Poluttering is a speech fluency disorder that, like stuttering, is one of the psychological behavior disorders. Patients do not speak fluently, often swallow syllables, and like to blend words so that others do not understand them. A combination of psycho-social therapy and speech therapy steps are used to treat patients.
What is poluttering?
Speech is the number one means of human expression. Speech expression is a highly complicated process involving a wide variety of organs and anatomical structures. The tongue, palate, and pharynx, for example, are irreplaceable for speech. Equally irreplaceable are certain parts of the brain. Apart from the Wernicke or speech center, a wide variety of cognitive abilities within multiple brain areas of the right and left hemispheres are involved in speech expression. Language actions also require a certain amount of attention, perceptual ability, and memory. Against this background, almost all areas of the human brain are involved in the production of situationally appropriate, correct, and meaningful sentences. As complex as the language action is with its neuronally diverse interconnections, as many language disorders exist. One of the most common is stuttering. A somewhat lesser known speech disorder is poluttering, also titled battarism, tachyphemia, tumultus sermonis, or paraphrasia praecepsv. The speech fluency disorder has not been conclusively studied to date.
Causes
Because little research exists related to poluttering, the cause of the fluency disorder remains unexplained. Only hypotheses exist regarding the etiology. In earlier years, polterine was thought to be a behavioral disorder. In the meantime, however, medicine suspects a combination of perceptual disorder, processing disorder, control disorder, planning disorder and timing disorder behind the disorder. Despite the still unexplained etiology, the ICD-10 classifies polterine as a disorder from the grouping of psychologically induced behavioral disorders. Under this group, the speech disorder is included in the subgroup of other behavioral and emotional disorders that begin in childhood and adolescence. In this context, the speech flow disorder must be differentiated from stuttering and tic disorders, which are also included in this group. As a speech flow disorder, poluttering can have purely physical causes in addition to psychological causes and, in this context, is associated primarily with degenerative diseases such as dementia.
Diseases with this symptom
- Stuttering
- Tic and Tourette syndrome
- Dementia
Symptoms, complaints and signs
Patients with polterism speak with difficulty of understanding. Their speech is characterized by irregularities that result in disturbed speech rhythm. Jerky starts and faulty sentence patterns characterize the speech of those affected. Overhasty speech is just as characteristic as sound merging in the sense of elision. Unstressed syllables are often swallowed. The speech does not sound fluent and is full of interjections and revisions in the sense of sentence rearrangements. Poluttering patients seem less engaged when speaking and cannot immediately identify their own disorder in the situation. Secondary symptoms may include disorganized speech, lack of awareness of speech rate and flow, and learning difficulties. Affected individuals are easily distracted and often hyperactive. Their attention span for auditory processing is reduced. Obligatory symptoms include abnormal speech rate with a tendency to stutter, syllable and sound blending, sound substitution, sound change, slips of the tongue, and embolophrasias such as phrases, sentence breaks, stretches, or repetitions. Optional symptoms include concomitant additional language disorders and speech formation weaknesses, disorders of semantics and word finding, pragmatic disorders due to disturbed social language behavior, and attention disorders.
Diagnosis and course
Poltertone is diagnosed by a speech-language pathologist. After the initial contact, the speech therapist collects spontaneous speech samples and differentiates poluttering from stuttering in terms of differential diagnosis. Children up to seven years of age are tested for speech comprehension. In addition, testing of oral diadochokinesis takes place.The speech therapist also conducts tests on the patient’s speech tempo variation and communicative-pragmatic ability. Apart from that, the auditory retentiveness for syllable sequences and numbers is tested. Using a reading text, the speech therapist tests the clarity of articulation and linguistic structuring ability. After this initial appointment, a follow-up appointment is scheduled for further diagnostic testing. Under certain circumstances, additional neurological or psychiatric diagnostics may need to take place. Prognosis depends on the cause of the disorder.
Complications
Poluttering is associated primarily with a variety of psychosocial problems. If poluttering is not treated with speech therapy, difficulties arise for those affected, particularly in the area of social ties. Social isolation, withdrawal from the social environment up to the complete break off of all contacts and the job can be the consequence. Polterers are often avoided by their environment, as social interaction with them is perceived as unpleasant. Those affected often polarize strongly in conversation, do not let the other person get a word in edgewise and often lose the “thread” when talking. Listening to a poltergeist is therefore difficult and perceived as exhausting, so that they are often avoided as a result. Such a negative social experience also leads to an increased disorder awareness in polterics, which has an additional bad effect on the acceptance of the disorder and the motivation to change something about it. Of course, intensive logopedic treatment also leads to a high disturbance awareness, but in the course of therapy, work can then be done on acceptance and identification of the disturbance. Increased frustration is another consequence of therapy for poluttering, in the course of which patients first become aware of the full extent of the disorder. Better organization and planning skills must be learned, which most sufferers lacked during the course of poltering. In addition, self-reflection on one’s own speech tempo and speech control initially brings with it many difficulties, such as an inner defensiveness or a marked initial worsening of symptoms. Initial worsening in polterism usually occurs during therapy because patients must first learn to observe and control themselves, a skill they have lacked.
When should you see a doctor?
Poluttering is a speech disorder that often manifests itself in childhood. For this reason, it makes sense for parents to monitor their child’s speech development. If poltering is suspected, it makes sense to seek professional advice early – because early intervention usually proves beneficial in poltering. It is often advisable to raise the problem with the pediatrician, for example, during a preventive checkup. A visit to the pediatrician is advisable at the latest when the child is regularly rumbling. If, on the other hand, the rumbling occurs only once (for example, during an isolated event that is very exciting for the child), no intervention is usually necessary. The situation is different if the poling is tied to specific situations. If the poluttering occurs only in specific situations, but is a regular occurrence there, medical advice is also helpful. In this case, the child may not be suffering from poluttering or another speech disorder, but from other problems. An anxiety disorder, for example, can be considered, which can also explain speech abnormalities. Regardless of how often the poluttering occurs, the speech disorder can put psychological stress on the person affected. Even in cases of great stress, it therefore makes sense to talk to a doctor about the problem. In many cases, the symptoms can be alleviated or remedied.
Treatment and therapy
Fixed therapy plans exist for the treatment of mental speech disorders such as stuttering. For those with poluttering, the situation is somewhat different, as the disorder has not been adequately researched for a fixed plan. Thus, although no set therapy plan exists to treat patients, virtually all patients with poluttering speech are managed in fluency shaping programs. In these programs, therapy for psychosocial issues occurs first. Poltering speech can have psychodynamic causes, but it can also lead to psychosocial problems itself, as patients are no longer understood by their environment.In order to exclude a worsening of the mental situation, therapy must be given primarily in this direction. At the same time, treatment of the flow of speech often takes place. Together with the speech therapist, the patients work primarily on the speed of speech. They practice different speech rates, paying attention to the pauses. In addition to pronunciation and syllable pronunciation, all other speech problems that may be present are part of the therapy. Since poluttering can be associated with stuttering under certain circumstances, therapy is often provided for this as well. In the case of a neurological history, causal therapy is additionally performed depending on the neurogenic damage.
Outlook and prognosis
Whether or not poltering can be treated in a patient depends greatly on the mental state of the affected individual and therefore cannot be universally predicted. In many cases, however, poltering leads to social problems. Especially in children, bullying and social exclusion can occur due to poltering. In extreme cases, this leads to psychological problems. The patient’s everyday life is restricted by the poltering and the quality of life decreases. Treatment is only possible to a limited extent, since the symptom is often triggered by a psychological problem. Therefore, treatment also takes place concomitantly with a psychologist. Men are usually more affected by poluttering than women. Treatment with the help of speech therapy can lead to success in many cases. This is especially the case if the poluttering is not congenital and has occurred as a result of a specific event. It is not uncommon for those affected to have difficulty communicating with other people. This can likewise lead to problems at work. In most people, dyslexia occurs in addition to poluttering and has limited treatment options.
Prevention
Pronounced poluttering can be prevented by parents visiting a speech therapist with their children at the first signs of speech. Other preventive measures do not yet exist, since the causes of the disease are still insufficiently researched.
What you can do yourself
Affected persons have numerous possibilities in everyday life to influence the way they speak. In the case of stuttering, the more intensively they concentrate on their speech and try to influence it, the more affected they suffer. Symptoms such as blockages or repetitions then intensify. A polterer, on the other hand, is helped if he concentrates before speaking and consciously reduces his speech tempo. An upright posture is important to build up the body tension necessary for good speech breathing and balanced articulation. Polterers can speak particularly well while standing or walking quietly. When sitting, it is advisable to stand up without using the back of the chair. When communicating with others, the polterer should try to maintain eye contact. The reactions of the person speaking clearly reflect whether everything said has been understood. A questioning look should therefore be the signal to repeat the utterance again slowly and with clear articulation movements. Relaxation exercises for the whole body, stretches and also learned relaxation methods are suitable as small exercises for in between. Cheeks, lips, tongue and the lower jaw should also be loosened from time to time. Such exercises are taught in logopedic therapies and can be learned quickly.