Numerous jokes and the unfortunately often imitated symptoms of stuttering show again and again that many people consider this ailment to be a comical affair. Others think that exhortations, teachings, self-control and firm will can remedy the speech disorders. However, both one and the other opinion testify to ignorance of the fact that stuttering is a disease – a speech disease.
Symptoms and causes of stuttering
In stuttering, fluent speech is interrupted by spasmodic movements of the respiratory, laryngeal, and speech muscles. In normal speech, breathing, laryngeal function and articulation movements, for example of the lips and tongue, must be coordinated. This happens unconsciously and is therefore not evaluated as a special performance. When this coordination is disturbed, a noticeable, characteristic speech disorder, stuttering, develops. Since it is a fairly common condition – about one percent of the total population is affected – the symptoms are familiar to everyone. Fluent speech is interrupted by spasmodic movements of the respiratory, laryngeal and speech muscles. We distinguish here two types of spasms, The clonic spasms lead to rapid repetitions of some sounds, especially the explosive sounds (k, p and t). In tonic spasms, the sounds can be pronounced only after prolonged pressing. Consonants cause greater difficulty than vowels. Stuttering occurs mainly in free speech, answering, and in difficult situations, less so in following along, counting, whispering, and singing. Some people stutter only when dealing with a certain group of people, for example, superiors or strangers, while they can talk uninhibitedly at home or with friends. Insecurity and inhibitions thus hinder the stutterer in intercourse with other people; as a result, he not infrequently becomes shy of people, his self-confidence dwindles, so that he can eventually lose his mental equilibrium completely. Inferiority complexes and even suicidal thoughts appear. Thus, an extremely agonizing suffering develops, a functional disorder called neurosis due to abnormal reaction of the nervous system to the environment, a real, highly stressful disease that requires appropriate understanding and helpfulness of the environment. Stuttering often appears in children, where similar cases have already occurred in the families. This does not mean that stuttering is hereditary. Damages, which the child experiences during, before and shortly after birth, nutritional disorders, infectious diseases, which cause a general reduction of physical and mental resistance, frightening experiences, accidents, educational mistakes, conflicts in the parental home, imitation and others can then trigger the stuttering. In some stages of life there is a special danger. Children from three to four years of age usually want to speak more than they can. However, their vocabulary is not yet up to the increased demands, and their speech tools are not yet trained for rapid speech. Thus, “getting stuck” and “rolling over” can occur. This repetition of syllables does not occur infrequently at a certain stage of linguistic development and is not yet to be regarded as pathological. It is a pathologically conditioned reflex that can be overcome. This so-called developmental stuttering must not become conscious to the child. If possible, this stuttering should not be noticed by the educators. Under no circumstances should a child be encouraged to repeat incorrectly pronounced words correctly. The symptoms usually disappear by themselves after a short time. The next cliff is the start of school. Changes in the environment and new tasks can trigger the speech disorder again. The last crisis is the time of puberty with its physical and mental changes. Thus, stuttering usually begins in childhood and adolescence.
Treatment and therapy
In the treatment of stuttering there were and are numerous mistakes. As late as 1841, cutting out a wedge-shaped piece from the back of the tongue was recommended. This procedure was very painful because anesthesia was not yet known. In some cases it was even fatal. Today, it is difficult for us to imagine success, because stuttering is not an organic disease, for example, due to an abnormal tongue.Despite this, however, parents come to the consultation again and again with the erroneous view that cutting the lingual frenulum can help. Hypnosis and electrotherapy do not help against stuttering either. For treatment, it is advisable to present the child to a speech, nerve or pediatrician or even a speech therapist. One is always surprised to see adult stutterers in the consultation who have been struggling with the condition since childhood without ever having sought medical help. In the treatment it is important to recognize and take into account the roots of the suffering, which lie in the sphere of experience. In older patients, speech exercises are used to try to relax the patient and establish a new type of speech, a measure that often takes a long time and unfortunately is not always successful. Calming medications have a supporting effect. In children, adequate sleep, easily digestible food rich in vitamins, a calm home atmosphere, consistent, but not strict, education and a regular daily routine should be provided. Sports with a rhythmic course, such as jogging and slow swimming, have a beneficial effect. It is also extremely harmful to criticize or even punish children because of their speech defect. Dealing with them requires calm and patience on the part of family members and educators. At school, special consideration must be given, mainly during oral exams, which in some cases should be avoided altogether. For severely stuttering and unsuccessfully treated children, speech therapy schools have been established in almost all German states, sometimes with boarding schools, where, according to the curriculum of normal schools, the lessons are taught by speech therapy pedagogues and therapy is in this way integrated into the whole daily routine. So there are enough possibilities to help people who stutter. It is important that they are recognized and taken advantage of, that patients do not resign themselves, but are enabled by the understanding and support of those around them to correctly assess and overcome their suffering.
