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Thursday 8 December 2005, 3.00-3.30pm
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BRITISH BROADCASTING CORPORATION

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Programme 3. - Stammering

RADIO 4

THURSDAY 08/12/05 1500-1530

PRESENTER:

BARBARA MYERS

CONTRIBUTORS:

FRANCES COOK

PRODUCER:

ANNA BUCKLEY

NOT CHECKED AS BROADCAST

MYERS
Did you know the worst thing you can do for someone who stammers is to finish their words for them. But if it's your child who's struggling can you just ignore it and hope it will go away? Will it or will it get worse, especially when they start school and other kids point the finger? Should you seek professional help and if so what techniques can therapies offer? Does teaching breathing control have a place or is the psychological approach more successful? What part can parents play or indeed partners of adult stammerers?

Well whatever your question about stammering or stuttering - it's the same thing - call us now 08700 100 444 or if you prefer you can e-mail checkup @bbc.co.uk. And please do let us know if you've found a way forward, what worked for you.

Well joining us today to take your calls is Frances Cook, she's a speech and language therapist. And our first caller is on the line. Michael is calling from Buckinghamshire. Michael, who used to have a stammer which has gone now. That's good news, what happened?

MICHAEL
Well it all goes back a long time, I always seemed to have a stutter which I believe went with the fact that I was forced to use my right hand when I was naturally left handed, that was I believe in a nunnery - but - not in a nunnery but it was some sort of school for the very young that was controlled by nuns. My mother came from an old theatrical family and she was always ignoring the fact that I had a stutter and that I should go on the stage. And she put me into a show called Dancing Years and it was way back in the late '40s, '50s ...

MYERS
And did that help, were you able to perform, we've heard ...

MICHAEL
No, absolute nightmare. I used to stand on the side of the stage and just make up a new script with words that I could actually say, which would terrify my fellow actors, as you can imagine.

MYERS
Okay, so fast forward us to later on in life and how have you managed to get rid of your stutter?

MICHAEL
Well I had the stutter right up until I was about late 30s and gradually it went. I had to give up the stage, naturally, and I just went into several different jobs and then I became self-employed, which I've been ever since, round about mid 30s. And it just went, it just seemed to go and ...

MYERS
I mean what's the key to that, are you saying you kind of grew out of it although it took a length of time, you stopped trying to do well on the stage?

MICHAEL
I think it was really a question of confidence in myself, that I could do things perhaps on my own.

MYERS
Okay, you mention the word confidence, I think it'll crop up in this programme from time to time and Frances is nodding enthusiastically. Confidence is the key to this?

COOK
Well I think that every single person I've ever met who's come and talked to me about their stammering problem has said if only I could be confident in those situations it would make all the difference. And interesting - I was very interested in the fact that acting has been a problem because there are very many actors we know about who take to the stage and don't stammer doing that.

MYERS
Is that because they've got a script and are not having to actually make the words up?

COOK
I think it's partly that and I think it's also that they're not being themselves, they're actually playing a different part. And so in our caller's case he's now in a career that he's enjoying, he's taking personal responsibility for it and there's no pressure there and that's a lovely story to hear.

MYERS
It is and thank you for that Michael, I think that will give courage to a lot of people.

MICHAEL
In the intro you said something about singing, earlier on this morning, and I have never had any problems with stuttering when I sing, I just wanted to get that bit in.

MYERS
Thank you very much indeed.

Let me read an e-mail, we've had a lot of e-mails today, perhaps that's not so surprising. Michael Hay is - he wants to make the point that non-stammerers - that's the rest of us - don't really know how much it affects people. And also affects them when they're not speaking because all we can see, if you like, is the struggle when a stammerer is speaking, we can't see what's happening underneath. So actually life is full of fear for people who do stammer, has that been your experience Frances?

COOK
I think stammering is so unpredictable for so many people, you can never be certain whether you're going to stammer or not and there's a whole psychological backdrop that builds up over the years of going into a situation which has been difficult in the past, you go in expecting it to be difficult, that makes you feel uncomfortable, physically you can get very tense and the likely result is that you will stammer in that situation again. So there's a whole backdrop of psychological issues there.

MYERS
Let's go to another caller, Ian Trevor is in Peterborough and something in particular brought it to your mind, in terms of trying to stop stammering because you wanted to read stories to your daughter, is that right?

TREVOR
Yes that's right. I first considered having some therapy when I was about 35 and I'd recently had a daughter, she was six months old and like any parent I wanted to be able to read a story to my daughter and that was causing me considerable trouble. So I got in touch with an organisation called the Starfish Project and I have worked with them for the past three years to work on my speech, to desensitise myself to my stammer and develop a technique that allows me to speak - I hesitate to use the word - but speak normally I suppose.

MYERS
Excellent. And can you read to your daughter?

TREVOR
Oh absolutely yes, that's no problem at all.

MYERS
Was there a sort of underlying fear that maybe you would be passing on your stammer by having your daughter listen to you if you were stuttering whilst reading, is that what was in your mind?

TREVOR
That was a fear that I had, I don't think that was particularly founded but it's bound to be one of those things that goes through a stammerer's mind. I was not particularly self-confident or comfortable with the way that I sounded and as a consequence of that I suppose you automatically put two and two together and think this may well rub off on my daughter. And so I was keen to try something.

MYERS
So you're very well motivated. I'm glad it's worked out. Can I just ask Frances to comment on that, whether I think perhaps there is a feeling that parents might pass on a stammer either because there's a sort of physical thing going on or perhaps just the way children imitate what they hear, is there any real evidence to suggest that that's what happens?

COOK
That's a very interesting question and one that I'm often asked. There is no research evidence that suggests a child will catch it through imitation. However, interestingly, the research is telling us that it is - has a genetic link, so perhaps in about 50% of the children that we see you would expect to see a family inheritance factor - father or mother - who may have stammered or still stammers. So people are concerned when they do have their first child.

MYERS
Okay, we'll move if we may to a mother, Georgina, she's in Buckinghamshire and is concerned, which is to say has had a child who stammers. But I think you've overcome it in some way have you?

GEORGINA
No, actually it's quite the reverse, I was offering advice. Two of my four children stammered between the age roughly three and four and I found that by not allowing them to see that it bothered me, listening, letting them finish what they had to say, it went away very quickly. And I'm convinced that it's parents who make a big thing of it, show they're concerned, show they're worried about so many things - not just stammering - that it makes a child self-conscious and perpetuates the stammering, often into adulthood, as we know.

MYERS
Can I add into that an e-mail from Mrs Crostick [phon.] because I think it rather backs you up in what you're saying there. Her daughter is four, started to stammer and mum told her well all your little words are trying to come out at once, try and slow them down, make them take their turn. This made her laugh and made her feel calmer and - so this lasted for a few months but it went away. So she didn't ignore it but she sort of defused the situation. So what advice would you give to parents of under-school age children where they may be stammering.

GEORGINA
You're still talking to me?

MYERS
May I put the question to Frances Cook, our speech and language therapist but thanks for raising it Georgina.

COOK
I think it's actually an important point and I absolutely agree that parents have the key, they have all the skills and the instincts to help their own children. The difficulty of course is that of the 5% of children who may start to stammer between the ages of three and five probably four out of five of them will grow out of it, it's very difficult to predict which children are at risk of persisting with the problem because so many children grow out of it. But parents have a wonderful role and being open, being able to acknowledge, being able to make speaking fun and if there is a momentary hesitation just acknowledging it and being comfortable with it is much better.

MYERS
But if you ignore it with that in mind and not put too much emphasis on it and it happens to be that child who isn't actually going to just go through a stage of development and the problem persists can you rather miss like a window of opportunity to try and grapple with it if you do just ignore it?

COOK
I think that if any parent is worried and their child is showing signs of being concerned about it they shouldn't wait, they must come in and have some speech therapy or some advice and guidance around that. Our knowledge is much greater than it was and we have certain key ways of deciding with the parents whether their child is at some risk, so whether it's a genetic factor or whether the child's speech and language profile is - how the speech and language is developing might be important. But if a parent is concerned that's our key first starting place to saying come along let's talk about it.

MYERS
Okay thank you very much. We've had an a-mail from Terry Sweeney who says his father was one of six children, the four boys stammered, the girls didn't. They were all quite good at singing though and they didn't stammer when they sang. What about this gender difference, is it more boys than girls?

COOK
Yes that's well established in the research literature, three or four times as many boys as girls do start to stammer. We don't understand it but it's interesting because it's so much related to other speech and language problems. If you go to a speech therapist in the community health centre they'll have far more boys than girls coming along whose language skills are slower or developing in a different way. So it goes across other fields.

MYERS
Yes, do you think it connects with the male brain and in a way therefore give slightly the lie to the fact that this maybe to do with confidence and more psychological things, that it actually may be hard wired in?

COOK
I think it's very much a physiological start to it and we'll talk about the psychological bits later, which I think are the result of the stammer rather than causing it. And so these children who are coming with this predisposition to stammer more of them will be boys and we have to be very cautious about missing out that early opportunity, as you were saying earlier.

MYERS
And Michael, who started us off, did mention that he was left handed and I wonder, we didn't deal with that, but is there some relevance, would people who are instinctively left handed but being made to use the other hand, would that necessarily cause problems, would that be an explanation possibly for stuttering in some children - they just get a bit confused?

COOK
It was a very early theory that in fact I was taught when I was in training as a speech language therapist and they've done a lot of research now and there is no evidence at all that changing handedness does anything more than irritate the child. So there were lots of children whose handedness was changed at that stage but they didn't start to stammer. So - but the research is looking at the way in which the language centres of the brain and the fluency centres and the speech centres what might be happening within that to make one child more vulnerable to stammering than another. It's something to do with dominance but not handedness.

MYERS
Thank you very much. We'll go to Leicester and Phil who's on the line who - well you tell us about your worries or the worries you did have Phil?

PHIL
Hi thanks for taking my call.

MYERS
A pleasure.

PHIL
I had a stammer or have had a stammer since I was four. I'm now 32. I always avoided situations and certain words, a bit like some previous callers. For example, a simple one would be filling my car up at a petrol station, I would always avoid either pump number 11 or pump number 8 because those were difficult words for me. So I would sit in a queue for pump number 3 purely because I could say 3 rather than 11. I last June - I got married and I wanted to obviously say my vows and give my wedding speech and didn't want my stammer to prevent me from doing that. So I went on a four day intensive course last November run by the Macguire Programme and that taught me a breathing technique and also a number of tools which I could use in order to be able to control my speech.

MYERS
And we can hear you breathing actually, that's - you're deploying that method now as you speak to us on the phone are you?

PHIL
That's right, yes.

MYERS
So it's a conscious thing?

PHIL
Yes it is a conscious thing. The idea being that the more you use it, it eventually becomes subconscious.

MYERS
And how did you get on with the wedding vows?

PHIL
Absolutely fantastic. People did comment afterwards that they were the loudest and clearest vows they'd ever heard and I must really have wanted to get married.

MYERS
How brilliant. Thank you very much Phil, it's really good to hear that. A number of things emerging I think from that. Motivation's obviously quite important. Let me ask Frances - do you come across people who can make the change really having struggled for a length of time when there's a big occasion, in this case wanting to be able to say your vows, terrific motivation?

COOK
I think that's probably the most important thing when you really, really want to make a change and I think it's lovely to hear that somebody has been able to do that so successfully and must be very proud of it and it's exciting to hear that.

MYERS
And what do you think about that technique that he mentioned, which involves breathing and being conscious of the breathing?

COOK
I think that people always associate stammering with a breathing difficulty and people talk about take a deep breath if only you breathe properly it will be alright. And I think with a subject like stammering it's so complex that for some people it really works very well to think about pausing, taking a small breath, controlling the breathing, as we were talking about earlier. And it can be really helpful, for other people that's not the route that they want to follow and they don't find it so helpful, so it has to be an individual solution.

MYERS
And Phil did mention that he couldn't cope with the numbers 11 and 8, I think he said. I would like to read something from Alan who has messaged us to say that he really for a long time has convinced himself that he couldn't say words beginning with 13 different letters. He says, yes half the alphabet lay outside my scope. And what he goes on to say is what I didn't realise was that every time I avoided a word, a letter or a sound then the fear level just grew and grew. What would you make of that, I mean avoiding stuttering is not an answer then?

COOK
I don't think so. However, in the first instance it is important to know that you want to keep yourself safe and if avoiding a certain word makes you feel okay, we would call it a coping strategy. But it's very short term so as part of therapy we would want to be able to face the fear, see what it's all about, practise doing it in different ways and not have to be mentally struggling all the way through.

MYERS
Alan actually has just joined us on the phone. Alan thank you for messaging us in the first place and thank you very much for getting on the phone.

ALAN
Hello good afternoon.

MYERS
And to you and well you've avoided things all your life, have you kind of got over it now?

ALAN
I, as you just indicated, wasn't able to use 13 letters or rather had convinced myself that I couldn't use 13 letters of the alphabet and so I became a walking thesaurus, whenever a word came on the horizon I would change it around. But five years ago, just like the previous gentleman, I also went on a programme, the Macguire Programme, and I learnt the new breathing technique, which I no longer use, because I used that to overcome my fears and place myself in situations which I thought I couldn't do. But word substitution - I have written a little poem, if I may share it with you?

MYERS
We'd be pleased to hear it if it's nice and short.

ALAN
Yes.

MYERS
Go ahead.

ALAN
It's called Changing the words around.

I couldn't say muffin, I couldn't say butter
If I ordered a burger I'd stumble and stutter
So instead of me saying the words that I should
I'd swap them for others I hoped that I could
But you can't always leave out the words that you dread
There are times when a certain thing has to be said
My sister's called Sarah, my best friend is Ben
They just wouldn't answer to Lucy and Len.
Whenever I spotted a difficult sound
I'd hastily juggle my sentence around
I spent so much energy word rearranging
Whenever I spoke I was chopping and changing
Each time I avoided a troublesome sound
I felt rather guilty and very soon found
That my fear of speaking increased even more
The number of problem words started to soar ...

MYERS
I'm going to jump in there. Only because we were enjoying that very much but I'd like Frances to comment on what you've been saying and your approach to dealing with this and congratulations on your poetry and on overcoming the difficulties.

ALAN
If I could add please just one quick thing.

MYERS
Be very quick.

ALAN
I moved on to public speaking because that was my greatest fear and earlier this year I was one of the eight finalists in the United Kingdom Public Speaking Championships, only because I went out and faced my fear of stuttering for more than 50 years.

MYERS
Congratulations, I think that's a fantastic story, thank you Alan. Do you want to just add to that Frances, I mean he said such a lot of interesting things there?

COOK
I think it's just wonderful, I loved the poem, I think they ought to publish it somewhere because it will certainly engender confidence in other people if they understand the problems of avoidance. As I said earlier it's about a coping strategy and I think with any form of therapy and the different sorts of therapy to be able to face that fear, as he was saying, and learn how to cope with it better and communicate more easily that will give you the confidence.

MYERS
There are a number of different named therapies and I've had e-mails from all sorts of people mentioning them. Including Alexander technique and there's one here from Roy in Devon who talks about his son who's had a pronounced stammer and has been helped with hypnotherapy. So when people are looking for a therapy that might be helpful what should they bear in mind? And can I just roll into that another e-mail from Simon - sorry not from Simon - from Ann who's saying the trick is really not to get involved in very expensive courses which offer a cure because that's really missing the point. So what should we bear in mind?

COOK
I think we should avoid the word cure because that smacks of illness and I don't think stammering comes into that category. I think that when we're looking at the research base then there are - there's a great deal of hope out there, there are very many different opportunities for therapy. I mean I would always recommend the NHS route because the professional code of practice makes sure that the speech therapist has a proper training, but perhaps I'm biased in that.

MYERS
You work in the NHS yourself.

COOK
I work in the NHS.

MYERS
And the trouble is of course when you mention the NHS and we all have a lot of confidence in NHS trained professionals but there's always the question of waiting lists for these specialty topics.

COOK
Yes, that's absolutely right but I think that now more and more the government is recommending that the patient should have the choice, we use the patient in the medical model. And that it is really up to our consumers, our users, to go out there and seek the therapy that they need and if they are having difficulties with the waiting list then our colleagues in the British Stammering Association will be very, very helpful in lobbying and helping them to select the right sort of therapy.

MYERS
Let me read an e-mail from Simon who says he considers himself a stammerer but he doesn't fit the usual profile. He says: I often find I can't even stammer, the blockage is too complete. Could a speech and language therapist help Simon?

COOK
Oh yes and there are courses available where he could meet other people who have the same sort of covert hidden problem or where he's struggling so badly to speak at all. The range of people and the types of stammering is huge and if he were able to come in and to have some therapy then there will be routes for him - a pathway for him that will be helpful.

MYERS
I'm going to offer the last word to Bill who's in Chelmsford, but you haven't got very long.

BILL
Okay. I was born in the East End of London to a very, very poor family and although that was bad enough the most - the thing concerned me most was my stammer. Now I had no help with it at all but I was an extrovert who had to be an introvert. I wasn't helped at school at all, I was very often caned because I couldn't things and this went on and on and I joined the army at 14, I became a musician. And I just had to listen and could not talk and it worried me so much I wanted so badly to speak...

MYERS
I need to ask you quickly to say what helped because we've got just a few seconds.

BILL
I got no help at all but one thing that I derived from being a stammerer was that because I had to listen so much I trained myself to a wonderful memory and when I did eventually learn to speak I learnt to read - because I couldn't read or write because of it - I went to university and I did very, very well indeed.

MYERS
I'm going to have - Bill I'm really sorry, I'm going to have to cut you off, we're out of time. Thank you very much for that, not enough time for all this. And next week it's sore throats.


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