Stammer

What is a stammer?

Stammering, or stuttering, is a problem with the normal flow and timing of speech. Attempts to say something may be interrupted by repetition of a syllable, prolongation of the sound or a complete block on speech.

There is often embarrassment about having a stammer. People who stammer may find they are quite fluent if they sing, whisper or speak as part of a group.

Recent research now suggests that the root cause of stammering is ‘faulty wiring’ in the brain, which means that there are problems with the nerve circuits in the brain which are needed for the planning and execution of speech.

Symptoms

The severity of stammering may depend on the child's surroundings. The child may have problems initiating speech or flowing from one syllable to the next - all stammers sound different. Some deal with the problem by simply not speaking at all.

Some children with stammers also develop a tic or tremor (shake).

Causes and risk factors

There's no simple, obvious cause of stammering, but it's likely to be due to a variety of factors rather than a single one.

Genetic factors might, for example, generate a basic problem with the way the brain handles speech - there is a growing volume of research showing that those who stammer may have differences in the structure of their brain and how it works. For example, recent studies of young adults suggest disruption of connections between different brain areas involved in listening to and producing speech. As a result there may be reduced activity in the areas of the brain involved in generating speech such as the ventral premotor cortex, while other studies have found abnormal levels of a brain chemical called dopamine, and increased activity in a brain structure called the basal ganglia.

Meanwhile environmental factors, such as problems in the home or at school, may aggravate these root abnormalities in how the brain is wired.

Stammering usually begins between the ages of three and five - 90 per cent of cases are evident before the age of eight. One in 20 children will have a stammer at some time, but most recover, with or without help. Only one per cent of adults stammer.

It's four times more common in boys than in girls. In families where a person has a stutter, there's an increased risk that other members will have the same problem.

Treatment and recovery

A stammer should be diagnosed by a speech therapist (your GP can refer you), who can advise on what the problem is and how it's best treated. It’s critical that this is done as early as possible.

Research suggests that the rates of improvement are very high if parents can get help for a young child with a stammer from a speech and language therapist as soon as a stammer is apparent (usually at about two to three years of age when a child is starting to string words together into sentences). But if the child hasn’t received this sort of specialist help by the age of about seven then the chances of stammer-free speech are very low.

While there's no easy cure for a stammer, therapy can make a big difference. Speech and language therapists can teach the affected child a variety of techniques and may also suggest the use of technical aids, for example, to mask other people's voices. One simple approach that helps many people is simply to speak more slowly.

Other treatments include development of social skills, self awareness, assertiveness training and communication skills.