October 22 - International Stuttering Awareness Day:

Stammering - socially misunderstood communication disorders

Thushanie Jayasuriya

"Hello my name is Sh...Sh....Sh... Shehan" Or "My name. name. name is Shehan". We hear these types of responses from friends, family and people we meet in our day to day lives. Sometimes when we talk we tend to take an extra second or so to say the word, sometimes we just repeat the word in order to grab that extra second to construct our thoughts and speak out our sentence.

But sometimes when we hear a person have blocks and frequent repetition in their speech we tend to notice that there speech is different, we have come to classify this as stammering. Even a little child can differentiate between stammering speech from a normal non fluent speech moment. I guess they say that we as human beings are predisposed to recognizing stammering. Stuttering and stammering are terms used interchangeably to name the same speech disorder.

This article is written in commemoration of world stuttering awareness day which falls on October 22, 2009, in the hope of helping us as people in the society to understand a little bit more about this speech disorder and learn to be a little more insightful about our fellow colleague, friend, even our children or a stranger that would come across on the street. We would also be looking in to avenues of help available.

We would commonly recognize stammering as disruptions in the flow of speech. Well of course this is a very laymen's definition of what stammering is. But then there are number of ways that the medical world has come to define it. The definition of stammering has kept on changing throughout the passing years but it has happened in a good way, the definitions has given us the opportunity to understand the speech disorder more and find ways to help people with stammering. It has also lead to a number of new avenues in research so that it brings about more knowledge and understanding.

Bbasic facts about stammering

Stammering is seen more in males than females, there is evidence that indicate that stammering condition can run in families, each person stammers differently. It can vary from one day to another and from one situation to the other.

People who stammers do know what they want to say, it's just that sometimes they find it difficult to physically produce the sounds/ words. Sometimes takes a little extra time.

Most of the time the onset of stammering condition is in childhood between the ages of two years and 5 years. But sometimes you can see late onset of people/children beginning to stammer at later ages too.

Some neurological condition that can happen in adult hood like stroke and accidents which can cause head injuries can result in acquired or neurological stammering. (stammering in adulthood)

History shows that there are a lot of famous people that have stammered.(Winston Churchill, Marilyn Monroe)

People who stammer have normal intelligence.

Most of the time people with stammering don't stammer when they sing.

Most of the time people with stammering have difficulty talking on the phone.

Sometimes talking in loud places makes stammering worse.

Speaking to a crowd or a large number of people can be difficult most of the time to people with stammering but not impossible.

Stammering occurs in all countries, all culture in all different socio economic classes.

Now that we have some idea of what stammering is let's try and find answers to some of the most common questions that most of us would ask about stammering. These would be: What causes stuttering? Is there a cure for stammering? Who can help my friend/ child? How can I help?

What causes stammering?

Well, a lot of researchers around the world are carrying out a lot of clinical studies and various other scientific and research methods to find out an answer to that question. Yet we have not been successful to find an exact answer. The research findings indicate that stammering is not a result of one single cause, it is believed that this is a result of a number of factors coming together.

Current research tends to suggest that there is a physiological basis for stammering in the brain structure but it is yet to be known.

Is there a cure?

If the stammer is identified in children at an early age, this means if a professional (Speech and language therapist/pathologist) is involved and is able to identify with a child before secondary features set in, the child has a better chance of out growing the problem.

But for an adult who stammer the news remains that in most cases there is no cure but intervention can help you reduce the stammer and help you control it better.

What are the symptoms of stammering?

Stammering is categorized as a speech disorder. Definition of stammering would be a disruption to the flow of speech characterized by repetitions of words, phrase, blocking, hesitation, prolonging of sounds. This is involuntary (out of one's control)

There are number of different way in which the symptoms are classified. The two major categories are overt symptoms and covert symptoms.

The overt symptoms are symptoms that we all can see and hear, features like, repetition of sounds and words, blocking of words and sounds, etc. The physical feature that we see when a person stammers is also categorized under this section (certain facial expressions and body movements). The overt symptoms are also known as the primary symptoms. These set of symptoms we first notice in children and adults both. The overt symptoms are measured using different assessment by speech and language therapists.

It is the covert symptoms of stammering that most of the time the public observers are not aware of, it is the hidden aspect of stammering. Covert symptoms are harder to identify. Covert symptoms are also known as the secondary symptoms. On most occasions at the initial stages or at the beginning point of stammering we don't notice the secondary symptoms in children. If we start to notice children starting to show secondary symptoms of stammering then, we say they have gone to an early stammering stage.

Stammering is an individual experience that the person goes through which is mostly shaped by the experiences the individual has faced in their life. Avoidance is the most common feature, most of the time people with stammering avoid words, situations and even feeling simply because they might stutter on the word.

Fear is the other factor that we as observers can not see or feel, most of the time a person with a stutter might fear to get in to a conversation, fear that they would stutter on the next word he/she is about to say or the word after that. These are but a few of the covert symptoms that I have spoken about. Covert aspect of stammering is unique to each individual; any intervention that is aimed at helping a person needs to pay a lot of attention to the individual's experiences and needs.

Through experience

In my work as a speech and language therapist working with people who stammer both with children and adults clients, I have come to understand that stammering is one of the most socially misunderstood communication disorders. We as family members, spouses and observers in order to help people when they stammer make suggestions like, relax and talk or talk slowly, sometime fill in the words when they get stuck or complete their sentence they started. Sometimes we go to a level and say they should be more confident. Well we do all this with a good intention but the most important thing we need to realize it being supportive and accepting that the person is important. It is the individuality in the society that we need to learn to understand and respect.

Avenues of help

Speech and language therapist are a group of professional that work with people who stammer. Speech therapy will help you understand yourself and learn more about you're stammer. It will also help you understand the effects that stammering has had in your life. This knowledge will help you cope with the situation. Speech therapist will also help you with a bag of techniques to help you control your stammer.

As parents speech therapist can help you understand your child and his/ her stammer. Speech therapist will help you cope with the stammering situations better and help you with strategies to cope with your feelings about your child's stammering.

There are other professional that can help, psychiatrist, counsellors.

Feel free to drop in to any speech therapy clinic in the country to get information, advice, help you seek.

How can we help? As parents

* As parents it is always important to learn to pay attention to the child and what he or she is saying rather than the way they are saying it. Even when you see your child stammer.

* Let the child say the word even when he/she stammers without us as adults going to help him/her and fill in the difficult word. This will help them build the confidence in themselves and help them not view stammer as a central focus in their lives.

* It is always nice to have a talk with your child if he/she wants to talk about the stammer,

As listeners

* As listeners it is important to show patients and good listening to the thing that the person who stammers focusing on what is being said rather than the manner.

* Maintaining eye contact and a relax posture when talking to the person rather than looking away, even though we could feel uncomfortable.

* Time always helps. It helps the person who stammers cope with the stammer with the stammers and get the messages across in the way they wanted.

* When you say things in a rhythmic manner like religious chants and prayers it helps to reduce the stammer in people and they tend not to stammer.

* Talking in different way help reduce stammering but professional help is recommended.

* Finally, just ask the person who stammers ways he/she would feel comfortable when communicating with him/her.

(The writer is a Speech and Language Therapist)