stammering

'My name is Robert Hilton and I am proud to say that name because I can say my name and it feels really good.'

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The smile on Robert's face says it all. Having stammered all his life, he has learned to control his speech so that he can do something that most us take for granted – complete a sentence without stumbling over his words.

stammering / stuttering

In Britain, Robert is one of 450,000 adults in Britain who stammer, and one of 43 million people worldwide who have trouble getting their words out. Stammering, also called stuttering, is an involuntary block in the normal flow of speech. Sounds, syllables or words may be repeated or prolonged, often with accompanying blinking, lip twitching, and jaw or body spasms resulting from the huge effort of trying to speak. Certain situations, such as talking within a group or on the telephone, may make things worse, while a stammer may almost disappear while singing, or talking alone or one-to-one with a close friend or colleague.

Stammering affects people of all races and social classes but it is about four times more common in men than in women and it tends to run in families. So research is looking for genetic links and for possible abnormalities of muscle control.

Speech is a complicated business which requires coordination of breathing, coming together of the vocal cords and movement of the palate, tongue, jaw and lips. Stammering is most likely to start in childhood when a child's speech and language abilities can't keep up with their verbal requirements. They stutter as they search for the right word. One in 20 children are affected but, fortunately, many grow out of this so-called developmental stammering.

children

Parents can encourage their children to relax and speak slowly, and not put pressure on them or complete their sentences for them. Some do need help from a speech therapist, and early treatment can prevent later problems. For example, a child who is clearly becoming upset or frustrated at not being able to speak properly or has behaviour problems or a family history of stammering, may well benefit from specialist help.

adults

Some people do continue to stammer as adults, which can have damaging effects on working and social lives.

'People tend to think that because a person cannot speak properly they must be a bit thick. People have regarded me as being strange, a freak or maybe mentally retarded,' Robert explains. 'At school it made me feel very embarrassed and I became very shy and introverted. In the past, I've had shop assistants just walk away from me because they wouldn't wait until I had finished my sentence.'

Sean's stammer put an end to his dream of becoming an electrician in the RAF.

'The medical officer told me that, because of my stammer, I could not have a place in the RAF. My confidence went out of the window and it really messed me up. In pressurised situations I just turn into a wreck,' he says.

trying different techniques

Although it's tempting to hide away and avoid situations that make stammering worse, a lot can now be done to help children and adults speak more fluently. Treatment is available on the NHS or privately through a referral to a speech and language therapist, while some people find intensive group courses helpful (see help and info).

Speech and language therapists use one or a combination of techniques aimed at helping an individual to stammer more fluently, speak more fluently and/or consider any psychological problems that may be contributing to the stammer.

'We aim to help people to become a bit more open and accepting about their stammering, to avoid a bit less and to learn ways to modify their stammering so their speech is easier and physically less tense,' explains speech therapist, Carolyn Cheasman.

One of these methods, called block modification, involves identifying what you do when you stammer and when you avoid it and how you feel about stammering. Then you can experiment with ways of talking, which will reduce the likelihood of stammering and help you become less sensitive about your stammer.

Avoidance reduction therapy is also geared to taking the embarrassment out of stammering and helping people face up to rather than avoid situations where they need to speak.

Techniques aimed at helping you to speak more fluently involve slowing down and relaxing the way you speak. This can be achieved by prolonging syllables, pausing and flowing words together. Techniques learned with a therapist or a small group can then be extended to everyday situations.

Counselling and other 'talking therapies' can help relieve stammering where underlying emotional problems have contributed to the problem, whether in childhood or later. Exploring unhappy situations at school or at home can help people understand their subsequent behaviour and develop coping strategies that do not involve stammering. These may include relaxation and anxiety control.

finding your own way

Everyone is different and no single treatment for stammering works for all. What is important is to find the approach that works best for a particular individual. Robert benefited from a three-day intensive course that helped him modify his breathing so that he could speak in complete sentences.

Nadeela discovered words that she could introduce into a sentence when she was blocked that allowed her to get her speech back on track.

'I speak three languages – English, Urdu and Punjabi – and I stammer in all three of them. There are a few words that always get me out of a block and get me to the end of a sentence. If I was on the phone, it was always ’sugar’. I could pretend something was wrong that the other person didn't know about, so I could carry on. If I were speaking face to face I would say ’excellent’ and carry on. ’Sugar’ and ’excellent’ are my trick words,' she explains.

Sean is learning not to avoid difficult words, but to elongate his words so that he can complete his sentences.

'I can try and anticipate the problem and ease out of the word. I try to elongate it and it works. But it's mentally exhausting to practise all the techniques,' he says.

None of the treatments for stammering bring overnight results. It takes hard work and a lot of practice to change the speech patterns of a lifetime. But for Robert, Sean, Nadeela and the hundreds of other people who do learn to control their stammers, being able to hold a conversation with friends, family or even perfect strangers is well worth all the effort.

(January 2001)

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