Stuttering: what it is, what causes it and what to do – Feel good

Who saw The King’s Speech, a 2010 film directed by Tom Hooper, will remember the excellent Colin Firth as Prince Albert, Duke of York and second son of King George V, afflicted from childhood by a severe form of stuttering that denies him the attention of his father. , the favor of the court and the affection of the English people. In his eyes full of confusion and disappointment we can see all the suffering that unites them who stammer, an army consisting of about a million Italians (around 1.5% of the population), among which stand out 150 thousand young people under the age of 18, who struggle with fatigue that affects their lives every moment. One is dedicated to stuttering awareness world day, which is celebrated on October 22 all over the world and allows us to delve into this verbal feature that is not so well known and is often the subject of false clichés.

What is stuttering?

By stuttering we mean a complex cognitive phenomenon, which shows great variability both between individuals (that is, between different people affected by it) and within the individual: “Classically, stuttering is considered to be characterized by the systematic repetition of sounds, pa-pa-pa style . or ta-ta-ta, appearing in all situations and areas of life. To be clear, a bit like we see in some characters portrayed in movies,” says the doctor Valentina Letorio, neuropsychologist and head of the stuttering clinical area of ​​the Vivavoce Medical Center in Milan. “In fact, in the majority of cases, stuttering is occasional, periodic or intermittent: this means that some people only stutter in certain situations or in certain contexts, others have more difficulty on some days, others alternate weeks or months of complete linguistic ‘normality’ .

What forms of stuttering are there?

Often, stutterers adopt some strategies, such as using synonyms or descriptions (word turns) in place of the words that are most difficult for them: “In fact, a characteristic feature of stuttering is that the person, even before speaking and then at the moment he thinks about what he wants to express, he already feels like he’s going to jam and therefore has time to change his words, sounds or letters. Others instead they adopt behavioral “tricks”., clearing your throat or pretending, for example, that you have lost your mind, in order to have time to overcome the block,” explains the expert. This is why stuttering is not just what we all think we know, consisting of prolonged sounds, hesitations, pauses or blocks, but it can present itself in many other formsthrough the use of intermediate levels, short and broken sentences, synonyms, turns of phrase, changes in speech rate, silences, refraining from doing or communicating.

At what age does stuttering start?

Generally, the age at which stuttering starts is preschool, around 2-3 years, but there are cases where it manifests around 6-7 years. “Many children and adolescents have a occasional stuttering, which appears above all at school, at the moment of greatest communicative pressure, when a teacher questions them and has to give an opinion, while the rest of the class listens to them. In these social situations, stutterers feel more tired and often stop saying what’s on their mind, using a different and sometimes inappropriate vocabulary,” warns Dr. Letorio. Unfortunately, most of the time, this is mistaken for excessive shynessdue to lack of preparation or language poverty, which affects academic performance.

How important is stress

It is quite common to associate it with stuttering stereotype of an anxious person, whose introversion creates the problem. Instead, for some years now it has been understood that the exact opposite is the case: it is not stress that causes stuttering, but he stutters – because those who are affected by it already know the situation or the words they will get stuck in – to provoke anxiety, stress and embarrassment, which in turn can increase the frequency and intensity of stuttering. “In short, it’s about a vicious circle that can turn seemingly banal situations into real obstacles: introducing yourself to someone, calling a restaurant to order a pizza, ordering a coffee at the bar, asking for information on the street. It doesn’t necessarily have to be a rally or the thesis of the thesis that causes a crisis”, assures Dr. Letorio.

What are the causes of stuttering?

But then what does stuttering depend on? In the last 10-20 years there has been an increase in studies and scientific evidence on the subject, which have shown a familiarity component. “Although it cannot be defined as hereditary, stuttering is a trait that found in multiple individuals from the same family unit, although not in all cases. It was also identified a gene which could be involved, but which explains only a small part of the phenomena associated with stuttering.’ In addition, an incomplete integration was detected between the motor, promotor and sensory areas responsible for language production: “A recent line of research even shows the excessive production of dopamine, the neurotransmitter involved in the learning of automatic movements, such as walking but and speech,” says the expert.

Does it also occur in adults?

Stuttering rarely begins in adulthood: usually, these very rare cases are due to head trauma, which has compromised the area of ​​the brain on which language production depends. “However, all those linguistic ‘jams’ that we can all have, especially in social situations where we feel particularly pressured, should not be confused with stuttering. It can happen to anyone, they are emotional blocks, but they have nothing to do with stuttering.”

What to do to solve stuttering

In preschool ageit is quite common to witness spontaneous remission of stuttering: within 6-7 years, 88% of children resolve their discomfort without having to resort to any treatment. “In this thin evolutionary window, there is not yet full automation of language production mechanisms, both phonetic, morphological and syntactic, so a word instability at one or more of these levels can lead to intermittent episodes of transient of stuttering”.

In all other cases, however, it is necessary based on a multidisciplinary team, consisting of a psychologist, speech therapist, neurologist, physiotherapist and psychotherapist, who can take responsibility for the person at 360 degrees. “It is important to intervene, because stuttering can affect life choices: there are young people who interrupt their studies or who give up some opportunities in the academic or professional field”, admits Dr. Letorio. “Not to mention intimidation and the discrimination they may face, especially at school, or the need to rely on family or friends to deal with common everyday challenges, such as making a simple phone call.”

How can it be solved?

With a specific and individualized rehabilitation program, stuttering can be resolved and already within a few weeks it is possible to collect the first results: “We proceed to work not only on the aspects of speech and speech therapy, but also on the aspects stress management and in the correct motor control of all the parts related to phonation, such as the tongue, lips and diaphragm, working on the areas mainly involved in the problem”, concludes the expert.

“Once control of their movements is regained, the patient is guided to face the daily challenges of life, from the simplest to the most stressful, until they regain confidence and mastery of language and their own abilities.”

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