Who, What, Why: How do you overcome a stammer?
King George VI's battle to overcome his stammer is the focus of a major film. How do modern-day stammerers tackle the condition?
It has won the praise of critics and earned its cast and crew a string of award nominations - yet for those affected by it, the disability at the heart of The King's Speech is all too painfully real.
Stammering may have been played for laughs in the likes of the sitcom Open All Hours but the new Colin Firth drama portrays how heartbreaking and debilitating it can be.
Nonetheless, early intervention can effectively cure stammering in many children up to the age of six or seven and it can also speed up natural recovery, says Dr Rosemarie Hayhow of the Royal College of Speech and Language Therapists.
Among older children and adults, techniques to improve fluency and minimise the stammer can make a difference.
The King's Speech depicts King George VI's stammer and his attempts to tackle the condition with the help of Australian speech therapist Lionel Logue, played by Geoffrey Rush.
- Treatment up to the age of six or seven vastly boosts the chances of recovery
- With older children and adults, speech therapists teach techniques to increase fluency and reduce the impact of the stammer
- Earpieces can also make a difference to some sufferers
Written by David Seidler, who suffered from a profound stammer as a child, it offers a depiction of the disability that is far more sympathetic than is typical of film and television.
However, while it examines the King's childhood and his relationship with his father, stammering is a physiological, not a psychological condition, which stems from subtle differences in the way that the language parts of the brain transmit information to the speech muscles, Dr Hayhow says.
Young children aged around three or four stand a very good chance of making a natural recovery, she adds. Early referral allows the stammer to be monitored so the right time to start treatment can be chosen. Most children of four to seven years will need therapy to help them overcome their stammering.
In one treatment approach the speech and language therapist teaches parents ways of responding to stammer-free and stammered speech - the child is praised and encouraged for speaking fluently and learns how to smooth the stammered words. Other treatments focus on how members of the family communicate with each other and find ways to make it easier for the child who is stammering.
When treatment is less successful it can still reduce the negative impact that stammering can have on a developing child, says Dr Hayhow.
However, by the time the child gets to school age, he or she will be spending so much of their time at school that the impact of parents will be reduced, as will the chances of the youngster growing out of it.
Social pressures begin to exert an influence, too. "The child becomes more aware of their difficulties and they begin to anticipate problems," Dr Hayhow adds. "They also don't realise they may have got into negative thinking patterns."
With older children and adults, therapists will employ strategies to increase the speaker's fluency and reduce the impact of the stammer on quality of life.
Fluency therapy may involve training stutterers to slow their speech to control their breathing and the way they form words.
Modification techniques do not get rid of the stammer but reduce its impact - so that, for instance, the sound of the stutter is softened. This feeling of greater control over their own speaking, in turn, lessens anxiety, which can help reduce stammering.
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Devices which use an earpiece to block out the sound of the stutter's own voice or play it back to themselves, so it sounds as though someone is talking along with them, can also be effective.
Leys Geddes of the British Stammering Association says it is important that sufferers do not just try one therapy and then give up - they may in fact benefit from one method more than another, or from a combination of techniques.
"My own view is that you want to try everything," he says.
"Everybody is different. Don't go around thinking maybe it'll get better (without help)."