stock illustration graphic for stutter stammer
Stuttering can be related to stress or neurological and psychiatric issues. Graphic used for illustrative purpose only. Image Credit: Mohamed Hassan from Pixabay

Dubai: Although there is no known cure for stuttering, experts say early intervention and speech therapy are effective tools to treat or manage it. On the occasion of World Stuttering Day (October 22), they are also highlighting the importance of raising public awareness to counter social stigma associated with the speech disorder.

Explaining the condition, Dr Sriram Raghavendran, specialist psychiatrist at NMC Specialty Hospital - Dubai Investments Park, told Gulf News: “Stuttering, also called stammering or in the more apt medical term, ‘childhood-onset fluency disorder’, is a condition that involves frequent and significant problems with normal flow of speech.

Dr Sriram Raghavendran

“People who stutter know what they want to say but have difficulty speaking. They may repeat or prolong a syllable, a consonant or vowel sound, or a word. They may even pause while speaking because they’ve reached a problematic word or sound.”

He added: “But we have to understand it is not the fault of the child to have this disorder. Stuttering can be related to genetic factors, stress, and other neurological and psychiatric issues. We have to bring more awareness to remove the stigma on stuttering.”

Dr Raghavendran said the recent edition of Diagnostic and Statistical Manual of Mental Disorders (DSM), an up-to-date criteria for clinicians to communicate about their patients, has provided a more apt medical term for stuttering, which is ‘childhood-onset fluency disorder’.

‘Not a defect’

The specialist psychiatrist with over a decade of clinical, teaching and research experience in psychiatry and psychology, has categorically stated that childhood-onset fluency disorder should not be seen as a defect in children.

“Stuttering is something that comes without warning and parents should be very supportive. They should also get a proper support system,” said Dr Raghavendran, noting that intervention should be done at the early detection of the condition.

He continued: “Parents can bring their children to a psychiatrist and/or a speech language pathologist. There should be proper coordination and multi-disciplinary team approach to childhood-onset fluency disorder. Get treatment as soon as possible.”

Signs and symptoms

According to Dr Raghavendran, stuttering signs and symptoms may include “difficulty starting a word, phrase or sentence; prolonging a word or sounds within a word; repetition of a sound, syllable or word; brief silence for certain syllables or words, or pauses within a word”.

There can also be addition of extra words, such as ‘um’, or difficulty proceeding to the next word. The speech difficulties may be accompanied by rapid eye blinks, tremors of the lips or jaw, head jerks or facial tics (sudden twitches).

Dr Raghavendran said: “Stuttering may be worse when the person is excited, tired or under stress, or when feeling pressured. It is common for children between the ages of two and five years to stutter. For most children, this is part of learning how to speak and the situation improves as they grow. Stuttering that persists, however, requires immediate treatment to improve speech fluency.

He added: “Stuttering can affect a child’s view of himself/herself, and how others see them. The child may become withdrawn to lessen feelings of embarrassment. Then this drawback may have an added consequence of worsening the stuttering.”

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Shagufa Hussain

Shagufa Hussain, speech therapist at NMC Medical Centre Deira, said stuttering or stammering is a speech order that has an adverse emotional impact on an individual, but it can easily be addressed with speech therapy and medical intervention.

Hussain, who specialises in paediatric audiology and speech therapy, cited the recent case of Zubair Mohammad (name changed on request), a five-year-old year boy from the UK living in Dubai.

Hussain told Gulf News Zubair came on August 29, 2022 with the complaint of stuttering since more than six months. Hussain observed that the child stuttered more in vowel sounds and connecting words. He had lot of repetitions at word initial position.

“Zubair was also showing more of physical concomitant behaviour like clenching his jaws tightly during stutter, closing his eyes tight till the word comes out, increasing his loudness when stuttering. A lot of tension was also observed in the neck and jaw area when anticipating stutter,” Hussain added.

After a series of tests, Zubair was evaluated on a ‘Stuttering Severity Instrument-4 (SSI-4)’, a standardised test that is administered to check for frequency of stutter, duration and physical concomitants during stutter. He was found to have a “moderate stuttering condition”.

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Therapy routine

According to Hussain, Zubair was given speech therapy twice a week for one month. He underwent “fluency-shaping” techniques such as slowed speech or stretched syllable technique. The boy was asked to break every word down to its syllable.

He also learned passive airflow technique to help him to ease the beginning of sentences and maintain fluency, as well as reducing the tension in the tongue and lips to ease the flow from one sound to the next and continuous phonation.

Gaining control

Hussain said: “Master Zubair stopped stuttering after speech therapy was given for a month. He was at the initial stages of stuttering and was able to come out of it after our intervention.”

She added: “For developing children, a genetic disposition to stuttering combined with environmental factors may cause their dis-fluencies to increase over time and persist into adulthood. Stuttering usually goes away by adulthood, but it does persist in around one to two per cent of the adult population. There is no cure for stuttering but speech therapy can be effective in helping people gain control over their speech.”