Stammering as a Speech Disorder - Essay Example

?Introduction Stammering is a speech disorder characterized by repetition and prolongation of sounds, syllables or words, resulting to interruption of normal speech flow. The speech interruption process is involuntary and the affected person could make lengthy pauses in the course of his or her speech due to the inability to produce sounds of certain syllables. Speech disruption are normally accompanied by other characteristics including visible effort while talking, fast eye blinks in addition to spasms or shaking of the lips wile talking. People suffering from this condition have trouble of communicating verbally and this undermines their quality of life immensely. This paper examines the causes, symptoms, effects of stammering and methods of treating and managing the condition. Causes of stammer Researchers have studied stammering for a long period but a lot of information about the disorder remains relatively unknown. However, research studies indicate that the condition is caused by a combination of several factors, including developmental and environmental factors. From these contributing factors, the causes of the disorder are classified into two groups namely developmental and acquired. The beginning of developmental stammering is during early childhood and it progresses to the adulthood. Normally 20 percent of children are affected by developmental stammering from the age of about two and half months. During this age, most children are learning about speech and language skills (Bogue, 2005). Developmental stammering is the most common type and it is normally characterized by repetition of syllable or words. These signs are accompanied by other secondary symptoms including observable physical tensions while speaking. As the child develops into adulthood, he or she may start avoiding people or situations that require verbal communication. However, many young children are not cognizant about their speech disruptions. Children who develop the condition early may experience various patterns of stammering. In most situations, the speech disruption is in two episodes, occurring in sequences of stammering followed by periods of relative speech fluency (Bogue, 2005). Developmental stammering is easy to manage and most patients recover from the condition. However, in other situations, the affected children encounter much more difficulties while speaking as stuttering develops into an advanced stage. In such children, the initial relaxed stammering develops into a more tense and repetitive speech disruption accompanied by pauses and speech prolongations (Bogue, 2005). According to Lewis (1902), the development of stammering in children could be influenced by environmental factors such as parenting of the affected child. Exerting intense pressure on the affected child in order to acquire normal speech increases development of stammering, because it undermines the confidence of the child (SFA, 2000). In addition, unregulated speech correction techniques applied by guardians make the affected child to become more anxious and fearful, which are some of the factors that accelerate the development of more chronic stammering (SFA, 2000). As the child grows older, secondary stammering symptoms become evident. These include avoiding social contact and situation requiring verbal communication, rapid blinking of the eyes and trembling of lips. Other behavioral symptoms that develop after the child becomes cognizant of stammering condition include phobia of sounds, people and situations that involve talking. The secondary reactions to stammering become more evident in adolescence and early adulthood causing a lot of humiliation, shame and disappointment to the affected persons. In rare situations, adults with normal speech ability acquire language impairments, which lead to stammering (Lewis, 1902). According to NIDCD (2007), acquired stammering sometimes occur from neurological impairment, arising from medical conditions such as stroke, injury or trauma on the head, brain tumors and abuse of certain drugs. Acquired stammering is normally associated with repetition of sound or part of a word and secondary symptoms such as nervousness, trembling of the lips and rapid eye blinking are absent (Bogue, 2005). Other causes of acquired stammering include experiencing distressing event such as the death of a loved one, divorce, separation and breakdown of other intimate relationships. In addition, negative mental response to physical suffering sometimes causes stammering. Stammering that happens from these psychological events occurs abruptly, after subjection to a particular traumatic event and the resulting speech impairment remains relatively unchanged by various communication experiences . In addition, the affected person is not cognizant of the speech disability (Lewis, 1902). The exact causes of developmental stammering are not well known however, researchers contend that genetics and sex of a person play significant role in development of the condition. A research study conducted by Yairi and Ambrose (1992) showed close association of developing stammering in families with history of the condition. This study and others demonstrates that stammering has strong genetic link and is inheritable along the generations. Children born in families with stammering history have higher chances of developing the condition than those without such genetic link. However, the association of genetics with stammering is controversial because there are people who have the condition but with no ancestry of the condition. This implies that environmental factors play a critical role in development of stammering condition, especially in people without family history of stuttering. According to Yairi and Ambrose (1992), genetics play a role in development of stuttering because spoken speech is one of the last traits acquired in the course of human evolution and development. However, one of the most convincing links of genetics with stammering condition is the discovery of three speech genes, namely GNPTAB, GNPTG and NAGPA. Mutations in these three genes cause stuttering (Weber, 2011). The genes are situated in the autosome and they encode enzymes involved in the lysososmal – enzyme-targeting path. Most of mutations occurring in the three genes are missentic in nature (Weber, 2011). Most people with the stammering condition demonstrate a heterozygous mutation of the three genes (Weber, 2011). Therefore, there is high probability that stammering is genetic condition and children borne to parents with the condition have high chance of developing the disorder. Researchers have established a close association between stammering disorder and the sex of a person. According to Yairi and Ambrose (1992), a higher proportion of males develop long-term stammering disorder than females. The scientific explanations for this finding are varied, with neurologists attributing the trend to neurological differences between the two sexes. On the other hand, sociologists attribute the difference in stammering between males and females to social cultural factors during early child developmental stages (SFA, 2000). Sociologists contend that the differences arise because society exerts more pressure on stammering boys than girls especially in their early stages, leading to anxiety, and fear that eventually exacerbate development of the disorder. In addition, both boys and girls demonstrate different language acquisition skills, where girls show higher language competency ability than boys from early stage (SFA, 2000). Hence, boys have higher chance of developing stammering speech disorder than girls. However, the explanations of different stammering prevalence in girls and boys are varied across various scientific and social disciplines. Another risk factor besides genetics and sex is the time since stuttering started. According to Yairi and Ambrose (1992), between 75 and 80 percent of children who begin stammering at the age of 30 months recover naturally within a period of one to two years. Children who stammer before attaining three years of age have the highest chance of developing normal speech within six months without any external speech assistance (Yairi and Ambrose, 1992). Moreover, children who stammer for longer than six months have difficulties in developing normal speech ability on their own and therapy is highly recommended (NIDCD, 2007). Children who stammer for more than one year have the slightest probability of outgrowing the disorder and the problem normally persists into adulthood (Yairi and Ambrose 1992). Therefore genetics, sex and the age at which stammering begins are some of the most prevalent risk factors of the disorder. Children endowed with clear speech with few errors have higher chance of outgrowing stammering compared to those who speech is flawed (Yairi and Ambrose 1992). However, children suffering from stammering disorder do not necessarily have lower language skill and they are in fact within the threshold of acquiring normal speech. Signs and symptoms of stammer People with stammering disorder normally produce sound with repetitions of whole words or part of words and they prolong the sounds of the speech (SFA, 2000). Although people with normal speech ability also stutter occasionally, people with stammering disorder have higher frequency. Stammering patients demonstrate diverse signs and symptoms, both repetition of words and speech elongation are the common symptoms. In some patients, the speech becomes completely blocked or non-existent. Blocked speech is normally characterized by opening the mouth for considerable duration to speak but little or no sound comes out orally. After some time accompanied by considerable effort, the person might eventually manage to complete the word with flawed sound (Bogue, 2005). According to (Bogue, 2005), stammering patients demonstrate all or some of the following symptoms. They repeat sections of words instead of the whole word, producing repetitive sounds more than one time in every eight to ten seconds (Bogue, 2005). Due to the apparent difficulty in producing and repeating sounds, stammers become increasingly disappointed when the person they are talking to fails to comprehend their speech. Another sign of stammering is raising the pitch unnecessarily, rapid blinking of eyes and physical tension that is demonstrated by failure to keep eye contact while talking (Bogue, 2005). People suffering from stammering disorder are culpable of using more physical gestures such as hands, fingers and head to make their point than those with normal speech ability. As stated earlier, stammers have difficulty in pronouncing certain words and consequently they develop the tendency of avoiding the difficult words in their speeches or substituting such words with less demanding ones. In some cases, they cease talking in the middle of a sentence (NIDCD, 2007). The apparent difficulties in speaking exerts heavy demand on their respiratory system and consequently they occasionally run short of breath and demonstrate unusual breathing patterns during their speech (Lewis 1902). Other signs of stutterers include avoiding verbal communication in both direct and indirect physical contact and hence such people evade making telephone calls or speaking their mind out voluntarily. In addition, they make unusual facial and other body movements, which are caused by abnormal muscle relaxation and contraction. Hence, they sometimes demonstrate visible tightening of the jaws, trembling of the lips and unusual tongue movements during articulation (Lewis, 1902). The rate of stammering intensifies especially while talking through the phone, addressing people in authority when speaking in stressful situations and talking to the public especially in large audiences (SFA, 2000). However, SFA (2000) notes that while repeating a phrase severally and while talking in chorus with people with normal speech ability, the rate of stammering reduces. Other situation that reduces stuttering includes change of accent. People with stammering speech disorder experience different levels of severity depending on the personality. In addition, the prevailing communication environment affects stammering. Some situations could intensify the intensity of stuttering while others minimize it. How stammering affect the person Stammering individuals encounter various physical and psychological challenges in their daily activities. According to Bogue (2005), stammering exerts heavy psychological suffering to the affected person and most patients suffer from low self-esteem. This makes them vulnerable to feelings of helplessness and low self-confidence. Therefore, most people with the disorder succumb to self-pity, depression and resignation to their condition. One of the major causes of psychological problems is prejudice and discrimination that the sufferers undergo in school, working places and other social places. For long period, stammering disorders has not been receiving adequate attention from the policy makers. In schools for instance, there is no curriculum developed specifically to cater for students suffering from the disorder. Therefore, the students suffer the indignity of sitting the same oral exams with others, subjecting them to further frustrations and embarrassment (Bogue, 2005). In work places, stammers are often overlooked in job promotions due to their perceived communication incompetence. Stammering individuals suffer from aphasia in varying degrees. Aphasia impairs their ability to learn a language due to difficulties in remembering and pronouncing words (Lewis, 1902). The continuous effort to find synonyms of difficult words does not only increase the anxiety of the sufferer, but it also results in misunderstanding especially while communicating with articulate individuals. Therefore, stammering exerts immense emotional and mental strain to the sufferers leading to mental disorders and suicidal tendencies (Bogue, 2005). According to Bogue (2005), mental strain on stutterers is demonstrated in their reduced attention span. People suffering from the disorder are normally incapable of concentrating on particular thing for a long period. Therefore, fields and occupations that require high levels of concentration such as academia, have low number of people suffering from the disorder. Moreover, stutterers have trouble in following through and completing challenging projects (Lewis, 1902). The resulting mental strain arising from the speech incompetence isolates the individual from the larger society. In most situations, stammers isolate themselves from other members of the society because they fear being ridiculed. This prevents them from accessing moral and emotional support from friends and hence their socio- economic progress is greatly undermined. Stammering affects the wellbeing of the affected person adversely. According to Bogue (2005), stammering reduces the vitality of the affected patient. This is due to reduction in appetite and insomnia that are mainly caused by mental strain, anxiety and psychological problems directly and indirectly associated with the disorder. Bogue, (2005, pp 67-75) sums the mental and physical anguish that people who stammer as thus; “continuous depression of spirit wears out the body and mind. The lungs do not function properly and oxygenated blood is never sufficient to reinvigorate the body”. Bogue (2005) argues that the energy that is supposed to energize the organs, tissues, cells and organs systems is instead directed to articulation, anxiety and incessant worry about their condition. In work places, SFA (2000) notes that people with stammering disorder experience discrimination right from the recruitment stage to their careers if they manage to impress the recruiters. In a world where communication skills is of paramount importance, stutterers face the double challenge of achieving the right competence for the job and also demonstrate they have better communication skills that people without the disorder. Hence, they face stiffer challenges in the pursuit of their careers due to stammering. Methods of treating stammering disorder Currently there is not cure for stammering. However, there are various therapeutic interventions to remedy the disorder. The methods of treatment applied to a stammering individual differs from patient to patient depending on age, the communication goals intended, health status of the person among other factors (NIDCD, 2007). Treating people with stammering disorder involve various specialists including speech therapists, psychologists and other medical experts in order to establish the fundamental causes and treat the condition comprehensively. In young children, early intervention could prevent escalation of developmental stammering into adulthood (NIDCD, 2007). In order to establish whether young children have the problem, medical specialists recommend early evaluation of the risk factors that increase the possibly of developing the problem. Treatment of young children normally entails training the parents or the guardians on appropriate ways of supporting their child to produce fluent speech (NIDCD, 2007). Some of the appropriate approaches of treating stammering in young children include provision of a relaxed environment at home that provides the child with many opportunities of speaking. Parents are normally advised to set aside enough time speak with the affected child especially in situations where the child is ready and eager to speak (SFA, 2000). To enhance the self-confidence of the affected persons, guardians are advised against criticism and reacting negatively to a stammering child (SFA, 2000). In addition, guardians should resist from compelling the affected children to speak in a particular way or to put the child in a stressful situation in order to make him or her develop normal speech. Parents should speak to the affected child in a slow, relaxed and loving manner in order to alleviate the pressure the child could be experiencing. It is important to appreciate that even young children experience psychological and physical trauma fro the disorder, and exerting more demands on the stressed child could aggravate the problem (NIDCD, 2007). Listening attentively to a stammering child and waiting until he or she finishes a difficult word is therapeutic and parents should resist the temptation of trying to complete the sentences. Moreover, the guardian should be honest and talk openly to the affected child especially when the child inquires about her speech condition (SFA, 2000). Furthermore assuring young children that stammering is not a disability enhances their self-esteem to explore their talents without undue limitations. For adolescents and adults, treating stammering entails offering stuttering therapy, drugs and use of electronic devices in appropriate situations. According to NIDCD (2007), stuttering therapies for teenagers and adults are intended to reduce the frequency of stammering while speaking. Therefore, the affected persons are trained on certain aspects, including talking more slowly, controlling their breath as they speak, and techniques of progressive sounding simple syllabic words to more complex and longer words or sentences(NIDCD, 2007). In addition, stuttering therapies address psychological factors that undermine fluent speech such as anxiety and panic attacks among other mental problems (SFA, 2000). Although no drugs are yet approved to cure stammering, medications are sometimes used in speech therapy to alleviate disorders that aggravate stuttering. Some of medical conditions treated using drugs include depression, anxiety, panic attacks among others. The drugs for treating some of these disorders have been applied in clinical trials to treat stammering (NIDCD, 2007). However, the clinical trials indicate that drug therapy is relatively inefficient in treatment and management of stammering (NIDCD, 2007). Other methods of treating the disorder include application of electronic devices such as headphones and fluency appliances. These devices are normally inserted in the auditory canal of the patient with encoded speech to improve their fluency. However, the effectiveness of electronic devices is yet to be conclusively established and research is underway to improve on the existing models. Conclusion Stammering is a speech disorder that affects all people in the society irrespective of their age. Most patients suffer from developmental stammering at the onset of childhood although stuttering is sometimes acquired later in life from neurological impairment. Some of the risk factors associated with stuttering include inheritance from the affected ancestors and age at which the person develops the condition. In addition, boys have higher chances of acquiring the disorder than females. Stammering has profound physical and psychological effects on the patient. Social prejudice and insensitivity to the needs of stutterers aggravates the mental and physical challenges that the patients undergo. However, early diagnosis and offering appropriate intervention enhances recovery of the patients. Stuttering is not a disability and many stutterers have achieved remarkable feats in their lifetimes. It is therefore important to offer the patients with moral support to enhance their self-esteem. References Bogue, N.B (2005). Stammering: Its cause and cure. New York: Kissinger Publishers The author is a prominent sufferer of stammering and has written extensively on the topic. In this book, he describes the challenges of stutters, giving valuable insights on the how the condition develops and its physical and mental effects on the patients. Writing through personal experiences makes the reader indentify with daily challenges of stutterers. The book is essential for the assignment because it is insightful and opens more opportunities of researching stammering. Lewis, A. G.(1902). The practical treatment of stammering and stuttering. Oxford: GA Lewis Publishers. This book examines various methods of treating stammering condition. In this book, the author explores the various underlying causes of stammering to patients of diverse ages from early childhood to old stage. This book is essential because it critically examines the benefits and shortcomings of various treatment interventions for the condition. NIDCD (2007). Voice, speech, language: NIDCD stuttering fact sheet. Retrieved from http://www.nidcd.nih.gov/staticresources/health/voice/StutteringFactSheet.pdf This article is written by National Institute on Deafness and Other Communication Disorders (NIDCD) a distinguished authority in the field of communication disabilities. The article candidly examines the development of stammering disorder, with special emphasis on the causative and risk factors, in addition to all other relevant information about the condition. The article is essential for this assignment because it offers holistic information about stammering. SFA (2000). If your child stutters: A guide for parents. 5th ed. Memphis, TN: Stuttering Foundation of America. The book is written by Stuttering Foundation of America (SFA). It reveals personal experiences of parents with children suffering from the condition. The book emphasizes on the role that parents and environment plays in speech development. Specifically it demonstrates how parents should support children suffering from the condition. Yairi, E., and Ambrose, N. (1992). A longitudinal study of stuttering in children: A preliminary report. Journal of Speech, Language and Hearing Research, 35: 755-763. In this journal article, the authors evaluated a sample of children suffering from the condition to establish the inherent risk factors that increase the chances of acquiring the disorder. They examined the family history of children, the sex and the earliest age at which the children developed the condition. The article is essential because it offers practical insights on the risk factors of stammering. Weber, J. (2011). Stuttering via GNPTAB, GNPTG and NAGPA gene sequencing. Disease Prevention through Genetic Testing. Retrieved from http://www.preventiongenetics.com/ClinicalTesting/TestDescriptions/stutteringpanel.pdf In this article, Weber, a professional geneticist examines the genes responsible for stammering. In particular, he examines the above named genes, their role in speech development and how they influence stuttering. The article offers valuable insights on how mutation of the genes contributes to stuttering. Read More