Speech Therapy for Stuttering
Qualified speech-language pathologists (speech therapists) who have undertaken the appropriate speech therapy education and who are accountable to a professional body will be cautious about any claims of a universal cure for stuttering. In fact, it is not considered possible to cure a stutter (stammer), in the accepted medical sense of the word (BSA, 2006). It is noteworthy that the word ‘cure’ never appears in the Royal College of Speech and Language Therapists’ Clinical Guidelines (RCSLT, 2005). With respect to stammering the College notes that, “Some clients retain a life-long vulnerability to fluency disruption and so may require repeated episodes of care at different stages in their lives” (RCSLT, 2005:74).
We have seen elsewhere (see Stuttering) that people with a so-called secondary stutter are aware of the disruptive effects that excessive repetitions, prolongations, hesitations and blocks have on their speech. There is frequently a reduction in the total output, i.e. the person does not speak as much as might be expected for someone of their age, educational background, occupation, and so on.
In addition, people with an established stutter may engage in avoidance behaviours and, in severe cases, this may lead to social isolation. Indeed, it is likely that, without assistance, the stutter will become more complex over time.
What can be done to help?
Assistance and advice on how to stop stuttering is available for any degree of stuttering, no matter what the person’s age.
If you, or anyone you know, require assistance for stuttering, we strongly recommend that you consult a qualified speech therapist. As indicated above, Speech therapists are governed by a Professional Body and must abide by a code of ethics. They will also have specialist training in disorders of fluency. A variety of interventions are available. However, they are not all suitable for everyone, as it depends on the presenting features of the person’s stutter. The following section gives an overview of some treatment considerations.
There is a range of treatment options available but they must be selected with care. The choice of approach will be influenced by such things as whether or not the stutter developed gradually or suddenly. Developmental stuttering initially commences in childhood (but it can extend into adulthood). On the other hand, an acquired or late onset of stuttering in adults may co-occur with other changes (e.g. neurological signs, a change in medication, psychological state). Additional factors such as these must be taken into account.
The severity and nature of the stutter will also influence treatment options. For example, a person whose speech is pervaded with blocks (i.e. the coming together of two articulators with such excessive force that the speaker is unable to easily release the contact between them, resulting in considerable muscle tension) is unlikely to benefit from a technique known as Syllable-Timed Speech. This is because the technique requires the client to speak rhythmically to a set beat on each syllable of an utterance (e.g. one syllable each second). The potential difficulty for the client is that he or she would find difficulty initiating their speech (owing to blocking) and, therefore, unable to keep pace with the timing/beat of the utterances.
In addition, such considerations as whether or not the stutter is accompanied by overt features (e.g. facial tics; blushing) or covert features (e.g. attempts to hide/mask the dysfluency) will influence the choice of treatment. A particularly useful and popular therapy for when any overt features are more significant than any co-occurring covert features is fluency shaping (RCSLT, 2005). The method teaches a slowed speech technique, with easy phrase initiation supported by soft articulatory contacts and breath-stream management.
As well as the above considerations, it may be that the detrimental emotional effects of stuttering are the most pressing concern for some people. In such cases, a psychological approach (e.g. Personal Construct Psychology) or counseling may be the appropriate way forwards. Some clients report that they have benefited from clinical hypnotherapy when administered alongside more traditional speech therapy.
There is, therefore, no ‘one size fits all’ treatment for stuttering. Consequently, a full assessment by a qualified speech therapist is essential: the therapy approaches being determined by the assessment findings and goals agreed with the client.
BSA (2006) Is There a Cure for Stammering? British Stammering Association [WWW] http://www.stammering.org/cure.html Accessed 29.01.2010.
RCSLT (2005) Clinical Guidelines (Royal College of Speech and Language Therapists) Bicester: Speechmark Publishing Ltd.