Stuttering

Stuttering

Stuttering is a type of
speech disorder in which the normal flow of speech is interrupted by the
repetition or delayed pronunciation of words, syllables and sounds.
It’s the easiest disease to treat, and the hardest to cure.

How Speech Is Produced

Speech begins with breathing. Our lungs fill with air, more air than we
would inhale if we weren’t talking. We expand our upper chest, as well
as our diaphragm, to get all this air in. Our lung pressure and
respiration muscle tension increases.
Next, we release air through
our throat, past our vocal folds. Our vocal folds are a pair of small
muscular folds in our larynx. If we tense these muscles slightly, and
release a little air, our vocal folds vibrate. This is called phonation.
If we place our fingers or palm across the front of our throat, and hum
or talk, we can feel our vocal folds vibrating.
If we tense, our vocal folds too much, we’ll block off our throat and prevent any air from escaping our lungs.

Vowels are produced by our vocal folds, and modified by our
articulation muscles (lips, jaw, and tongue). Some voiced consonants,
such as /b/ and /d/, are also produced with vocal fold vibration, and
modified by our jaw, lips and tongue. Other consonants are voiceless,
such as /p/ and /t/, and are produced only by our articulation muscles
modifying airflow, without our vocal folds vibrating.
Our ears are
essential but overlooked speech-production organs.We can’t speak
correctly if we can’t hear. Some theorists have proposed that stutterers
have defective hearing in some way. Despite over 40 years of research,
no such defect has ever been found.
A normal hearing reflex, while
not causing stuttering, could make recovery from stuttering more
difficult. The stapedius muscle reflex of the middle ear attenuates our
vocal perception 5-15 dB (about an 80% reduction in sound). The
attenuation is greatest at the lower frequencies of our vocal fold
vibration. If we can’t hear our vocal folds, we can’t control them.

Neurology Of Stuttering
CAUDATE NUCLEUS

The caudate nucleus is referred to as the “central switchboard” of the
brain. Recent positron emission tomography (PET) brain scans have found
the left caudate to be underactive in stutterers. The area is
underactive whether the person is stuttering or fluent.
The
“thinking” signals from the frontal lobes don’t connect properly to the
speech areas of the brain, due to malfunctions in the connecting caudate
nucleus “switchboard”. The result is poor control of the speech-
production muscles, such as the vocal folds, lips, and tongue.
It is
alsobelieve that the problem with the left caudate may be caused by
abnormally high levels of the neurotransmitter dopamine in this area of
the brain.
LEFT/RIGHT HEMISPHERE PROCESSING
Normal speakers use
both the left and right hemispheres of the brain for speech, but the
left hemisphere is dominant. Neurologists believe that the left
hemisphere is specialized for speech and language, and the right
hemisphere is used for processing music, environmental sounds, and
emotions.
One recent study using positron emission tomography (PET)
brain scans found abnormal right-hemisphere dominance during stuttering,
and normal left-hemisphere dominance when the stutterers talked
fluently (reading in chorus with another person).
Another PET scan
study found that only stutterers with linguistic impairments had the
abnormal right-hemisphere dominance. Stutterers with normal language
abilities had the normal left-hemisphere dominance.
The abnormal
cerebral dominance can be interpreted in several ways: The unusual
right-hemisphere activity could be the product of emotions and anxieties
of stuttering. Or it could be that there is something wrong with
stutterers’ left-hemisphere speech centers, and the inefficient
right-hemisphere takes over speech activities.
CENTRAL AUDITORY PROCESSING

Some subtle abnormalities have been found in stutterers’ brain
processing of sounds. These abnormalities are usually in discriminating
small timing differences between sounds. Researchers speculate that the
part of the brain that processes incoming sound timing may also process
outgoing speech timing.
PET research has found that the brain’s
auditory processing areas shut down in stuttering. This diminished
central auditory processing may explain why stutterers have poor
awareness of what we do when we stutter.

What causes stuttering?

There are two types of stuttering that are more common. (A third type
of stuttering, called psychogenic stuttering, can be caused by emotional
trauma or problems with thought or reasoning. At one time, all
stuttering was believed to be psychogenic, but today we know that
psychogenic stuttering is rare.)

Developmental stuttering

Developmental stuttering occurs in young children while they are still
learning speech and language skills. It is the most common form of
stuttering. Some scientists and clinicians believe that developmental
stuttering occurs when children’s speech and language abilities are
unable to meet the child’s verbal demands. Developmental stuttering also
runs in families. In 2010, for the first time, NIDCD researchers
isolated three genes that cause stuttering. More information on the
genetics of stuttering can be found in the research section of this fact
sheet.

Neurogenic stuttering
Neurogenic stuttering may
occur after a stroke, head trauma, or other type of brain injury. With
neurogenic stuttering, the brain has difficulty coordinating the
different components involved in speaking because of signaling problems
between the brain and nerves or muscles.

Symptoms of Stuttering

PRIMARY STUTTERING BEHAVIORS

Laryngeal dis-function is widely-believed to be the core stuttering
behavior. However, laryngeal dis-function in stuttering is not simple.
Some studies have found abnormal laryngeal activities with stuttering,
other studies have not. Regardless of whether stutterers use our vocal
folds in a abnormal way, changing how we use our vocal folds is usually
the most effective way to improve fluency.
• Articulation disorders.
Many studies have found dis-functions of the lips, jaw, and tongue in
stuttering. As with the laryngeal dis-functions, the unusual muscle
activities occur in only some persons who stutter, and sometimes when
the person is talking fluently, or even when not talking.
• Breathing abnormalities have been found during stuttering.

SECONDARY STUTTERING BEHAVIORS
• Avoidance of feared words, such as substitution of another word.
• Postponement of the feared word, with pauses or filler words.
• Starting tricks, such as an “uh” before the feared word.

• Escape tricks, such as head jerks, exhausting one’s breath and
speaking on residual air, “backing up and getting a running start,” etc.
• “Anti-expectancy” speech behaviors to prevent stuttering such as speaking in a rapid monotone, or affecting an accent.

STAGES OF STUTTERING

STAGE ONE – NORMAL DISFLUENCY (AGES 2-6)

Learning speech and language are the most complex and difficult skills
children learn. Most, if not all, children have problems with speech or
language at some point.
Dis-fluencies tend to be single, such as “That my-my ball,” or “I want some…uh…juice.”
Dis-fluencies tend to be interjections, revisions, and word repetitions.

The child does not manifest struggle behaviors, or visible tension, or
frustration or embarrassment. The child experiences dis-fluencies as if
he stumbled while walking, and recovered his balance and continued
walking without a problem.
Dis-fluencies occur when the child is planning a long or complex language structure.

Changes in the child’s environment may also cause temporary normal
dis-fluencies. This could involve parents’ divorce, the birth of a
sibling, moving to a new home, etc.

STAGE TWO – BORDERLINE STUTTERING (AGES 2-6)

The symptoms of borderline stuttering are:
• Dis-fluency on more than 10% of words.
• More than two units of dis-fluencies together (“That my-my-my ball”).
• More repetitions and prolongations than revisions or incomplete phrases.
• No secondary symptoms or reactions to stuttering.

STAGE THREE – BEGINNING STUTTERING (AGES 2-6)

The symptoms of beginning stuttering are:
• Dis-fluency on more than 10% of words.
• Episodic dis-fluency. The child stutters for weeks or months, between long periods of fluency.
• Stuttering when excited or upset, when seeming to have a great deal to say, or under high environmental demands.

• Repetitions become rapid, tense, and irregular. A sound or word is
repeated three or more times. The child is substituting the neutral
vowel (“uh”) for the appropriate one (e.g., “luh-luh-luh-like”).
•
Prolongations. Sounds are prolonged at least a half-second. Fixed
articulatory postures occur, or freezing of speech-production muscles.

• Increased speech-production muscle tension. A rise in vocal pitch,
caused by tensing the larynx. Blocking airflow and stopping the voice.
Wide mouth opening or tongue protrusion. Irregular breathing patterns.
• Stuttering only on the first word of a sentence or phrase.
• Stuttering on both content words and functions words, such as “like,” “but,” “and,” or “so”.

• Secondary or escape behaviors, such as rapid eye blinking, nodding
the head, facial grimacing, quivering lip, raising eye brows, flaring
nostrils.
• Unconcern or unawareness of stuttering.

STAGE FOUR – INTERMEDIATE STUTTERING (AGES 6-13)

At these ages the child begins to fear and avoid stuttering.
• Usually this begins with fear and avoidance of certain sounds or words. Word substitution begins.
• Blocks become common, in addition to repetitions and prolongations.
• Escape behaviors are used.
• Stuttering becomes chronic, without periods of fluency.
• Stuttering occurs on content words — the major nouns, verbs, and adjectives.
• Stuttering varies between situations, such as talking on the telephone, speaking to strangers, etc.

STAGE FIVE – ADVANCED STUTTERING (AGES 14 THROUGH ADULT)

• Vivid, fearful anticipation of stuttering.
• Feared words, sounds, and situations.
• Affects self-image — thinks of himself as a stutterer. Chooses his friends, social activities, and jobs to avoid talking.
• Many advanced stutterers develop their substitutions and avoidance behaviors so well that you never know that they stutter.

How is stuttering treated?

• Provide a relaxed home environment that allows many opportunities for
the child to speak. This includes setting aside time to talk to one
another, especially when the child is excited and has a lot to say.
•
Refrain from reacting negatively when the child stutters. Instead,
parents should react to the stuttering as they would any other
difficulty the child may experience in life. This may involve gentle
corrections of the child’s stuttering and praise for the child’s fluent
speech.
• Be less demanding on the child to speak in a certain way
or to perform verbally for people, particularly if the child experiences
difficulty during periods of high pressure.
• Speak in a slightly slowed and relaxed manner. This can help reduce time pressures the child may be experiencing.

• Listen attentively when the child speaks and wait for him or her to
say the intended word. Don’t try to complete the child’s sentences.
Also, help the child learn that a person can communicate successfully
even when stuttering occurs.
• Talk openly and honestly to the child
about stuttering if he or she brings up the subject. Let the child know
that it is okay for some disruptions to occur.

• Breathing
Exercises: Regulated breathing can help relax your body and especially
the jaw and throat that usually tighten up in stressful situations in
people who stutter. Breathe in and breathe out deeply a couple of times
before you start talking. This will help you calm down and allow for
more oxygen intake. Repeat a particular vowel sound that you may have
trouble producing and follow it with deep diaphragmatic breaths.
Meditational breathing every day and help bring about calmness, reduce
stress and allow for your mind and body to be relaxed.
• Speech
Exercise: It is helpful to think about what you are going to say, play
it in your mind once, relax your breathing, and then say what you want
to say. Do this in front of a mirror, practice a few sentences first at a
very slow pace. Increase the speed slowly and gradually till you feel
you are comfortable with talking in a normal pace. Set achievable and
realistic goals for yourself.
• Reading Exercises: Taking deep
breaths, practice reading a book at a slow pace. Do not stress yourself
out to get the right pace.

Acupressure Treatments: DU20,CV23,24, ST4, H5, GB34,UB42,44,47,49,52

Home remedies

Give one fresh green ‘Amala – Indian Herb’ to a child to chew and eat
,it helps the child to stop stammering as this remedy will thin the
tongue ,and the speech of a child will become clear, have it until
results are obtained.
According to ayurveda, massaging the top of
the head with warm brahmi oil and leaving it on for half an hour before
washing it off with warm water will help in eliminating stuttering and
stammering speech problems.

Rub 7 seeds of almond on a grater
with 7 seeds of black pepper with few drops of water make the paste and
to it add some sugar candy (‘mishri’; sugar crystal),lick this mixture
for 15 days early in the morning, empty stomach .This will help to stop
stammering or stuttering in a child.
Mix some black pepper powder to homemade butter and have it until stammering or stuttering is stopped.
Take a bay leaf and place it under the tongue, it helps to improve the speech.

Green coriander leaves and golden shower flower’s fruit pulp is mixed
with water and is churned to make a medication for stammering or
stuttering, Gargling with this mixture for 21 days. It helps to thin the
tongue surface and clear the speech.
A single exercise which
parents can perform with the children who stammer, that is, take a thin
muslin clean cloth ,ask the child to put out its tongue, hold the tip of
the tongue with the cloth and give a slight jerk to the tongue and pull
it forward , if this is dome for few months the child will start
speaking clearly .(just pull once a day )
There are certain foods
like Indian gooseberries, black pepper, almonds, dried dates and
cinnamon which when chewed on regularly are known to strengthen the
speech organs

Stuttering Homeopathic Remedies

Homeopathic remedies are non-toxic natural medicines safe for everyone
including infants and pregnant or nursing women. You may use 6X, 30X, 6C
or 30C potencies.
Agaricus – similar to Lachesis, talkative, rapid
speech; delirium tremens and stuttering; alcohol abuse symptoms and
withdrawal; stuttering with muscle cramps and tics.

Argentum
nit – walks and talks fast; fear of heights, lots of fear; talkative;
digestive problems; can’t talk to groups of people; craves sugar.

Bovista – stuttering, especially reading;, certain words; awkward speech; drops everything; often in children.

Bufo rana – stuttering or stammering in backward children; epileptic,
retarded, especially in anger, hits; tendency to masturbation.

Calcarea phos – shy fearful, restless children that are thirsty; headaches; growing pains; chews fingernails.

Cannabis sativa – stammers from embarrassment; fear of making mistakes; “pot” intoxication i.e. losing train of thought.

Causticum – especially in children, when feeling embarrassed ma, may be
neurological or emotional; inability to move tongue or from words;
deviations of tongue with inability to curl or manipulate tongue to form
words; excitement; NWS (never well since) stroke; worse excitement,
embarrassment and right side of face; child sticks out tongue and it
deviates to the right; dyslexia, lisping, consonants, transposition of
syllables; mouth distorted; speaks normally unless stressed.

Cicuta virosa – stammering in epileptic children; twitching, jerkins and spasms of body; speech is a side symptom or issue.

Cuprum met – restless children; muscular defects from birth; loss of
speech; paralysis of tongue; in epilepsy tongue darts in and out like a
snake.

Gelsemium – stuttering after fever or viral infections;
complains that the tongue is too heavy; lack of coordination; trembling
tongue; close to Causticum – caused from fear or stress; worries about
getting in front of people

Kali brom – very restless children with hands and feet in constant motion; stuttering worse in the evenings.

Lachesis – stroke with paralysis; stuttering especially left-sided;
loss of voice; alcoholic, rambling speech, jumps from one subject to
another; words run together; mumbling speech.

Lycopodium –
father or family dominating; speech, learning, dyslexia, broken self
confidence psychological emotional responses, embarrassment; low self
esteem; feels worse 4 pm to 8 pm.

Mercurius solubis – often in
children; rapid stammering stuttering speech; connected with hearing
difficulties, with inner ear problems, recurring tonsillitis, ear
infections; can’t hear to form words well; stage fright; introverted;
feels detached; muscles can’t keep up with brain.

Natrum
muriaticum – grief, rejection, then speech difficulties; wants to be
alone; craves salt; sensitive emotionally; in children that are shy.

Nux vomica – grumpy, irritable; sour, bitter taste in mouth; articulation and speech difficult; digestive problems.

OP – stuttering, stammering especially after stroke in adults,
especially vocal cords from shock and anticipation. Slow paralysis of
muscles.

Silicea – thin children with slow mental development; shy; feels cold; skin problems; worse after vaccinations (#1 is Thuja).

Stannum met – weak voice that leads speech problems; elderly with history of lung disease; weak lungs.

Stramonium – autistic children; severe voice changes; fears of water
and doges; wild look in eyes; violent behaviors; severe night terrors;
can’t stand to be alone.

Thuja – cant’ finish words or
thoughts; talk trails off at the end of the speech – fade; repeats at
the words of another to finish; tendency to get warts.

Veratrum album – mumbling speech; also talking to themselves; religious fears; colon problems.