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Stuttering
What is stuttering?
Stuttering, sometimes referred to as stammering
or disfluent speech, is a speech disorder. As a person
who stutters tries to speak, he or she may exhibit these characteristics:
- frequent repetitions (prolongations) of
speech sounds, syllables, or words
- rapid blinking of the eyes
- tremors in the lips or jaw
- other struggling behaviors
Stuttering affects more than 3 million
people in the United States. Although it most frequently occurs in
children between the ages of two and six, it can affect all age groups. It
occurs three times more often in males than females.
What causes stuttering?
The exact mechanical causes of stuttering are not completely
understood, but it is thought to be a hereditary condition.
What are the different types of
stuttering?
There are several types of stuttering, including:
- developmental
This is the most common type of stuttering, which occurs in children.
As their speech and language processes are developing, they may not be
able to meet verbal demands.
- neurogenic
Neurogenic stuttering is also a common disorder that occurs from
signal problems between the brain and nerves and muscles.
- psychogenic
Psychogenic stuttering is believed to originate in the mind in the
area of the brain that directs thought and reasoning. This type of
stuttering may occur in people with mental illness or who have
experienced mental stress or anguish. However, although stuttering may
cause emotional problems, it is not believed to the result of
emotional problems.
How is stuttering diagnosed?
In addition to a complete medical history and physical
examination, diagnosis of stuttering may also include:
- detailed history of the development of
the disorder
- evaluation of speech and language
abilities by a speech-language pathologist
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Voice
and Speech
Speech is a
complex process that starts with muscle movement, which
involves:
- phonation
(voice)
- respiration
(breathing process)
- articulation
(throat, palate, tongue, lips, and teeth)
These muscle movements are
initiated, coordinated, and controlled by the brain, and monitored
through hearing and touch.
Voice production, or phonation,
is generating and modulating sound as part of the speech process.
Voice is created in the
vocal cords (or vocal folds) of the larynx.
The larynx, often referred
to as the voice box, is a two-inch long
tube-shaped organ located in the neck at the top of the trachea
(windpipe). The cartilage in front of the larynx is sometimes
called the "Adam's apple."
The vocal cords
(or vocal folds) are two bands of muscle that
form a "V" shape inside the larynx.
The area of the larynx where
the vocal cords are located is called the glottis.
The area above the cords is called the supraglottis,
and the area below the cords is called the subglottis.
The epiglottis is a flap at the top of the
trachea that closes over the larynx to protect it from food that
is swallowed into the esophagus.
Breath enters the body
through the nose or mouth, and then travels to the larynx,
trachea, and into the lungs. It exits along the same path.
Normally, no sound is made by the vocal cords during breathing or
exhaling.
When a person talks, the
vocal cords tighten, move closer together, and air from the lungs
is forced between them. This makes them vibrate and produces
sound.
Source: National Institute on Deafness
and Other Communication Disorders
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Treatment for stuttering:
Specific treatment will be determined by the physician(s) based on:
- patients age, overall health, and
medical history
- extent of the disorder
- expectations for the course of the
disorder
- patients tolerance for specific
medications, procedures, or therapies
- patients (or familys) opinion or
preference
The goal of treatment is to focus on
relearning how to speak, or to unlearn incorrect ways of speaking. Although
there is no cure for stuttering, early intervention may keep stuttering from
becoming a life-long problem. Speech and language evaluation is suggested
for children who exhibit stuttering or struggle behaviors associated with
speech for more than six months.
Medications and electronic devices to treat
stuttering are sometimes used.
Parents
of children who stutter may be encouraged to:
- provide an atmosphere in the home
that is relaxed and allows ample opportunity for the child to
speak
- listen attentively to the child
- wait for the child to say the
words without saying them for him or her
- speak slowly and in a relaxed
manner, which may encourage the child to speak the same way
- talk openly about the stuttering
if the child brings up the subject
- avoid criticizing, punishing, or
asking the child to repeat words correctly
- avoid asking the child to speak
for others
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