a bit more? That is what is bugging me. I have found out that when I am relaxed I do tend to release a very slight flow of air, maybe ½ second before speaking, but when I am excited or stressed I don’t, because I rush to say what I want and I want to say it as fast as I can and then I don’t have time for that and as a result I stutter or get a block. Maybe I am wrong, but when I speak normally through the “plastic tube” (2 straws joined together) I can hear a very slight flow of air a moment before saying the word, so I am a bit puzzled.

PS: Sorry for such a long post, I haven't realized I wrote so much.

Peter Louw said...

Dear Delekhan, I think you are on the right track here. Good flutters ARE very soft, so if they are present, even when the mike doesn't pick them up, you are doing well. You have the basic idea; now you need to apply it by, for instance, using it when reading a short text in private. That's the Reading Exercise which I discuss in my book. Don't try to use the airflow in real speaking situations at this stage yet because your technique is probably not yet a firm habit. Regarding your second paragraph: it's very good that you produce airflow naturally. Dr. Martin Schwartz has hypothesised that those children who do outgrow stuttering, do so because they have unconsciously applied some kind of airflow before speaking, so preventing a locking of the vocal cords. It's a good question whether normally fluent speakers also have airflow before speaking. Personally I doubt it, because normal speakers don't need it; but we do. I don't think you should force or exaggerate the airflow because it's easy to create a "pushed" flow which will be counterproductive. Yes, when excited or stressed it is more difficult to apply a fluency technique. That goes for all fluency techniques, not only the airflow technique. But that's where practice comes in. The more we practise, the easier it becomes to apply the technique. This is also where stress management comes in. Stress control should be part of stuttering management. Speaking when excited is problematic. One of the drawbacks of fluency techniques are that one loses some spontaneity. One more thing: the airflow does not stand on its own; it must be combined with slowing the first syllable (SFS). SFS in itself is a powerful technique; combined with airflow it is a mighty weapon against stuttering. A last word: ensure a smooth transfer from airflow to speaking and guard against stopping the flow just before speech. All the best! Kind regards.

Delekhan said...

Thank you very much sir, I couldn’t remember under which article I wrote my comment, so I read it only now. In the meantime I have read both yours and Dr. Schwartz’s book which offer excellent in-depth explanations of the technique itself and everything which has to do with it, so I highly recommend them to anyone who wishes to learn it. As for me, now I am absolutely sure this is the right technique for me because:
1) I find it very logical – for me everything I have read about it makes sense
2) I am not a heavy stutterer, but I have developed a bad habit that when I get a block I tend to force the word out, which works for some time, but as I aggravate my vocal chords more I stutter more and after a few hours of speaking I start to stutter badly. This technique manages blocks in much more civilized (and effective) manner.
3) before I started to stutter (I started to stutter suddenly after waking up when I was 17, now I’m 24) I had another problem – I spoke too fast, so people sometimes had trouble understanding me, so it should also help me to reduce my speech rate. It is better to speak slowly than too fast. So as we say in our country I could use it to kill two flies with one hit.
As for stress management I have no problem with that, I have been once to speech therapist and he taught me deep breathing relaxation technique which I practice regularly for 20-30 minutes before going to bed for many years now and this has become a habit for me. It does not help with my stuttering as much I would have liked, but it does help in general with mental abilities, so even if I was fluent I would still practice it.

OK, so now I know everything I need to do. I won’t have any professional support because in my country there are no trained professionals but I am not worried, I have already started practicing and will be back in 6 months to report back the results. Thank you again, all the best.

Peter Louw said...

Dear Delekhan, Many thanks for your kind words about my book. I am very glad that you found it helpful. You are obviously a person who works hard to achieve objectives, so I'm sure that you will go very far, not only regarding speech but in other spheres of life. So many people who stutter are not prepared to put in the work, and regrettably they don't achieve their objectives. Just a few final comments which you're probably aware of anyway: 1) It's not easy to work on your own when tackling stuttering. The ideal is to have lots of support, also group support, as mentioned in my book 2) The fact that you started stuttering so late in life is actually a good sign for the prognosis - if you started late, it may be easier to get rid of it, compared to those who began as children, where the stuttering is deeply entrenched through many years of stuttering 3) Yes, the Airflow Approach makes sense, that's what also attracted me, it has the "ring of truth". But it's still not a wonder cure, it's just a range of principles and guidelines. 4) I trust that you have also checked out my Stuttersense blog, where you will find lots of additional information on this approach, for instance the vitamin B1 (thiamine) course which seems to help about 30% of adult stutterers quite significantly. A link to that blog will be found within my book blog. 5) Very good that you are doing deep-breathing relaxation exercises at night, that will certainly reduce "base-level tension" and indirectly also reduce stuttering. All the best.