Trauma leaves a mark. The feeling of being ‘different’ or being thought of as
such, always leaves a mark. Multiple studies prove that children who stutter
[https://stamurai.com/blog/five-stuttering-exercises-to-help-your-child/] are at
a higher risk of bullying [https://stamurai.com/blog/reining-in-the-bullies/],
social exclusion, and negative perception of self. Such traumatic experiences
leave their scars. As adults who continue to stutter or who have recovered from
their disfluency, those early rejections and emotional violence color their
understanding of themselves and the world around them.

‘Black Sheep’ of the family
People who stutter have a genetic predisposition towards it or other speech
defects. 

Children born to a parent who stutters have a better understanding of their
condition and how to deal with it. 

However, for parents who don’t, the experience of raising a child who stutters
[https://stamurai.com/blog/parents-guide-to-help-child-who-stutters/] can be
challenging or frustrating. 

The condition is certainly not something that can be remedied by stern force or
intimidation. Neither do children who stutter respond well to parents who though
compassionate, don’t quite know what to do or how to address it. In either case,
the feeling of being ‘different’ or needing to be ‘fixed’ persists.

Distorted Sense of Self
As humans, we are heavily dependent on language and speech to communicate, form
bonds, and develop our own identities. 

With speech impediments like stuttering
[https://stamurai.com/blog/online-speech-therapy-for-stuttering/] comes a sense
of shame [https://stamurai.com/blog/stuttering-in-children-understanding-shame/] 
at the inability to communicate or explain oneself adequately, along with a fear
of judgment and rejection. 

Some studies suggest that adults who stutter have internalized the negativity
and the disrespect and have begun to expect and accept it. 

When bad and rude behavior goes unchecked, because one has learned to live it,
trouble isn’t far behind.

Compromised Personal Relationships
A negative perception of self adversely affects one’s relationships with
friends, family, peers, and even intimate & romantic partners. 

The fear of rejection amongst people who stutter has pervasive effects on their
self-confidence which inadvertently affects their relationships. 

Moreover, misinformation or lack of information can create misleading
stereotypes that people who stutter constantly chafe against.

Mental Health Issues
The emotional and psychological
[https://stamurai.com/blog/adolescent-stuttering-psychological-impact/] strain
that dealing with their disfluency puts on people who stutter makes them prone
to depression [https://stamurai.com/blog/stuttering-depression/] and social
anxiety. 

The damaging assumption [https://stamurai.com/blog/stuttering-misconceptions/] 
that stuttering is a symptom of mental instability is wrong. Emotional fatigue,
low self-confidence, and social functioning are rather a product of such
destructive and misguided profiling of people with speech defects.

Silver Lining of the Cloud
Having dealt with dismissive or obstructive behavior from a young age, people
who stutter are extremely empathetic towards those who feel themselves to be
marginalized. 

It is their compassionate ability
[https://stamurai.com/blog/stuttering-life-lessons/] to pay attention to
everyone’s needs and abilities that make people who stutter loyal and resilient
friends, partners, and employees
[https://stamurai.com/blog/what-employers-should-know-about-candidates-who-stutter/]
. 

Each and every one of us is a myriad number of things and has varying ambitions,
interests, reactions, and emotions. How terrible to be defined or let our lives
be defined by a singular label?! For that label, the past, or someone’s
misinformed opinion dictates our present and misshape our future.

If you stutter, consider opting for online speech therapy for stuttering
[https://stamurai.com/blog/online-speech-therapy-for-stuttering/] as early as
possible. A cutting-edge speech therapy app [https://stamurai.com/] like
Stamurai can help you manage stuttering in numerous ways. 

Children who stutter can benefit a great deal from early intervention
[https://stamurai.com/blog/stuttering-in-childhood-early-intervention/]. Speech
therapy exercises for adults
[https://stamurai.com/blog/stuttering-exercises-for-adults/] and children
[https://stamurai.com/blog/five-stuttering-exercises-to-help-your-child] can now
be practiced at home.

The Lasting Effects of Stuttering

Did you know that over 70 million people worldwide stutter? That amounts to one
in 100. And in the US alone, there are over 3 million people who stutter. 

Stuttering will not fit into any one particular age group or time frame. Some
people stutter a little while some have more, some people have stuttering over a
longer time, while some stutter for a shorter duration. 

It can gradually develop over the years and can appear out of the blue
[https://stamurai.com/blog/the-unexpected-development-of-stuttering-in-adulthood/]
. There are many misconceptions and poor reputation about stuttering. But people
who have stuttering can live a very healthy and wholesome life. 

Read on more as we bust the 11 most popular misconceptions or myths associated
with stuttering.

Stuttering Misconception #1: Anxiety and Nervousness Cause Stuttering


Absolutely not! While stressing about situations can worsen stuttering, it is
not the root cause of it. Researchers are yet to find the exact reason for
stuttering but have linked it to be a more neurological issue.

Telling a person to relax or calm down, may affect them negatively, and puts an
increased pressure to speak normally. And children who have negative experiences
with peers, grow up to have a lot of insecurities. 

A little bit of encouragement and patience
[https://stamurai.com/blog/parents-guide-to-help-child-who-stutters/] can go a
long way in easing them into holding a good conversation.

Read: Different Approaches For Treating Preschool Kids Who Stutter
[https://stamurai.com/blog/stuttering-treatment-preschool-kids/]

Stuttering Misconception #2: Stuttering is Purely Psychological


If someone is genetically predisposed
[https://stamurai.com/blog/cellular-causes-of-stuttering-in-adults-and-children/] 
to stuttering, a constantly stressful environment at home and sudden changes can
precipitate a stutter. 

However, that is not reason enough to believe that stuttering is completely 
psychological
[https://stamurai.com/blog/is-stuttering-biological-or-psychological/].

Emotional factors are involved with stuttering, but they are not the primary
causes of the disorder. Anxiety and fear of talking and social situations can
develop in adolescents
[https://stamurai.com/blog/adolescent-stuttering-psychological-impact/] and
adults, who have been stuttering for a prolonged period.

So, psychological counseling
[https://stamurai.com/blog/psychotherapy-and-stuttering-treatment/] and 
cognitive behavioral therapy
[https://stamurai.com/blog/stuttering-and-cognitive-behavioral-therapy-cbt/] 
(CBT) are parts of the stuttering therapy recommended for high-school children,
young adults, and adults who stutter.

Stuttering Misconception #3: People who Stutter Have Low IQ


This is one of the most blatant and common myths about stuttering. There is no
correlation between condition and intelligence.

Research conducted by the British Stammering Association reveals that people
have the ‘same range of intelligence’ irrespective of whether they stutter or
not.

They might be a little bit slow in conveying the message, but they are clear in
their thoughts.

People who stutter have gone on to become writers, actors, scientists, and even
politicians. Some of them are Albert Einstein, Winston Churchill, Marilyn
Monroe, Bob Love, and US President Joseph Biden
[https://stamurai.com/blog/joe-bidens-stutter-and-life/].

Stuttering Misconception #4: Kids will Outgrow Stuttering


Many adults and teenagers keep believing or hoping that one day they might
overcome this issue completely. That’s not always possible and gives false hope.

Usually, children between 18 months and 5 years start showing symptoms of
stuttering [https://stamurai.com/blog/what-is-stuttering/].

And if there is an early intervention
[https://stamurai.com/blog/stuttering-in-childhood-early-intervention/], through 
online speech therapy for stuttering
[https://stamurai.com/blog/online-speech-therapy-for-stuttering/] or a speech
therapy app like Stamurai [https://stamurai.com/], it can help them solve this
issue completely.

Sometimes, it can even go away on its own. But, for many, the symptoms do not
start until they are older (between 7 to 12), and it becomes difficult to
reverse them.

Stuttering Misconception #5:  Stuttering is a Result of Past Trauma


There have been instances where severe emotional and/or physical trauma has
caused stuttering in a person. These could have been examples of psychogenic
stuttering
[https://ghost.stamurai.com/neurogenic-stuttering-vs-psychogenic-stuttering/].

Psychogenic stuttering is rare and is typically seen in young adults or adults.

Children who stutter typically exhibit signs and symptoms of developmental
stuttering.

Developmental stuttering
[https://ghost.stamurai.com/causes-of-stuttering-in-adults/] coincides with the
child's rapid learning of new language skills. Recent research shows that
anomalies in brain structure and function predispose a child to stutter.

Stuttering Misconception #6: You Can ‘Catch’ Stuttering from Hearing Other
People


Again, definitely not. You cannot get stuttering by imitating or spending time
with a person who does. It is not the flu or fever.

This condition can be because of family dynamics, neuromuscular development,
genetics, and even their environment.

If your child is imitating the stuttering by talking to a family member/friend,
they will eventually be bored with it. But, if they do continue to stutter, it
might be because of their genes or anomalies in their brain
[https://www.bbc.com/future/article/20200922-why-some-people-suffer-from-a-stutter]
structure.

Read: Stuttering In Adults: Treatment, Diagnosis, Symptoms & Causes
[https://stamurai.com/blog/stuttering-treatment-for-adults/] 

Stuttering Misconception #7: Bad Parenting is to Blame for Stuttering


Several people believe that stuttering is a result of emotional instability or
constant fighting at the home of a child. The truth is, stuttering has its cause
in the genes. And there is little parents can do to stop or alter genetic
expression.

Yes, undue stress, like watching parents fight a lot, or an overly competitive
household, can increase a child's stuttering, but stress can never cause a child
to stutter. Stuttering is NEVER the result of bad parenting.

Read: Best Stuttering Exercises To Help Your Child
[https://stamurai.com/blog/five-stuttering-exercises-to-help-your-child/]

Stuttering Misconception #8: It’s Okay to Complete Other Person’s Sentence


This is even more hurtful than asking them to take a deep breath before talking.

Dr. Drayna quoted, “Would you tell someone walking with a brace on their leg to
just walk better?”.

Similarly, you cannot complete the sentence on their behalf. This will affect
them by making them shy, hide their condition, and eventually become introverts.
Rather, understanding their condition can help them be open and assertive.

Read: For Parents: Steps To Help A Child Who Stutters
[https://stamurai.com/blog/parents-guide-to-help-child-who-stutters/]

Stuttering Misconception #9: Labeling a Child as ‘Someone who Stutters’ May
Worsen their Stutter


Stuttering cannot be made better or worse by identifying or labeling a child who
stutters.

Contrary to an infamous study that says otherwise, identifying someone who
stutters in their early years actually increases their chances of overcoming the
shame, fear, and anxiety related to stuttering.

Talking about stuttering openly can allow the child to learn more about speech
disfluency and speech disorders. It can allow them to grow as human beings and
not be defined by a speech disfluency.

Stuttering Misconception #10: Stuttering is Just a Bad Habit


Stuttering is not a habit. Chewing nails or cracking knuckles are habits!

Stuttering is an involuntary speech fluency disorder that a person cannot
control. Decades of research show that stuttering arises due to mutations in
multiple genes that cause multiple anomalies in the speech processing and
production centers of the brain.

Stuttering therapy involves weeks of intensive speech fluency techniques and
speech modification strategies, along with psychological counseling.

Admonishing someone for biting their nails may work, but scolding a child or
humiliating them for stuttering will only make them retreat from speaking.

Stuttering Misconception #11: PWS Always Stutter


Stuttering is not a binary condition. People who stutter (PWS) don't stutter
constantly or similarly all the time.

There may be times when a person doesn't stutter at all. These may include
instances like when they are talking alone
[https://ghost.stamurai.com/why-dont-we-stutter-when-talking-alone/], reading
out loud, or talking to a pet.

Then, there are people, who have become quite the perfectionist at hiding their
stutter.

They substitute words, avoid high-octane situations, and choose to remain quiet
to avoid stuttering. They practice covert stuttering and they mostly pass as
fluent!

Stuttering is a spectrum. Not everyone who stutters shows it at all times.
However, that does not make them "fake stutterers" or fluent.

Final Words


Stuttering is far more common and complex than you can imagine. 

But, when handled properly, given proper speech therapy, and practice sessions,
it is easily manageable and increases fluency. 

Check out our Stamurai app [https://stamurai.com/], which is a convenient way to
practice speech therapy whenever you want.

Read: Top Questions About Stuttering Treatment
[https://stamurai.com/blog/stuttering-treatment-faq/]

Stuttering: 11 Common Misconceptions Busted

Job interviews are arguably one of the most stress inducing moments in anyone’s
life. More so if you feel or think that you are unable to represent yourself to
the best of your abilities. In a culture where articulation is heavily equated
with intellect, the obsession with the appearance of skill can rob people with
speech defects of significant opportunities. The employer’s concerns might be
about the efficient communication between the team members. The best approach is
to ascertain the practical requirements of the job and what it entails in terms
of communication related issues.

Good communication is about more than just fluency. Fluency can be attained and
mastered. To be able to communicate is about one’s ability to listen and
empathize with people from different walks of life. It is about thoughtfulness
and sensitivity in both speech and actions. And who better to understand and
manage sometimes clashing personalities than someone who has learnt patience and
hard work through his/her life’s experiences.

Be honest with your interviewer
Stutterers should honestly address their speech impediment with the prospective
employer and discuss the various ways that might make them perform their duties
better. The impact if any that the speech disfluency might have on certain areas
of their job and how they might tackle it. People with speech disabilities can
have varied professions including high pressure jobs in sales, medicine, public
relations. One’s skills and intellect are certainly not defined by their speech
defect. However, hiding one’s stuttering can create a vicious and toxic cycle to
anxiety and fear that shall push back any progress made to attain fluency.

Approach the interview with confidence
Studies suggest that people who stutter are less likely to apply for a job that
they think will trigger their stuttering adversely. 70% believe that their
capabilities are misjudged and 28% strongly liken their not receiving a
promotion to their speech defect. In moments of self-doubt, it is pivotal to
remind oneself of the perseverance and diligence that you bring to the
workplace. The intuitive understanding of non- verbal and emotional
communication that makes stutters naturally superior managers.

Plan for the interview
While displaying your qualities and skills required for the position, an
interview is also an opportunity to learn more about the organization. A chance
to know about the energy and goals of the company and if it aligns with your
vision of yourself in the future.

Homework isn’t just for school anymore
Research the company or organization that you are interviewing for. If possible,
try to learn more about the person most likely to interview you whether it is
via a phone call or an in-person interview. You will know you are fully prepared
when you have a couple or more questions for the interviewer. This works as both
a brilliant presentation of your attention to detail and provides a framework
for your working relationship if hired for the job.

Employers who appreciate honesty and conscientiousness in their employees will
find in stutterers keenly intelligent and insightful members for their team.

Stuttering and Jobs - It’s what you say, not how you say it

Stuttering definition – in simple words
It is true that each one of us faces some form of disfluency while talking
especially when facing a particularly stressful situation, fending off fatigue
or speaking a new language. However, these do NOT qualify as stuttering or
stammering.

Only when these disfluencies make it difficult for a person to express
themselves and interrupts their flow of speech almost regularly does it become
stuttering. Stuttering is when disfluencies disrupt the forward flow of speech
due to their severity or high frequency
[__GHOST_URL__/understanding-degrees-of-stuttering-severity/].

Stammering prevalence
Stuttering is present all across the world, in all the cultures. We have
prominent figures in world politics, researchers, physicians, authors and, even,
singers, who stutter. Sadly, not all the factors that contribute to stuttering
are currently known to the scientific community.

Close to 5% of everyone stutters at some point in life. However, the prevalence
of stuttering
[https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935336&section=Incidence_and_Prevalence#:~:text=The%20prevalence%20rate%20for%20stuttering,age%20of%20the%20children%20included.] 
has been estimated to be about 1% according to new research published by Craig
et al. in 2002.

Stuttering core behaviours
Experts characterize stuttering by the unnaturally high frequency and/or
prolonged stoppages in speech. There are three core behaviours one can find in
the speech of people who stutter –

 1. Repetitions of sounds, syllables or monosyllabic words
 2. Prolongation of sounds
 3. Blocks or blockage of airflow in speech

Stuttering secondary behaviours
People who stutter often develop “management” tactics to bypass words they find
difficult to pronounce. The secondary behaviour of those who stutter primarily
consists of –

 1. Avoidance – entirely avoiding a word or syllable or consonant in the
    anticipation of stuttering. The person might use a synonym or avoid voicing
    his opinion/thoughts altogether if he or she anticipates stuttering.
 2. Escape – blinking of the eye, interspersing words with sounds like “uh,” or
    head nods that may help the person terminate a stutter. Escape behaviour can
    range from a simple blink to an elaborate twitch of the neck and facial
    muscles. Deciphering the escape behaviour of someone who stutters is
    incredibly challenging for the untrained eye.

Stuttering – Feelings & Attitudes
Emotions and attitudes
[__GHOST_URL__/channel-your-emotions-to-reduce-your-stutter/] are critical in
stuttering. Depending on how the people around a child, who stutters react, the
child can improve or show regression in their speech quality.

Those who stutter have difficulty in expressing their feelings and thoughts.
Their stuttering can become worse, if they face recurrently negative reactions
from their listeners. While fear, anxiety and embarrassment do not cause
stuttering, these emotional reactions can worsen a person’s core behaviours of
stuttering.

How does it start – when young 80% children recover.
In most of the cases, it is impossible to state when a child stuttered for the
first time. However, research shows that environmental pressure and emotional
distress can trigger a predisposed child to stutter. These environmental factors
can include moving to a new neighbourhood, family discourses, losing a best
friend or even bullying in school [__GHOST_URL__/reining-in-the-bullies/].

The incidence of stammering in children is about 5% although 75% recover without
any professional intervention.

How is it different from normal disfluency?
According to Frieda Goldman-Eisler
[https://en.wikipedia.org/wiki/Frieda_Goldman-Eisler] (1968), all normal speech
shows some level of disfluency. People intersperse meaningful words with “umm”,
“like”, and “uh”. While they do create disruptions in the normal flow of speech,
people often resort to them for the want of a better word to express themselves.

Such disfluencies are incredibly common in people who don’t stutter, as well as
people who stutter.

However, these disfluencies reduce the “naturalness” of the speech in people who
stutter.

What causes stuttering – genetics, sensitivity of child
According to modern research (Van Riper, 1982
[https://www.youtube.com/watch?v=oKV1ecN_QEM]), stammering is not a homogeneous
speech disorder. In fact, speech pathologists and therapists now believe that it
has an incredible heterogeneity.

However, modern methods of data collection and research have shed some light on
the different factors that contribute to disfluencies in speech.

 * Some children have family members (mother, father, or grandparents) who used
   to stutter. They might have a higher predisposition towards stammering than
   other children of the same age.
 * Childhood stress might be another contributing factor. Children between the
   ages of 2 and 5 years are most vulnerable to stammering. This is the period
   when most childhood stresses make their presence felt. (Joining kindergarten,
   moving to a new neighbourhood or making new friends).
 * The environment is another leading factor that can precipitate disfluencies
   in vulnerable children. Highly stressful environments like overly competitive
   households can contribute to stammering in toddlers.

Beginning stuttering in adulthood
Stuttering in adults is less common than it is in children. It can begin
suddenly in adults, who have never stammered before, with no familial history of
speech disfluencies. In such cases, it is known as late-onset stuttering or
acquired stuttering.

Here are the four reasons why stuttering may develop in adulthood –

 1. After an emotional trauma or psychological stress – although very rare,
    psychogenic stuttering occurs in people who have experienced sudden
    emotional setbacks or psychological trauma. PTSD can precipitate sudden
    speech disfluencies in adults who have no history of stammering.
 2. Physical trauma to the head – accidents, falls, and even cerebral strokes
    can result in neurological damage in the speech centres of the brain. There
    can be damage to the neuronal networks responsible for transmitting messages
    to and from the speech processing centres. Direct trauma to the brain and
    concussions can cause a person to stutter. Surgery and/or medication in
    relevant cases can reduce the severity of some forms of neurological
    stuttering. Neurodegenerative diseases like Alzheimer’s and Parkinson’s can
    also contribute to speech disfluencies among adults.
 3. Stuttering due to a medication – pharmacogenic stuttering is not rare among
    cases of acquired stuttering. Several medications can cause adults to
    stutter suddenly. Sometimes, changing the dose of a particular drug can also
    lead to speech fluency challenges. In such cases, stopping the consumption
    of the pharmaceutical compound or adjusting its dose can relieve or reduce
    stuttering almost immediately.
 4. Idiopathic causes of stuttering – in many cases, doctors, speech therapists
    and specialists cannot decipher the exact reason of stammering that occurs
    suddenly during adulthood. However, there’s no need to give up home just
    because the cause is unknown. SLPs can still help you re-acquire some level
    of fluency through regular speech exercises. Therapy may even help you
    identify the root cause and enhance your fluency over the next few weeks.

Stuttering in adulthood can be concerning, especially if you work in a position
where you have to deal with company communications or customer assistance. In
such cases, it is better not to hide your condition, but to speak with the
management. Seek help from your lawyer, check the medical policy of the company
you work with and make an informed decision about your future. Stuttering is no
reason to quit your current job, especially, if the work environment is
accommodating and supportive.

Managing and treating stammering: speech therapy
Stuttering can vary in severity (on a scale of 1 to 10, 10 being most severe)
irrespective of the person’s age. On one hand, the professional therapy takes
into account the severity of stuttering, and the age of the individual in
question, on the other they consider the clinical methods or approaches that can
work best for the individual.

In the case of children, stuttering can begin at the age of just 18 months. Most
children are unaware of their speech impediments and they do not develop a
negative attitude towards their speech disfluency or any secondary behaviours.
Speech therapists often find it easier to treat children and cure them of
stuttering with a higher rate of success as compared to adolescents and adults.

In most cases, adolescents already have strong negative feelings associated with
stammering. These feelings stem from the ridicule, condescension and, even,
anger they face while growing up with a stammer. It is not enough to offer
speech therapy, but SPLS also need to provide emotional support and necessary
counselling that can help them overcome their escape and avoidance behaviours.

Treating stammering in adults [__GHOST_URL__/treatment-for-stuttering/] is often
the most challenging since they have fully developed core and secondary
behaviours, along with a slew of negative emotions that come with stammering. It
is a long journey towards fluency for the adult and their SLPS that focuses not
only on their disfluency, causes of stammering and the triggers, but also
ameliorating the negative emotions that accompany stammering at a matured age.

Currently, there are hundreds of recognized speech pathologists, who follow
their most-trusted methods for the treatment of a stuttering.

Stuttering - Symptoms, Causes and Therapy

What is the treatment for stuttering?
Do you stutter? Or, is it your child, who’s showing symptoms of stammering? 
Stuttering [__GHOST_URL__/what-is-stuttering/] can make it extremely difficult
for anyone to express what they are feeling. Which is why getting help from a 
speech-language pathologist (SLP)
[https://www.asha.org/public/Who-Are-Speech-Language-Pathologists/] is extremely
necessary for those who stutter. Treatments for stuttering are most effective
when they are started in the earliest.

Treatments for stuttering vary depending on the severity and the age of the
person who stutters.

Treatment for a pre-school aged (2 to 3.5 years of age) child who stutters
Let us begin with the potential treatment for a child who stutters. The team
typically consists of the child, the child’s parents and other family members,
even their teacher and the SLP. The child’s treatment plan depends on the
following –

 * How much the child stutters
 * The child’s language and speech skills
 * The child’s reaction to their own stuttering
 * The impact of stuttering on the child’s everyday life
 * Others’ reaction to your child’s stuttering
   [__GHOST_URL__/stuttering-in-children-understanding-shame/]

The treatment approach includes either one or both of these strategies –

Integrated strategies
An integrated strategy involves the clinicians counselling the parents to reduce
their level of anxiety and fear about their child’s speech impediment. The
initial focus is always alleviating the concern of the parents and other family
members. It is also about understanding the concerns of individual family
members and guiding them towards making changes in family-child communications.

Direct strategies
During direct treatment, the SLP interacts with the child to understand their
fluency problems and facilitate improvement. Speech modification, stuttering
modification, and reduction of secondary behaviour
[https://ghost.stamurai.com/what-is-stuttering/] are parts of direct treatment for children
[https://ghost.stamurai.com/five-stuttering-exercises-to-help-your-child/].

Indirect strategies
Family members are the key players in indirect treatment approaches. The SLP
focuses on counselling the family members regarding necessary changes in the
child’s environment that can support fluency. It may include the reduction in
the rate of communication, and rephrasing sentences to facilitate fluency.

Treatment of stuttering in older preschool-aged children (3.5 to 6 years)
Children of this age may have begun stuttering very recently or may have been
stuttering for several months. Thus their parents are well aware that it is not
a transient speech issue. It is common for children of this age group to feel
negative about their stutter.

Typical core behaviour of this age-group includes partial repetition of words,
rapid and irregular rhythm of speaking, and some prolongations. The SLP may
notice excessive tension during the repetition and prolongations. Secondary
behaviour also become noticeable by the time the child is of older preschool
age. Such secondary behaviour may include rapid blinking, eye twitching,
twitching of the lips, head nodding and sudden increase in pitch.

However, strong fear is still absent from most candidates of this age group.

Charles Van Riper advocates the Lidcombe Program for older preschool-aged
children. The SLP teaches the guardians of the child to reinforce his/her fluent
speech. Only then the SLP teachers the parent how to respond to stutters. The
parent of the child who stutters is supposed to use varied and
situation-appropriate verbal contingencies after distinct fluent speech.
However, the parent must only use gentle comments on the child’s stutter. The
parent can also ask the child to repeat the stuttered word ever so gently.

The Lidcombe program involves several clinic visits with the child. During the
first visit, the SLP determines the severity score of the child’s stuttering.
All subsequent clinic visits involve multiple goals –

 * Assessment of the child’s current stuttering
 * Discussion of the child’s and parents’ progress
 * Introduction of new techniques, when the SLP deems it appropriate

Although the fluency goal of every individual who stutters tends to be
different, preschool-aged children who have only stuttered for months may reach
desired fluency or regain spontaneous fluency within a year or two of the
conclusion of the treatment.

Older preschool-aged children may not have any recollection of their stutter.
They may not require speech monitoring later in life as well.

Treatment for school-age (6 to 14 years of age) children who stutter
By the time a child reaches 6 years, their stuttering core and secondary
behaviours [__GHOST_URL__/what-is-stuttering/] are well developed. Therefore,
they require more-than-one goal-based approaches depending on their unique
necessities. Children of this age exhibit complexities in disfluent behaviour
since fear, anxiety, embarrassment and avoidance
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/] become part of their
habit.

The approaches for school-aged children and adolescents who stutter are
different from those used for preschool-aged children.

Strategies to reduce the impairment of body function
Most SLPs use a combination of speech modification and stuttering modification
to improve the fluency of a school-age child, who stutters.

Speech modification strategies may include –

 * Control of rate
 * Continuous phonation
 * Prolongation of syllables
 * Loose articulatory contact
 * Easy onset

Stuttering modification strategies typically reduce the speaker’s physical
tension. According to techniques introduced by Van Riper
[https://www.youtube.com/watch?v=oKV1ecN_QEM] in 1973, stuttering modification
helps the individual learn about speech mechanism during disfluencies and also
during a fluent speech.

Increasing their awareness about the speech mechanism and teaching them
self-monitoring skills can help reduce the frequency of stammering
[https://ghost.stamurai.com/stuttering-misconceptions/]. It can help children modify the
moments of stammering and make them less tense.

Reduction in avoidance of words
Children often cope with stuttering by avoiding certain words or introducing
interjections (“uh”, “um”). Speech therapy for stuttering can help children
increase the spontaneity of their conversations by improving their fluency. SLPs
work towards reducing avoidance behaviour [__GHOST_URL__/what-is-stuttering/] in
children and early teenagers so they can say exactly what they want to say and
the way they want to say it!

Reducing negative reactions
Desensitization, self-disclosure, cognitive restructuring and support are the
three main approaches that aid in reducing the negative reactions an individual
may associate with their stuttering.

 * Desensitization – the SLPs help individuals face their fear of stuttering in
   carefully structured environments. It prepares them for real-life situations.
 * Self-disclosure – it is popular as “Advertising” in the stuttering community
   and therapy sessions. It involves conversing about stuttering, how it affects
   the individual and offer advice on responding to an individual who stutters.
   For school-aged children, it is often achieved via a classroom presentation.
 * Cognitive restructuring – it is also referred to as counselling, where SLPs
   or therapists can help individuals, who stutter see themselves in a new
   light. They can learn to identify their negative emotions and attitudes, and
   their influence on their speech.
 * Support – it can be in the form of group activities, daily exercises within
   the family or structured venues for practising activities the individual has
   learned from the sessions with the SLPs.

Encouraging approach behaviours in individuals who stutter
SLPs don’t restrict treatment inside the therapy room. It is important for the
child to find the courage and confidence to display their acquired speech
strategies and participate in discussions outside the treatment room. Often
phone conversations and video conferencing techniques are used by SLPs to
encourage a child’s generalization activities.

Treatment of stuttering for teens and adults who stutter
The treatment for teens and adults
[https://ghost.stamurai.com/stuttering-treatment-for-adults/] who stutter can be long-term
and intensive because their core and secondary behaviours
[https://ghost.stamurai.com/what-is-stuttering/] are more difficult to alter as compared to
children. Teenagers and adults can opt for treatment on an individual or group
basis.

Currently, the individual may opt for treatment that offers the following forms
of therapy –

 * Block modification – The goal of this treatment is not to achieve complete
   fluency, but to help the individual stutter with more ease.
 * Avoidance reduction – The aim is to enable the individuals to accept their
   stuttering and give them the confidence to speak in situations that they
   would rather avoid.
 * Fluency modification – Slowed speech and prolonged speech are popular
   treatment techniques SLPs use for adult and teenage clients. The aim is to
   replace stuttered speech with a prolonged or slowed speech in the clinic set
   up and then extend the techniques outside the treatment room.
 * Psychological approaches – Personal construct therapy (PCT)
   [https://en.wikipedia.org/wiki/Personal_construct_theory] and cognitive
   behavioural therapy (CBT)
   [https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/]are two of
   the most sought after ways that help the client reflect upon the influence of
   stuttering on their life. It is especially necessary for teenagers and
   adults, who may have already faced considerable ridicule, differential
   treatment and bullying at high school or work due to their speech
   disfluencies.

Treatment for stuttering at any age share a few common goals which include the
improvement of fluency, increasing their understanding of stammering and share
their experiences with fellow individuals of similar age who stutter as well.

Stuttering Treatment

An act of aggression need not be verbal or physical to be bullying. It can be a
vindictive, non-verbal act of condescension and intimidation. Silent knives cut
the deepest and as a child the cross of social and peer alienation is heavy
indeed to bear. As a child who stutters, social interactions in school and on
the playground are difficult as it is. But if further complicated by bullying
and teasing, it can make them retreat into a shell of loneliness and isolation.
As parents of children who stutter, these interactions can further frustrate the
progress you have made with your child in accepting their speech defect.

We can hope and envisage a future where children do not have to deal with the
trauma of bullying but as things stand now, we can’t eliminate bullying. We can,
however, empower children who stutter to respond with confidence to such crude
behavior. Parents and speech therapists can help stutterers acknowledge being
bullied and help diminish its adverse effects.

Acknowledge and Educate
Acceptance is the first step towards improvement. As parents of a child who
stutters, you must first acknowledge your child’s speech defect. Only through
your acceptance and encouragement will he/she acknowledge it and learn never to
be ashamed of it. Secondly, as parents, teachers or speech therapists of a child
who stutters, it is your job to provide a safe environment for the child to
admit that he/she is being teased or bullied.

Educating a young child about his/her stutter and how it is simply a result of
their genetics and in no way their fault is extremely important. As teachers in
a classroom setting, it is important to educate the other students about
stuttering and speech defects. This reduces the confusion and sense of
alienation that surrounds it and can reduce bullying. It certainly helps the
young child feel as though he/she can confide in their teacher without fear of
ridicule.

Seek Help
It takes a village to raise a child, especially if the child is highly
intelligent and sensitive as most children with speech defects tend to be.
Trained and experienced speech therapists who work with young children can
notice and recognize signs of bullying. Teachers can notice a child’s inclusion
in his/her peer group. As parents of a child who stutters or stammers, it is
important to build a healthy social network amongst the various adults who play
significant roles in your son/daughter’s life. Lead by example and surround your
child with self-assured adults who value his/her opinions. Build his/her
self-esteem and arm your child with the tools to face the harsh realities of
life.

Humor as a weapon
Bullies are cowards at heart. And the best way to deal with a coward or display
his/her cowardice is with humor. Speech therapists and parents can work with
children and teach them how to use wit as a weapon. Humor can help a child who
stutters overcome his natural shyness in social interactions and handle peer
pressure better.

Reining in the Bullies

Is stuttering gender specific? Yes. Well… it is certainly biased in terms to
inheriting the condition, recovering from it, and social roles that it imposes.

Genetic pre-disposition
Speech defects like stuttering are a result of a lack of control of one’s
sensory- motor reflexes. This structural anomaly of the motor and sensory
regions of the brain has been traced to different factors. Whether it is a
combination of genetic and environmental factors or the inheritance of X-linked
chromosome remains unclear. However, statistics state that the chances of the
men who stutter are to transmit the condition to their daughters is 9% whereas
for their sons, it is a staggering 22%. Women who stutter are likely to pass the
pre-disposition towards stuttering to 17% of their daughters and 36% (roughly
double) of their sons. Thus, mothers are more likely to pass down the genetic
anomaly to their children, of whom men are more likely to inherit the speech
impediment than women.

Difference in Brain Structure
The structural anomalies between the two hemispheres of the brain that has been
attributed to speech defects also differs among men and women. Scientific
studies with the help of functional magnetic resonance imaging (fMRI) and
diffusion tensor imaging of the brain structures of male and female stutterers
illuminate the differences. There exists significantly higher connectivity
between the two brain hemispheres in women who stutter that it does in their
male counterparts.

Recovery Rates
Of all the reported cases of young infants and children who stutter, 80% recover
from the impediment. Either through hard work and the help of speech therapists
or naturally (without treatment, which occurs exceptionally rarely). Of these
80%, most are women whereas men carry the speech defect into adulthood. As
children, the sex ratio of men and women who stutter is 2:1 respectively.
However, among adults the men who stutter to that of women is 4:1.

Whether women are resistant to inheriting speech defects, neurologically better
equipped to recover, or their cases remain unreported and undocumented is an
important topic of scientific inquiry. Gender, however, remains one of the most
distinguishing and significant factors for the predisposition towards stuttering
and other speech impediments.

Is Stuttering Gender Specific?

Our well-being, our happiness, and our sense of self is intrinsically tied to
being able to express our emotions, our anger, experiences and memories. And
knowing that someone is listening, who holds it in regard, is interested, cares.

The human need for love and acceptance resides in everyone. So does the fear of
embarrassment, exclusion, and depression. For people with speech defects like
stuttering, the fear of isolation from family and friends and the possibility of
depression is further exaggerated by the constant threat of not being able to
communicate.

The first step towards recovery perhaps is the acceptance of one’s problems.
Identifying it and allowing yourself to seek a life that doesn’t feel numb and
isn’t dictated by fear. The stigma that society unfairly associates with speech
defects and with depression can be crippling and can stop people from
acknowledging that they need help.

It is okay to need help. It is okay to ask for it. Whether from a speech
therapist, a therapist, family member or a friend. No one simply snaps out of
depression. It takes time, might take years. Be kinder to yourself. You need not
feel guilty and it most certainly is not your fault. As difficult and painful as
it might be, talking about depression takes the hurt and shame out of the
condition. Afterall, it is a clinical/medical condition. One that can be cured.

As children who stutter transition into adolescence, they become more vulnerable
to depression and other psychological difficulties. The fear of bullying,
negative reactions from their peers keep them from seeking help. Adult
stutterers suffering from depression have carried this habit of stifling their
emotional needs to ‘fit in’.

Do not be stifled by your need to conform to what society deems suitable. Do not
let your mind imprison your future. Because, irrespective of how you tell your
story, the people who love you, will listen. They do care.

Stammering - Step Back from the Abyss of Depression

Addressing a crowd, holding their attention, and introducing or explaining an
idea is frightening as it is. But, for someone who stutters, their anxiety about
their speech can amplify the fear and difficulty
[https://ghost.stamurai.com/overcome-stuttering-fear-and-insecurity/].

After all, despite numerous public figures acknowledging their disfluency, the
sense that stuttering is less than permissible in public persists. Whether
speaking on stage at a conference or presenting a project in a classroom, public
speaking can be a daunting task.

How to Stutter Less During Public Speaking?
1. Don’t try to hide your stutter
What happens when you stutter publicly? According to Lon L. Emerick, he once
worked with a student in Lansing, Michigan. She had a debilitating stutter that
kept her from speaking in a group.

He told her to find and approach as many people in the next week and show them
her stutter. Essentially, it was a voluntary stuttering
[https://pubmed.ncbi.nlm.nih.gov/15129746/] exercise. By the end of the week,
she had approached 947 listeners and she had stuttered as much as she could.

She was exhausted, yes. However, her stutter had completely evaporated too. She
could no longer stutter involuntarily!

According to Emerick, trying to keep your stutter a secret from the audience is
a burden. The harder you try, the more difficult it becomes to proceed with the
speech smoothly.

2. Note the reactions of listeners
When you are approaching new listeners, you will notice a wide range of
reactions.

Studies show that most people may feel visibly uncomfortable when the speaker
begins to stutter, but they are also empathetic. As per the experience of
speech-language pathologist (SLP) Nichole Lowenbraun, when she followed her
professor’s instructions to stutter on purpose in a public place, she found that
listeners were encouraging, helpful, and patient.

Overall, people showed tremendous empathy and patience.

If you ever decide to try this exercise, you will realize that listeners don’t
care that you stutter as long as you have something meaningful to say to them.
They may even try to help you by completing your sentences or trying to find the
right words. It’s not an insult, especially, when you are talking to a stranger.
It shows how much they are trying to understand the daily struggle you face
during communication.

3. Own your Stutter
Even when all eyes are on you, you are the one in control of the room. 
Acknowledging your stutter
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/] 
allows you to relax into the presentation or speech without the fear of losing
the audience’s attention.

Audiences, small or big, want you to succeed when you have the floor. You can
capitalize on it.

Show them that irrespective of your disfluencies and pauses you will say what
they have come to hear. Don’t feel guilty if you need a moment to gather
yourself. Everything good in life comes after a brief period of waiting!

4. Passion Trumps Fear
A great idea that excites you is infinitely easier to talk about and discuss
than something prosaic and irrelevant. 

Being passionate about a subject doesn’t mean that your stutter won’t resurface.
However, it can ensure that the conversation will be more enjoyable. It shall
certainly be memorable.

5. Ashes to Gold
What is the worst-case scenario? A slip of the tongue, a mistake in your speech,
or a hostile audience can be handled with humor and sincerity.

Get comfortable in the room where you are to give the presentation (or speech)
and practice in it.

Good communication skills are more than just fluency. It is about eye contact,
voice modulation, posture, and confident body language. Fluent speakers aren’t
necessarily good communicators. When speaking in public, people with or without
speech strive to engage their audience.

6. Practice Positive Visualization
Positive visualization can help you overcome stage fright before a big event.

Several studies show that when PWS visualize themselves giving a smooth
performance on-stage, they are more likely to talk with higher fluency than
those who don’t use positive visualization.

You may try another form of positive visualization that’s similar to Sherlock’s
“Mind Palace” technique.

Create a mental space that makes you feel safe, comfortable, and confident. It
can be the visuals of your pets, children, or friends. Anything that can calm
your nerves before the speech can help in positive visualization.

7. Practice Giving the Presentation
When at home, create an audience for yourself. Ask your friends to give you 20
to 30 minutes per day. Request your family to be present when you speak.

Most of us who stutter, don’t stutter while speaking alone
[https://ghost.stamurai.com/why-dont-we-stutter-when-talking-alone/]. So, we
need an audience, whether real or virtual to create the right ambience. Speaking
in front of more than one person can trigger our stutter.

You can get constructive feedback on many things such as the contents of your
speech/presentation as well as your body language and communication style. . You
can also ask for feedback on your fluency after you have rehearsed your speech
for a couple of days.

Asking for feedback right away might dampen your spirits
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/], because
none of us can truly give the perfect speech on the first try.

Our suggestion is - practice a couple of times out aloud before you go on Zoom
or Duo, or invite your family for a sit-in.

8. Record Yourself Giving the Speech
Are you curious about how the audience may perceive your speech? The best way to
test it is by recording yourself
[https://ghost.stamurai.com/why-dont-we-stutter-when-talking-alone/] at home.

Once your speech is almost ready, whip out your phone and turn the video
recording on. It may feel a little weird at first. However, it is one of the
best ways to evaluate one’s speech and delivery style.

Record yourself after you have rehearsed your speech a few times.

Go through the recording to identify the words that make you hesitant/nervous
and trigger your stutter. Apply techniques
[https://ghost.stamurai.com/stuttering-exercises-for-adults/] like easy onsets,
light articulatory contact, and deep breathing to make your speech more fluent
the next time.

Record yourself once you have applied these techniques. Mark the differences.

Make notes in your speech which detail the pauses, inclusion of pacing or
rhythmic speaking and other fluency techniques.

Maybe, take a page out of Biden’s
[https://ghost.stamurai.com/joe-bidens-stutter-and-life/] speech material that
he shares with Brayden Harrington
[https://www.nbcnews.com/politics/2020-election/when-joe-biden-met-brayden-how-chance-meeting-led-stirring-n1237705] 
during his tour.

9. Familiarize Yourself with the Presentation Space
‘Winging it’ is something even the best of the best speakers and stage
personalities DON’T do during events.

Everyone tries to squeeze in a “dress rehearsal” just like the old times in the
theatre. It is not paranoid to want to check out the presentation space before
the big speech.

When you stand on the dais, you know exactly how many steps to the right or left
will make the audience feel seen. You will know how to utilize the entire stage
especially if it’s big and you are expecting a larger than regular audience.

Nothing is worse than sound problems on top of speech disfluencies. When you
have put in so much of hard work to smoothen out your speech, then why not make
sure your sound equipment doesn’t malfunction while you are addressing the
crowd?

10. Exercise Patience
On some days, stuttering seems to be worse and each person who stutters knows
that.

If you are having such a day, just remember to be kind to yourself. Have a
little patience
[https://www.stutteringhelp.org/blog/stuttering-requires-patience-and-adaptation]
.

Do some breathing exercises, meditate and do something that relaxes you. You can
take your dog for a walk, cook or bake something at home, read your favorite
book, or watch an inspiring movie.

Don’t just give up right away.

After you have relaxed a little, get back to practicing stuttering exercises.

Once you have finished your exercises and warm ups, try rehearsing your speech
again!

11. Practice Body Movements That Channel Nervous Energy
Even when you have your speech memorized and the kinks in your speech smoothened
out, you may get the jitters.

Nerves can take over irrespective of how well you have prepared your speech. You
may realize that even when testing your speech in front of your friends and
family.

Butterflies in your stomach. Blood rushing to your face. Cold and clammy hands.
These are the typical signs of feeling tension before a performance. And that’s
perfectly alright. Even the best speakers and performers get them!

So, what can you do to stop your nerves from interfering with your speech?

Try channeling
[https://ghost.stamurai.com/channel-your-emotions-to-reduce-your-stutter/]your
energy through movements instead. Practice pacing, and using one or both hands
(depending on the type of microphone you will be using) to let the excess energy
flow out.

Getting a little exercise every morning, and some meditation can also help you
channel the nervous energy right out of your body before it interjects your
speech.

12. Get Enough Rest on the Days before the Presentation
We have all pulled all-nighters before our finals in high school or grad school.
However, that was quite a while ago.

If we try the same today, we will be tired and that will reflect on our speech.

Studies
[https://www.researchgate.net/publication/289182077_Rest_and_reaction_time_to_speech_Comparison_of_stuttering_and_fluent_speakers] 
show that our fluency depends on how much rest we allow ourselves the night
before the event. Nothing can replace 8-hours of sound sleep. No amount of
coffee can make up for a jittery night that you have spent going over your
speech time and again.

Make it a habit to go offline as soon as you finish office work. Don’t drink
caffeinated drinks after 7 pm. Rest your eyes by keeping the TV switched off and
using a blue-light filter on your phone. You can also get blue-light blocking
glasses for yourself.

Minimizing your exposure to blue light will help you fall asleep faster. You
will sleep more soundly than before.

Keep an alarm exactly when you intend to wake up and refrain from hitting snooze
too many times.

You will be amazed to see how much of a positive impact a good night’s sleep can
have on speech fluency.

13. Keep Notes Handy When You Go on Stage
No speaker goes on stage without a set of notes. You may have your speech
memorized, but keeping cue cards handy can help you pick up if there’s an
unexpected interruption on-stage.

Highlight the important portion of your speech, and print cards out for each
slide. Using images, slides and videos during your presentation will keep the
audience engaged.

Keeping your notes handy will help you minimize the effort of memorizing every
small bit on your part. You can focus on your fluency, body language and
delivery since you know you have the cues to fall back on!

Which Exercises Can Help You Speak Fluently and Confidently During a Public
Speech or Presentation?
Out of the several exercises you can do to reduce your stuttering, these are a
few you can master and practice regularly at home. These are parts of any 
treatment for stuttering
[https://ghost.stamurai.com/stuttering-treatment-for-adults/] and they can help
you stutter less during your big speech -

1. Deep Breathing or Costal Breathing
Costal or deep breathing can help you relax. It can reduce the tension in your
vocal cords and articulators.

What we typically do is breathe shallowly. Only our shoulders move when we do
so. Costal breathing means you take a deep breath in and exhale slowly.

One of the easiest ways to master costal breathing is by placing one hand on
your belly and the other on your chest.

When you inhale, you should feel your belly rise significantly. This happens
because the intercostal muscles expand.

Exhale slowly. Try to feel your belly fall and chest rise when you let the air
out.

You can apply this technique during easy onsets, continuous phonation, and other
stuttering techniques to maintain fluency during your speech.

Dedicate 10 minutes every morning to practice deep breathing. It will induce
fluency and it will calm your nerves by enabling you to focus on your breathing
pattern.

2. Speaking After Exhaling A Little
Couple your costal breathing exercises with this technique. When air is
naturally flowing from your lungs through your larynx, your vocal cords should
be relaxed.

It is much easier to speak with fluency when your vocal cords and articulators
are relaxed.

Try to inhale till you feel your belly rise to its fullest extent. Then exhale a
little bit slowly and begin talking.

Practice this every time after costal breathing.

Include pauses and breaks in your speech where you can breathe deeply, and begin
speaking once you have exhaled a little bit.

3. Rhythmic Speaking
Speaking with a rhythm is a popular technique among many speech therapists and
speakers who stutter.

It’s almost impossible to stutter when one is singing. Rhythmic speaking is
similar in concept. You need to find and apply a constant rhythm to your speech
while speaking. You can choose to add a subtle melody
[https://ghost.stamurai.com/stuttering-and-singing-what-we-understand/] as well
if you think speaking in a sing-song voice is something you can pull off.

The relevant information is shared at 2:09 minutes in this video.You need to
maintain a regular beat. You can tap your foot, hand, or even a finger to each
syllable. It is a fluency-inducing exercise that can help you reduce or even
overcome your stuttering while speaking.

Practice this every day during your speech. Mark the syllables and feared words,
if necessary. Putting some rhythm into your speech may be all you need to remain
fluent and confident during your speech.

4. Easy Onsets
Easy onsets are particularly useful for words that begin with a vowel. When
saying a word that begins with a vowel, you can try to add a small /h/ sound
before it. For example, instead of saying, “apple” you can try saying
“hhh-apple.”

When you do that, you will notice that you need less force to get the word out.
That happens because when you add the /h/ sound your vocal folds are far apart,
allowing you to phonate easily.

Gradually shorten the /h/ sound like this – “hhh-apple” to “hh-apple” and
eventually, “h-apple.”

Adding the small /h/ sound can make all the difference. It will allow the air to
pass from the lungs through your larynx.

You should also try this when you are exhaling after a deep breath. It will help
your vocal cords relax and make vowel sounds with lesser effort. Keep practicing
this and soon you will see that you can apply easy onsets to particular words in
your speech that you find difficult to pronounce.

5. Light Articulatory Contact
Light Articulatory Contact (LAC) is a useful technique for pronouncing words
that can stop the airflow. For example, words with b, p, d, g, t, and so on.

You can apply LAC to words that begin with a hard consonant like Permit, Top,
Dump, Gut, and Bottom.

You may get stuck on a word like “permit” if you press your lips too hard. Try
to take one deep breath and initiate the word while making a light contact on
“p.”

LAC should work on all words in your speech that begin with hard consonants. You
may even be able to pronounce your most feared words without any block during
your public speech.

6. Bouncing
Bouncing is effective as a stuttering modification technique
[http://www.stutteringsource.com/blog/the-411-on-easy-bouncing] that you can use
on-stage. People who stutter often repeat words or parts of words with hard
consonants.

For example, while saying “tomato” you might get stuck on the initial “tuh”
sound. Such that the word comes out as “tuh-tuh-tuh-mato.”

As per this technique, instead of avoiding the stutter, you gain the impetus
from the repetition to move forward. All you have to do is instead of making the
“tuh” sound you need to try to make a “taa” sound.

Combine it with speaking while exhaling to successfully say “taa-taa-taa-mato”
instead of becoming stuck on “tuh.”

This technique will help you slide into difficult, and feared words
effortlessly, even when speaking in front of people.

7. Use an App to Monitor Your Speech and Progress
Stamurai [__GHOST_URL__/stamurai-app-to-stop-stuttering/] uses
analytics and machine-learning algorithms to offer users customized training
plans. You can use the exercises daily to improve your speech.

Stamurai is a speech therapy app that allows users to track their progress.

It is a state-of-the-art stuttering therapy app that features practice sessions,
breathing exercises, customized training plans, and guided meditations.

Join group video calls to test your improvement and gain valuable feedback on
your progress. Stamurai can help boost your confidence before the big event.

You can also opt for online speech therapy for stuttering if you want 
one-on-one
therapy [https://stamurai.com/blog/online-speech-therapy-for-stuttering/] from
the comfort of your home.

Public Speaking With A Stutter: Tips & Exercises

“Oh, you should just speak slowly,” “maybe it’s the anxiety getting to you”-
children who stutter have heard these suggestions ad nauseam.

Do they help reduce their stutter? No. Does it make them become more conscious
of their speech disfluency? Yes!

The truth is anxiety, fear, or shyness do not cause stammering
[https://ghost.stamurai.com/what-is-stuttering/]. Children who stutter or
stammer may do so more frequently when they have to talk in front of their
classmates, new people or unfamiliar situations. However emotions do not
precipitate stuttering [__GHOST_URL__/stuttering-misconceptions/].

Modern sciences have found multiple mutations on several chromosomes that
correspond to stuttering. These mutations can be heritable, although the male
population is more susceptible to stuttering than the female population. 60% of
the people who stutter have a family history of stuttering.

So, is there anything you can do to help a child
[https://stamurai.com/blog/parents-guide-to-help-child-who-stutters/] who
stutters? Well, of course. You can, for instance, help your child practice
stuttering exercises at home.

[https://stamurai.app/z4HKmlNXigb]Before we start discussing the top stuttering
exercises to help your child, let's understand the basics.

Why Is Stuttering Common Among Preschool-aged Children?
In the case of preschool-aged children who stutter (CWS), speech therapy,
regular speech exercises and practice can reduce and may even eliminate
stuttering [__GHOST_URL__/how-to-stop-stuttering/]. Stuttering is
common in children between the ages of 2.5 years and 3 years, when they are
acquiring their language skills at an incredible speed. Such stuttering is known
as developmental stuttering
[https://ghost.stamurai.com/causes-of-stuttering-in-adults/], and it is common
in children; it disappears on its own within a few months.

Many speech therapists recommend waiting and observing a child’s speech if s/he
has been stuttering for significantly less than 6 months. If they have been
stuttering for more than 6 to 12 months, parents of CWS should seek the help of
a speech-language pathologist or speech therapist.

Who Is At A High Risk Of Stuttering?
Stuttering or stammering is quite common. According to experts, many children
experience stuttering when learning a new language or expanding their vocabulary
at a rapid pace. Children outgrow their stammering on their own in many cases,
but it might become a lifelong condition for some. High risk factors include –

 * A family history of stuttering.
 * Incidence of stuttering for more than 12 months.
 * The child is male [__GHOST_URL__/is-stuttering-gender-specific/]
   . Girls recover faster. A girl who has been stuttering for more than 12
   months is at a higher risk of persistent stuttering.
 * A child who begins stuttering later (onset after 3.5 years of age) has higher
   chance of persistent stuttering.

Children on the autism spectrum
[https://ghost.stamurai.com/stuttering-and-autism-spectrum-disorder-diagnosis-and-treatment-in-children/] 
have a high risk of developing stuttering at an early age. Other disorders and
conditions that co-occur with stuttering
[https://www.researchgate.net/publication/10572760_Co-occurring_disorders_in_children_who_stutter] 
include ADHD, Tourette’s Syndrome (TS), hearing impairments, central auditory
processing disorder, and cerebral palsy.

How Will You Know If Your Child Is Stuttering?
Developmental stuttering has a few signs that are hard to miss. These symptoms
of stuttering include –

 * Difficulty in starting a word, sentence, or phrase
 * Repetition of a syllable, an entire word, or a particular sound
 * Breaking of words or undue pausing, and missing syllables
 * Prolongation of parts of words or entire words
 * Adding sounds like “um” or “uh” at the beginning of the next word

Along with these signs, you can also notice the following –

 * Twitching or trembling of the lips and/or jaw
 * Tightening of facial muscles
 * Clenching fists
 * Rapid and abrupt blinking
 * Jerking of the head

If a child experiences physical duress while trying to get the words out, it may
signify a serious stammering
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/] 
problem. You may also notice their voice changing pitch and rising with each
repetition.

These are the signs that you need to take proactive measures
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/] to help
ease your child’s stuttering instead of waiting for it to ride itself out.

What Should You Do If You Notice Your Child Stuttering?
You should seek the help of a speech-language therapist. It might sound
intimidating, but speech therapy for children can consist of quite a few simple
stammering exercises at home moderated by their parents.

In many cases, the SLP takes an indirect approach and talks to the parents and
other members of the family.. The stuttering treatment for kids aims at reducing
the family’s concern and altering their family-child interactions.

[https://stamurai.app/z4HKmlNXigb]What Are Some Exercises Parents Can Do With
Children To Reduce Stuttering?
At Stamurai [https://stamurai.com/], we are always here, to help you understand
speech therapy for stuttering and its implications. Here are some of the most
common activities your SLP might ask you to do with your child –

1. Adopting a Slower Rate Of Speech With Pauses
A slower rate of speech has two purposes –

 1. It serves as a model for your child. S/he can learn what a more fluent and
    smoother way of speaking sounds like.
 2. It makes your child feel less rushed. They realize they can take more time
    to respond and be more fluent
    [https://www.tandfonline.com/doi/abs/10.3109/02699206.2014.1003970?src=recsys&journalCode=iclp20]
    .

Here’s how we sound most of the time while holding a conversation with a fellow
fluent adult – “hey, howryoutoday?”

While talking to your child, you might want to talk like this “Heey, How aare
yoou today?”

You can also add more pauses to your speech to make it slower, but sound more
natural. So, instead of your usual rushed speech, try to…taallk…more like…this.
The…slight pauses…throughout your speech…will make you…sound more…relaxed…and
calm.

You can also try to stretch the first word of every sentence “aaaaas you play or
converse with your child.” Adding the extra stretch to the first word will show
your child how to ease into a word and embrace fluency naturally in
conversations.

2. Introducing Syllable-Timed Speech
Syllable-timed speech (STS) technique can reduce your child’s stuttering by
almost 96% in around 12 months. However, it only works if you practice it with
your child every day!

Here’s how you can include syllable-timed speech in your daily conversations
with your child –

Speak. like. this. Each. per. iod. rep. re. sents. a. break. in. the. syll. a.
bles. of. the. words. in. a. sent. ence.

Children under the age of 6-years can reduce their stuttering by 96% if they
practice syllable timed speech for 10 minutes, 4-6 times per day for 12 months.

It might be difficult for you to syllable-time your speech in daily
conversations. You can master it easily before you try it with your child by
tapping your leg for each syllable.

You can learn more about STS from this video 

If you feel weird speaking with syllable-timed speech at first, it’s completely
understandable. Keep your voice normal and speak at a normal speed. Simply think
of it as adding “finite limits around each syllable” during your daily
conversations.

3. Trying Reduced Demands
A child who stutters, finds it difficult to start a conversation spontaneously.
All we need you to do is dial down the demands around speaking.

Research on child psychology shows that asking too many questions can make your
child feel stressed or anxious, which can worsen his or her stuttering. So let
them share their emotions, knowledge and experiences spontaneously.

Allow your child to take the lead on what they want to discuss, play or watch.
Do not finish their sentences or guess what they’re trying to say. Give them the
time to finish their own sentences
[https://www.huffpost.com/entry/stuttering-advice_b_6740732].

Instead of asking them questions, make close-ended comments. For example,
instead of asking “hey, what are you playing there?” you can say, “I see you are
playing Minecraft.”

Learning comes naturally to children and there’s little reason to believe that
not asking enough questions will set his or her learning process back.

4 Adopting New Verbal Responses
Verbal responses are like giving your child feedback on their speech. Since
children’s brains have high plasticity (ability to learn new things), they can
learn to speak fluently even when you don’t teach your child complex speech
therapy techniques.

Here are the five verbal responses you can use while talking to your child –

When they are fluent –

Make sure to praise them. Say “that was great buddy”, “hey, no bumps” and “I’m
loving your smooth speech man.”

You can ask them to evaluate their own speech like “do you think that was better
than before”, “was that smooth.”

Acknowledge their smooth speech by saying “That was really smooth,” and “smooth
again.”

When they are having a bad day or stuttering, you can –

Acknowledge their stutter by saying something like, “that got stuck there a
little” or “that was a difficult word.”

You can ask for self-correction. “Can you say that again for me?”

However, not every child reacts positively to comments on their stutter or
self-correction. If your child reacts negatively, simply drop it.

Stick to positive verbal responses only. Make sure you give them at least 5
positive responses for every 1 comment on their bumpy speech.

5 Increasing Listening Time
Children who stutter have trouble expressing themselves. Having a family member
lend a listening ear can make a significant difference in the child's attitude
towards his or her own speech. Be sure to dedicate some "listening time" each
day for your child.

It can be after play school when they have a lot to share about their
experiences, or right before the child heads out for their playtime. Quality
listening time lets your child know that you “are there” for him or her although
you should intentionally make sure not to make suggestions or give instructions,
especially on their speech during this time!

Attentive playtime with the child can show significant improvement in a child’s
speech. For example, mirroring a child’s expression during the playtime with
vocal cues, like sounds of disappointment when the child’s face shows the same
emotions can build confidence in the child, in the long run.

You should let your child lead you during the interactive playtime which should
also be unstructured, spontaneous, and enjoyable for your child.

[https://stamurai.app/z4HKmlNXigb]Wrapping It Up

When your child is showing symptoms of stuttering which includes repetitions,
prolongations, and blocks, you should immediately consult a reputed speech
therapist [https://stamurai.com/blog/online-speech-therapy-for-stuttering/]. A
professional will take into account your child’s predisposition towards
stuttering, the severity
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/]and
suggest stuttering treatment(s) accordingly.

These stuttering exercises are commonly suggested by speech therapists.
Practicing them at home can help your child attain more fluency and confidence
while sharing their thoughts.

Best  Stuttering Exercises to Help Your Child

A significant number of adults have persistent stuttering characterized by
repetitions, blocks and prolongations. Stuttering treatment for adults primarily
consists of fluency enhancement and stuttering modification techniques alongside
counseling sessions.

Although stuttering treatment for adults usually takes more time, it is also
effective, since the treatment methods are direct. An adult client can take
responsibility and track their progress during the course of the therapy.

Stuttering treatment is an intensive process. Advanced stuttering not only
requires the attention of a good speech-language pathologist (SLP) but also a
cognitive behavioural therapist (CBT) or psychological counsellor.

Symptoms of Stuttering
Repeated words, syllables or sounds along with the disruption of the normal rate
of speech characterize stuttering. Repetitions, prolongations and blocks
comprise the three core behaviors of stuttering.

The stress from stuttering may contribute to secondary behaviors like -

 * Physical symptoms [https://www.asha.org/public/speech/disorders/stuttering/] 
   like twitching of the lips, blinking of the eyes and tension in the face or
   upper body
 * Frustration or aversion towards face-to-face communication
 * Pausing before beginning to speak
 * Rearrangement  or replacement of words in a sentence
 * Pausing abruptly or hesitating before starting a dialogue
 * Difficulty starting a sentence or uttering particular sounds

Secondary behaviours of stuttering in adults are much more complex. Adults have
acquired and perfected them through years of practice. Avoidance and escape are
difficult to detect in adults who have been stuttering for more than a decade or
two.

Most children who stutter are either unaware of their speech disfluencies, or do
not feel frustrated by their stutter. Kids, especially preschoolers
[https://ghost.stamurai.com/stuttering-in-preschool-kids/], hardly show any secondary
behavior of stuttering.

In some cases, adults may even successfully suppress their stammering by using
synonyms or reconstructing an entire sentence. While these are common among
adults who stutter, these aren’t always intentional behaviors.

The negative emotions and attitudes are stronger in adults who stutter than in
children. Negative reactions from listeners contribute to the increasing
negativity among adults who stutter.

Negative attitudes may manifest in the form of withdrawal from social
situations, damage of self-esteem and/or reduced self-confidence.

How Does an Expert Diagnose Stuttering?
The differential diagnosis of stuttering should only be made by professionals.
Only a doctor, speech-language pathologist (SLP) or speech therapist can
diagnose stuttering and its type.

Since stuttering may have different causes, it is important to consult a
healthcare professional for the correct diagnosis.

An SLP may perform several assessments including speech rate analysis,
stuttering severity tests and language skill tests before arriving at a
conclusion. The diagnosis will depend upon multiple factors including the age of
the individual, their family history and the severity of stuttering
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/].

The SLP will also determine how the disorder affects the person’s mental health,
social skills and their overall ability to function.

Stuttering is a childhood-onset fluency disorder. According to DSM V
[https://www.apa.org/monitor/2014/07-08/stuttering-dsm], it has a couple of
diagnostic criteria.

 1. Disturbances in the flow of speech and interruptions that are unsuitable for
    the person’s age and/or linguistic skills. These should persist over time
    and should have one or more of the following traits -

 * Repetitions of sounds and syllables
 * Prolongations of vowels and consonants
 * Pauses within a word
 * Silent blocking and/or audible blocking
 * Excess physical tension while pronouncing words
 * Whole (monosyllabic) word repetitions
 * Substitutions of feared words (circumlocutions)

 1. Anxiety about speaking and limitations in social participation, effective
    communication, academic or occupational performances.
 2. Typically, the onset is early, in the developmental years (by 6 years of
    age).
 3. The disfluency is not due to sensory or speech-motor deficit, or
    neurological causes (like brain injury or stroke).

The SLP has to rule out sensory deficits, normal speech disfluencies, side
effects of medication, adult-onset disfluency disorders and Tourette’s Syndrome
during differential diagnosis.

What are The Available Stuttering Treatments for Adults?

Today, you can find several stuttering therapy techniques that may suit your
needs. There are several ways to speech fluency. You may choose to visit a
clinician or receive speech exercise updates on your mobile phone.

Either way, you should know about all the various stuttering treatments that you
may consider before choosing one or more.

Stuttering Treatment for Adults - The Options
1. Speech Therapy
Speech therapists or clinicians can help you learn how to pace your words,
cancel a block and pull out of it. A professional may help teach you how to
manage situations that trigger stuttering.

You can learn fluency shaping
[https://ghost.stamurai.com/stuttering-fluency-shaping-techniques/] and stuttering
modification techniques, which you can apply to daily conversations.

Speech therapy is undoubtedly the best course of treatment for stuttering in
adults. Whether you are receiving it from a SLP in-person, or via a cutting edge
anti-stuttering app [__GHOST_URL__/stamurai-app-to-stop-stuttering/], speech
therapy is undoubtedly the best long-term treatment for stuttering.

2. Psychological Counseling and CBT
Coupling traditional speech therapy with CBT can increase the efficacy of the
stuttering treatment. CBT for adults who stutter may address -

 * Educating and informing the person about stuttering
 * Giving them a new perspective to their problems
 * Helping them adopt a positive attitude
 * Assisting and supporting the adults find their own solutions
 * Challenging and resolving the unhelpful and negative thoughts
 * Teaching relaxation techniques to combat anxiety and stress
 * Improving their communication skills

Combining CBT or counseling with speech therapy offers a holistic approach for
the treatment of stuttering in adults.

CBT may help counter the negative feelings and attitudes that adults typically
garner from years of rejection or refusal. In fact, it is the only way to
address the secondary behaviors.

3. Support Groups
When the world seems bleak, nothing helps more than reaching out to people who
may be going through something similar.

Support groups are instrumental in helping people who stutter. These groups
provide a safe-zone for sharing life experiences, fears, expectations, dreams
and treatment progress for everyone who stutters.

You can find a stuttering support group
[https://ghost.stamurai.com/benefits-of-talking-to-other-people-who-stutter/] in your
locality, or find one online. Participating in group meetings, or simply
observing others journey through stuttering can imbibe confidence and hope.

Sharing with like-minded individuals can reduce stress, anxiety and fear. It may
even open new avenues for therapy, and self-treatment.

Support groups offer the opportunity to connect and communicate with real people
without the fear of being judged or bullied.

4. Electronic Devices
For years, researchers have been working on electronic devices like DAF
[https://ghost.stamurai.com/daf-stuttering-guide/] (delayed auditory feedback) and FAF
(frequency altered feedback) to assist those who stutter. Modern-day speech
therapy apps also include such tools.

Many of such devices assist the speakers in slowing their speech down. There are
others that provide a “choral effect”, so the speaker hears their own voice as
if they are speaking in unison with others.

They work best when the user receives guidance from a clinician while using
them. SLPs may change the frequency of the feedback depending on the progress of
the speaker.

These devices are indeed effective for adults who stutter. However, they come
with their own sets of limitations since the user has to wear
headphones/earphones for DAF or FAF to work.

Stuttering Treatment for Adults - What You Must Know
The therapist must understand that the adult with advanced stuttering may not
fear the situations and words only, but also the stuttering itself.

Here are a few facts about the treatment of advanced stuttering every adolescent
and adult must remember –

It Can Be A Lengthy Process
The treatment of adolescents and adults who stutter can take a long time since
it needs to focus on many aspects such as -

 * The emotions of the individual
 * Integral beliefs associated with stuttering
 * The secondary behaviours

While preschool children may take only a couple of months or a year to show
marked improvement in fluency, adults must remember that patience and
persistence are going to be their only friends in the long journey towards
fluency.

Thus, it is of utmost importance for adults to work with their SPLs to set
realistic goals before they begin working on his/her speech. An integrated
approach that includes exploring their nature and severity of stuttering,
learning controlled fluency and increasing approach behaviour.

An adult has to unlearn a significant amount of coping behaviour they have
learned over the years they have been stuttering. It requires hard work on the
part of the therapist, counsellor and their client.

There Is No One-size-fits-all Treatment
Each client comes with different levels of stuttering severity, emotional
turmoil and stuttering related beliefs. Therefore, it is impossible to stretch
one particular stuttering treatment to every adult.

The treatments vary according to their experience related to stuttering, their
upbringing, traumas related to stuttering, and even their perception of the
listener when they stutter. Of all treatment processes, controlled fluency is
most important. The performance of the patient during controlled stuttering
sessions will dictate the future of their treatment.

Integrated treatment should always include an increase in approach behaviour and
reduction in avoidance over the years. SLPs have associated low levels of
avoidance and increase in approach behaviour with an improvement in the fluency
of speech.

An integrated approach pays attention to the negative emotions, attitudes, and
avoidances of the client. The use of controlled fluency or superfluency can
positively influence the attitude and emotions via recurring experiences of
fluency.

Neurologically speaking, it can kindle speech regulation and emotional
regulation by stimulating the left hemisphere. At the same time, it can dampen
avoidance behaviour in the same person. The skills acquired after integrated
therapy can include slowed speech rate, easy phonation onset, proprioception,
pausing, and light articulatory contact.

Treatment May Not Remove Speech-processing Deficits Completely
Adults who stutter may continue to possess some speech-processing deficits even
after the completion of successful treatment. Brain imaging studies show that
adults with stuttering may continue to display lower-than-average left-brain
activity, despite receiving complete speech therapy sessions by an expert.

Dealing with residual stuttering is a long-term commitment and it can be a
continuing task for the client and his/her therapist. A study
[https://pubs.asha.org/doi/10.1044/1092-4388%282008/07-0019%29] conducted
recently where a majority of the 216 participants chose fluency over freedom
from stuttering as their therapy goal.

Keeping Yourself Motivated
You need to keep a measure of your progress and the result of the regular
therapy. Make a note of the percentage of syllables stuttered to capture the
snapshot of progress before and after speech therapy. Your therapist should be
able to help you learn how to measure stuttering severity using easy-to-track
methods.

Don’t forget that speech therapy is a long journey for adolescents and adults.
Therefore, it is important to stick to your exercises
[https://ghost.stamurai.com/stuttering-exercises-for-adults/] and attend the appointments
with your therapist for continuing improvement of your speech fluency.

Adults who stutter can seek out
[https://ghost.stamurai.com/benefits-of-talking-to-other-people-who-stutter/] online forums
or communities near their location to share their feelings and emotions about
stuttering. Finding a safe space to share life experiences that may have
occurred due to stuttering can help one find confidence.

It will help you set realistic goals for your speech, as well as to measure the
progress once you begin attending the therapy sessions with your SLP.

Understanding the Main Causes of Stuttering
Developmental stuttering [__GHOST_URL__/causes-of-stuttering-in-adults] begins
early and typically coincides with the period of rapid linguistic development of
a child. Stuttering is a heterogeneous childhood disfluency disorder. Therefore,
one or many of the following factors can cause stuttering
[https://ghost.stamurai.com/what-is-stuttering/] -

1. Genetics
Stuttering tends to cluster in families. A child who has a close blood-relative
who stutters, may continue to stutter as an adult. Genes influence a person’s
predisposition towards stuttering.

2. Neurology
Genetics also influence the neural network and activities of a person. People
who stutter have distinct differences in the right and left hemisphere
activities in their brains. Their right hemispheres are more active than the
left, which might explain their speech disfluency to a certain extent.

3. Cellular Factors
Recent studies have shown
[https://ghost.stamurai.com/cellular-causes-of-stuttering-in-adults-and-children/] that mouse
models with a deficiency of astrocytes (star-shaped cells) in their corpus
callosum show stuttering-like vocalizations. Scientists led by Dr Dreyna
postulate that people who stutter may have a lower density of astrocytes in
their corpus callosum as compared to those who don't stutter.

4. Childhood Stress
It is important to remember that children who have family members who stutter
have a higher risk of developing stuttering from sudden childhood stress.
Several children go through highly stressful situations but do not show lasting
effects on speech.

5. Environmental Changes
Similarly, children genetically predisposed to stuttering have a higher chance
of developing speech disfluency as a result of these changes. Environmental
changes may include moving to a new and unknown neighborhood, losing friends,
separation of parents or getting a new sibling.

You can find out more about the causes of stuttering right here
[https://ghost.stamurai.com/is-stuttering-biological-or-psychological/].

Types of Stuttering
Genetic predisposition, emotional trauma, physical trauma, and several
neurodegenerative diseases may contribute to stuttering. Currently, experts have
described four different types of stuttering
[https://ghost.stamurai.com/the-unexpected-development-of-stuttering-in-adulthood/] based on
the probable causes.

1. Developmental
Developmental stuttering is the most common type. It begins in early childhood
as toddlers begin to acquire new speech and language skills.

2. Neurogenic
Sudden changes in the neurological pathways or activities associated with the
brain centres for speech process and development may lead to neurogenic
stuttering [__GHOST_URL__/neurogenic-stuttering-vs-psychogenic-stuttering/].
There is no particular age-barrier for this type of stuttering. Neurogenic
stuttering may be a result of stroke, brain trauma, neurodegenerative diseases
and/or brain tumor(s).

3. Psychogenic
Diagnosing psychogenic stuttering is challenging. It may result from severe
emotional trauma and distress. Post-traumatic stress disorder (PTSD), severe
anxiety, and/or chronic depression may manifest in the form of stuttering along
with other symptoms in adolescents and adults.

4. Drug-induced
Drug-induced stuttering is typically seen in adults. It may result from a sudden
change in medication or its dosage. A new medicine or even the use of a
recreational drug may induce stuttering in adults with no prior history of
speech disfluencies. Typically, reverting to the older dosage or replacing the
new medicine with another one stops drug-induced stuttering.

What are the Available Medicines for Stuttering Treatment?
Currently, there is no FDA-approved medicine for stuttering
[https://ghost.stamurai.com/stuttering-medicine/]. There are a few psychoactive compounds
that induce fluency in patients/clients.

Drugs like haloperidol, risperidone, olanzapine, ziprasidone and clonidine can
contribute to reduced stuttering and increased fluency in adults who stutter.

New-age medication that may inhibit the vesicular monoamine transporter 2
(VMAT2) may help reduce stuttering. New research shows that drugs that decrease
dopamine synthesis may help in inducing fluency.

What Kind of Research Is Being Conducted on Stuttering?
In the last few years research on stuttering has progressed significantly.

In 2021, Dr Maguire led the study
[https://neurosciencenews.com/astrocytes-stuttering-17761/]of risperidone action
on increasing the activity of the astrocytes in the striatum. Risperidone can
reduce stuttering by boosting the metabolism or activity of the striatum.

In 2019, Dr Drayna and his team genetically modified mice with a Gnptab
mutation. These genetically engineered mice had a reduced density of astrocytes
in the corpus callosum. These mice made abnormally long pauses in vocalizations
which the team considered similar to those in people with the same mutation.

NIDCD researchers have identified
[https://www.stutteringhelp.org/genetic-and-neurological-factors-stuttering] 
four genes and their mutants that are directly linked to stuttering. Dr Drayna
has contributed significantly to the current knowledge on the role of genetics
in stuttering. Genetic factors play an important role in at least 50% of the
cases.

Currently, research [https://www.nidcd.nih.gov/health/stuttering]is also ongoing
to determine which children will outgrow stuttering and who are at risk for
persistent stuttering.

Scientists are now using fMRI, MRI and PET scans to determine the differences in
the brain structure and function of people who stutter.

A combination of genetic engineering, drug studies and imaging techniques may
soon be used in the future to help and treat people who stutter.

Stuttering in Adults: Treatment, Diagnosis, Symptoms & Causes

Case 1
Ever since he was a child, he was aware of his stuttering. So much so, that
whenever his parents took him to a pool party for neighbourhood kids or a
birthday party, he could feel his chest tighten and breathing stop. Saying his
own name in front of a bunch of strangers was always the worst! His lips would
twist, his face would scrunch up and throat would close as he tried to let the
first syllable flow out of his mouth.

On such days, lying in bed at night, he would dream about a future when he would
have completely fluent and “normal” speech as an adult. He was aware that almost
all the role models of his life – Bruce Willis and James Earl Jones had one
thing in common – they no longer struggled with stuttering. So he had hoped that
his stutter would disappear magically once he reached adulthood.

Little did he know that the fear of speaking in front of strangers and the
anticipation of a block would chase him through high school into college and
well into his professional life. As he grew older, his aversion increased and
then followed the overwhelming shame of not being able to say the most common
words even 3-year-olds could say without thinking twice.

He shut himself up. Began working from home. Limited communication to emails and
messages, and avoided phone calls altogether. Going out for groceries and paying
bills was just too much! So he chose to get all essentials delivered at his
doorstep and paid bills online.

He had always been suspicious of speech therapists and self-help groups. At 31,
he prefers to live alone, hide away from gatherings and has dedicated his life
to working from his home. On some nights, he still wonders about a magic pill or
potion that can cure stuttering overnight. On other nights he fantasizes about
how his life would turn out without stuttering.

Case 2
She was a bright and outgoing kid who was never afraid of new adventures. She
was chatty and always at the top of her class. Her speech disfluencies never
seemed to get in the way of her achievements till she was out of middle school.

In high school, she quickly realized that speaking differently was a quick
ticket for a one- person lunch table in one corner! She was a smart kid, so it
didn’t take her long to understand that getting stuck on every day-words can
make one the attention of bullies.

She began suppressing her emotions and her stutter. In fact, she made a list of
all the words that she was afraid of and avoided saying them at all costs. She
pretended to not know the answer when the teacher called her up to the board.
Her grades dropped quickly, but she was successful in hiding her stutter almost
completely.

She was so good at it that her parents weren’t even aware that she was still
stuttering. She was superbly covert and stuttering was indeed a foreign concept
to her because she refused to accept her speech disfluency. Her shame kept her
from accepting the help she needed years ago for a speech disorder that affects
7 million people across the globe.

Instead, she found herself sinking deeper into despair, fear and the stress that
comes from hypervigilance. It wasn’t until her 23 rd birthday when she found
herself at the office of a psychological counsellor that she finally found the
courage to face the fear that had been chasing her since her early teens.

Her counsellor helped her accept her speech disfluency and helped her get in
touch with a renowned speech therapist. Along with regular therapy, and practice
she is now able to steer clear of the hyper-vigilance that almost ruined her
life.

She is now able to understand that the journey for advanced stuttering towards
fluency is a long one. However, she no longer feels the necessity to hide her
stutter. Yes, she still stutters! But she does so with flair and confidence. She
has found new friends through support groups and she has found happiness since
she shunned her avoidance and escape behaviours.

At 28, she has earned a second master’s degree in clinical psychology and she is
successfully using her experience with the shame she had experienced as an
adolescent and a young adult to guide others towards recovery.

Decoding Shame: our response to trauma
Trauma doesn’t have to be physical or life-threatening. The very fear of losing
the respect of our peers or having adults think anyone who stutters is less
intelligent than their classmates or friends is sometimes enough to contribute
to a life-long trauma. Like in Case 2, feeling different from the others and the
fear of being singled out by bullies was enough to drive the person into a
shell!

For many who stutter, trauma exists on a wide spectrum and doesn’t stem from a
particular incident only. The inability to communicate or use the very words we
want to use create repeated experiences of trauma. And this is true for both
children and adults.

One should not think that going into speech-language therapy will absolve them
of the shame (in case they are feeling it) instantly. Since the shame is only a
reflection of the trauma, sometimes, cognitive behavioural therapy (CBT) is must
alongside speech therapy to face the trauma. Only then can a person rid
themselves of the shame that may come from it.

Bidding adieu to shame
Stuttering is nothing to be ashamed of. Yet the shame of stuttering can manifest
in different psychological and physical forms, which are mostly negative coping
mechanisms for the individual.

Speech therapy and CBT are extremely helpful, but advanced stuttering typically
comes with complex secondary behaviours (avoidance and escape). Self-awareness
and honesty are the two most important factors that can help you on your path to
freedom from shame.

Apart from sleeping well, eating well and taking care of your health, you will
need to put in an extra bit of effort to recover from the effects of the trauma.
We have seen that mindfulness practices like yoga, breathing exercises and
meditation always help in catalysing the progress of an individual on the path
to recovery.

Stamurai is a speech therapy app that can help you will regular speech
exercises. You can also find the latest findings on yoga, meditation and
breath-work that can help you with your fluency. Apart from being regular with
your therapist’s appointments, you can turn to similar speech therapy apps to
accelerate your healing process.

Share your story!
We know how difficult and daunting it can be for you to go out there and tell
your story on a forum filled with strangers. That’s precisely why Stamurai has a
video conferencing mode which will put you in touch with others who have
struggled with stuttering. You can share your stories and find inspiration where
you least expect it!

Across the world, there are several stuttering associations, support groups
(online and in real-life setups) and discussion forums that can genuinely help
you find people, who care. You can even ask your SLP for the location and
timings of support groups in your area. Support is crucial for fighting shame
successfully. People who stutter often cite support as an important factor on
their path to self-improvement and fluency.

Of course! There’s a side effect – you might end up with a bunch of life-long
friends.

If you feel ready, you can go ahead and share your story with us. Write to us at
speechtherapy@stamurai.com

Stuttering in Children : Understanding Shame

A child who stutters takes his cues from his parents and authority figures in
his/her life. If they have a practical and supportive attitude towards the
speech defect, the sense of alienation and unsurmountable difficulty is
lessened. Similarly, as an adult the profound friendships and relationships that
stutterers have will be with people who aren’t hostile or wary of their
communication.

It surely isn’t possible for someone to live anyone else’s shoes or truly
comprehend someone’s life experience, but an awareness of the condition helps
develop an empathy for it. For most people, our education and understanding of
social norms, etiquettes, and humanity comes from what we see represented in
media. In recent years, “The King’s Speech” did for stuttering what “My Left
Foot” did for cerebral palsy or “Rain Man” did for autism. It brought attention
to an impediment and recognized it in our collective public consciousness.

Colin Firth as King George VI and Geoffrey Rush as Lionel Logue as the king’s
speech therapist capture the tenuous and intangible intimacy that exists between
a stutterer and those who work with them to overcome the speech defect. A
cleverly crafted script that with each interaction with the different
significant people in the king’s life explores a different facet of the
experience one has when they stutter. It subtly and effectively emphasizes how
critical supportive relationships are and how essential consistent coaching is.

The king’s struggle for control over his words, his pain, self-doubt, and anger
when it slips through his fingers, all in front of an audience of thousands is a
visceral experience. The fear that Firth manages to convey is palpable, so is
the soothing balm of acceptance and pride in his friend and pupil that Rush
conveys. In that, more than perhaps anything else, “The King’s Speech” is unique
and praise- worthy. It is accurate in capturing the experience of stuttering.
The constant boxing-match that goes on in the mind of a stutterer with itself.
Not an incurable disease that is to be treated with condescending caution or
ridicule. The mechanics of speech therapy are individual to each person who
stutters. However, “The King’s Speech” gets the heart right, with both the
quarrels and humor that come from the unlikely friendship between the King and
Logue.

Cultural Awareness of Stuttering through “The King’s Speech”

Not being able to say what you want to say is bad enough! Sometimes, this
includes one’s name, address, and contact number.

Whenever we talk to someone who stutters, we hear a lot of complaints including
missed job opportunities, messed up conference calls, fear of answering the
phone or even talking to a brand rep at the mall. Stuttering makes one’s life
difficult. It brings about a flurry of negative emotions that range from
embarrassment to anger.

Yet, research shows that there might be some benefits to stuttering.

Right now, if you are struggling with the lack of fluency in your speech, you
might find it difficult to believe us right away. That’s why we are bringing
forth research materials and surveys from the last decade which go on to show
that stammering has its own advantages.

You are a perfectionist!
You may not have explored your entire potential if you don’t yet know that you
have a perfectionist personality. According to published research by Paul H.
Brocklehurst, people who stutter are more aware of the mistakes they make (not
only in speech), and they are more eager to correct their mistakes.

It makes them keen workers, eager learners and automatically, more driven
towards perfection than their more fluent counterparts. When you perceive
yourself to be significantly error-prone it’s your inner perfectionist talking!
You strive for perfection in work and daily life.

You can channel the same love for perfection and begin practising speech
exercises. Whether you are working with a speech therapist and a psychological
counsellor, or you are alone on the path of self-improvement, you can consider
befriending an app like Stamurai to help you practice daily for attaining the
fluency you desire in your speech.

Your emotional intelligence is more developed
It’s easy to see stuttering as a drawback. When you can’t even say your name in
front of the entire class or a panel of interviewers, that makes it incredibly
difficult to believe that it might have some positive impact on your life.

However, research shows that people who stutter typically have a higher
understanding of others in suffering. Thousands of those with fluency problems
go onto becoming scholars and researchers in the field of speech pathology to
understand themselves better and to help the millions out there.

Surveys and studies show that people who stutter may have a significantly higher
level of empathy, patience and listening intelligence during emotionally
stressful situations. You have the hidden ability to be more understanding of
other’s shortcomings and differences.

You are likely more sensitive towards the necessities and feelings of others in
difficult situations.

Stuttering gives you the scope for personal growth
With the right help (from your SLP and CBT counsellor), you can pave the way for
personal growth. Visiting a speech-language pathologist (SLP) or a good and
experienced therapist is essential in this journey. Once you begin to see that
stuttering does not define you, there is no stopping you!

Studies by Stephanie Hughes, Ph.D., CCC-SLP & Edward Strugalla, M.H.S., show
that a person who stutters has immense potential for growing and strengthening
their character. You have more determination, patience and tenacity that you
probably give yourself credit for.

You work really hard to compensate for your stuttering
People who stutter are not just emotionally intelligent and perfectionists, but
they also strive to compensate for their speech disfluencies by giving
additional effort in other areas or skillsets. In most cases, people who stutter
have very specialized skills in other areas and once they begin to explore these
skills, they can become highly successful.

For example – many people who stutter are gifted musicians and singers. Singers
who stutter while talking rarely ever do so while singing. Sometimes, some have
to work a little hard in polishing these skills, but most are already born with
these special skillsets which include a gift for music, arts-and-craft, and
writing.

Stuttering actually gives you the chance to plan what you want to say and how
you want to say it well in advance. So, it has probably already given you strong
language skills. Or, you are on your way to developing that pretty soon.

If you think you don’t have enough skills, you just haven’t found the
opportunity to explore all your talents yet!

The take-home message
Thousands of renowned researchers and therapists in the field of speech and
language have speech disfluencies including stuttering. Contrary to what you may
think right now, a speech therapist with the first-hand experience of speech
disfluency may be more capable of helping someone who stutters.

Never forget how Charles Van Riper was one of the revolutionary researchers and
therapists, and the father of speech pathology although he stuttered throughout
life!

It is quite evident that stuttering is not all negative. It brings along unique
aspects of intelligence, skills, talents and character strength that no one can
deny!

The Positive Aspects of Stuttering

What's common between Elvis Presley, Kendrick Lamar, and Ed Sheeran, besides
their undeniable talent for music? They were and are prolific singers popular
all across the world for their music.

These are all famous personalities with tremendous talents who began singing as
an outlet because they stuttered well into adulthood. Early on, the only time
they were confident was when they were either singing for their friends and
family.

Sheeran, Lamar, and Carly Simon all found out that their stammering simply
disappears when they sing.

Why Do We Not Stutter While Singing?
While you are likely to think that it's just a fortunate coincidence, research
shows that it might not be the case.

According to Dr Barry Guitar, one of the leading personalities in modern speech
pathology research –

 1. While singing we move our tongue, lips, and vocal cords quite differently
    from when we speak.
 2. Whether it’s a famous singer or a bathroom singer, the person doesn’t feel
    the pressure to communicate while singing, which they face during
    conversations.
 3. The regulation of breathing is critical in singing. Regulated breathing also
    helps in minimizing blocks and prolongations.
 4. In most cases, singers already know the lyrics by heart. There is no “word
    searching” that may contribute to stuttering.
 5. Modern imaging techniques show that the language and communication centres
    of the brain function differently when a person is singing as compared to
    when they are talking.

Successful Singers Who (used to) Stutter
Some of the most popular singers stuttered as children. Many of them stutter
while talking even today! The one thing that binds them together is the freedom
of expression they enjoy when they are singing.

Many of these internationally recognized singers now have Grammys, Billboard
Music Awards, BBC Music Awards, and Pulitzer Prize for Music!

Here are some of the most popular examples of famous singers who struggled with
stuttering at some point in their lives:

1. Ed Sheeran
Ed Sheeran
[https://stamuraiapp.medium.com/do-you-know-about-ed-sheerans-stuttering-journey-40740d8589e5] 
may be a Grammy winning singer, but he still struggles with fluency. He credits
Eminem and his rap songs to help him overcome his worst stuttering phase.

The fast pace, easy-to-remember lyrics and groovy melody helped Sheeran remain
fluent when he rapped along with The Marshall Mathers LP at home as a child.
That’s when Sheeran discovered the magic of music!

Singing helped Sheeran break free from stuttering. Even now the world-renowned
singer struggles to get the words out when he feels overwhelmed, but singing has
never let him down.

2. Kendrick Lamar
Kendrick Lamar is a 7-time Grammy and Pulitzer winning rapper and songwriter who
has stuttered [https://www.stutteringhelp.org/content/kendrick-lamar] ever since
his early childhood. Instead of giving up, he focused all his energy into making
music.

His dedication, focus, and never-say-die attitude earned him critical acclaim
and international fame. Today, he is one of the most distinguished songwriters
of the world.

3. Chris Martin
The Coldplay lead singer had a stutter growing up. He still stutters
occasionally. It didn’t stop him or his band from receiving close to 600 awards
and award nominations between 2000 and 2021.

4. Kylie Minogue
Kylie Minogue is an internationally acclaimed singer and actress. She is the
highest-selling Australian singer of all time.

Despite her overwhelming success, she has spoken about her struggles with speech
disfluency. Singing was the only “exercise” that worked for Minogue. She began
to sing more frequently to stop stuttering.

5. Megan Washington
In a now popular Tedx Talk, Megan Washington opened up about the incessant
bullying she faced because of her childhood-onset stutter. Attending years of
therapy helped her discover the smooth-speech technique.

Although she is not comfortable with the sing--song way of talking, she admits
that it is similar to singing. Today, she stutters proudly and she focuses on
her music.

6. Elvis Presley
Very few know that the beloved King of Rock and Roll used to stutter even as an
adult.

If you watch his live performances closely, you will notice that Elvis does 
stutter [https://www.stutteringhelp.org/content/elvis-presley] while talking to
the audience in between songs! However, on stage, his voice and singing are bold
and effortless.

He had the dream of becoming a successful performer and he didn’t let his speech
disfluency get in his way despite not receiving formal speech therapy.

Before they became world-renowned singers, songwriters and performers, they were
children and teens with a stutter! However, instead of focusing on just the
problem, they relied on singing as a way to express themselves.

In the long run, they discovered their love, passion and talent for music. Then,
there was no stopping them!

The Therapeutic Effects of Singing
Singing is as natural as speaking. Therefore it serves as a valuable tool during
stuttering treatment. Research shows
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2996848/] that singing engages the
auditory-motor feedback pathways.

Singing stimulates and strengthens the muscles involved in articulation,
respiration and phonation. Intense singing practice can bring long-term changes
in the pulmonary and cardiovascular systems.

Currently, the most popular stuttering treatments include fluency shaping
[https://ghost.stamurai.com/stuttering-fluency-shaping-techniques/] methods. A recent study
[https://pubmed.ncbi.nlm.nih.gov/502508/] showed that singing can reduce
stuttering just like other traditional fluency-enhancing techniques.

Andrews, Howier, Dozsa and Guitar observed
[https://pubmed.ncbi.nlm.nih.gov/7120960/] that singing a known song for 10
minutes can reduce stuttering frequency by as much as 90% in PWS. A 2009 study
[https://pubs.asha.org/doi/10.1044/1092-4388(2008/07-0040)] conducted by
Davidow, Bothe, Andreatta and Ye has shown that singing can reduce stuttering
and may have a long term positive effect on the fluency of a person who
stutters.

Should Your Child Be Singing Even Before They Can Learn to Talk?
We saw “magic” when American Idol contestant Lazaro went on stage and shook the
entire world with one of the most heartfelt auditions. While Keith Urban was
famously criticized on every possible social media for his spontaneous comment
“You should sing all the time,” he did have a point.

Singing makes it easier for a person to stutter to express themselves. It is not
only an avenue for self-expression, but undergoing vocal training and voice
training will give any child the confidence necessary to go through daily life.

In our previous posts, we have discussed how a child who stutters may slowly
develop a lack of confidence. The negative attitudes and feelings associated
with stuttering can keep a person who stutters from achieving their full
potential.

Just imagine, if you are a parent of a child who is struggling with speech
impediments, you can always encourage your child to “sing it” to you. It is a
small step that can help your child find his or her first control over
breathing, phonation, and enunciation.

Introducing your child who stutters to the world of music is like handing the
control of their expression back to them!

Can You Use Music to Manage Stuttering?
Using music therapy to address speech disfluency is becoming a common practice.

Rhythmic speech cueing [https://psycnet.apa.org/record/2014-42500-013] (RSC) is
a speech rate control technique that uses auditory rhythm to enhance fluency,
articulation, and understandability of speech. In RSC, the client receives
auditory stimulation. It is typically a continuous rhythmic pattern (background
music or metronomic pulse).

The rhythm and tempo are the most important factors during RSC. Therefore, it is
prudent to work with a speech therapist who has an idea about your rate of
stuttering. They can set a tempo and rhythm that may be most effective for
inducing fluency.

Music Lessons and Speech Therapy Can Go Hand in Hand
Speech therapy is always beneficial for someone with a stuttering problem. It is
especially beneficial for a child, who has just begun to show signs of
stuttering.

Early intervention in the form of speech therapy guided by an experienced
speech-language pathologist (SLP) can help children overcome the struggles of
stuttering, and keep the negative emotions at bay.

Addressing stuttering in children
[https://ghost.stamurai.com/five-stuttering-exercises-to-help-your-child/] is much easier
than in adults, since in the latter case, SLPs may have to deal with advanced
forms of stuttering, in addition to addressing cognitive behavioural issues that
arise from not being able to express one’s feelings in their desired words.

A study done in 1982 at the University of New South Wales shows that after
singing, participants showed a 90% reduction in stuttering. The participants
went on to show a consistent increase in phonation duration. In the case of
non-fluent aphasia (the inability to speak fluently), Melodic Intonation Therapy
(MIT) by Sparks, Albert, and Helm-Estabrooks, in the 70s, has shown significant
improvement in speech fluency.

An introduction of guided music classes in coordination with an experienced SLP
can help a child find an avenue of expression. Moreover, a child can always rely
on a new skill like singing to make friends, and socialize in kindergarten,
elementary school, or even in middle school!

Stuttering & Singing : What We Understand

Stuttering is classified as a speech disorder. People who stutter usually repeat
sounds, syllables, and words. Or they tend to have uneven speech rate or have
difficulty in communicating thoughts in a flow. It is more common than you
think, and about 70 million people worldwide get affected by the same. About 5%
of children stutter at some point, and from that, 1 in 5 will stutter in their
adulthood.

Stuttering can become a hindrance to daily life. Traditionally, only speech
therapy was used in treating stuttering. Over time, there have been treatments
like psychological counseling, assistive devices, and prescription medication,
which are less effective than speech therapy. Speech therapy involves changing
their breathing patterns, controlling the speaking rate, pausing when necessary,
practicing word lists, and reading aloud. A lot of times, speech therapy can be
really beneficial for children and adults, but then the relapse happens.

It is really devastating when relapse happens. If you are one among the people
who got relapsed or seeing your loved one go through, have you wondered the
reasons?

 * Failing to Practice: Speech therapy can be taken from an experienced and
   certified practitioner. But the time given by them is limited and can be an
   expensive affair, whether you are paying from your own pocket or your
   insurance. The ideal thing is to learn the techniques, come back home, and
   practice every single day. Our Stamurai app helps you keep up the practice
   with different sets. And, you can set a reminder which works for you, or
   better yet, we shall send you reminders anyways.

 * Lack of Motivation and Interest: Speech therapy does not work like magic for
   stuttering. It is a long process of learning and practicing. But, without
   proper motivation or the thought of doing the same thing over and over again
   for a prolonged time, can make one lose interest. To fight it, try and make
   it interesting. You can try playing while practicing like shooting hoops or
   solving a puzzle. And, if you want to keep your interest in children, then
   make it an adventure game. Pair an activity you love that does not need too
   much focus with speech therapy to keep it light.

 * Lack of Self-Correction and Monitoring: When not in a professional setting or
   guided by professionals, sometimes what you think is right can be a wrong way
   to do it. But this is a strange territory, as worrying too much also does not
   do any good. Only way is to strike a balance by seeing you are on track on
   and off. Also, it is always good idea to include new things or phrases to
   increase your confidence level.

These three are very crucial if you want your speech therapy to be a success.
But one must remember that other factors that contributes to failure as well.
Such as:

 * Gender: According to research done in 1983, females who have stuttering
   problem recovered, and was able to maintain success than male.

 * Genetics: Family history matters in the outcome of the treatment. People who
   have stuttering in their family history have high chances of relapse.

 * Relationship with Support Group and Therapist: If you do not have a good
   relationship with your therapist, do not hesitate to look for another. Or if
   your support group is not as supportive, it is time to give up and look for a
   different group.

 * Neurological Load: Whether it is kids, teens, or adults, everyone is burdened
   with their set of jobs to do apart from the practice. So, most of the time
   they are worn out before starting practice.

Check out our Stamurai App that can be downloaded for Android and Apple devices.
It is easy to use, simple, and makes practice fun. We also have incorporated a
tracker, which will hold you responsible for the amount of practice, just like
your fitness trackers. Have any questions? Talk to us at support@stamurai.com!

High Relapse After Stuttering Speech Therapy : Understanding the reason

A genetic pre-disposition along with various neurophysiological reasons are
attributed as the cause or onset of stuttering. The speech impediment in most
cases presents itself early, usually between the ages of two and five years. A
significant amount of research has been done to study and treat stuttering in
infants and children. Speech therapists are trained to understand and guide
children who stutter through both the technical and emotional aspects of
disfluency.

However, not much is discussed about the sudden onset of speech impediments in
adult or senior (over 55 years) individuals. There can a number of reasons for
the disfluency besides a family history of it.

Changes in Brain Structure
Trauma in form of a stroke or aneurysm can alter brain structure and
motor-neuron pathways. The part of the brain that controls how language is
processed and speech formulated when damaged causes disfluency. A concussion
caused by a fall or head injury can lead to structural changes in the human
brain.

Degenerative Neurological Disorders
Neurological disorders that over time damage multiple brain functions like
Dementia, Alzheimer’s Disease, Parkinson’s Disease and Epilepsy are cause the
onset of stuttering and other speech impediments in adults. It makes it
extremely difficult to form, arrange, and speak words. This form of the
disfluency can range from not being able to verbalize words to an inability to
construct a sentence.

Changes in Medicines
With age come a plethora of ailments and an equally high concentration of
pharmaceuticals to combat them. A negative reaction of one or more of these
medications can be changes in speech patterns, diction, and fluency.

Drug Abuse
The abuse of narcotics like heroin, cocaine, and LSD can cause trauma and
deoxygenation in the brain leading to the onset of disfluency. Abusing and
overdose of barbiturates (medicines that treat seizures, headaches, and
seizures) can also traumatize the brain and lead to speech impediments.

Emotional Trauma
Anxiety, depression, and emotional distress brought on by increasing financial
pressures, uncertainty and fear about one’s mortality, confusion, loss of memory
and autonomy can trigger impairment in self-expression. The sudden onset of
stuttering due to underlying psychological distress isn’t exactly sudden and
occurs with a genetic history of the impediment.

Age has emerged as one of the strongest factors of risk for speech defects. The
accumulated evidence suggests that stuttering when it develops later in life is
both persistent, aggravated and difficult to recover from. More can be learnt
about persistent stuttering by studying the adults afflicted by a sudden onset
of stuttering that continues into advanced years. The differences between these
cases and those of young children can help understand the impediment more
extensively.

The Unexpected Development of Stuttering in Adulthood

The lockdown and self-quarantine have brought forth several changes for people.
These changes are especially pronounced for households with children.

Unlike the sweet summer last year, when your child was at school, you were busy
with household work or buried till your nose under paperwork at the office, this
year, things are different. 2020 has so far been a baffling year that has made
working from home, homeschooling and remote classes the new normal.

For parents of children who stutter, you might be shouldering a bit more
responsibility than other parents – setting up online speech therapy sessions,
practising their speech exercises or overseeing them do so correctly. We know
you already have your plates full! So we won’t add to the list of to-dos.
Instead, we will help you transform speech therapy from a “chore” to enjoyable
family time.

First things first – you need to forget worrying about whether your child has
dedicated enough time after school lessons to practice their speaking
strategies.

You need to think about using the same time your child uses to practice speech
strategies for increasing communication between you and your child. These will
have a few benefits you should be able to see by the time the lockdown measures
are lifted – your child will have increased confidence while speaking, you will
have a stronger bond with your child and you will learn more about stuttering
and your child’s experiences in school and other social situations.

Here’s how you can go about it –

 1. Have a real conversation – Forget about breathing exercises and phonation.
    Focus on the content. Does your child enjoy reading fairy tales or does he
    enjoy video games? Just let your child talk and be sure to listen. Spend the
    precious time you now have by holding a real conversation. Chat like you
    have never chatted before. If they have siblings, include them in the
    conversation as well. Do not mention speech therapy, fluency or stuttering
    unless they do so. Don’t make the conversation about improving fluency.
    While your child is surely smart enough to understand that this is about
    helping their speech, make sure they enjoy the quality time you spend
    together without feeling monitored.
 2. Read your favourite stories – Reading is not just for bedtimes. You can read
    stories of great wars, famous personalities, fables and much more. Be sure
    to intersperse their favourite topics with inspirational stories about
    kings, queens, politicians, sports personalities and actors who have
    achieved much despite speech disfluencies. Stamurai has a wide collection of
    short stories and biographies on such inspiring personalities who overcame
    stuttering to win worldwide fame and accolades. Stick to heroes your child
    will relate to. Apart from the Stamurai app and blog, you can find inspiring
    stories online in the form of free downloadable eBooks on Kindle or in PDF
    format for your child.
 3. Ask your child to teach you to stutter – It is a crucial part of speech
    therapy – a child who stutters can learn much about breathing control and
    muscle control when teaching others to stutter voluntarily. Make sure the
    sessions are respectful for your child, especially, if their siblings are
    around. They should not feel ridiculed or objectified. Begin to explore
    their feelings about stuttering. If there comes an opportunity during this
    session, ask your child how it feels for them to stutter. It will open new
    windows into your child’s psyche as you find out how they feel and how they
    think. Explore their experiences, and emotions in specific situations. It
    can not only strengthen your bond, but it might also give you an insight
    into their social life. You will be able to find out if they feel bullied or
    harassed at school or in other social situations.
 4. Explore the facts about stuttering with your child – Exploring the facts
    about stuttering is quite the opposite of discouraging for children. Most
    children have the natural ability to see the silver lining in situations and
    they are much better at adapting to adversities than us, adults. So, if you
    are feeling guilty about upholding the facts and stats about stuttering to
    your child, especially since some of the facts make it apparent that
    stuttering does not have a permanent cure, don’t be! Learning the facts will
    provide your child with the knowledge they need to answer the curiosities of
    adults and fight their bullies. Let them learn how unique they are! Bust the
    myths about stuttering together. Tell them that they are smart, intelligent,
    cognizant and completely capable of achieving what their peers are right
    now, and even more.

Yes, life is difficult for a child, who stutters, especially when their teachers
and classmates are not sensitive. Take this time you have to prepare your child
to face the odds in life by arming him or her with the correct information,
confidence and hope.

Your love and care will make a whole lot of a difference in their life. Most
importantly, once their speech therapy resumes, they might even perform better
and show much improvement within a shorter period simply because you imbibed
them with the confidence they dearly need.

Help your child's stutters during this never-ending lockdown?

A very recent study [https://www.mnsu.edu/comdis/isad10/papers/rasskazov10.html] 
shows that 62.57% of the English speaking participants do not stutter when
speaking alone in a room. Interestingly, around 27.47% of the people did not
stutter when speaking to their pets.

The study included 1485 Russian speakers and 171 English speakers. In this
rather large scale study, the results were quite consistent as around 65.67% of
the Russian speakers did not stutter when they spoke alone inside a room or read
out loud to themselves either.

[https://stamurai.app/z4HKmlNXigb]We Don’t Stutter When Alone: What Drives
Stuttering in Social Situations?
It simply reiterates what many of us who stutter already know – we speak without
any disfluency when we are not around people. However, the moment we step
outside, whether to go for a movie, to a restaurant to meet friends or enter a
family gathering, our stuttering keeps us from expressing ourselves freely.

At least two important questions can arise from this phenomenon –

 1. Why do we NOT stutter when alone?
 2. Can we extend this non-stuttering to situations when we are not alone?

A recently published study
[https://www.nyu.edu/about/news-publications/news/2021/october/study-finds-that-adults-who-stutter-don-t-stutter-when-they-re-a.html] 
shows that the perception or feeling of being heard plays a significant role in
the speech fluency of a speaker who stutters.

Researchers have dubbed this the “talk alone effect.” PWS who believe that they
don’t have an audience do not stutter during private speech. Private speech can
be when they are talking to themselves in their room, or reading aloud to
themselves.

Several anecdotal reports have presented this phenomenon, but this is the first
time that a team of NYU researchers have provided evidence for the “talk alone
effect.”

During this particular study [https://pubmed.ncbi.nlm.nih.gov/34534899/] led by
NYU Steinhardt Professor Eric S. Jackson, participants were left alone with a
task on the computer which primed the environment for private speech.
Researchers also told the participants that people who talk to themselves during
the task tend to perform well, and that no one would be listening to them at
all.

As compared to other speech conditions like conversations and reading, the
participants did not stutter while “talking alone.”

Jackson concluded, “The possibility of having a listener introduces the
possibility of social evaluation. A person who stutters considers the social
component while speaking in front of a listener.” Removing the possibility of
being socially evaluated and judged puts the speaker at ease.

The study brings forth an important side to the precipitation of stuttering in
adults [https://stamurai.com/blog/causes-of-stuttering-in-adults/] and children
[https://stamurai.com/blog/parents-guide-to-help-child-who-stutters/] - a social
component. According to Jackson, “Stuttering is not just a speech disorder. A
strong social component lies at the core of stuttering.”

Why Do We Stutter In Front Of Others?
Children and adults tend to not stutter when talking to themselves, or singing
[https://stamurai.com/blog/stuttering-and-singing-what-we-understand/] in their
rooms/bathrooms, talking to babies or pets. Some don’t stutter when angry,
others seem to stutter severely when angry.

Similarly, your child may be stuttering
[https://stamurai.com/blog/what-is-stuttering/] in school, but not as much when
at home.

Stuttering is a combination
[https://stamurai.com/blog/is-stuttering-biological-or-psychological/] of
physical and physiological factors. Therefore, decoding the reasons for not
stuttering in certain situations is not as easy as you might want them to be.

One of the most common reasons behind this phenomenon is that when talking to
the self, you are more relaxed. You don’t have to think about how people will
perceive or judge you. Speech disfluencies are more common in stressful
situations. While non-stutterers might think that stressful situations only
include job interviews and examinations, but for people who stutter, simple
social interactions can be stressful as well.

[https://stamurai.app/z4HKmlNXigb]Why Is Producing Fluent Speech Not As Easy As
People Make It Out To Be?
Speech is always about expressing oneself.

It has two distinct components – verbal (the words) and non-verbal (mood,
attitude, feelings, and emotions).

Conveying how you feel is a huge part of the communication process. One could
say that these emotions occlude the word selection and speech production process
in those who stutter.

As we have discussed earlier, people who stutter have significantly different
brain structure
[https://stamurai.com/blog/cellular-causes-of-stuttering-in-adults-and-children/]
.

According to Dr Barry Guitar, and several other researchers, in the case of
people who stutter, nerve fibres in the left hemisphere of their brain can’t
conduct impulses along the nerve bundle.

It makes speech processing and production a rather slower process as compared to
people who don’t stutter. The right hemisphere of the brain is the location of
emotions including fear and anxiety, which dominates the surrounding neural
connections.

Why Can’t We Pretend To Be Alone While Talking In Front Of Others?
An adult or a child can stutter less, more, or not at all, depending on the
stress level he or she experiences. In an environment where the person who
stutters is confident and comfortable, they will stutter less or not at all.
These situations can include home for some, singing classes for some, and an
animal shelter for others.

[https://stamurai.app/z4HKmlNXigb]Brain imaging studies [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3574760/] 
show that when people are relaxed more, they stutter less. However, contrary to
this theory, people who stutter, often state that the more they try to relax
forcefully, the more tense or anxious
[https://stamurai.com/blog/how-to-overcome-fear-and-tension-if-you-stutter/] 
they become. It is like a vicious cycle, which even some children cannot escape.

Therefore, extrapolating the emotions
[https://stamurai.com/blog/channel-your-emotions-to-reduce-your-stutter/] and
feelings that enable fluent speech at home to public situations isn’t easy at
all.

How Can We Find The Fluency In Our Stuttering?
This is where the role of a speech therapist
[https://stamurai.com/blog/stuttering-treatment-how-can-a-speech-language-pathologist-help/] 
becomes indispensable. For children, typically, speech therapy is more effective
than in the case of adults.

In the case of adults, speech therapy often requires the support of cognitive
behavioural therapy
[https://stamurai.com/blog/stuttering-and-cognitive-behavioral-therapy-cbt/] for
addressing the negative attitudes that accompany their speech disfluency.

Getting rid of stuttering is not a one-day task.

While you may be able to speak fluently or almost fluently in front of a mirror,
or while reading out aloud or while singing along with your favourite singer,
you need to kindle and preserve the same level of comfort, and confidence while
talking to real people in the real world.

The first step towards overcoming your fear
[https://stamurai.com/blog/overcome-stuttering-fear-and-insecurity/],
embarrassment and/or anxiety of stuttering is by embracing your stutter
[https://stamurai.com/blog/should-you-accept-your-stuttering-yes-absolutely/].

Accept that you might stutter while talking to a person or in a group.

Next, accept the fact that stuttering does not make you less important or any
less capable than your peers. Once you learn how to stutter confidently
[https://stamurai.com/blog/voluntary-stuttering-and-fluency/] (and maybe with
some swag too), you will automatically find yourself stuttering less and less
every day with continued therapy and practice.

Why Don't We Stutter When Talking Alone?

Different people who stutter will certainly differ in terms of the severity of
the condition. Moreover, the severity of the impediment can vary within one
person, from one situation to another, one social interaction to other, day to
day, sometimes within a single day.

Why does it vary?
What makes a person’s stutter worse or severe is unique to them and how external
factors like stress, fatigue, and anxiety affects them. The pressure and fear of
disguising or hiding the stutter can also aggravate the condition.

How does the severity manifest itself?
Stuttering is characterized by the prolongation, struggle to pronounce, and
repetition of certain words and syllables. The longer the prolongation or
repetition, the more severe the impediment.

How is the severity of a stutter measured?
The severity or degree of stuttering is graded by most researchers by the
percentage of syllables prolonged or repeated while speaking. Speech
pathologists and therapists conduct tests to examine the ratio of non-stuttered
and stuttered syllables in a conversation. The most prominent method of
classification of the degrees of severity is as follows –

 * Less than 5% of syllables stuttered is considered mild.
 * 5-10% is considered mild to moderate.
 * 10-15% is considered moderate.
 * 15-20% is considered moderate to severe.
 * Above 20% is considered severe.

Speech therapists and pathologists try to ensure that the child/adult being
examined feels comfortable and willing to converse so as to get as accurate a
result as possible.

Does the severity of stuttering increase with age?
Stuttering is pre-dominantly a result a genetic pre-disposition towards it,
though it can occur suddenly in adults due to head trauma and other factors. And
if left untreated, it does increase in severity and becomes more difficult to
treat. As one grows up, objectively speaking, one deals with more stress,
anxiety and societal pressures than children. So, a child who stutters needs to
be cared for, guided, and educated in how to cope with and navigate these
pressures as early as possible.

Depending on the severity of the disfluency, the speech therapists curate and
customize the treatment required. Whether through word/ phrase substitutions or
through vocal and breathing exercises, the better understood the condition, the
better is shall be treated.

Understanding Degrees of Stuttering Severity

For a kid, stuttering may or may not cause a significant emotional impact. Since
it is common, and most kids do not have any inhibitions, their daily lives are
typically the same. And, all the more, the parents would work with them day in
and day out to help them cope up, practice, and take them to speech therapy.
But, when you are a teen, young, or even an older adult, stuttering may hold you
back from your day to day life. While that’s not the only reason, it will also
keep you back from doing things you love.

Why You Should Accept Your Stuttering?
 * Open to a World of Possibility: When you accept that stuttering is a part of
   life, you can do anything you want. Did you want to be a part of a college
   club? Do you want to hang out with your colleagues after work? All you need
   to do is clear your schedule.

 * Understand People Better: Stuttering sometimes can be a lonely world. And,
   even when people try and help you by saying things like ‘Hey relax, take a
   break’ or ‘Just accept the way you are’ can be hurtful. But when you adjust
   your attitude and have a conversation with them, you might realize that the
   issue was in your head than their mind. It will help you connect with your
   people and form long- term relationships.

 * Lessen Your Anxiety: If you have been taking therapies and working on your
   speech every day, it adds extra tension on you to perform well all the time.
   Your thoughts may range from ‘If I don’t do that, people will know I
   stutter.’ Hiding from people continually can be exhausting. Once you let go,
   your anxiety will come down, thereby reducing the stutter.

 * Reduces the Pressure to Be Perfect: It is in continuation of the previous
   point. Your constant need to be perfect and in sync is a myth. Celebrities
   like Tiger Woods, Julia Roberts, Emily Blunt, Nicole Kidman, Ed Sheeran,
   Shaquille O’Neal have battled stuttering at some point. And, once you start
   connecting, you will also find people who are similar to you.

Ways to Accept Stuttering
There are many ways to accept your stuttering. There are no right or wrong ways
about it. It depends on person to person and their ways to cope with it. Some of
them include:

Wear a Pin: The stutter association gives out a pin to wear them as a badge on
your dresses and bags. You can wear them to publicly talk about it or make
yourself visible for people who need to connect.

Find a Support Group: The best way to talk about your feelings and accept the
issue is to find a support group. By that, you will come across other’s
experience and how they deal with it, which in turn gives you the boost to
handle your issues. In support groups, you can also make a like-minded friend.

Speech Therapy: Speech therapy is the most common way to combat stuttering. But,
gone are those days where you need to take time and rearrange your entire day to
visit a therapist. You can now download the Stamurai app to practice your speech
therapy daily based on when you are free. You can also connect with us on social
media and join our online community.

Accept your stuttering might be a huge milestone and scary. But, it will only
make you more genuine and sincere.

Should You Accept Your Stuttering? Yes, Absolutely

People who stutter can be highly successful in their jobs and in their lives. We
have met with professors, researchers and academicians, who still struggle with
stuttering. We know about actors, directors, poets, authors, entrepreneurs and
politicians who have speech dysfluencies.

Do you believe it was always easy for these highly successful and popular people
to socialize or express their thoughts?

Whether you come from an affluent background or a humble one, the struggles of
stuttering, the frustration of not being able to express your own thoughts
remains the same. As children, most of us have been bullied by students and
sometimes by our teachers. High school was no different – lunch hour was always
lonely! Each time we got stuck on a word, the burden of shame and anxiety seemed
to increase till it held our tongue down like a lead anvil and we went home
feeling like a failure.

Sadly, for the many of us, who love to speak with ourselves during our “alone
time”, or read poetry when no one’s listening, such feelings of failure are
still real. Personally, I find it difficult to identify when the cumulative
trauma actually began. However, I know for sure that it would have continued
till today had I not found the help I needed.

Today, you might find it difficult to leave your house or speak to a stranger,
but that does not mean, you cannot overcome the hardships and meet success on
your way!

Here are some of the practices that have helped me over the past few years to
take control of my negative emotions and reduce my anxiety –

 1. Include 5 minutes of mindfulness to your day – When you are just sitting
    around at home, or waiting for the reply to an email, you can practice
    mindfulness. You can use guided meditation if you are a first- timer. The
    goal is to not judge or justify your emotions. Mindfulness is about
    accepting whatever emotion you are feeling and increase your tolerance for
    all sorts of emotional pain. Mindfulness will also help you feel less
    afraid, anxious and embarrassed when it’s your turn to speak. Once you are
    the master of your emotions, there is no stopping your fluency!
 2. Practice grounding – We practice grounding only when emotional pain becomes
    too difficult to bear. It works by focusing on the exterior world, for
    example, the work you may be doing right now. It is only a technique that
    allows us to distract ourselves from the harsh emotions of anger, sorrow,
    disappointment, and anxiety for a period. Grounding is what allows us to be
    in touch with the realities that surround us rather than the negativity that
    tries to take hold of our minds. Grounding can be a physical exercise or a
    mental one. For example, it can be as simple as touching the pen in your
    pocket before you start speaking or making a mental note of all the colours
    your listeners are wearing today. You can also choose to think about your
    favourite animals, birds or flowers to ground yourself to what is real and
    far away from the rage, fear or aversion you are feeling within.
 3. Use resourcing to feel better – Everyone has at least one good memory or a
    happy place that they go to when they feel troubled or despaired. Resourcing
    is the method of using happy or positive memories to reinstate a positive
    emotional state despite the sadness, disappointment or frustration you might
    be feeling. Sometimes, it can be the memory of a sunny afternoon you spent
    with your dog at the park, or a lazy Sunday spent on the couch with nothing
    but chips and diet coke for dinner. This exercise helps build resilience.
    The resilience zone is what helps in managing strong negative emotional
    responses and brings calming sensations.

According to experts including Charles Van Riper and Barry Guitar, stuttering is
a problem that has multiple unknowns. That is precisely what makes it extremely
difficult to cope with the emotions the bubble up once a person who stutters
begins to face criticism, mockery and discrimination.

Accumulating trauma often contributes to crippling anxiety made worse by peers
lacking empathy.

The treatment for stuttering is not uni-dimensional. Moreover, it is not the
same for every individual. Your speech-language pathologist or speech therapist
should be able to guide you towards fluency through speech exercises. However,
for many adults emotions play a strong role due to the accumulated trauma,
embarrassment and anxiety that has controlled their fluency for years, or even
for decades. Therefore, you might want to seek the help from a cognitive
behavioural therapist, along with the support of modern technology (mobile apps)
that can help you focus all the energy towards a more positive direction.

Channel your Emotions to Reduce your Stutter

Most of you have found Stamurai because you stutter, or you want to help a
friend or family member who does. Speech exercises and motivational talk can
help those who stutter, but it is incredibly important for those around them to
create a support network.

To be supportive the first thing someone needs to learn is how to talk to
someone who stutters. So, today’s post is slightly different – it is not just
for those with speech dysfluencies, but for their families, friends, teachers
and peers.

Why is this post important?
People who stutter are often perceived as less intelligent by the ones who have
never experienced speech dysfluencies. It is far from the truth. Some of the
most successful entrepreneurs, scientists and researchers, doctors and speech
therapists, teachers and professors, actors and singers stutter when they speak.

It is time for us, the ones who don’t stutter, to change our opinion and
perception about the ones who do!

How we address a person and converse with them says a lot about how much we
value them and respect them. It is easy to say that we must never discriminate
against someone with fluency issues, but it’s difficult to practice that. You
may have a friend, family member, student or colleague who stutters. You might
find it awkward at times to hold a conversation with them simply because you
don’t know if you should finish their sentences, urge them to slow down or just
be patient.

Well, let’s find out, shall we?

The do’s and don’t’s of talking to someone who stutters –
 1. DO NOT offer them speaking advice – “Maybe you should slow down”, “organize
    your thoughts before you speak”, or “maybe you should get some more rest” –
    are pieces of “advice” PWS have received thousand and one times. Although
    they might smile and nod when you offer your advice to them, it really does
    not help. In the case of people who are otherwise fluent, but experiencing
    some level of disfluency while talking, these are helpful advice. However,
    the causes of stuttering are multifaceted and slowing down does not get rid
    of one’s stuttering. In place of helping, you can come off as patronizing
    and condescending. It can end your conversation prematurely, change its
    direction or put the PWS off completely. So, no matter how much you have
    read about stuttering and the treatments for stuttering, please refrain from
    giving any advice when a PWS is trying to hold a conversation with you.
 2. Be patient – There is nothing a person wants more than to be heard. So, why
    try to rush a person through their speech or try to complete their sentences
    and find words for them, when they are sharing their thoughts and ideas with
    you. It happens more often with PWS that they’d like, and honestly, it’s
    more than just a tad bit disrespectful. They might even have a better
    knowledge of the language and a vibrant vocabulary, which you will never
    find out if you keep interrupting. The key to becoming a good friend or a
    strong part of one’s support system is by being a good listener. Maintain
    proper eye contact, don’t fill in for them, and just listen! Holding a
    successful conversation with someone who stutters is as easy as that.
 3. Don’t be afraid to ask twice – We know it can be difficult to understand
    what someone is saying especially if the person is experiencing too many
    blocks, repetitions and prolongations during the speech. Even therapists
    have to double-take at times to understand their clients. So, don’t just
    keep smiling and nodding your head if you don’t understand what a person
    with a stutter is saying. Asking them to repeat themselves for clarification
    just shows that you are invested in the conversation, and you have respect
    for their opinions/thoughts. Just be polite about asking the person to
    repeat that’s all. Something as simple as “pardon me, could you please
    repeat what you just now said?” or “I’m sorry, I quite didn’t catch that.
    Could you please say that again?” can be very effective.
 4. Focus on the matter of the conversation – Have you ever tried to hold a
    conversation with someone inside a bar, or in a school corridor? All you
    have to do is focus on what the person is saying and filter the noise out.
    You can use the same strategy to talk to someone who stutters. If you are
    really interested in a conversation, the repeats, blocks and prolongations
    will automatically mute themselves in your brain after a while and you will
    be able to hear what the person wants to say. While all you need to do is
    focus on the matter of the conversation, you need to acknowledge the fact
    that the speaker may take a couple more minutes to finish what they are
    saying due to their speech dysfluency.
 5. Accept that stuttering is NORMAL – Sometimes, we get too caught up in the
    definition of normal. With 70 million people around the world who stutter,
    it is nothing more or less than normal. It is up to the people with fluent
    speech to accept the fact that it’s indeed ok for people to stutter. It is a
    speech dysfluency that does not make a person any less capable, intelligent
    or knowledgeable than someone without speech problems. It is up to everyone
    to destigmatize stuttering.

Talking to someone who stutters should not be any different from someone who
doesn’t. You need the same basic listening skills that you need to carry on any
conversation in your daily life. As long as you remember to treat someone who
stutters with the same respect as others, you will find it quite easy to hold a
pleasant conversation with them.

Changing the perception about stuttering: 5 tips for talking to someone who stutters

What is autism spectrum disorder?
Autism is not a disease. It simply means that the person’s brain functions
differently from the majority of the people. It is a spectrum disorder, which is
a developmental disorder. Children and adults with autism spectrum disorder can
show a variety of signs and symptoms that are atypical. They primarily exhibit
deficits in areas of social interactions and repetitive behaviour.

People who fall under the ASD often show difficulties in the interpretation of
nonverbal behaviour, social interactions, and reciprocal relationships.
Additional criteria for the diagnosis of autism include repetitive or
restrictive behaviours, fixations or restrictive interests, under or
overreaction to sensory stimuli, repetitive movements and inflexibility in
behaviour.

Relationship between autism spectrum disorder and speech fluency
Autism can vary significantly in severity – Profound (severe) Autism, Moderate,
Mild (High Functioning) and Asperger Syndrome. The spectrum sees a high
variation of different types of intelligence, motor skills, verbal communication
and social-emotional interaction.

The social deficits observed in autism, people within the spectrum can face
difficulties in verbal communication. It calls for the intervention of
speech-language pathologists (SLPs) for support in certain areas of language as
well as communication. The documentation of fluency issues in autism is still
expanding and much remains to be observed, and learnt about the atypical speech
dysfluencies that occur along with ASD.

Over the last couple of decades, several different types of dysfluencies have
been identified which include –

 1. Stuttering
 2. Cluttering
 3. Excessive non-stuttering-like disfluencies (NSLDs)
 4. Word final dysfluencies (WFD) or atypical dysfluencies

SLPs have identified these types of speech dysfluencies in preschool-aged
children as well as adults.

How do the cognitive features of autism relate to fluency?
Till date, several theories have emerged regarding the cognitive uniqueness of
autism that might influence the fluency of the individuals. These theories
attempt to explain the manifestation of all the symptoms of autism and the
variation of the intensity of symptoms across the spectrum. The most popular
theories include the Theory of Mind (Baron-Cohen, 1995), Executive Functioning
Deficits (Ozonoff, Pennington and Rogers, 1991), Impairments in Central
Coherence (Frith, 1989), Information Processing (Minshew and Williams, 2008).

However, to date, no one theory has successfully explained all the aspects of
ASD and the different intensities of symptoms across the spectrum in individuals
of different age groups. Among all the theories mentioned above, Executive
Functioning Deficits draws attention to the weakness or even lack of working
memory in many cases. Working memory includes the skill of holding information
in one’s mind to carry out a task. Interruptions in the functioning of the
working memory can lead to the loss of one’s train of thought. Working memory is
crucial in carrying a conversation forward. In such cases, conversational speech
can be highly disfluent including non-stuttering like dysfluencies like
revisions and interjections.

Why are fluency disorders so common among people with autism spectrum disorder?
The further examination of existing literature on autism and its relation to
working memory revealed quite a few conflicts. Studies by Joseph et. al. (2005)
discovered that during self- ordered pointing test in school-aged children those
with ASD did not rely on verbal communication to meet the demands of their
short-term working memory like the control participants without ASD. Similarly,
fMRI studies by Koshino et. al (2005) shows that adults with ASD used visual
cues instead of verbal codes to complete tasks.

These results go on to show that people in the spectrum use different mechanisms
or strategies to use working memory than those outside the spectrum. Therefore,
the literature suggests that individuals with ASD not only think differently but
also respond to the demands of their working memory very differently from those
with ASD. There is a good chance that these strategies take care of any overload
on the working memory. At the same time, when there is an overload, the person
may use NSLDs as placeholders to regain their train of thought during a
conversation.

At the same time, individuals within the spectrum may use WFDs as atypical
strategies to compensate for an overload of their working memory. That is
evident from research by Scaler Scott et al (2013) that shows that people with
ASD who use WFDs have reduced the frequency of WFDs with a controlled increase
of pausing during a conversation.

What is the treatment for typical and atypical disfluencies for individuals
within the spectrum?
SLPs trained in the assessment and therapy of speech dysfluency can help in
assessing the level of disfluency of SLDs and NSDLs in individuals with ASD.
Their first goal is to typically identify the type of dysfluency and then work
with the individual to set goals.

 * If the individual has stuttering or SLDs, the SLP can help by teaching breath
   control, speech exercises and control of muscle tension that govern
   stuttering. You can find many similar exercises and literature on stuttering
   and stuttering like disorders on Stamurai.
 * In the case of cluttering, the SLP will work with the individual to regulate
   the rate of speech, timed pauses and emphasis on clarity.
 * For atypical disfluencies like WFDs, the SLP may try to identify the root
   cause of the disfluency. They might work with a psychologist or therapist to
   explore the extent of the symptoms of ASD and the atypical
   disfluency/disfluencies as a coping mechanism(s).

Treatment programs for speech dysfluency can be highly varied depending on the
intensity of the stuttering, NSLDs and WFDs, and the features of autism that
manifest within the individual. Till now the only published work on the complete
treatment plan is only for stuttering like dysfluencies by Brundage, Whelan and
Burgess (2012). In this case study, the team reported success in the treatment
of an adult within the spectrum with SLDs.

The existing literature on autism and the treatment of WFDs suggests that there
is the chance of spontaneous recovery in younger children with ASD, and the
management of long-term challenges that come with WFDs in ASD. However, it is
clear that the world needs a large-scale study that involves more people (with
ASD and control), with varying ability levels, age groups and different
approaches to treatment.

References
1. https://www.nhs.uk/conditions/autism/what-is-autism/
2. https://www.sciencedirect.com/science/article/pii/S1877042815020595
3. https://www.stutteringhelp.org/autism-spectrum-disorders
4. https://www.sciencedirect.com/science/article/pii/S1877042815020595
5. 
https://network.autism.org.uk/good-practice/evidence-base/autism-and-disfluent-speech

Dysfluent speech and autism spectrum disorder

Dysfluencies in speech can be developmental or acquired. Acquired dysfluencies
can be of multiple types including neurogenic and psychogenic.

What is neurogenic stuttering?
Neurogenic dysfluency is mainly due to damage to the central nervous system
(CNS). Modern research can associate neurogenic dysfluency with multiple areas
and types of cerebral (brain) damage. It can be a result of direct brain trauma
from accidents, disease(s) of the brain and/or spinal cord. More specifically,
it can result from the damage or injury of the cerebellar region, cortex or
subcortex of the brain, or the neural pathways.

Such diseases and injuries can include –

 * Head trauma
 * Cerebrovascular incidents (stroke)
 * Ischemic attacks (temporary halting of blood flow to the brain)
 * Cysts, tumours, and/or other neoplasms
 * Encephalitis, meningitis, AIDS or Guillain-Barre syndrome
 * Degenerative diseases of the brain or nervous systems like Parkinson’s, ALS
   or Multiple Sclerosis
 * History of drug use or side effects of prescribed medication

In most of the cases, neurogenic dysfluencies arising from trauma or diseases of
the brain or nervous system can be identified. In rare cases, individuals may
show the presence of stuttering without any distinct indication of trauma or
neurological damage.

[https://stamurai.app/z4HKmlNXigb]What is psychogenic stuttering?
Psychogenic dysfluency or speech disorders include a broad category of speech
fluency problems that may arise from the manifestation of one or more
psychological processes. It is a less-researched and even lesser-talked about
area of speech dysfluencies since speech disorders are typically difficult to be
categorized into psychological or psychosomatic.

A person might have both speech disorders and psychological disturbance(s).
However, it does not mean that the person has a psychogenic disorder. For
example, a person with a typical voice disorder may suffer from anxiety or
depression. That does not mean the cause of their voice disorder stems from
their depression or anxiety. The voice disorder may be explainable by
differences in the structure of their vocal cord(s).

The causes of psychogenic speech disorders including psychogenic stuttering can
include –

 * Depression
 * Conversion disorders
 * Emotional response(s) to traumatic events
 * Anxiety

In fact, it can include any psychological disorder that interferes with the
individual’s voluntary control of speech or a component of speech. These can be
perceived as dysfluencies like stuttering or changes in voice.

[https://stamurai.app/z4HKmlNXigb]Who can experience neurogenic stuttering?
Neurogenic stuttering can develop after brain trauma or disruption of the neural
connections in the brain. Therefore, it does not have a particular age of onset.

In most cases, neurogenic stuttering occurs in those who have had a fluent
speech in the past. Some may have experienced developmental stuttering
[https://ghost.stamurai.com/causes-of-stuttering-in-adults/] but recovered in their
adulthood. Although it can occur at any age, it has the highest incidence in the
geriatric population.

Differential diagnosis of neurogenic stuttering
There are a few characters that help in distinguishing neurogenic stuttering
from other forms of stuttering –

 * Repetitions, blocks and repetitions can occur at any position of the word as
   opposed to developmental stuttering where dysfluencies only occur at the
   beginning of the word.
 * The speaker may experience annoyance, but they do not appear overly anxious
   about their fluency problem.
 * There is an absence of an adaptation effect
 * Secondary symptoms common in developmental stuttering are almost absent.

Treatment of neurogenic stuttering
Like every other form of stuttering, neurogenic stuttering calls for the
intervention of a speech-language pathologist (SLP). Since a huge spectrum of
neuropathologies can cause stuttering, the intervention of only an SLP is not
enough.

One of the tell-tale signs of neurogenic stuttering is that the same person had
fluent speech before the accident or incident or the manifestation of the
disease. Therefore, the treatment of neurogenic stuttering requires diagnosis by
neurologists.

The evaluation includes the assessment of the fluency problem by the SLP as well
as the neurologist. The person’s case history, communication impairments and
medical status play a significant role in the diagnosis as well as the treatment
of neurogenic stuttering.

 * Non-pharmacological treatments include delayed auditory feedback (DAF)
   [__GHOST_URL__/daf-stuttering-guide/] that decreases the rhythm of speech to
   improve fluency.
 * Frequency Altered Auditory Feedback (FAF) is another technique that uses
   pitch distortion to create the “feeling” that someone else is saying the
   speaker’s speech in another voice.
 * Masking Auditory Feedback (MAF) is another non-pharmaceutical technique which
   adds external noise to the speaker’s voice so that the speaker can no longer
   hear their voice.

The studies on these methods to treat neurogenic stuttering are rare. However,
treatment of the cause (trauma, lesion or disruption of neural pathways in the
CNS) can relieve neurogenic stuttering in mid-aged adults.

The treatment of neurogenic stuttering in the geriatric population due arising
due to degenerative conditions of the brain or CNS is often more difficult to
treat, especially since there is little evidence of pharmacological treatment
working in favour of the patients.

Who’s at risk for developing psychogenic stuttering?
There is no particular age group for developing psychogenic stuttering. It can
begin abruptly even in people without any history of developmental stuttering.

Psychogenic stuttering typically results from emotional trauma and even from
emotional stress. It is often difficult to diagnose psychogenic stuttering since
it has no particular age for onset.

Moreover, two different individuals experiencing the same or similar trauma may
not develop stuttering together. In fact, one of them might never develop
stuttering at all.

Differential diagnosis of psychogenic stuttering
Diagnosing psychogenic stuttering can be challenging even for the most
experienced SLPs and psychologists. According to Roth, Aronson and Davis (1989),
psychogenic stuttering has a few common characteristics –

 * Psychogenic stuttering mainly affects phonation and articulation
 * A history of psychological stress or trauma before the onset of stuttering
 * Atypical dysfluencies – repetition of stressed syllables with little response
   to choral reading, DAF, FAF or white noise.
 * No secondary behaviours like avoidance or escape like in case of
   developmental stuttering
 * The presence of la belle indifference (the person is unphased or unaware of
   their stuttering)

[https://stamurai.app/z4HKmlNXigb]Treatment and counselling of psychogenic
stuttering
In the case of psychogenic stuttering, the SLP of the patient has to collaborate
with their psychologist, psychiatrist or neuro-psychiatrist and other healthcare
professionals who can draw up a complete history of the patient’s health,
medical and surgical data.

The SLP’s role while treating a client with psychogenic stuttering is that of
the communication counsellor. It includes a detailed discussion of how the
individual’s psychogenic stuttering has impacted their ability to communicate.

Depending on the primary symptoms the client shows, the SLP can and will use
different non-pharmacological treatment techniques. For example –

 * The SLP can recommend a manual laryngeal musculoskeletal reduction technique
   if the client’s primary symptom involves changes to the voice. The therapist
   may also recommend the use of abdominal breathing exercises.
 * Speech modification strategies like changing the timing of pauses between the
   words and syllables can also work.
 * The SLP may try different postural changes of the jaw to relieve the tension
   that may be contributing to the stuttering.

The treatment of psychogenic stuttering calls for an SLP along with mental
health counsellors or psychologists, irrespective of the age of the client. Even
children can experience psychogenic stuttering, which can be difficult to
distinguish. If stuttering appears suddenly in children between the ages of 5
and 10, it might be psychogenic in nature. However, it is critical to consult a
speech therapist to get a differential diagnosis. Parents must never assume the
nature of stuttering in children before approaching for treatment.

Both neurogenic and psychogenic stuttering are forms of acquired stuttering.
They exhibit disorders of rhythm of speech in the forms of involuntary blocks,
repetitions and prolongations of sounds.

There are several superficial similarities between psychogenic and neurogenic
stuttering. The role of an SLP is critical in the development of a treatment
plan for anyone suffering from any form of acquired stuttering.

Neurogenic Stuttering vs. Psychogenic Stuttering

Everyone who is trying to come to terms with their stuttering
[https://ghost.stamurai.com/stuttering/] share a common dream – one day they will wake up and
speak with complete fluency.

Sadly, that remains a dream for most, especially those who do not have access to
speech therapy and counselling. Most individuals talk without any repetitions,
blocks and prolongations. However, even the most fluent speaker experiences some
dysfluency during their lifetime.

However, a person who stutters severely does so on at least 50% of the words
they speak. They tend to stutter more when they are under duress, but stress,
fear and anxiety do not precipitate stuttering [__GHOST_URL__/stuttering/] in
children or adults!

So, when someone asks “how to stop stuttering?” there are quite a few factors a
speech therapist needs to assess before giving them the right answer. The truth
is, the treatment or cure for stuttering not only changes with each age group,
but also with every individual depending on their personality, emotions and
avoidance behaviours.

What is developmental stuttering?
Developmental stuttering [__GHOST_URL__/stuttering/] typically begins in
children when they are developing their language skills at lightning speed. It
is typically between the ages of 2 and 3.5 years. It is a common form of
stuttering which depends on multiple factors including genetics, heredity and
environment. There are other forms of acquired stuttering that demand different
courses of treatment.

Here, we will talk about how to stop developmental stuttering and its treatment
in children, adolescents and adults.

Is there a treatment or cure for stuttering?
The treatment of stuttering [__GHOST_URL__/treatment-for-stuttering/] depends
upon the age of the patient, the symptoms exhibited by them and their overall
general health. The severity of stuttering dictates the course of treatment and
its success. It is too early to conclude that stuttering cannot be cured.
Sometimes, the treatments work well enough so that the person is able to speak
fluently most of the times with the help of breathing and speaking exercises.

Currently, there are applications like Stamurai [https://stamurai.com/] that
help individuals with stuttering [__GHOST_URL__/stuttering/] to practice their
speech while away from the SLP’s clinic. It is indeed true that not all types of
stuttering have a cure, but it is also possible to overcome the fear or
anticipation associated with stuttering, which in turn, reduces the frequency of
dysfluencies.

The treatment of stuttering [__GHOST_URL__/treatment-for-stuttering/] is often
complicated by –

 * Lower self-esteem of the individual [__GHOST_URL__/stuttering-depression/]
 * Poor performance in school/at work [__GHOST_URL__/reining-in-the-bullies/]
 * Poor social and personal relationships
 * Limited participation and introverted nature

The SLP can directly work with the client to improve their speech fluency and
decrease the impact it has on their work and social life. Adults often require
psychological counselling in addition to speech therapy to encounter the 
emotional problems [__GHOST_URL__/channel-your-emotions-to-reduce-your-stutter/] 
that result from stuttering.

What is the treatment for a child who stutters?
A child exhibits signs of developmental stuttering [__GHOST_URL__/stuttering/] 
may show improvement or complete recovery within a couple of months without any
intervention. According to works of Yairi and Ambrose in 1999, more than 74%
recover without therapy, and as per data from Mansson (2000), 71% recover within
2 years without treatment. Follow ups after 4-5 years show that 85% of these
children continue to speak fluently.

However, if stuttering in children
[https://ghost.stamurai.com/five-stuttering-exercises-to-help-your-child/] continues for
years, well into the child’s elementary school age, then it demands the
attention of a speech language therapist.

Indirect therapy is mainly useful for a child. It is especially useful for
children under the age of 6 or 7. Preschool-aged children can benefit from the
indirect approach which ropes in the parents, guardians, and teachers of the
child. Indirect therapy targets to make changes in the home and school
environment. The ulterior idea is to change the way the adults communicate with
their children at home or school.

Indirect approaches depend on –

 * Speaking calmly and slowly to the child in question
 * Taking out “listening time” for the family
 * Not interrupting the child or completing their sentences
 * Spending time on family activities including word association games, puzzles,
   playing, walking together or simply chatting about each of your days.

Indirect therapy aims to make the family environment as relaxing as possible for
the child to remove as many external stimuli for stuttering as possible.

Direct therapy demands the involvement of the speech-language pathologist (SLP)
working with the child directly. It can be one-one sessions of therapy in small
groups. Sharing, talking to other children who stutter and learning new
techniques to reduce tension while speaking are all integral parts of the direct
approach.

Is there a cure for children who stutter?
Stuttering in children
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/] often goes away on
its own. In other words, it cures itself within a couple of months of starting.

Good and timely therapy of stuttering in pre-school or kindergarten-aged
children can bring about near-perfect fluency with only mild traces of
repetitions, blocks or prolongations that become prominent only when they feel
fatigued, stressed or sick.

What is the treatment and cure for adolescents who stutter?
Adolescents who stutter have significantly higher social anxiety than their
non-stuttering peers. Therefore, tweens and teens who stutter not only require
intensive speech therapy, but also psychological counselling to reduce their
social anxiety and increase their confidence in social scenarios.

According to the researcher, speech pathologist and author Barry Guitar, how to
stop stuttering in adolescents has various phases –

 * Exploring their stuttering
 * Learning superfluency or as Guitar referred to it – controlled fluency
 * Encouraging and increasing approach behaviours
 * Maintaining their progress with daily practice, speech assessment and therapy
   sessions

Apps like Stamurai [https://stamurai.com/] that include speech therapy exercises
that the person can perform when at home, or in between classes. The practice of
speech exercises, correct breathing techniques and controlled fluency is
critical outside the therapist’s office is extremely important to maintain
fluency.

Tweens and teens typically have complex negative emotions
[https://ghost.stamurai.com/channel-your-emotions-to-reduce-your-stutter/] associated with
their stuttering. These require just as much attention as their stuttering
during therapy. The goals include removal of avoidance or escape behaviour.
These are integral parts of behaviour change that allow the individual to attain
fluency in speech. Reducing anxiety and fear which arise from anticipation is
important if the client strives to achieve controlled to mild fluency.

When treating tweens and teens, SLPs have to take into account individual
fluency goals. While the ultimate goal is to acquire spontaneous fluency
irrespective of the situation, the duration to achieve the goal can vary
significantly. After extensive treatment, the clients can achieve periods of
spontaneous fluency that can last between weeks to months. However, stuttering
can return in high octane situations like pre-exam periods, viva voce, or
talking to the opposite sex.

Is there a treatment or cure for stuttering in adults?
In the case of adults, first, the SLP needs to find out what is causing the 
stuttering [__GHOST_URL__/stuttering/]. If the stuttering is not developmental
by neurogenic or psychogenic
[https://ghost.stamurai.com/neurogenic-stuttering-vs-psychogenic-stuttering/]or
pharmacological in nature, then the therapist has to work with general
physicians and other experts to address the dysfluency.

For adults with developmental stuttering, the intervention of a speech therapist
and a cognitive behaviour therapist is indispensable. Adults should remember
that treatment can take quite a long time since by adulthood stuttering has
caused them to develop strong negative feelings, avoidance behaviour and certain
beliefs that act as guards.

A good speech therapist always tailors the treatment for the client’s needs.
This includes addressing the severity of their stuttering, the intensity of
negative emotions associated with their speech dysfluency and setting the goal
realistically. The success of therapy depends on reducing avoidance behaviour
and increasing approach behaviours in adults.

Typically, adults who stutter [__GHOST_URL__/stuttering-treatment-for-adults/] 
continue to experience speech-processing deficits, though they can successfully
compensate for them. Since stuttering is a complex speech disorder that stems
from aberrant brain activity and neural connections, it may be impossible for
some adults with severe stuttering to achieve complete fluency. Therefore, the
measurement of progress is of utmost importance to keep their spirits high.

For daily motivation, you can download mobile speech therapy applications that
help with daily exercises. You must remember that your treatment does not stop
the moment you step out of the therapist’s office, but it continues throughout
your daily routines. Make speech exercises a part of your daily routine for the
best results.

So, how to stop stuttering at any age?
When someone says “cure,” we tend to picture it in the form of a pill
[https://ghost.stamurai.com/medicine-for-stuttering-what-we-know/]. Sadly, in the case of
stuttering, there is no easy cure, especially if one has been stuttering for
more than a few years. Children often take lesser time to recover as compared to
adults, despite the severity of their stuttering.

You can achieve controlled fluency or superfluency with speech and cognitive
behavioural therapy if you are an adolescent or adult. However, you must
remember that it takes time and a lot of hard work to become fluent and make up
for the speech deficits that you may be facing right now.

Sources
1. https://www.stlouischildrens.org/conditions-treatments/stuttering
[https://www.stlouischildrens.org/conditions-treatments/stuttering#:~:text=There%20is%20no%20cure%20for,learn%20to%20breathe%20while%20speaking.]
2. 
https://www.healthychildren.org/English/ages-stages/toddler/Pages/Stuttering-in-Toddlers-Preschoolers.aspx
3. https://www.stutteringhelp.org/stuttering-therapy-children
4. https://pubmed.ncbi.nlm.nih.gov/18617050/
5. https://www.nhs.uk/conditions/stammering/treatment/
6. https://www.medicalnewstoday.com/articles/321995#long-term-treatments

How to stop stuttering?

“It’s dementia”, “it’s the fear of public speaking”, “he’s just not a good
candidate” – a lot of comments and opinions have tried to take charge of Joe
Biden’s narrative ever since Biden called himself a “gaffe machine” on the
debate stage. While there were rumours about Biden losing his edge and falling
victim to old age, it is no longer a secret that Joe Biden
[https://en.wikipedia.org/wiki/Joe_Biden] has struggled with severe stuttering
[https://ghost.stamurai.com/stuttering/] since early childhood.

In Detroit when it was finally Biden’s chance to take control of the narrative
something unexpected happened. The entire nation of the United States of America
saw Biden freeze, stumble and struggle to get the words out. Biden was
experiencing what he had experienced as a child and an adolescent – his 
stuttering [__GHOST_URL__/stuttering/] was taking control of the narrative
instead.

This continued to happen multiple times – in fact, every time Biden went up on
stage on November 2019. So, the world was more than glad when Joe Biden stood up
to talk about his struggles with stammering.

Every time we look at the US presidential campaign we are struck by his
impeccable demeanour and well-strategized choice of clothing. So, when Joe Biden
says, “I haven’t stuttered in so long…but I remember the feeling…”, it indeed
offers a view of his very human and vulnerable side. It is evident that Biden’s
memories of childhood stuttering make it a difficult and emotional subject for
him to talk about. However, that imbibes hope in the millions of people out
there who are currently struggling with their speech dysfluencies.

Humiliation and shame come with stuttering says Biden
Nicknames like “Stutter boy”, and “Stut” didn’t leave Biden either during his
adolescence although he was popular in school and a prolific athlete. He clearly
remembers being bullied [__GHOST_URL__/reining-in-the-bullies/] by one of his
teachers at the Archmere Academy in Claymont, Delaware. When people see him on
TV and glossy magazine covers right now, they mostly see his white privilege –
growing up in a wealthy family and attending college on scholarship. It is
indeed difficult for anyone to realize that he has to win a small battle
multiple times every day even now when he has to face debates and interviews.

According to the presidential candidate, “shame comes with stuttering
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/]”. Although he hasn’t
felt it in a long time, it has part of his life back in elementary school and
high school. He went to an all-boys prep school which meant showing any sign of
weakness was nothing less than a liability. And even modern society sees
stuttering as a weakness.

Joe Biden went on record stating that “stammering is not a sign of low
intelligence [__GHOST_URL__/stuttering-misconceptions/]. It is the only handicap
people still mock.” Humiliation and shame is something every person who stutters
has felt at least once in their life. That is one of the primary reason Biden
took time to meet with 12-year old Brayden when he was in Concord this February.
Biden showed Brayden his speech complete with the markings that showed where
Biden should pause to ease his stutter. He showed a strategy to Brayden and
helped him normalize his speech dysfluency with that small step.

Stuttering doesn’t define or limit a person
Joe Biden, the 47th Vice President of the US, could come this far because he 
didn’t let his stutter define him
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/]. He credits
his mother for that. “Don’t let it define you. You can do it. Remember who you
are, Joey” she said every time Biden was about to face a new challenge. She was
the person who reinforced the belief that a person is more than their speech
dysfluency and that was crucial for his self-confidence.

Biden still finds it difficult to pronounce all the words, especially when he
feels the pressure mount. He hasn’t had professional speech therapy
[https://stamurai.com/]while growing up, but only his teachers (nuns) who taught
him to put a cadence to his speech. It has inspired his love for poetry, but it
has also helped him stutter more fluently.

How did Biden manage to stutter almost effortlessly for decades?
He tried to control his stutter and speech by reciting poetry in front of a
mirror at home, studying every expression closely. Not stuttering and just
saying the feared words gave him the confidence to carry on as a popular student
who would later go on to become the Vice President of one of the most powerful
nations of the world. His small everyday achievements filled him with empathy
and understanding for other people’s handicaps that we clearly see when he
interacts with his fans and interviewers off-stage.

Speech therapy is important for anyone who faces speech dysfluencies,
especially, since people rarely have understanding friends or compassionate
family members. For any adult who stutters, the ultimate goal is not 100%
fluency, but stuttering with ease.

Joe Biden's stutter - How it shaped his life?

Stuttering has been present across almost every culture with similar incidence
and prevalence. In the early days of medical sciences, experts considered
stuttering to be the result of physical abnormalities of the tongue and larynx.
As a result, surgeries to correct these anomalies were frequent.

However, clinical treatments that targeted the larynx and the tongue rarely
showed any improvement of the symptoms. Finally, in the early 1900s, Travis and
Orton postulated that stuttering may have its roots in brain function rather
than a physiological abnormality of the tongue or larynx.

Most modern theories of stuttering are based on the work of Travis and Orton
[https://pubs.asha.org/doi/10.1044/jshd.0504.309] in the 1930s. The
establishment of the possibility that stuttering emerges from anomalous cerebral
activity paved the way for new theories and inspired modern medical research.
After much debate, research and taboo, the Diagnostic and Statistical Manual of
Mental Disorders (DSM 5) now defines stuttering as a childhood fluency disorder.
It typically results from the underactivation of the primary speech centres in
the brain.

Why is there no stuttering medicine yet?
Individuals who stutter and their loved ones have always hoped for a
pharmacological cure for stuttering. Currently, there are no pharmaceutical
compounds that can fully alleviate the symptoms of stuttering
[https://ghost.stamurai.com/stuttering/]. There are no FDA-approved drugs for the cure of
stammering.

[https://stamurai.app/z4HKmlNXigb]Genetics play a significant role in the
incidence of developmental stuttering. Familial studies and twin studies by
Yairi and Ambrose suggest genetic dependence of stuttering. Genes related to
stuttering have been mapped to chromosome numbers 1, 7, 12, 13, 15 and 16 in
recent genetic studies linked to stuttering in children and adults.

Newer studies by Montag et al published in 2012 and Chen et al in 2014 show that
there is an association between the dopaminergic genes (SLC6A2 and DRD2) and
stammering. However, almost all available dopamine blockers come with
significant side effects that dilute their efficacy in reducing the repetitions,
blocks and prolongations in dysfluent speech.

Like most genetic and developmental disorders therapists and doctors can
prescribe medication for the management of stuttering. However, there is no
medicinal treatment that cures the childhood onset fluency disorder. Combining 
cognitive behavioural therapy
[https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/] with
medication often shows better outcomes than using medication only.

Haloperidol and reduction in stuttering intensity
Data from the 1980s show that there is enough correlation between
first-generation dopamine-blocker haloperidol. The compound can improve the
fluency by increasing brain activity in the primary speech centres, but
haloperidol can have serious side effects. The constant use of haloperidol has
been linked with extrapyramidal symptoms, dysphoria, sexual dysfunction and
tardive dyskinesia.

Research shows a relationship between stuttering and elevated dopamine levels.
Moreover, drugs that enhance dopamine activity like L-dopa make stuttering much
worse in people who stutter.

Another dopamine blocking agent – Pimozide, which is similar to haloperidol, has
shown positive responses in clinical trials. However, it has significant side
effects upon prolonged usage. Contraindications include an elevation in the
prolactin levels, tardive dyskinesia, extrapyramidal symptoms, dysphoria and
cardiac conduction concerns.

Not all antipsychotics and antidepressants reduce the stuttering intensity
On the other hand, paroxetine, the antidepressant that reduces the reuptake of
serotonin (SSRI) does not exhibit any clinical response in stammering.
Similarly, tricyclic antidepressants show little effect on the symptoms of
stuttering. A comparative study of clomipramine and desipramine show that
clomipramine show increased improvement as compared from the latter based on
self-reported fluency scales according to two studies published in 1995 by
Gordon et al. and Stager et al.

[https://stamurai.app/z4HKmlNXigb]New-age dopamine blockers work better with
fewer side effects
Second generation dopamine blockers like olanzapine and risperidone have better
effects on stuttering symptoms and exhibit lower side effects as compared to
first-generation dopamine blockers like Haloperidol. Both these compounds have
are better tolerated than haloperidol.

Risperidone shows increased activity in the cortical speech areas and striatum.
According to research, doses between 0.5mg and 2mg per day decreases stuttering
intensity significantly. Although risperidone is well-tolerated, it can increase
overall plasma concentration of prolactin leading to severe side effects
including sexual dysfunction, amenorrhea, galactorrhea and dysphoria upon
prolonged use. Patients treated with risperidone also exhibit increased
metabolism of the left striatal function as per FDG PET studies conducted by
Maguire et al in 2000 (as compared to patients treated with placebo).

Olanzapine has a different tolerability profile as compared to risperidone. It
has lower risks of causing dysphoria, sexual dysfunction and amenorrhea, but it
can contribute to drastic weight gain in patients. Doses of olanzapine between
2.5mg and 5mg can effectively reduce stutter, but these doses can also result in
an average of 4 kg (11 pounds) of weight gain.

A recent study shows that olanzapine might be more effective than haloperidol in
reducing the intensity of stuttering. The compound downregulates the
post-synaptic GABA-A receptors. They act as complete or partial GABA-A agonists
and contribute to decreasing the intensity of stuttering in the targeted
population.

Treatment of stuttering with new and unique pharmaceutical compounds
Ziprasidone is another compound that is well-tolerated and effective for the 
treatment of stammering [__GHOST_URL__/treatment-for-stuttering/]. It is also an
atypical antipsychotic. Another newer compound that has fewer side effects but
reduces the intensity of stuttering is asenapine. It leverages the sublingual
administration and does not contribute to unwarranted weight gain like
olanzapine. Aripiprazole is another compound that acts as a partial agonist of
the D2 and 5HT1a receptors. Aripiprazole is an FDA-approved drug for the
treatment of Tourette’s in children.

Other alpha receptor agonists like Clonidine, calcium channel blockers like
nimodipine and verapamil, and selective GABA-A agonists like Pagoclone have
limited efficacy with a flurry of side effects.

New drugs as stuttering medicine
A new category of drugs that inhibit the vesicular monoamine transporter 2
(VMAT2) is under review as you read this blog. These compounds decrease the
synthesis of dopamine through the VMAT2 inhibition. These drugs including
valbenazine and deutetrabenazine have shown significant promise in the treatment
of tardive dyskinesia, Tourette’s, and abnormal movements associated with
Huntington’s Chorea. At the same time, these compounds pose the risk of
precipitating depression via the non-selective inhibition of monoamines and a
sharp decrease in serotonin levels in the brain.

Should you take medication for stuttering?
The perfect medicine for the treatment of stuttering is still far away. The
ongoing research does hold promise and keep the hope for a medicinal cure of
stuttering alive. Right now, almost every pharmaceutical compound available in
the market for the treatment of stuttering belongs to groups of antipsychotics,
atypical antipsychotics or medication for Tourette’s syndrome. Therefore, there
are scores of side-effects the patient and their loved ones have to deal with
during constant use.

There is no replacement for a good speech language pathologist for the treatment
of stuttering. Even if you are taking medication, you should not discontinue
speech therapy. A combination of speech exercises
[https://ghost.stamurai.com/stuttering-exercises-for-adults/] and medication has been most
effective in treating the signs and symptoms of stuttering.

Is There A Stuttering Medicine Available Right Now?

Yoga is becoming incredibly popular across the globe with the stress levels
mounting due to the pandemic. Lots of people who are not getting enough outdoor
exercise are turning to yoga at home to remain healthy and stave off weight
gain.

Yoga is not one exercise. It is a collection of different static and dynamic
postures (or asanas) that focus on every organ and muscle group of the body. It
can vary in intensity and difficulty between the beginner, intermediate and
advanced levels. It is an ancient form of workout that benefits every organ
system and the nervous system of an individual.

We have heard famous personalities claim how yoga has helped them overcome
speech and fluency disorders. Although the research on yoga and how it affects
stuttering is not extensive, there is enough proof that ascertains its
remediating effects on the intensity of stammering in children and adults.

[https://stamurai.app/z4HKmlNXigb]Does yoga really help reduce stuttering?
According to Heather Kauffman’s research published in 2016, yoga modulates the
activities of the autonomic nervous system. Several other studies already show
how yoga can reduce anxiety, increase focus and absolve physical and mental
stress. While we know that stress, fatigue or anxiety do not cause stuttering,
they can make blocks, repetitions and prolongations much worse in a person who
stutters.

Stuttering is a heterogeneous speech disability. Regular practice of yogasanas
can reduce the intensity and frequency of stuttering by simply alleviating the
physiological stress on the muscles involved in speaking. Moreover, mindfulness
is a natural part of most asanas, which offers peace of mind, confidence and
control of one’s brain functions necessary for the production of fluent speech.
While yoga might not be a magical cure for stuttering, it is indeed an
accessible option for those interested in gaining more control of their body and
mind, necessary to stutter with ease.

Why is it critical to take charge of one’s emotions before they can control
their stutter?
When stuttering and anxiety work as two elements of a feedback loop. A person
might be anxious because they anticipate stuttering, which might cause
tightening of the muscles in and around the vocal cord necessary to produce
speech. This can result in repetitions, blocks and prolongations that contribute
to more anxiety, which further worsens the stutter. It seems like a never-ending
vicious loop.

Well, it doesn’t have to be, if you can manage to control the physical strain or
reduce the level of resident anxiety. Yoga can give you a way to control your
negative emotions including anxiety, shame, and fear that stuttering almost
always brings along. Taking control of your emotions
[https://ghost.stamurai.com/channel-your-emotions-to-reduce-your-stutter] and getting rid of
the negativity can help people who stutter to move away from escape and
avoidance behaviours.

[https://stamurai.app/z4HKmlNXigb]Why should yoga be a part of speech therapy
for children and adults?
Yoga can be a fun and enriching experience for children who stutter. as modern
parents, we might seek out the best speech therapists and counsellors for our
children, but yoga has multiple benefits on the physiology and psychology of
growing children that modern science cannot deny.

Here’s how a child or even an adult can benefit from yoga as a part of speech
therapy –

 1. Yoga and learning – Each asana is named after a creature or element of
    nature like the downward dog or the tree pose. Children can have fun
    exploring new vocabulary and the make-believe that comes with assuming each
    pose named after an animal. Adults can learn new poses, their Sanskrit names
    and their benefits for each part of the body. Adults can complete yoga
    courses and get certifications that can help them expand their job and
    career options. Including yoga in speech therapy can be enriching and
    empowering for adults and children alike.
 2. Yoga and respiration – Controlling one’s breathing is crucial for managing
    one’s stutter. However, for children, breathing exercises can be quite
    boring and difficult to remember. Incorporating breathing exercises as a
    part of therapy in the form of pranayama is not only interesting but also
    quite easy to remember as each breathing technique in yoga has a name.
    Teaching conscious breathing to children and adults is much easier through
    yoga and pranayama. Simple techniques like Anuloma-Viloma, Bhramari and
    Kapalbhati can help a person gain control over their breathing and engage in
    coordinated movement of their facial and vocal muscles.
 3. Yoga and speech production – Yoga, pranayama and meditation involve fine
    motor planning via execution of breathing techniques and chanting. The
    execution of yoga sessions in predictable routines among a select group of
    people can create a familiar environment that encourages the learning of
    motor sequences among children and adults. Children and adults who have
    trouble with fine motor planning can find confidence from the repetition of
    the gross and fine motor routines, and choral speaking that occurs during
    pranayama and meditation chants. Therapists can include other chants and
    modify the sequence of exercises to encourage sound production among their
    clients.

How does yoga help those who stutter?
Research by Kauffman shows that yogasanas can induce the activation of the
parasympathetic nervous system and the suppression of the sympathetic nervous
system. The parasympathetic nervous system is responsible for lowering blood
pressure and cortisol levels in the body. Its activation releases
neurotransmitters that promote relaxation and naturally reduce the anxiety
response of the body. Lowered cortisol and adrenaline in the system allows the
person to relax physically and mentally.

Yoga not only consists of asanas but also breathing exercises (pranayama) and
meditation that can result in the activation of the parasympathetic nervous
system becoming dominant. In such conditions, the person can control their
feelings and execute their speech without letting stress, fatigue or anxiety get
in their way quite easily. Several studies on people who stutter note that
meditation, pranayama and asanas clinically reduce blood pressure and other
signs of stress. Regular practice of yoga imbibes confidence that definitely
contributes to smoother and effortless stuttering.

Can yoga cure stuttering?
There is currently no guaranteed cure for stuttering. Yoga can help a person
relax which is necessary to produce sound and speech. According to Ginsberg
(2000), stuttering involves complex physiological, emotional and anxiety
factors. A disorder as heterogeneous and complicated as stammering calls for a
wholesome treatment or therapy plan. Indeed the relationship between stuttering
and yoga isn’t direct or simple, but it is also true that yoga has several
potential positive effects on the lives of those who stutter.

Yoga for Stuttering: Can Yoga Aid Speech Therapy?

Stuttering is a common speech fluency disorder. Today, between 0.72% and 1% of
the world's population stutters. People who stutter include children,
adolescents, adults, and the elderly. Some begin stuttering from early childhood
and stutter well into their senior years.

There are several cases where children show symptoms of stuttering but recover
on their own within a year or so. Then there are the others who stutter
throughout their childhood and adulthood before seeking speech therapy.

Although rare, there are a few cases of sudden onset of stuttering in adults. In
such cases, it is important to consult a medical professional as well as a
speech-language pathologist to determine the causes of stuttering.

If someone develops stuttering as an adult, it may be a case of acquired
stuttering. Keep reading to find out why you or someone you know may be
developing a stutter in adulthood.

[https://stamurai.app/z4HKmlNXigb]What Causes Stuttering in Adults?
Any child, adolescent or adult who began stuttering when they were between 2 and
4 years old, has developmental stuttering. Developmental stuttering is the most
common form of stuttering. The prevalence and incidence of developmental
stuttering vary significantly per year according to country and region.

Roughly 2% of adults between the ages of 21 and 49 years stutter due to
developmental reasons. Repetition of one-syllable words, silent or audible
blocking, broken words or pauses, prolongation of vowels and consonants, and
words produced with unnaturally high physical force are all symptoms of
stuttering.

Why Does Developmental Stuttering Continue Well into Adulthood?
Can you develop a stutter in adulthood? Yes. However, a majority of the
population begins stuttering in their early childhood and continues to do so in
their later years due to lack of speech therapy and stuttering treatment
[https://ghost.stamurai.com/stuttering-treatment-for-adults/].

Here are a few reasons why many individuals continue to stutter in their
adulthood.

1. Genetic factors
More than 80% of the children who stutter typically have a family history of
stammering. Multiple chromosomal aberrations may contribute to stuttering.
Preliminary studies show that genes on chromosome 18 may contribute to
developmental stuttering.

Studies by Cox and Yairi in 2000 have identified three chromosomes (16, 13 and
1) that may contribute to developmental stuttering. Another study by Riaz,
Steinberg, Ahmad, Pluzhnikov, and Riazuddin et al. in 2005 has shown a strong
link between genes on chromosome 12 with familial stuttering. In 2006,
Wittke-Thompson et al. published a study that showed that chromosome 15 is
associated with persistent stuttering.

Another recent study showed that in the case of males, stuttering was linked to
a gene on chromosome 7. In the case of females, stuttering was linked to a
specific location on chromosome 15.

[https://stamurai.app/z4HKmlNXigb]2. Brain Structure and Function
A study by Brown et al published in 2005 showed that people who stutter have
lower activation of areas involved in auditory functions. The mechanisms
associated with hearing one’s own speech may not function optimally in those who
stutter.

fMRI studies have shown that people who stutter typically exhibit a higher 
right
hemisphere activity [__GHOST_URL__/how-brain-repairs-stuttering/] during the
speaking. The excessive activation of the right precentral sensorimotor complex
is prevalent during speech tasks among children who stutter.

Studies by Chang et al. include the anatomical differences in the brain
structure of children and adults who stutter.

3. Language
Stuttering begins in children when they are rapidly developing their language
skills. It begins as children start using bigger words and longer sentences to
express themselves. It is common for parents to notice symptoms of stuttering
like repetitions, blocks and prolongations appearing for the first time in their
children between the ages of 2 and 4 years.

Language factors have more impact on how a child stutters – like the beginning
of a word that starts with a consonant. However, children who stutter
[https://ghost.stamurai.com/stuttering-treatment-preschool-kids/] have more phonological
challenges as compared to those who don't stutter. There is no consistent result
that indicates a higher prevalence of stuttering in multilingual children.

[https://stamurai.app/z4HKmlNXigb]4. Environmental Factors
Stressful environments can precipitate stuttering in already vulnerable
children. Environmental stress can include an overly competitive household or
sudden changes in the neighbourhood.

Unexpected changes to a child’s routine or sudden emotional trauma resulting
from loss can worsen stuttering. However, predisposition and environmental
factors work together to precipitate stuttering. Only stress does not induce
stuttering in a child who has no history of stuttering in the family.

Most adults who stutter do so since their early childhood. Developmental
stuttering often responds to regular and rigorous speech therapy. Speech
language pathologists along with psychological counsellors can help adults
reduce their frequency and intensity of stuttering over time.

Acquired Stuttering: What Causes People to Develop a Stutter Suddenly in
Adulthood
Adults who are fluent in speech can experience the sudden onset of stuttering.
Acquired stuttering is the broad term for this condition. It can happen due to
multiple physical, psychological and psychosomatic factors.

If someone you know begins stuttering in their adulthood, you should treat the
situation with urgency and seriousness.

Here are the different types of acquired stuttering that can affect adults –

1. Neurogenic Stuttering
It is an acquired speech disorder that generally arises after trauma to the
brain. It can be the result of a cerebral vascular accident (CBA) or a
neurodegenerative disease.

In at least 50% of the cases, aphasia, verbal apraxia or dysarthria accompanies 
neurogenic stuttering
[https://ghost.stamurai.com/neurogenic-stuttering-vs-psychogenic-stuttering].

Medical history and comorbid conditions play critical roles in the differential
diagnosis of neurogenic stuttering. One sign of neurogenic stuttering is that it
can occur at any location on a word. The stutter does not have to be at the
beginning of the word or its second syllable.

[https://stamurai.app/z4HKmlNXigb]2. Psychogenic Stuttering
This type of stuttering in adults arises from psychological factors. It may
occur alongside other psychological disorders. Often psychogenic stuttering is
the result of severe emotional trauma. It can also occur due to prolonged
psychological trauma.

It is extremely rare. Many psychologists and speech therapists consider it a
conversion reaction. Medical history of the individual is important for the
differential diagnosis. It can help rule out other forms of acquired stuttering.

You should remember that the presence of neuropathy does not invalidate the
diagnosis of psychogenic stuttering.

3. Pharmacogenic Stuttering
New medication or an overdose can cause sudden stuttering in adults. Medical
research shows that drugs like broncho-dilator theophylline, selective serotonin
reuptake inhibitors (SSRIs) or tricyclic antidepressants can cause
stuttering-like disfluencies in adults as a side effect.

Drug-induced stuttering is distinct from neurogenic stuttering. Speech
therapists and medical professionals can work together to reverse the effect of
the medicinal compound. It may be necessary to reconstruct the recent drug
history of the person, vary the dose or replace the drug entirely to stop the
stuttering.

4. Lesser-known factors that can contribute to new stuttering in adults –
Stress
Only stress rarely precipitates stuttering in adults who are not predisposed to
the disorder. However, it does happen. For example, severe stress caused by
financial issues or bereavement can trigger speech disorders. Even a car crash
or a similar accident can cause them to stutter. It is rather difficult for
doctors and speech therapists to determine stress as the causal factor because
the brain scans and other neurological examinations do not know any aberrations
in the brain structure or function.

A Relapse of Old Speech Disfluencies
Relapse
[https://ghost.stamurai.com/high-relapse-after-stuttering-speech-therapy-understanding-the-reason/] 
is a common cause of stuttering in adults. Dr Charles Van Riper and Dr Barry
Guitar state that when preschool aged children recover from developmental
stutter, they may not have a memory of their speech impediment at all.
Psychological stress, emotional trauma and anxiety in adulthood, and other
factors like change in medication or neurological stress can lead to the relapse
of old speech disfluencies in adults. If the person does not have a record of
their childhood disfluencies, treatment and recovery, it may seem like a sudden
onset without a prologue.

Spasmodic Dysphonia
It is a comparatively rare disorder that presents itself as a recurring block of
the larynx (voice box). It typically begins in the middle-age. Spasmodic
dysphonia causes involuntary spasms in the larynx muscles. It causes the voice
to break and it can create a strangled or strained sound. The problems can range
from not being able to produce a particular sound while speaking to the
inability to talk.

The effects are sometimes very similar to stuttering in adults.

Stuttering is a complex speech fluency disorder that can occur in children and
continue until their adulthood. An adult can begin stuttering suddenly. However,
that is an immediate cause for concern since it signifies neurological, or
psychological disorders or the side effects of a new medication.


Why have I started stuttering in my adulthood?
The plausible reasons for the sudden onset of stuttering will depend upon
multiple factors, such as -

 * Any history of speech disfluencies
 * Co-existing medical conditions
 * Recent development of health issues like a cerebrovascular disease or
   neurodegenerative disorder
 * Occurance of a traumatic brain injury, brain tumor, or brain surgery
 * New medication [__GHOST_URL__/can-some-medicines-make-stuttering-worse/] or
   changing the dose of an existing medication like a selective serotonin
   reuptake inhibitor (SSRI)
 * A recent traumatic event or exposure to prolonged emotional/psychological
   trauma

One or more of these factors can contribute to the onset of speech disfluencies
in adulthood. It is impossible to state why you have begun stuttering suddenly
without a full health checkup.

If you have a history of brain injuries, tumors, surgeries or neurodegenerative
diseases, your doctor might recommend brain imaging studies to understand the
cause of your stuttering.

[https://stamurai.app/z4HKmlNXigb]2. Can you develop a stutter later in life?
Although rare, it is completely possible to begin stuttering later in life (as
an adult). Some adults may find themselves slowly beginning to stutter, while
others may find themselves in the middle of repetitions and blocks quite
unexpectedly. The nature of the stutter will depend upon the cause. To know more
about the potential causes of stuttering in adulthood please refer to the
article.

3. Why do I stutter sometimes?
Every individual experiences some extent of speech disfluency throughout the
day. At the same time, a person who stutters may not do so every time they
speak. Some PWS report increased frequency and intensity of stuttering when they
are anxious, afraid, stressed or worried.

Someone who stutters may do so on about 10% of the words while speaking or
reading aloud. On the other hand, someone who stutters mildly
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/] may do so on
around 5% of the words while reading aloud.

It is quite normal for a child to stutter, but it is rare for adults to begin
stuttering without a history of speech problems! You should consider speaking to
a speech-language pathologist (SLP) and your doctor (GP).

[https://stamurai.app/z4HKmlNXigb]4. Why have I been stuttering so much lately?
Did you stutter as a child? If so, then it may not be a new speech disfluency
but a relapse
[https://ghost.stamurai.com/high-relapse-after-stuttering-speech-therapy-understanding-the-reason/] 
of your old stutter.

Relapses may occur due to lack of practice, as well as increased stress. Stress
does NOT cause stuttering, but it can worsen existing speech disfluencies.

If you have no history of stuttering then you should speak to a medical health
professional and a speech-language pathologist (SLP). A sudden onset of
stuttering in adulthood may have one or more causes. Your stuttering may be
neurological, drug-induced, or psychological.

It is important to consult your GP, neurologist, psychologist/psychiatrist and
SLP to determine the exact cause(s) of your stuttering.

5. Can adulthood stuttering be cured?
In case you are not experiencing a relapse of developmental stuttering
(childhood-onset fluency disorder) there may be a cure.

The treatment depends upon the nature of your acquired stutter.

Neurogenic stuttering typically occurs due to anomalies or disturbances in the
brain structure and function. Your neurologist or neurosurgeon may be able to
guide you towards the right course of treatment. Speech-language pathologists
(SLPs) and speech therapists play integral roles in the treatment of neurogenic
stuttering in adults.

Psychogenic stuttering may have its roots in deep-seated emotional or
psychological trauma. It may be a part of PTSD. In such cases, you may need the
help of a psychologist, psychiatrist and/or cognitive behavioral therapist to
overcome your acquired stuttering. Cognitive behavioral therapy
[https://ghost.stamurai.com/stuttering-and-cognitive-behavioral-therapy-cbt/] (CBT) can help
you significantly in overcoming the anxiety and anticipation related to
stuttering. Mental health professionals may even recommend prescription
medication temporarily to reduce the intensity and frequency of your stuttering.

Pharmacogenic or drug-induced stuttering occurs due to a side effect of
medicines. Some medicines can not only make stuttering worse, but they can
induce stuttering in previously fluent people. If you have started taking a new
medication or changed the dose of an existing medicine before your stuttering
began, you may want to talk to the concerned doctor about it. Typically,
drug-induced stuttering can be reversed by replacing or adjusting the dose of
the drug.

6. Can ADHD cause stuttering in adults?
Attention Deficit Hyperactivity Disorder (ADHD) may cause speech problems and
poor articulation. However, these speech issues are more likely to be present
since the early childhood of the person who has ADHD.

It is unlikely for an adult who has had ADHD since childhood to develop speech
disfluencies as a result of it.

If you are living with ADHD and experiencing a sudden onset of stuttering you
should speak to your psychiatrist and general physician immediately.

[https://stamurai.app/z4HKmlNXigb]7. Can speech therapy help adults reduce the
instances of acquired stuttering?
Speech therapy works across all ages. The time it takes to work may increase
with increasing age.

That being said, the cause of your acquired stuttering will influence the
efficacy of speech therapy. You may need help from your doctor to cope with
acquired stuttering.

Adults can benefit from stuttering modification and fluency shaping strategies.
Learn more about them right here
[https://ghost.stamurai.com/stuttering-fluency-shaping-techniques/]!

Developmental & Acquired Causes of Stuttering in Adults

There have been early instances where almost every speech disorder was
categorized as stuttering. While stuttering is a disruption of normal fluency of
speech, cluttering is a little different from that. Here in this post, we will
discuss ‘cluttering vs. stuttering’ in detail.

First things first, let’s understand the basics.

What is Stuttering?
Stuttering has a few core characteristics
[https://stamurai.com/blog/what-is-stuttering/] including blocks, repetitions,
and prolongation of sounds, syllables, or entire words. On the other hand,
cluttering is a relatively lesser-known speech disorder quite distinct from
stuttering. The disruptions in the case of stuttering are not under the control
of the speaker.

A person who stutters may use secondary behavior to avoid or reduce the
frequency of their stuttering. In most cases, stuttering causes and is worsened
by [https://stamurai.com/blog/how-to-overcome-fear-and-tension-if-you-stutter/] 
negative emotions like embarrassment, fear, and anxiety. Those who stutter often
harbor a negative attitude that beats down their self-esteem.

What is Cluttering?
Individuals who clutter can produce incomplete phrases, fillers, phrase
repetitions, hesitations, and revisions. However, these are all without any
physical distress or tension.

Interestingly, in the case of cluttering, the speaker does not
[https://www.stutteringhelp.org/cluttering] always speak rapidly. The speech
comes in sudden bursts of undulated speech which can have disfluencies and
misarticulation. Most of the people who clutter are unaware of their speech
disfluencies. However, if they become aware, they can successfully make efforts
to control their speech disfluency. Their speech can become slower and more
understandable with practice and patience.

Strong emotions can precipitate cluttering. When excited, afraid, anxious, or
angry, cluttering can become much worse and more frequent. The first researcher
to recognize it as a speech disorder distinct from stuttering was Weiss in 1964.
He described it as a ‘central language imbalance,’ which may stem from a lack of
an organized formulation process.

But, what is mazing in speech?

A person who clutters often has trouble translating his thoughts into coherent
sentences. Similar language behavior is also referred to as "mazing" by some
speech-language pathologists.

Do keep in mind that cluttering often exists with other issues, such as
hyperactivity, distractibility, articulation disorders, learning difficulties,
and auditory processing problems.

Symptoms of Stuttering
The core symptoms that characterize stuttering include –

 * Repetition of syllables, words, or entire phrases.
 * Prolongation or stretching out word sounds.
 * Blocking or stopping while saying a particularly difficult word.

You can read other Stamurai blogs for more authentic information on the symptoms
[https://stamurai.com/blog/what-is-stuttering/], causes
[https://stamurai.com/blog/causes-of-stuttering-in-adults/], and treatment
options (adults [https://stamurai.com/blog/stuttering-treatment-for-adults/]| 
children [https://stamurai.com/blog/stuttering-treatment-preschool-kids/]) for
stuttering.

Symptoms of Cluttering
Let us first look at the core symptoms of cluttering.

Core symptoms of cluttering
Any two of the core symptoms listed below need to be present for cluttering
diagnosis. Typically, adults utter around 2.5 to 5.3 syllables per second, and
adolescents say between 2.5 to 5.5 syllables per second. Children who can speak
[https://stamurai.com/blog/children-speech-checklists/] should be saying between
2.5 to 5.0 syllables per second.

Any adult uttering more than 5.3 syllables per second may be at risk of
cluttering. However, since it is not the only indicator, at least two of the
following core symptoms should be present for a conclusive
[https://leader.pubs.asha.org/do/10.1044/distinguishing-cluttering-from-stuttering/full/] 
diagnosis.

 * A high speech rate
 * An irregular speech rate
 * Collapsing syllables
 * Incorrect use of pauses, volume, and syllable stress
 * Repetitions
 * Word structure errors, such as jumbling up the syllables in a long word or
   substitutions
 * Sentence revisions

Secondary symptoms of cluttering
Just like stuttering, cluttering also has secondary symptoms. These symptoms can
vary between two people who clutter. The more common ones include –

 * The use of filler words, such as "uhh," "umm," "well," "like," and "mostly."
 * Poor articulation or mumbling of words.
 * Difficulty in finding the right word or word retrieval.

A person who clutters often has trouble translating their thoughts into coherent
sentences. It is also referred to as "mazing" in speech by some experts and
speech-language pathologists (SLPs)

Cluttering Vs. Stuttering: Differences
 * Someone who clutters will talk better than someone who stutters under stress.
 * Interruptions may not disrupt the natural flow of speech of someone who
   clutters.
 * Cluttering does not affect the person's ability to talk in longer sentences.
   Whereas, stuttering may make it difficult for someone to say longer
   sentences.
 * Someone with cluttering may read unfamiliar texts fluently. Those who stutter
   may speak better if they rehearse their speech.
 * Someone who clutters typically has no awareness of their fluency problems. On
   the other hand, someone who stutters can experience anxiety, fear, and shame
   [https://stamurai.com/blog/stuttering-in-children-understanding-shame/] 
   related to speech.

Cluttering Vs. Stuttering: Similarities
 * Both cluttering and stuttering are fluency disorders.
 * Both cluttering and stuttering have people pausing or stopping when they
   don’t actually want to.
 * People with either cluttering or stuttering may leave words unfinished.
 * In either case, individuals may repeat syllables, words, and phrases.
 * Individuals with either stuttering or cluttering may stop in the middle of a
   sentence and rephrase.

With this information, you should be able to understand the differences and
similarities between a ‘clutter’ and a ‘stutter.’

Can Stuttering & Cluttering Co-occur?
Sadly, many people who stutter may also have symptoms of cluttering. SLPs may
classify individuals as having both stuttering and cluttering if they exhibit
the following symptoms –

 * Difficulty in finding the right words
 * Poor reading abilities
 * Poor ability to narrate an incident or poor story-telling
 * Below-average memory

According to Daly et. al. (1993), individuals who show symptoms of both
stuttering and cluttering may also show superior skills in science and math.

How Common Is Cluttering?
Researchers and SLPs have estimated that about 1 out of 3 children & adults who
stutter also clutter. However, you should note that people are more commonly
diagnosed with other fluency disorders such as stuttering. Cluttering does not
receive as much attention.

There are more clinical anecdotes than data
[https://www.asha.org/practice-portal/clinical-topics/fluency-disorders/#collapse_1] 
to support the claim that one-third of the children & adults who stutter also
clutter. A preliminary study on school-aged children shows the prevalence rate
of stuttering is between 1.1% and 1.2% among participants.

How is Cluttering Diagnosed?
Cluttering may be confused with other language disorders and learning
disabilities. In the past, cluttering has also been confused with attention
deficit hyperactivity disorder (ADHD
[https://stamurai.com/blog/adhd-and-stuttering/]) among children. It may be
because those who clutter also have reading and writing disabilities. Some may
also exhibit poor memory and integration of thoughts & ideas.

Diagnosing cluttering is challenging
[https://www.researchgate.net/publication/40041405_Differential_diagnostic_characteristics_between_cluttering_and_stuttering-Part_one] 
because everyone clutters to some extent, especially when angry, surprised, or
excited. So, the SLP should note at least one of the following traits for the
diagnosis of cluttering –

The person over-articulates
When they speak, the sounds and syllables overlap or blend together. It may
sound like they are not including all the syllable sounds in their speech.

The speaker may use too many interjections
The person uses normal disfluencies and revisions while talking. They may say,
"I want to…uh…get sushi" or "I would like to…I want to go out for dinner."

They may pause unexpectedly
A person who clutters may pause in places that are unexpected grammatically. It
can make their speech sound jerky or staggered.

Other characteristics that the speech therapist notes before making a conclusive
cluttering diagnosis are –

 * Almost no physical struggle while speaking.
 * Temporary improvement of speech when someone asks them to "pay attention" or
   "talk slowly"
 * Disorganized language and conversational skills.
 * Limited to no awareness of their fluency problems.
 * More than one blood relative, who clutters.

Only a trained Speech-Language Pathologist (SLP) should make the diagnosis. A
thorough assessment considers other fluency disorders that might better explain
the condition.

If additional symptoms of other disorders are present, they require assessment
and evaluation from other professionals including special educators,
psychologists, and behavioral therapists.

Examples of Cluttering
Let's consider the phrase "do you know where my book is?" It is a
straightforward question consisting of fairly uncomplicated words. Someone who
clutters maybe say it in the following manners –

“Do you...uh…you know where my book is?”

“Do you…have you seen my book?”

“Do…you know where…my book is?”

“Do you know where by mook is?”

Cluttered speech can be challenging to understand for the listeners. However,
telling the speaker to slow down at every instant can be incredibly frustrating
for the person.

Can Speech Therapists Help With Cluttering?
Do you want to stop cluttering? Well, qualified speech therapists can help
reduce your cluttering. Irrespective of age, one can observe an improvement in
speech after practicing exercises for cluttering.

You can reduce most cluttering symptoms through simple adjustments in speech,
such as the rate.

Therapy takes practice and patience. However, speech therapists can come up with
a custom speech therapy plan to alleviate cluttering symptoms.

The SLP or speech therapist can teach you how to –

 * Slow your speech down using speech therapy exercises and techniques
 * How to improve your speech fluency
 * Creating short-term and long-term goals for the individual
 * Improving your self-awareness about your speech
 * Developing and enhancing your self-monitoring skills

You can choose to attend speech therapy in person or via online personal video
chat. Remember to take feedback from your speech therapist or SLP about your
progress after each session.

Cluttering Vs Stuttering: What Is the Difference?

Stuttering is a chronic fluency disorder that affects more than 70 million
people worldwide. You may have this communication disorder, or you may know
someone who stutters. It is quite natural to worry about the future of an
individual who faces struggles when trying to say their own name. But, does that
mean the world should deny them the chance to prove their worth? Should
workplaces blatantly discriminate against people with stammering?

If you are someone who stutters, you already know how difficult it is to crack
a
job interview [__GHOST_URL__/stuttering-and-job/]! You know how much effort it
takes to convince the employers that you are just as capable as your competitor
who happens to have no speech or communication disorder, if not more capable!

What jobs can people who stutter get?
So this one is for everyone who is about to interview someone or hire someone
who stutters.

It is almost impossible to go through life without coming across someone who
stutters. It is an incredibly common speech fluency disorder
[https://ghost.stamurai.com/what-is-stuttering/]. Men are 4 times more likely to stutter than
women. In many cases, people who stutter began dealing with the speech problem
early in their lives and still continue to do so. However, stuttering does not
indicate incompetence or lack of intellect.

Today, you can find people who stutter
[https://medium.com/@stamuraiapp/celebrities-who-overcame-stuttering-45c406967998] 
meeting the responsibilities of company CxOs, professors, researchers, teachers,
soldiers, doctors, nurses, air traffic controllers and customer service
associates. While hiring someone who stutters, you need to keep in mind that you
need to foster an inclusive workspace that can motivate them to be productive.

[https://stamurai.app/z4HKmlNXigb]What should you know about a potential
employee who stutters?
There is a good chance that you have either interviewed someone who stutters, or
you will soon interview a candidate who stammers. Before you do so, you must
know a few facts about stuttering and employment –

 1. People who stutter are not always anxious, shy or fearful. It is a gross
    misconception [__GHOST_URL__/stuttering-misconceptions/]. The negative
    emotions may come from a less-than-friendly work environment. Those who
    stutter are complete individuals just like non-stutterers and they can
    experience a full range of emotions.
 2. Anxiety or fear is not the cause of stuttering. The causes of stuttering
    [__GHOST_URL__/causes-of-stuttering-in-adults/] may be genetic. Neurological
    anomalies in the brain can cause a person to stutter. However, these
    anomalies, in no way, compromise the person’s ability to meet their job
    necessities.
 3. Stuttering symptoms can vary between different people. Those who stutter can
    have “good” and “bad” days. On some days, they are likely to stutter more,
    on the others they significantly stutter less.
 4. Job interviews, phone calls and video conferences are some of the
    worst-feared situations for people who stutter. it is up to the employer to
    ensure that the person feels comfortable during a job interview, especially
    if it is a virtual one. If the person stutters excessively during the
    interview, you must not think that it’s indicative of how they will perform
    on the job.
 5. You may even come across someone who stutters with less severity but does
    not acknowledge himself or herself as someone who stutters. That typically
    happens due to the fear of discrimination, criticism or humiliation. It is
    not mandatory for someone with a speech disorder to disclose the fact.
    However, your office or team should be inclusive enough to feel him/her
    welcome.

[https://stamurai.app/z4HKmlNXigb]Why should you hire someone who stutters?
People who stutter develop particular skill sets that others generally don’t
have. Here are some qualities your potential employee who stutters might have –

 1. S/he may be a good listener – When people face trouble voicing their ideas
    and opinions, they begin to listen more. People who stutter often compensate
    for their lack of fluency with superior listening skills. An employee with
    good listening skills can be instrumental while noting important points
    during conferences and meetings. They are also more likely to understand
    client briefs and follow instructions correctly. They may even find it
    easier to deliver exactly what the client needs.
 2. He/she may be very observant – People who tend to quietly listen are often
    more observant and patient. Anyone, who has struggled for years with words,
    is likely to observe every small detail of an ongoing project. People who
    stutter often show higher levels of emotional intelligence since being at
    the receiving end of bullying [__GHOST_URL__/reining-in-the-bullies/] and
    criticism makes them wiser beyond their years. Hiring someone who stutters
    may be a great idea if your company deals with several important projects
    and demanding clients at the same time.
 3. They can improve team communication – People who stutter can change group
    dynamics for the better. Understanding someone who stutters requires more
    patience, more attention and better understanding. Having an employee who
    stutters can improve the communication of your team and the workplace in
    general. The other employees may even learn about new nuances of
    communicating and creating a workforce that’s more adaptable and versatile.

What should you NEVER tell a job candidate who stutters?
Instead of making assumptions about a person’s abilities, skills and
qualifications, you should have an honest discussion. In many cases, people who
stutter, have several skills and an adaptive attitude that others lack. They
typically develop these through years of trying to compensate for their
stuttering.

Here are a few points you must avoid while interviewing someone who stutters –

 1. Don’t ask them to relax or slow down – they have heard it too many times in
    their lives to count. Instead of providing them with valueless advice, you
    can work on your patience. If a candidate specifically mentions their speech
    impediment during the interview, you can simply thank them for the
    information and put them at ease.
 2. Don’t assume they will be bad at communications – if the job entails
    communication skills including phone use, messaging and emailing, ask the
    candidate about their experience and comfort level. You can always inquire
    how the candidate feels about handling daily communications as long as you
    come across as respectful.
 3. Don’t discriminate – do not deny someone a job simply because they stutter!
    Every company should make adjustments and allowances for people with
    impairments and stuttering is a speech disability, which does not cause any
    impairment in decision making or logical thinking.

It might be your first time interviewing a candidate who stutters, but if you
keep these few points in mind, the interview should proceed smoothly and
unbiasedly. Since stuttering is NOT a reflection of the person’s abilities and
intelligence, you should definitely give the new candidate a fair chance at the
interview.

[https://stamurai.app/z4HKmlNXigb]On the other hand, if you already have an
employee or coworker who stutters, you can find out the correct way to talk to
them
[https://ghost.stamurai.com/changing-the-perception-about-stuttering-5-tips-for-talking-to-someone-who-stutters/]
. Moreover, you can make them feel comfortable in an inclusive work environment.
Find out more about talking to someone who stutters with Stamurai
[https://stamurai.com/].

What employers should know about candidates who stutter

For years researchers have been trying to find the neurological cause of
stuttering. Experts have determined discrepancies in the neural circuits within
the brain that control the processing and production of speech. New research
[https://www.researchgate.net/publication/335144283_Human_GNPTAB_stuttering_mutations_engineered_into_mice_cause_vocalization_deficits_and_astrocyte_pathology_in_the_corpus_callosum] 
from 2019 shows that loss of a particular type of cells – astrocytes from the
brain is associated with stammering.

Stammering or stuttering is a lifelong speech fluency disorder. It typically
begins in young children who have begun learning a language or two, at a rapid
rate.

Stuttering in children is quite common and more than 70% of them recover on
their own by the time they are 6 or 7 years old. However, 1 in 4 children
continues to stutter throughout their life.

Even two decades ago, the cause of stuttering in some children was a mystery.
The lack of evidence led several researchers to investigate neurological
differences between the brains of those who stutter and those who don't. Brain
imaging studies have been used for studying the differences in neural networks
for quite a few years now. However, brain imaging studies are not enough to
state if the difference in structures is the reason or result of stuttering.

What Are The First Genes Tied To Stuttering?
In 2010, researchers identified several mutations in the gene GNPTAB that seemed
to be hereditary. The research published in the New England Journal of Medicine
showed that the particular gene is responsible for the production of a protein
that plays a role in the breakdown and recycling of cellular components inside
the cell’s lysosome (think of it like a dump-yard filled with enzymes that can
dissolve or destroy the cell’s junk).

GNPTAB works with a group of genes including the GNPTG and NAGPA to complete a
signalling mechanism that guides the necessary enzymes to the lysosome of the
cells. These three genes share a close relationship. The team found mutations in
both GNPTG and NAGPA in people who stammer. Approximately 9% of those who
stutter have mutations in any one of the three genes.

Which Brain Cells Are Responsible For Stuttering In Children and Adults?
According to the earlier studies led by Dr Drayna and colleagues, multiple gene
mutations contribute to changes in the structure and function of the brain.
These changes lead to one's predisposition to stuttering. The 2019 study used a
mouse model with a mutation in the GNTAB gene.

According to the recent publication, Dr Drayna’s team at NIH NIDCD engineered a
mice population with targeted mutations in the aforementioned gene and their
observations found their way to the Proceedings of the National Academy of
Sciences on 27 August 2019. This genetic approach has allowed researchers to
decode the neuropathy of stuttering at a molecular level via the identification
of the genetic mutations and at then at the cellular level by the identification
of the specific cell-types associated with stuttering.

Here are the sets of observations from the most recent study conducted by Dr
Drayna and his team –

 1. The researchers observed that the mice were normal in physiology and
    functioning. They were a healthy population, which further shows the
    viability of mouse models for studies such as these.
 2. The mice carrying the GNPTAB mutation vocalized with abnormally prolonged
    pauses. It is similar to the breaks and pauses those who stutter experience.
 3. The brain tissue from the mice carrying the mutated gene showed a
    significantly lower volume of astrocytes.

Note: What Are Astrocytes?
The astrocytes are star-shaped glial cells in the brain. They are also the most
abundant and astrocytes play a critical role in the transmission of impulses
inside the brain. Astrocytes are also critical support cells that provide the
neurons with necessary nutrients for functioning and vitality. They also help in
detoxification, guiding during migration and the regulation of metabolism. Thus
the loss of astrocytes from the brain can have a multifaceted impact on the
function of the brain.

What Role Do Astrocytes Play In Language Processing and Stuttering?
Dr Drayna’s team has shown that the loss of astrocytes is especially prominent
in the corpus callosum of the mice carrying the GNPTAB mutation. The researchers
used MRI to study the brain structure of the mice, which showed that the volume
of the corpus callosum was significantly lesser in the mutated mice as compared
to the control mice.

The corpus callosum is like a highway between the left and right hemispheres of
the brain. Over 200 million nerve fibres comprise the corpus callosum that
connects the two hemispheres. Apart from connecting the two sides, the main
functions of the corpus callosum include complex problem-solving and
coordination. It helps integrate signals that involve the right and left
hemispheres, such as, language production.

It is understandable why the loss of volume of the corpus callosum or the loss
of astrocytes that make up most of the corpus callosum may lead to stuttering
like vocalization defects in the experimental mice population.

The curious minds of the researchers did not stop at this – they went ahead and
conducted a set of follow-up experiments. They introduced the GNPTAB mutation
into specific brain cell types of mice, one at a time. The mutation in brain
cell types other than astrocytes did not correspond to similar vocalization
defects that the team observed in the case of mutated astrocytes. The extended
pause in vocalization.

How Many Mutated Genes Can A Person With Stutter Inherit?
Genes like GNPTAB and GNPTG have crucial roles to play in cell metabolism.
Dominant mutations in both genes in an individual can lead to a complicated
metabolic disease called mucolipidosis. Now, most people who stutter have only
one copy of the mutated gene. Inheriting both copies of the mutation is the only
way an individual can have mucolipidosis, which is a group of inherited
metabolic disorders.

Which is quite different from the genetic makeup of those who stutter. Since
they inherit only one defective copy of any one of the three genes – GNPTAB,
GNPTG and NAGPA, they are physiologically healthy and psychologically competent.
They don’t face metabolic challenges owing to mucolipidosis. The only
manifestation of the mutation is stuttering since the protein corresponding to
the mutated gene is still produced, but it’s not produced correctly.

Can Medication Make Up For Fewer Astrocytes and Reduce Stuttering?
Treatment with risperidone can increase the activity of the striatum and reduce
stuttering in adults. According to published research
[https://www.sciencedaily.com/releases/2021/02/210212145517.htm] by Dr. Gerald
A. Maguire and his team, risperidone may act by increasing the activity of the
star-shaped astrocytes in the brain’s striatum.

Risperidone is a common second-generation dopamine antagonist. For a long time,
researchers have associated stuttering with an increase of dopamine in the
brain. Risperidone works by blocking the dopamine receptors and preventing the
uptake of the excess neurotransmitter.

Risperidone is also one of the few drugs that doesn’t pose a high risk of
motor-system side effects like haloperidol.

Co-author SheikhBahaei states, “We don’t know exactly how risperidone interacts
with the astrocytes to increase their activity.” However the study
[https://www.frontiersin.org/articles/10.3389/fnins.2021.598949/full] clearly
proves that this compound boosts astrocyte activity in the Broca’s area and
striatum.

As part of the experiment, the researchers conducted a randomized double-blind
study with placebo control. 10 adults who stutter were part of this study. 5 of
them received risperidone and the other 5 received a placebo.

After 6 weeks of taking risperidone or placebo every day, the 10 participants
were assigned the task of reading aloud followed by a Positron Emission
Tomography (PET) scan. The researchers broke the blind after the PET scans were
complete.

Researchers also conducted PET scans of every participant before the medication
began. These scans revealed no significant difference in the activity of
specific regions of the brain involved in speech processing and production
between the participants.

PET scans of the two groups showed that those who received risperidone exhibited
higher glucose update in specific brain regions. Risperidone treatment may boost
the metabolism in the left striatum (putamen and caudate nucleus) and the
Broca’s area.

What’s The Future Of Stuttering Treatment?
This 2019 study by Dr Drayna et. al. is the first one that has identified the
specific genetic mutations that may be the potential cause of stammering in
children and in adults. 

While some lysosomal disorders are currently being treated via the injection of
the correctly manufactured enzyme into the individual’s blood. There might be
hope in the future for those who stutter to receive a similar treatment.

Several labs across the world, including that of Dr. SheikhBahaei are designing
and studying animal models to understand the different types of stuttering and
their causes. Understanding these complex circuits involved in speaking can shed
light on new treatment options with minimal side effects.

New compounds including second-generation dopamine blockers like risperidone may
open new possibilities of stuttering treatment by addressing the cellular causes
of stuttering.

Cellular Causes of Stuttering in Adults & Children

Autism, it is a term we have been hearing often in our social circles, and even
on the screen. TV series like Atypical have done justice to portray the life of
someone who a little different from the masses and how life transpires for those
around them.

Despite several controversial publications, opinions and judgements, we can
proudly say that people who fall in the autism spectrum may not be neurotypical,
but they are gifted and incredibly special in their own ways.

Are Stuttering and Autism Related?
Autism is not a disease. It is a spectrum disorder
[https://ghost.stamurai.com/speech-and-autism/]. Even today, neuroscientists, psychologists
and psychiatrists know little about the causes of autism. It is not hereditary
or does not happen due to external injuries during childhood. Researchers
classify autism spectrum disorder (ASD) as a pervasive developmental disorder
(PDD).

Autism spectrum disorder comes with a myriad of signs and effects – as you have
possibly understood by now, these effects are usually a mix of good and bad.
Some children and adults with ASD may be excellent in mathematics, arts, and
creativity. While at the same time they may have trouble communicating,
maintaining relationships and observing social norms.

Similarly, many who are in the spectrum also have fluency disorders. Such
fluency disorders include stuttering. Stuttering manifests in the form of
repetitions, blocks and prolongations. For example, a word like “cup” may sound
like “c-c-up” due to repetitions or “cuuuup” due to prolongations.

Stuttering in people with autism is typically restricted to the beginning of the
first syllable of a single-syllable word or the second syllable of a longer
word. End letter repetitions are not common for this type of stuttering.

How Many Children With Autism Stammer?
Autism and stuttering [__GHOST_URL__/what-is-stuttering/] may have a
long-standing relationship. Sadly, there is no objective data that quantifies
the incidence of stuttering among the population with ASD. Modern research is
providing the scientific community with evidence of an intricate relationship
between autism and stuttering, cluttering and/or word-final disfluencies.

According to studies published by Kathleen Scaler Scott (2013), stuttering like
disfluencies are common in those with Asperger’s Syndrome. Shriberg et. al.
(2001) states that 67 out of 100 males with Asperger’s syndrome exhibit
disfluent speech as compared to 40 out of 100 with high functioning autism.
However, right now, no study can conclusively state how many children with ASD
also stutter.

[https://stamurai.app/z4HKmlNXigb]Is Stuttering A Sign or Symptom Of autism?
Quite a number of children and adults with ASD have speech disfluencies such as
stammering. It is important to remember that neither is stuttering a form of
autism, nor is it a sign of autism in the case of most individuals.

People falling in the spectrum may also have a disorganized speech due to more
than one disfluencies, revision of thoughts and interjections in speech. Each
individual has a different combination of these symptoms and a varying level of
awareness of the same.

Diagnosing Stuttering in Children With ASD
Only a professional, who specializes in paediatric development can diagnose ASD.
Since it is a complex disorder that has widely varying signs and symptoms,
diagnosis can occur between the ages of 2 and 8 years. There can be a sudden
onset of stuttering in children with autism due to emotional stress, changing
environment and/or social challenges.

Children with ASD have multiple issues with communication and social
interactions. Hence it is challenging to notice speech disfluencies like
stuttering until they reach school-age. The interaction between ASD and speech
fluency disorders is a nascent area of research.

Speech-language pathologists, who are also familiar with ASD in children are the
ideal candidates for the diagnosis and therapy of speech disfluency
[https://stamurai.com/]in children with ASD. Their experience and
knowledge-based evaluation should help in distinguishing between the other
childhood fluency disorders that may affect those with ASD from stuttering.

The evaluation of the SLP can help in determining whether the speech problem
lies in the production of speech or the organization of language and the likes.
Understanding the root of the problem will determine the course of therapy.
After several sessions of conversation or storytelling with the child, the SLP
may decide to go forward with word-finding, storytelling or narrative language
activities to find the language deficits.

What You Should Know About Your Child With ASD and Stuttering
For a child with autism getting the right words out even without stuttering can
be difficult. The presence of a speech disfluency like stuttering makes
communication dreadful for many children as well as adults with ASD. Even the
most brilliant minds may take more than a minute to get a single word out. It is
like “the words keep getting stuck on a sticky tape in my brain,” as stated by a
6-year old with ASD and stuttering speech.

Children with ASD and stuttering may have difficulty in expressing themselves,
but they are in no way deserving of one’s frustration, impatience, irritation or
anger. In most cases, the child knows exactly what to say, but he or she has
difficultly in minting the words or processing speech.

Stammering is a disability indeed but coupled with ASD it can take a
debilitating form which may hinder the emotional growth
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/] of an individual. It
hinders their social life and the ability to form and maintain meaningful
relationships later on. Misperceptions about ASD and stuttering disorder can
cause children to become further withdrawn and it can affect their quality of
life as a whole.

Stuttering Treatment for those with ASD and Stuttering
The treatment
[https://www.sciencedirect.com/science/article/pii/S1877042815020595] for
stuttering depends on the needs of the client, which is especially true in the
case of those with ASDs. Stuttering further impacts communication and social
skills of those with ASD. Therefore, therapy is crucial. Since self-monitoring
and social interaction can be incredibly difficult for those with ASD,
therapists often focus on fluency tools during social interactions.

 1. Traditional stuttering tools – The child’s age and level of comprehension
    will determine how the therapist introduces these tools into practice.
    Children with a higher level of comprehension may benefit more from the
    techniques in a picture or written format. Those with lower comprehension
    levels can utilize less descriptive methods with more imagination of
    therapist models. For example, many child therapists use playdough or
    stretchy slime to represent prolonged speech. Visualization of their speech
    disfluencies playfully and tangibly may aid them to overcome the symptoms of
    stuttering to a great extent. Repeated practice is the key for children with
    ASD and stuttering to acquire greater fluency in speech.
 2. An aide for organizing thoughts – Visual cues and organizers like online
    visual mapping programs can help children collate and express their
    thoughts. The newly acquired skills should be evident in daily
    communication. Once again, practice is the only way to maintain the child’s
    ability to structure their thoughts and sentences.
 3. Introducing increasing pausing – The increase in pausing can allow
    additional time for the child to –
    a. Gather their thoughts
    b. Practice controlled breathing
    c. Apply the fluency tools (easy starts, easy onsets or prolonged speech)

[https://stamurai.app/z4HKmlNXigb]What Parents of Children With Autism and
Stuttering Should Remember
The parents of a child with both ASD and stuttering has an important role to
play in their emotional development. The way you support your child during his
or her daily conversations and activities will determine their level of
confidence while dealing with the outer world.

Here are a few points you must remember while speaking to your child –

 1. Do not complete a word or sentence for your child
 2. Keep positive and encouraging facial expressions
 3. Listen patiently and respond at the appropriate places
 4. Do not show impatience or frustration
 5. Do not rush your child to finish speaking
 6. Do not assume that he or she lacks the capability to understand what he or
    she is trying to convey
 7. Do not overwhelm your child with too many bits of information at one go
 8. Practice taking turns while talking

Not interrupting someone while they are talking is a basic social skill every
adult should possess. It shows respect for the speaker.

What I Wish Everyone Knew
Listening to a child with a speech disability should be no different. ASD makes
the diagnosis of an already withdrawn child more difficult than a neurotypical
individual. However, that does not mean there is no scope for the child to speak
with more fluency in the future.

We must remember that autism spectrum disorder is very common. 222 out of 10,000
children in the US, 106 out of 10,000 in Canada, and 23 out of 10,000 in India
have ASD. Autism is neither good nor bad. It is simply a disorder that makes a
person unique!

Speech therapy for those with autism
[https://ghost.stamurai.com/speech-therapy-benefits-for-autism/] and stammering can help
these individuals break free from their speech impediments, and help create a
more inclusive world.

Stuttering & Autism Spectrum Disorder: Diagnosis & Treatment in Children

Up to 5% of preschoolers between the ages of 2 and 5 stutter. It is typically a
short phase for most children that they outgrow within about 6 months.

Experts say that children rapidly learn new words and syntaxes of a language at
this age. That may contribute to some disruptions that we also call disfluencies
or stuttering in preschool kids.

Many children shuttle back and forth between periods of fluency and disfluency
during this time.

Sometimes, these periods of disfluency are preceded by stress, anxiety, fear and
tedium. While at other times, they are unprovoked by external stimuli. That
makes it superbly worrisome for the parents.

If you have noticed disruptions in your child’s speech, you may have been
wondering if it’s due to their rapid language acquiring process, or if your
child is truly developing a stuttering [__GHOST_URL__/what-is-stuttering/] 
problem. And you are not wrong to be worried.

Is Your Preschool Kid Stuttering?
For most toddlers, the period of disfluency is transient. It goes away in less
than half-a-year!

If it has been less than 3 to 6 months, we suggest that you give your worries a
temporary rest and observe the type of disfluencies in your child’s speech.

You can still consult a speech-language pathologist (SLP) to rule out stuttering
and other long-lasting speech disfluencies.

Sometimes, disfluencies don’t disappear but become more prominent
[https://www.asha.org/stuttering/#signs] over the 6 month period. The signs of
stuttering in children become more obvious as the days go by.

That’s when you should consult an SLP to explore the potential stuttering
treatments for preschool kids.

Risk Factors for Stuttering in Preschool Kids
Is your child exposed to the risk factors that increase
[https://www.stutteringhelp.org/content/recognize-risk-factors-stuttering] the
chances of stuttering in preschool-aged kids?

Some factors can make a child more predisposed to stuttering than others.

Listed below are the most common risk factors for stuttering in preschool kids:

1. Family history: If one or both of the parents stutter, there’s a good chance
that the child will continue to stutter into their adulthood.

2. Gender: Boys are more likely [__GHOST_URL__/is-stuttering-gender-specific/] 
to stutter than girls.

However, if your girl child has been stuttering for over a year without any
signs of self-recovery, there’s a good chance she will have the speech
disfluency for life unless a professional speech therapist intervenes.

3. Other disorders: Stuttering has been associated with other disorders
including Autism Spectrum Disorder [__GHOST_URL__/speech-and-autism/], Attention
Deficit Disorders, learning disabilities and literacy disorders.

If your child has been diagnosed with any of the disorders mentioned here or
otherwise, you need to consider an appointment with a speech therapist.

Causes of Stuttering in Preschool Kids
Stuttering is a complex disorder. Experts often say that stuttering is not a
disease, but the symptom of neurological differences
[https://ghost.stamurai.com/cellular-causes-of-stuttering-in-adults-and-children/] in one’s
brain that affect their speech.

Since it’s a heterogeneous childhood speech fluency disorder, it has multiple
causes.

Here are some that most commonly contribute to stuttering in preschoolers –

1. Genetics and Family History

Do you or your significant other stutter?

If there’s a blood-relative of the child who stutters, there’s a good chance
your child’s speech disfluencies are just signs of stuttering.

Researchers have linked
[https://www.annualreviews.org/doi/abs/10.1146/annurev-genom-090810-183119]
several genes to stuttering, and research shows that some of these genes are
inheritable too.

Childhood is the best time to get your kid started on stuttering exercises for
children [__GHOST_URL__/five-stuttering-exercises-to-help-your-child/].

Typically, early professional intervention has faster and better outcomes in
terms of reduction in the frequency and intensity of stuttering.

Many children even recover within a year of professional speech therapy.

2. Speech and Language Acquisition

Between the ages of 2 and 5, a child is rapidly expanding his/her vocabulary and
acquiring new language skills.

Children with a neurological/genetic predisposition for stuttering often begin
showing speech disfluencies at this age due to the neurological anomalies that
keep their brains from rapidly and smoothly producing speech.

It becomes easy to understand if you think of the disfluencies as products of
bottlenecks or obstacles the child’s neural pathways face during language
processing and production.

3. Stress

Several cases show that stuttering in young children coincides with new stress
that they face.

For example, the birth of a sibling or changing homes and moving to a new
neighbourhood or beginning school.

Stress can work alone or in combination with other factors like speech and
language acquisition to precipitate stammering in children with a neurological
predisposition towards the speech disfluency.

4. Environment

The environment of a child plays a crucial part in the development of stuttering
in children with a predisposition towards stuttering.

Experts have noted that children who stutter often come from overly competitive
households.

Parents may be using big words or talking too fast while communicating with
their child.

Both stress and environment can cause stuttering in preschoolers, only if the
children have a neurophysiological tendency towards stuttering.

The same situations may not affect another child of the same age and health if
s/he doesn’t have the genetic and familial factors working against them.

How Can You Address Your Child’s Stuttering As a Parent?
Preschoolers typically have more relaxed and loose repetitions that
speech-language pathologists classify as borderline.

At this juncture, parents may have to decide whether the treatment for their
children should be direct or indirect.

For borderline stuttering, indirect treatment is recommended by speech
disfluency experts such as Dr Barry Guitar.

It involves changing the environment that may have been contributing to their
stuttering.

Changing the environment at home completely depends on the parents and immediate
caregivers of the child.

Tips for Helping A Stuttering Preschooler

Talk to a speech-language pathologist immediately.

The longer you delay the meeting the lower is the chances of your child’s
natural recovery.

1. Dedicate a Listening Time

All children want to be heard. They have hundreds of new ideas and imaginations
every day that they want to share.

Stuttering may make them slow, but you need to give them the chance to express
themselves.

Your child is important. What s/he has to say is important.

So there’s no harm in dedicating 20 minutes in the morning and 20 minutes in the
evening for one-on-one conversations or activities.

Be there for your child even if s/he isn’t feeling particularly talkative on
some days.

2. Slow Your Rate of Speech

As a family, you need to ensure that you are not overwhelming your child’s
speech processing and production by speaking too fast.

Choose smaller words and maintain a slower rate of speech. That can help your
child more than you can ever imagine.

Make sure your speech sounds relaxed and calm.

Include pauses in the speech at the correct places. Your child’s SPL will help
you modify your speech for your child’s benefit as a part of the indirect
stuttering therapy.

3. Include More Positive Comments

Don’t criticize your child every time he or she stutters. Be positive and instil
confidence in your child.

Praise him/her every time she finishes saying a feared word.

When the repetition or prolongation is particularly severe, politely ask them to
repeat themselves.

Include the practice of praising fluent speech in your listening time and during
daily interactions.

4. Ask Fewer Questions:

It’s important to build their confidence. If possible stick to only a few
questions, demands and instructions per day.

Don’t make them feel pressured while conversing.

Learning comes naturally for preschool-aged kids, so asking fewer questions and
giving them fewer directives won’t slow their learning process down.

They might learn better from the positivity you adopt and your daily listening
cum interactive sessions.

When children have been stuttering for less than a year, they already have a
chance to recover naturally.

Indirect therapy aims to reduce the stress at home, encourage talking freely,
and increase their fluency levels, without directly interfering with their
speech.

What Should You Never Forget about Stuttering in Preschoolers?
Stuttering in preschool kids is fairly common.

The first signs of repetitions, prolongations and blocks shouldn’t worry you if
your child is trying to use big words in their sentences and learning at a rapid
rate.

You should, however, consult a speech-language pathologist if the stuttering
persists beyond 6 months of onset.

Unlike stuttering in adults [__GHOST_URL__/causes-of-stuttering-in-adults/], it
is much easier to reduce stuttering in children between the ages of 2 to 5
years.

The earlier you choose to visit a speech therapist for your child, the better
are his/her chances in regaining speech fluency.

Stuttering in Preschool Kids: What a Parent Should Do

You may be here because you have a student in class who stutters, or you want to
know what you should do if you ever have a student with speech disfluencies.

Either way, it’s a commendable effort and we will try to help you with all the
information you will need to understand stuttering
[https://ghost.stamurai.com/what-is-stuttering/], the effects of stammering on a child and
how you can guide them.

What Sets a Stuttering Student apart from the Fluent Speakers?
Firstly, let’s get to the nitty-gritty of stuttering.

It is a childhood-onset speech fluency disorder.

Stuttering has several causes [__GHOST_URL__/what-is-stuttering/] including
genetics, family history and anomalies in the brain structure.

Stress and anxiety make it even more difficult for someone who stutters to
express themselves in front of people.

Children are especially vulnerable to changes in their environment, anxiety and
pressure.

Identifying Hidden Stuttering in a Student
Younger children may not be as affected by their stutter and join conversations
in class more easily.

As children grow, they become more aware
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/] of their stammer and
may become more withdrawn.

Here are a few signs that your student may be trying to hide a stutter –

 1. You may have noticed that children who stutter tend to remain quieter than
    other children in your class.
 2. They tend to shy away from answering questions or participating in group
    tasks.
 3. They may even pretend to not know the answer just to avoid speaking.
 4. You may even find others mocking or bullying them for their speech
    disfluencies.

What Threatens Your Stuttering Student?
Everyday situations may threaten or unsettle children who stutter.

Such situations may seem benign to you and me, and anyone else who has never
stuttered before, but some of the instances we will discuss below can be jarring
for a child with speech disfluency –

 1. Asking for help from their classmates or the teacher
 2. Answering time-bound questions
 3. Reading out loud in front of the entire class
 4. Telling the cafeteria person what they want for lunch
 5. Oral reports
 6. Timed fluency tests
 7. Joining their classmates for playtime or group activities
 8. Volunteering for tasks

How to Help a Stuttering Student?
As the teacher, you have the responsibility to ensure that every child in your
class feels comfortable, confident and gets the right education.

It is also your duty to see that the child who stutters gets the chance to
participate in group activities and gains confidence from their in-class
interactions.

Not every school has an on-campus speech therapist. So, if you notice that the
child’s speech disfluency is causing them excessive distress and keeping them
from reaching their full potential as a student, you may consider talking to
their parents.

Encourage them to seek the counsel of a speech-language therapist in your area.
Early intervention can help children recover much faster than adults.

You can always follow this short guide to make your classroom more inclusive for
anyone with speech disfluencies –

Establish Rules For Speaking in Class
This should be true for any classroom with and without children who stutter.
There should be no interruptions while a child talks. If someone wants to share,
they can raise their hand and politely ask for permission to speak. There
shouldn’t be any signs of hurrying or annoyance among the listeners. Anyone with
something to say should be respected, and it is your responsibility to teach
that to your class.

Give Additional Time For Responses
Not every child has the same skills and talents. Some can finish arithmetic
problems in a jiffy, while others can sing like nightingales. Every child needs
the right environment to flourish. So, why shouldn’t the child with a stutter
get the same opportunity? Allow them extra time to finish answering a question.
Do not rush them.

Speak Softly and Unhurriedly
Children who stutter often have parents who have a fast pace of speech. You can
relieve some of the pressure they feel at home by adopting a slow and relaxed
pace while talking. Show them that they don’t need to hurry through their words.
They have all the time in the world to think, find the right words and express
themselves.

Always be Patient and Interested
Anyone who stutters suffers from the insecurity of sounding trite or driving
listeners away from them. It is important that you not only maintain eye contact
but also praise their ideas. If they finish saying a particularly long or
complex sentence or use a new word, show them your appreciation. It’s not how
they say it, but what they say that should genuinely interest you.

Refrain From Advising The Child Who Stutters
The child in question has already received hundreds of pieces of unwanted
advice. Don’t tell them to “slow down,” “breathe deeply,” or “start over.”
Chances are that the child already knows they sound different from the others.
There’s no point questioning their confidence and self-esteem as well. Instead,
be a good listener. If a particular sentence or part of a sentence is difficult
to understand, it is alright to politely ask them to go over it because you
couldn’t understand what he/she said.

Include Group Activities
Encourage class activities like reading aloud together (choral reading), and
reciting rhythmic poems that are in the syllabus. These are therapy techniques
that work marvelously well in treating stuttering. You can make them fun by
dividing the class into groups and getting them to recite different parts of a
poem or reading excerpts from stories in unison.

How to Prevent Bullying of A Stuttering Child at School?
Talk more about stuttering just like any other issue.

Don’t make it out to be something a person has to be ashamed of.

Discuss Stuttering In Class
If you notice others being mean to the child who stutters or simply ignoring
them, you should consider hosting a session on speech disfluencies.

Make it simple so the students can understand.

Deliver the message clearly.

Include stories of now-famous people who used to stutter and be sure to include
tips on why one shouldn’t bully someone who talks differently.

Preventing bullying [__GHOST_URL__/reining-in-the-bullies/] is a must.

The world needs to know more about stuttering instead of mocking people who
stutter. Starting with your class is a great idea!

Talk To Other Teachers as Well
Make sure you share your ideas of inclusion with the other educators in your
school.

The child should receive fair and equal treatment not only from you but also
from the other teachers.

If necessary, share what you have found out about stuttering and guides to
helping someone who stutters.

Talk To The Student Privately
If the student is particularly withdrawn and jittery about participating in
group tasks, you can give them some personal time to address their speech
problem. Ask them about any trouble they face inside and outside your class.
Sometimes, simply talking can help you find out if the student is feeling
bullied.

As their teacher, it’s your responsibility to keep an eye out for bullying in
the school. If you see someone mocking the child who stutters, instead of
admonishing them openly, you can ask the bullying child to make a presentation
or submit a report on stuttering.

It will both educate the child and teach them to show mutual respect to someone
who stutters.

Learn to be a good listener irrespective of the age of the person who stutters.
If the stuttering student is already seeing a speech-language pathologist, which
you can find out from their parents, learn about their progress, and explore
reasonable expectations from the child.

Supporting stuttering student is not that difficult when you have the right
information. You can find out more about the myths associated with stuttering
[https://ghost.stamurai.com/stuttering-misconceptions/] and what not to say
[https://ghost.stamurai.com/changing-the-perception-about-stuttering-5-tips-for-talking-to-someone-who-stutters/] 
to someone who stutters before you head back to the classroom.

What Teachers Need to Know About a Stuttering Student

There are days when we don’t find the right words. Then there are days when the
words don’t come out of our mouths. Either way, our stuttering keeps us from
expressing how we feel, what we like, and so much more.

It is a common notion that people who stutter (PWS) are shy, introverted and we
speak less.

Do we speak less voluntarily? Are we quiet and withdrawn by choice? Or, is it
because we have been through so much struggle to say a simple word, faced
mockery and judgement from the listeners?

Why Do We Need An App To Stop Stuttering?
For those of us who stutter, the world may seem a little bleak on the
particularly bad days when we have to go out and meet people, attend phone calls
or place an order at a drive-through.

After trying experiences we feel like sharing, but that entails more talking!
And that’s something we tend to avoid.

Wouldn’t it be great if we had an app to stop stuttering?

Finding the right people is not only difficult, but speech therapy for
stuttering tends to be costly in every corner of the world.

Whether the speech-language pathologist (SLP) specializes in child speech
therapy or adult stuttering treatment, they charge a bomb per session.

Moreover, we have the tendency to stop practising after a couple of sessions
either because the exercises seem boring or due to the lack of motivation.

It often results in high rates of relapse
[https://ghost.stamurai.com/high-relapse-after-stuttering-speech-therapy-understanding-the-reason/] 
in adults.

Wouldn’t it be great if we had access to a personal therapist from the comforts
of our homes?

If you share my thoughts, then you will find this app to stop stuttering very
useful.

Stamurai [https://stamurai.com/] is the speech therapy app available for
download from both Google PlayStore and iTunes Store.

The app combines fluency shaping strategies with stuttering modification to
offer its users authentic and effective stuttering therapy online.

How Can An App To Stop Stuttering Help Our Stutter?
Not all apps are the same.

Stamurai is a smartphone app that offers the complete treatment plan necessary
for you to stutter less or stop stuttering
[https://ghost.stamurai.com/how-to-stop-stuttering/] altogether.

Here’s are the most unique features of the world’s most versatile stuttering app
–

1. A Guided Training Plan
You can use the app to customize the speech exercises and practice material for
daily practice.

You can practice for 15 minutes to as long as you like every day.

The app is improving and evolving daily.

As you keep using Stamurai, it adapts to your training patterns. That’s the
beauty of an AI-powered anti-stuttering solution.

2. Bespoke Tools for Users
You will find several state-of-the-art tools effective for the treatment of
stuttering including breathing exercises and meditations for relaxation.

The speech therapy app also includes Delayed Auditory Feedback
[https://www.stutteringhelp.org/delayed-auditory-feedback] (DAF) –  an altered
auditory feedback technique that increases the time-gap between the spoken words
and their auditory perception.

It is a proven technique that contributes towards enhanced fluency in PWS.

3. Access to Several Speech Therapy Techniques
If you have never received speech therapy, it is only fair that you will want
someone to guide you.

Stamurai solves this problem by providing you with multiple instructional videos
that will help you master the speech exercises.

4. Daily Multiple Group Video Calls
You can download the app and find the section for scheduled group video calls
[https://stamurai.com/sessions] right in the “Today” section of the app.

Select any of the scheduled group video calls to browse the different timings
for the same.

Register for a slot and you will receive the link to join the call on Google
Meet 10 minutes before the call begins.

Each call is moderated by a trained professional, who knows how to facilitate a
safe environment for every participant to practise impromptu speaking, reading
and interactions.

You can also choose to just observe.

You can inform the moderator that you want to participate but not speak
anything. You can attend as many calls as you wish per week.

5. Receive Stats and Assessment Reports
You can receive scientific assessments on your progress and performance.

The data-based insights are effective in keeping the motivation up.

In traditional speech therapy setups, you have to rely on the therapist for
feedback and progress reports.

However, while you use Stamurai, you can access your progress statistics based
on how you have performed each day during your speech exercises while using
freestyle tools and as per your daily progress.

A speech therapy app [https://stamurai.com/therapy-protocol] like Stamurai is
especially necessary for people who have been stuttering for quite a few years
without seeing any remarkable progress from attending speech therapy sessions.

Before using any stuttering therapy app, you should always check the reviews of
the same.

Reviews and ratings make a product trustworthy, much like the Stamurai speech
therapy app reviews which detail how each feature and section has helped
long-term users find fluency and ease in stuttering.

Why’s Stamurai More Than Just another App to Stop Stuttering?
Apps like Stamurai are not just tools for therapy; they also foster dedicated
communities consisting of PWS, experts on stuttering, moderators, and speech
therapists.

If you have been trying to get in touch with a therapist, you can find one in
the community or write to Stamurai about your struggles.

It provides the wholesome speech therapy experience without the exuberant cost
of traditional speech therapy from speech-language pathologists.

Stamurai Goes the Extra Mile To Ensure You Practice Daily
1. Regular Updates and Notifications
When I began using Stamurai, I initially thought that it would be like any other
therapy experience I had had before. I would use it for two days or maybe five,
then forget all about it.

However, that is impossible with the dedicated effort Stamurai puts in to remind
you to continue your practice.

You will not only receive notifications from the team every day, but you will
get to see your progress in the Plan, Learn, and Freestyle sections of the app
in real-time.

2. Email Updates
Stamurai cares! The team sends out email messages to the users who have strayed
away from practice or given up using the app for too long.

The only way to reclaim control over one’s speech is with the daily practice of
speech exercises and the team understands that very well.

The app tracks everyone’s rate of use, progress, and duration of exercising.

So, don’t at all be surprised if you receive an email from the team asking if
you are doing alright, or if the app needs to alter something to make you feel
more comfortable with your daily sessions.

3. Awards and More
On group calls with 3 or more participants, the best speaker gets an award via
anonymous voting!

It is one of the most motivating attributes I have come across in stuttering
therapy.

Traditional stuttering therapy cannot include the awards or rewards aspect for
multiple reasons, but that doesn’t stop Stamurai from making your day or week
with one after your group call session!

4. Keeping Things Real
Stamurai keeps things real.

The app stresses on the fact that adulthood stuttering is difficult to “cure.”

That’s the primary reason this app teaches stuttering modification techniques to
all users.

The stuttering modification will enable you to face your feared-words and
trying-situations.

It will teach you how to control your speech fears and avoidance behaviours.
Stamurai’s technique will also teach you how to stutter more easily by reducing
physical tension.

These techniques include Preparatory Sets, Cancellations, Light Contacts and
Pull Outs.

Yes, We Need an App to Stop Stuttering just like Stamurai
There’s no perfect cure for stuttering.

Can you overcome stuttering 100%? No. But, you can always learn how to manage
your stuttering or stop stuttering as much as you do.

With Stamurai, you can become more fluent or stutter with ease with daily speech
exercises.

Technology-based methods like DAF can reduce your stuttering.

You can practice light contact, pull-outs, and choral reading to make yourself
at ease while pronouncing your feared words.

You can step out of your comfort zone with group calls in a safe environment.

Stuttering is a speech-disorder that not only affects how we speak, but also how
we think, and what decisions we take.

Stammering affects our life more than we would like it to.

However, we must not let it define who we are.

Stuttering will continue to be a part of our lives, but now we have access to at
least one app to stop stuttering, or rather, become more fluent at it!

You can download Stamurai, the stuttering therapy app for your android phone
[https://play.google.com/store/apps/details?id=com.stamurai.stamurai&hl=en] or 
iPhone
[https://apps.apple.com/us/app/stamurai-stuttering-treatment/id1488071175] right
away.

How Can Stamurai – an App to Stop Stuttering - Help You?

“Stuttering is the only handicap that people still laugh about”

Joe Biden was absolutely correct when he pointed this out.

Yes! The former vice president of the US and a candidate in the 2020 US
presidential election has a stutter.

Joe Biden’s stuttering is no secret.

In 2020, Biden is an expert in maneuvering the words and clearing the blocks
smoothly on most days.

Even with decades of practice in avoiding stuttering, Biden sometimes gets
caught on certain words.

His lingering stutter on the debate night in Detroit is hard to miss.

How Has the Political World and Media Reacted to Joe Biden’s Stuttering?
The first [https://globalnews.ca/news/6321381/key-takeaways-democratic-debate/] 
and second debates in June and July had been disasters, which prompted Biden to
call himself a “gaffe machine
[https://www.theguardian.com/us-news/2019/apr/25/joe-biden-2020-public-gaffes-mistakes-history]
”.

During his first debate, he was quite unprepared when Senator Harris questioned
his collaborations with segregationist senators.

His answers that night weren’t just meandering, but also quite difficult to
follow due to his repetitions and blocks.

Opposing party politicians and even journalists didn’t think twice to criticize
Biden for his inability to express himself on stage and defend his point of
view.

Popular personalities took to Twitter to mock him and question his ability to
run a country when he seemed to lose control of his speech during a mere debate!

Yes, even a popular politician was mocked due to widely held misconceptions
about stuttering [__GHOST_URL__/stuttering-misconceptions/].

His speech disfluency was not only ridiculed publicly for the world to see, but
his integrity, self-control, and capabilities were questioned by extrapolating
his presumed inability to control words.

Fox News took this a step further
[https://video.foxnews.com/v/6072239429001#sp=show-clips] and created a
mini-montage of the moments Biden stuttered, stopped, and faltered.

And that wasn’t
[https://www.theguardian.com/us-news/2019/dec/19/sarah-sanders-joe-biden-stutter-mocking-backlash] 
the end of it. More material surfaced all across the internet as Biden stuttered
more during the Atlanta debate in November.

Media moguls, reporters, and politicians took the opportunity to ponder about
his mental and physical health.

There were reports on his degenerating memory, the onset of neurodegenerative
diseases, and so on for months.

Interestingly, even a month ago, there were more articles on the web about Joe
Biden’s aging and dementia
[https://www.politico.com/news/magazine/2020/03/07/2020-dementia-campaign-123106]
, than his childhood stutter.

Do You Know about Joe Biden’s Stuttering?
Childhood is always difficult when you are different from the other kids in your
class or block.

Biden was smart, intelligent, and emotionally mature. However, he wasn’t spared
from bullying [__GHOST_URL__/reining-in-the-bullies/] either.

The first blow came from one of his teachers, who was also a Catholic nun.

Biden had to recite a passage from The Soul of America by Jon Meacham.

He still remembers the passage, a clear sign that his memory has not been idled
by dementia.

As a child, Joe Biden found it much easier to memorize an entire poem or a
section from a story and recite it from memory.

That’s what he was doing on that day when he said, “Sir Walter Raleigh was a
gentle man”, but the teacher wanted him to say “gentleman”.

“Mr. Buh-buh-buh-Biden, what was that word?” – she asked.

Biden left the classroom and walked home that day.

Joe Biden still thanks his mother for being supportive and standing up to his
teacher that day.

“You are more than your stutter. don’t let your stuttering define who you are”

And that stuck with him years later when he was a teen.

In high school, Biden was a popular athlete and the class president.

At Archmere Academy in Delaware, Biden received the nickname “Dash”. Sadly, it
didn’t refer to his speed, but his speech.

His classmates thought his speech was similar to that of Morse code “dot-dot,
dash-dash-dash.”

It was no relief that Biden had already begun to overcome it by then.

Being a strong athlete and a good student didn’t help with shame
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/].

According to Biden, shame is a big part of growing up with a stutter, even when
there’s a support system.

Old classmates and neighborhood kids forget the cruel nicknames, but names like
“Stut” or “Stutterhead” stick around forever in a person’s memory.

Did Joe Biden Receive Stuttering Therapy?
Biden tried and failed at conventional speech therapy when he was in
kindergarten. One more testament of speech therapy not being effective for
everyone.

However, personally, he never gave up.

He recited Yeates and Emerson before bedtime all by himself and noticed how the
rhythm helped him remain fluent.

Although he couldn’t have known it at such a young age, he was already
practicing a form of speech therapy that a lot of speech-language pathologists
(SLPs) recommend.

Interesting research
[https://www.frontiersin.org/articles/10.3389/fnhum.2014.00777/full] published
in 2013 in the Frontiers of Human Neuroscience by Fujii and Wan states the role
of rhythm in recovering from speech disfluencies like stuttering.

Joe Biden Denies Claim that Verbal Missteps Were Due to Stuttering
In politics and life, speech disfluency is perceived as a weakness.

That night in Detroit, Biden was targeted by Kamala Harris when she began with
the words, “I’m not saying you are racist, but…”

The words pushed
[https://www.850wftl.com/biden-stuttering-not-to-blame-for-verbal-screw-ups/] 
the already tired Biden off track and the sudden attack triggered his verbal
misfires throughout that debate.

It wasn’t the first time and it won’t be the last time politicians target Biden
for his speech disfluencies.

Over the months following the Detroit debate he has been criticized and mocked
on Twitter and during public campaigns by Trump.

His son Eric Trump, daughter-in-law Lara Trump, and American talk-show host Sean
Hannity made fun of his stuttering openly on public platforms.

Sadly, for Biden, his opposition sees his stutter as a vulnerability.



Several members and supporters of the Republican Party have seized the
opportunity to question Biden’s cognition and sentience citing his advanced age.

Why A Stuttering Presidential Candidate Is A Big Deal?
A lot has gone down in 2020, but one of the best things to happen was we got a
US presidential candidate who stutters.

He has served as the Vice President of the US for 8 years between 2009 and 2017.

Before that, Biden was the US Senator for Delaware from 1973 to 2009.

Why do we think that’s important? Simply because Biden is the living proof that
you can achieve [__GHOST_URL__/joe-bidens-stutter-and-life/] whatever you set
your mind to despite your speech disfluencies.

Some countries like the US classify stuttering as a disability, but it doesn’t
have to be an impairment.

The choices you make should never be driven by how you speak!

We have Joe Biden who goes around the country inspiring hundreds of thousands,
delivering public speeches [__GHOST_URL__/public-speaking-with-a-stutter/],
interacting with children who stutter, and motivating them to not limit
themselves.

The world needed someone like Biden to show that people who stutter (PWS) are
just as intelligent and capable as the ones who speak fluently.

What does Biden Say About His Stutter?
According to Biden, who mostly speaks about his stutter in the past tense, “I
find myself caught on certain words when I’m tired or stressed out.”

It is only natural for PWS.

Even those who have received extensive speech therapy and have moved past their
major blocks and fear of speaking can find themselves “stuck” on old,
feared-words when they are going through an emotionally or physically
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4317269/] trying time.

During a speech at the American Institute for Stuttering in 2016, he said that
he overcame his stuttering problem without formal speech therapy.

His interactions contribute significantly towards the normalization of
stuttering.

Joe Biden’s Advice to Those Struggling with Stuttering
Over the years, Biden has made several appearances on TV and given several
interviews that covered the subject of his childhood stutter.

Biden never really claims that he has had professional therapy, but he does
attribute his fluency to his teachers, who were also nuns at his prep school.

During the 25th anniversary celebration of The Lab School of Washington, Biden
said, “God’s gift to me was my stuttering.”

He embraced [__GHOST_URL__/should-you-accept-your-stuttering-yes-absolutely/] 
his stuttering completely and he has since inspired hundreds of kids to do the
same.

Recently, Biden’s conversations with a teen Brayden Harrington went viral for
all the right reasons.

Biden showed the kid his speech which had the notes on where to pause, where to
exhale, and where to stop.

He took stuttering and normalized it for a teenager who has trouble saying his
own name!

We need more people like Biden who inspire children and adults alike.

According to Brayden’s father, his son has been struggling with speech
disfluency and he has been bullied on multiple occasions.

You can see Brayden thank
[https://people.com/politics/13-year-old-boy-who-stutters-makes-touching-speech-about-how-joe-biden-made-him-feel-confident/]
Biden for boosting his confidence regarding something that has bothered him his
entire life.

Biden’s advice to people struggling with stuttering is “don’t let your stutter
define you or limit you,” which is exactly what his mother used to tell him
every time he headed out the door.

Do You Know about Joe Biden’s Struggle with Stuttering?

Tourette’s Syndrome (TS) isn’t a rare disorder. There are no specific diagnostic
tests for TS. The diagnosis depends upon the observation of signs and symptoms
by an expert physician. As many as 1 out of 100 kids may have TS and similar Tic
Disorders in the world.

Stuttering [__GHOST_URL__/what-is-stuttering/] is another common speech
disfluency-cum-disorder. It involves repetitions, blocks, and prolongations in
speech.

A person with stuttering typically begins showing signs and symptoms by the time
s/he is 2 to 4 years old.

Around 1% of the world’s population or 70 million
[https://www.say.org/stuttering-101/] people stutter.

What’s the Common Link Between Stuttering and Tourette’s Syndrome?
Early research [https://pubmed.ncbi.nlm.nih.gov/8725745/] on TS in 1996 showed
that 3 genes are common in five disorders – stuttering, TS, attention deficit
disorder, obsessive-compulsive disorder, and tics.

The 3 genes are responsible for controlling the release and levels of dopamine.

In individuals with at least one of the 5 disorders, these 3 genes are
permanently switched on.

Research also notes the use of dopamine antagonist drugs like Haldol for the
control of tics as well as a severe stutter.

Sadly, the efficiency of the drug to reduce stutters is only between 30% and
50%, with serious side effects.

Hence Haldol is no longer used to treat stuttering.

There are times when experts have commented on TS as “stuttering with the
extremities”.

Both disorders are susceptible to physical and emotional stress.

People who stutter (PWS) often experience worse blocks, repetitions, and
prolongations when they try to control it forcibly.

People with TS report similar experiences with their tics.

Is Stuttering A Part of Tourette’s Syndrome?
De Nil et al (2005) conducted a study
[https://www.sciencedirect.com/science/article/abs/pii/S0022399904005008] on 69
children exhibiting symptoms of TS from the Toronto Western Hospital and 27
children without TS from the General Medical Clinic.

While no medicines were altered during the study, the researchers recorded the
prescribed drugs in the case of each individual.

According to results, the atypical disfluencies were not exuberantly high in
those with TS, as one would expect. In fact, they were quite comparable to the
disfluencies the researchers noted in the children without TS or the control
group.

However, the disfluencies of the control group decreased in frequency with age.
The noted disfluencies in the group of 69 children with TS didn’t decrease.

It would be ill-considered to conclude the nature of stuttering in TS based on
one study.

A comparative study from the University of Akron infers that stuttering in
Tourette’s may be a result of the combination of multiple disfluencies.

What Is The Treatment for Tourette’s Syndrome?
There is no cure for TS, but there are quite a few options available that can
reduce tics and improve speech.

According to the Tourette Association of America, 6 different therapies may work
for someone with TS –

1. Medication
In some countries, along with behavioral therapy and deep brain stimulation,
experts at times recommend the use of alpha2-adrenergic agonists such as
clonidine, CNS stimulants, and atypical neuroleptics for managing
[https://www.omicsonline.org/india/tourette-syndrome-peer-reviewed-pdf-ppt-articles/]
severe symptoms of TS.

2. Comprehensive Behavioral Intervention for Tics (CBIT)
A child study [https://jamanetwork.com/journals/jama/article-abstract/185896]
published in 2010 in the Journal of the American Medical Association (JAMA)
shows that 52.5% of the participants who received CBIT exhibited reduced
intensity of symptoms as compared to the 18.5% who were the control group (no
CBIT).

Similar results in adult studies (38% of adults responding positively to CBIT)
shows that this form of treatment may be useful in controlling and reducing the
intensity of symptoms associated with TS and other tic disorders.

3. Speech Therapy
Speech-language pathologists (SLP) can help with the conditions that typically
co-occur with TS including stuttering.

Other co-occurring conditions include social language impairment, OCD, and ADHD.

Children and adults with TS with one or multiple of these co-occurring
conditions can benefit from speech therapy.

Very often these individuals have language-based learning challenges.

They have difficulty in learning new words, word relationships, and language
syntax.

They may also face difficulty in understanding questions, asking questions,
following or giving directions, and understanding sentences they hear.

The intervention of an SLP can help them with expanding their vocabulary,
gaining an understanding of spoken language and written language.

4. Medical Marijuana
The effects of marijuana on TS are not well-explored in many parts of the world.
The restrictions of research on marijuana have limited the studies of its
effects on various chronic diseases and disorders.

However, several publications from across the globe show that THC
(delta-9-tetrahydrocannabinol), a component of marijuana can reduce the
intensity of TS symptoms.

Currently, studies from Germany, Canada, and Israel report
[https://pubmed.ncbi.nlm.nih.gov/23187140/] the use of cannabis extracts and
medical marijuana in reducing the tics associated with TS.

CBD (cannabidiol) extract, oil, capsules, and edibles are now easily available
across several countries which makes the studies on the effects of CBD and THC
on people with TS much accessible.

5. Deep Brain Stimulation (DBS)
DBS is a new technique
[https://tourette.org/research-medical/deep-brain-stimulation/] that uses an
electrode implant in the brain.

It is used to treat Parkinson’s disease, OCD, and dystonia as well.

Currently, DBS is only used for patients who don’t respond to traditional
Cognitive Behavioral Therapy (CBT), or medicines.

It is an invasive procedure with promising results for the treatment of TS.

However, it has both short and long-term potential complications. Primary ones
include local bleeding, accidental stroke, unintentional alteration of speech,
or vision.

6. Dental Device
Dental orthotic devices have been in the discussion for the last few years as a
potential treatment for TS.

These devices may potentially reduce
[https://www.nsmedicaldevices.com/news/oral-splint-improve-tourette-syndrome/] 
the muscular tics of TS when individuals with TS wear them in the mouth.

Research is still ongoing on the effectiveness of dental devices in the
treatment of TS.

Not a lot of material is available, but the Tourette Association of America has
dedicated resources to several dental organizations, research, and clinical
experts in TS to explore the possibilities of the treatment.

What Is The Treatment For Stuttering?
The treatment for stuttering [__GHOST_URL__/treatment-for-stuttering/] depends
upon several factors including the severity of the stutter and the age of the
PWS.

A few therapies are common between stuttering and TS. Potential treatment for
stuttering involves the following –

1. Speech Therapy
For children, the method is indirect. Most children under the age of 6 years
have the chance of recovering [__GHOST_URL__/stuttering-in-preschool-kids/] 
quickly since their secondary behaviors have not set in.

Including speech exercises
[https://ghost.stamurai.com/five-stuttering-exercises-to-help-your-child/] in their daily
routine may disrupt their journey to natural recovery.

Older children, adolescents, and adults
[https://ghost.stamurai.com/stuttering-treatment-for-adults/] may benefit from regular speech
therapy under the guidance of an SLP.

Speech therapy may teach you how to stutter on purpose so you can gain a better
understanding of your stuttering.

It can teach you proper breathing techniques that relax all muscles involved in
the production of speech.

The aim of speech therapy is not ridding a person of his/her stutter, but to
make him/her stutter with ease.

With therapy, you may find speaking to be less of a struggle.

2. Electronic Devices
Technology has played a key role
[https://ghost.stamurai.com/stamurai-app-to-stop-stuttering/] in the treatment of stuttering.

Delayed auditory feedback
[https://www.stutteringhelp.org/delayed-auditory-feedback] (DAF) techniques have
been popular and effective in the treatment of stuttering. It involves
introducing a delay of a few microseconds between the spoken words and the
person’s hearing.

Another similar method mimics one’s speech to make it sound like choral
speaking.

Choral speaking/reading has been very effective in treating stuttering in the
past.

The use of technology ensures that a single person can enjoy the benefits of
choral speaking/reading on his/her own during private therapy or at home.

3. Cognitive-behavioral Therapy
CBT is critical for adolescents and adults who stutter.

Stuttering typically has lasting negative effects
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/] on mental health.

Emotions like anxiety, fear, and shame make their association with speaking as
the PWS grows older.

People with mild stuttering often shy away from speaking in public
[https://ghost.stamurai.com/public-speaking-with-a-stutter/] situations to hide their
stutters.

While those with severe stuttering often don’t apply for jobs
[https://ghost.stamurai.com/stuttering-and-job/] due to their experience with bullying and
discrimination.

CBT can help people recover their mental wellbeing while giving them the
necessary courage and confidence to embrace their stutter.

Additionally, it can address fatigue, stress, and self-esteem problems than
often have a detrimental effect on speech fluency.

How Are Tourette’s Syndrome And Stuttering Related?
Both Tourette’s Syndrome and stuttering present themselves early in children.

A child aged between 2 and 4 years can present symptoms
[https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Tourette-Syndrome-Fact-Sheet#3231_2]
like the twitching of lips, rapid blinking, shrugging, grimacing and nose
twitching if they have TS.

Similarly, a child with stuttering may exhibit blocks, repetitions, and
prolongations as early as 2 years of age.

While early-onset stuttering [__GHOST_URL__/what-is-stuttering/] might go away
on its own, TS never does.

Since some of the symptoms of stuttering overlap with Tourette’s Syndrome, it’s
often difficult for parents to tell the difference.

Sometimes, children with TS also exhibit repetitions, blocks, and prolongations.
However, that is more likely to be a co-occurrence of TS and stuttering rather
than an additional symptom of TS.

There is no evidence to link Tourette’s to stuttering. However, often these two
disorders occur together.

There is no test for the diagnosis of Tourette’s.

The diagnosis requires expert eyes and experience. Typically, motor tics and
vocal tics are telltale signs of Tourette’s, although both may not occur at the
same time.

Are Tourette’s Syndrome and Stuttering Related?

Stuttering is a complex disorder. It is variable.

You may have noticed that sometimes your child stutters more than usual, while
at other times s/he might sound fluent.

You must have realized that stuttering in teens is involuntary.

The intensity of stuttering in teens can vary with the level of stress, anxiety,
fear, or even physical fatigue.

However, since your child is already in teenage, you should know that it is
almost impossible for them to “grow out of it.”

An adolescent who stutters should receive speech therapy and practice speech
exercises [__GHOST_URL__/five-stuttering-exercises-to-help-your-child/] to
become more fluent in his/her speech.

[https://stamurai.app/z4HKmlNXigb]Causes of Stuttering in Teens
The first thing you must remember is that stuttering is not a sign of low
intelligence. Secondly, your child’s stuttering isn’t your fault.

Here are some of the scientifically proven causes of stuttering
[https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935336&section=Causes#Stuttering] 
in teens –

Stuttering Cause #1 in Teens: Genetics
Scientists have linked [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370225/] 
multiple genes to speech disfluencies. Children of parent(s) who stutter are
indeed more likely to stutter.

Stuttering has nothing to do with how a child is raised.

It is just like any other genetic condition that may or may not pass down from
one generation to another.

Since these genes are connected to language processing & production, auditory
processing, and other similar functions, there is currently no medical cure
[https://ghost.stamurai.com/stuttering-medicine/]for stuttering.

Teenage stuttering treatments [__GHOST_URL__/treatment-for-stuttering/] that
include speech therapy and cognitive-behavioral therapy (CBT) may work wonders
for an adolescent child struggling with speech disfluency and self-confidence.

Stuttering Cause #2 in Teens: Differences in Brain Structure & Function
Existing research suggests
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233907/] that people who stutter
(PWS) have structural abnormalities in the Broca’s area and Wernicke’s area –
the two areas associated with language processing and production in the brain.

The areas connecting the two are also different in both structure and function.

Brain imaging studies have also revealed anomalies in the areas associated with
auditory processing.

The fiber tracts connecting areas responsible for language, speech, and auditory
activities are also less dense.

A recent study shows
[https://www.nih.gov/news-events/nih-research-matters/brain-cells-underlying-stuttering-identified-mice] 
that the corpus callosum that connects the right hemisphere with the left in PWS
has fewer astrocytes.

The structural differences in the brain create functional differences that
result in stuttering.

Stuttering Cause #3 in Teens: Family History
When children continue to stutter into their teens, they will likely stutter in
their adulthood, unless they get speech therapy.

In such cases, scientists and speech-language pathologists (SLPs) have noted
that one or more members of the family (related by blood) of the teens also
stutter.

Stuttering is often familial
[https://www.stutteringhelp.org/genetic-and-neurological-factors-stuttering#:~:text=Genetics%20and%20Stuttering&text=The%20evidence%20for%20genetic%20factors,are%20more%20likely%20to%20stutter.]
and it should prompt you to seek the advice of an SLP before your teenager’s
stuttering becomes worse.

Stuttering Cause #4 in TeensEnvironment
Children who are already susceptible to stuttering
[https://ghost.stamurai.com/what-is-stuttering/] due to genetic or familial factors often
react to a drastic change in their environment with stuttering.

Changes may include moving to a new neighborhood, changing schools, separation
of parents, or the birth of a new sibling.

These changes only precipitate a stutter in children between the ages of
approximately 2 and 4 years old if they have a predisposition.

According to experts like Dr. Van Riper and Dr. Barry Guitar, the environmental
factors interact with
[https://www.researchgate.net/publication/225289735_Genetic_and_environmental_effects_on_stuttering_A_twin_study_from_Finland] 
genetic factors to produce stuttering.

Although high-octane situations like a viva voce, class presentation, or talking
to a new person may worsen the symptoms, emotions are NOT the cause of
stuttering.

In fact, stuttering is not the disorder itself. The symptoms result in
structural differences in the brain.

[https://stamurai.app/z4HKmlNXigb]How to Talk to a Teen Who Stutters
A teenager who stutters already knows that s/he sounds different from their
fluent peers.

They already have access to the web and other sources of information where they
can learn about speech disfluencies.

As a parent, it is your responsibility to learn the correct facts about
stuttering and guide your teenage child in the right direction.

Although a teenager who stutters is likely to speak less, even to his/her
parents, you should ensure that your child feels safe talking to you and sharing
with you.

That is the first step towards establishing two-way communication with your
teenage child.

Here are 5 things you can follow to strengthen your communication with a
stuttering child –

1. Learn More about Stuttering
You already know about the causes of stuttering.

Next, learn more about how stuttering affects a teenager’s life.

Studies show that stutter affects
[https://www.researchgate.net/publication/330549548_Self-esteem_and_anxiety_in_stuttering_children_and_attitude_of_their_parents]
an adolescent’s performance in school, social life, and public-speaking
situations.

A child may face bullying [__GHOST_URL__/reining-in-the-bullies/]or teasing in
school because of stuttering but not share it with their teachers or parents due
to embarrassment.

A study on teenagers who stutter by Keylonda Granger, John A. Tetnowski, the
University of Louisiana at Lafayette, & Jim McClure, Albuquerque, NM, indicated
that their stuttering had more impact on their lives than their parents
fathomed.

Sadly, during the teenage years, the impact of stuttering may be the greatest.
However, during these years, parental involvement in therapy and CBT is
typically the lowest.

2. Talk To Your Child about Stuttering
As a teenager, your child already has tons of new feelings to deal with.

So make it easier by talking to him/her directly about the causes and effects of
stuttering.

However, make sure they are willing to talk and you are not pushing them out of
their comfort zone.

It may take time, but they will gradually open up. Teenagers are not the most
communicative or easy to talk to, and we get that!

You have to be superbly patient while trying to create a safe space
[https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Parenting-Preparing-For-Adolescence-056.aspx] 
where they can spontaneously talk and share about stuttering.

Make sure your child knows s/he is not alone in this struggle. Share credible
sources of inspirational stories
[https://ghost.stamurai.com/joe-biden-stuttering-journey-and-struggles/], career options, and
positive therapy results with them.

3. Empower Your Child
Empowering a teenager is not easy, especially when social media and popular
media sets unrealistic standards for them.

To empower your child, begin by reinforcing that stuttering is not a defect. It
is also not a limitation.

You can seek the help of a professional counselor and SLP to help your child
regain lost confidence. Empowering your kid will help him/her embrace their
stutter.

Embracing one’s speech disfluency can empower him/her to believe in his/her own
decisions later in life as well.

4. Choose the Right Therapy
While your teenage son/daughter may be old enough to choose the weekend movies
or dinner, choosing the right therapy and therapist is still your
responsibility.

Look for speech therapists in your area. Check their reviews online. Search for
recommendations. You may get some help from the school authorities or the
appointed counselor at your child’s educational institute.

Combining speech therapy with CBT
[https://ghost.stamurai.com/stuttering-and-cognitive-behavioral-therapy-cbt/] can be
efficient in decreasing one’s stutter and reducing one’s fear of stuttering.

You can also help your teenager use a speech therapy app such as Stamurai
[https://stamurai.app/z4HKmlNXigb], available for both Android
[https://play.google.com/store/apps/details?id=com.stamurai.stamurai&hl=en] and 
Apple [https://apps.apple.com/us/app/stamurai-stuttering-treatment/id1488071175] 
devices that combines fluency shaping and stuttering modification techniques.

Stamurai speech therapy app is already used by thousands of teenagers around the
world. Many teenagers and adults have been able to significantly reduce their
stuttering with this app.

5. Stay Connected
Today, you can find websites and pages dedicated to parents of teenagers who
stutter.  Join these groups to find out more on the latest information on
stuttering.

You can learn about new research, therapy techniques, and technology that can
help your child stutter less.

Sign up for newsletters from the likes of the National Stuttering Association (
NSA [https://westutter.org/], US), Stuttering Foundation
[https://www.stutteringhelp.org/], The Stuttering Association for the Young (SAY
[http://say.org]), and the American Speech-Language-Hearing Association (ASHA
[https://www.asha.org/]).

Attend webinars on stammering and related topics.

Read up published research and authentic material to keep yourself updated on
stuttering treatments and opportunities for children who stutter.

[https://stamurai.app/z4HKmlNXigb]Is It Normal to Stutter During Puberty?
If you or your loved one has been stuttering since childhood, then stuttering
during puberty is nothing unexpected or out of the ordinary. However, if the
signs of stuttering have appeared suddenly without any history of speech
disfluency, you need to act fast.

 The sudden occurrence of stuttering during puberty may be because of one or
more of these factors -

 Neurogenic

Traumatic brain injury including concussions, brain tumors, neurodegenerative
diseases and even cerebral strokes can lead to stuttering in teens. Damage to
the areas of the brain responsible for language processing and speech formation
can cause the sudden incidence of stuttering in teens. The attention of
neurologists and other medical professionals may be necessary if the teen’s
stuttering turns out to be neurogenic in nature.

 Psychogenic

 An individual may begin stuttering suddenly after a traumatic event or
prolonged psychological/emotional turmoil. Post-traumatic stress disorder (PTSD)
is known to cause stuttering in a few instances. In such cases, psychological
counseling, psychotherapy and CBT may be necessary to address the root of their
speech disfluency.

 Pharmacogenic

 Have you or your teenager started taking a new medicine? Some medicines,
especially the psychoactive ones, have the side effect of inducing speech
disfluencies. Even some antidepressants that do not typically have profound side
effects may cause stuttering in a small percentage of the population. Speak to
your doctor and a speech therapist if you think your medicines may be
contributing to your stuttering or making it worse!

The Take-away Message
Being a parent is a colossal task, but being a teen isn’t exactly easy either.

While you have to deal with your own feelings of anxiety, protectiveness, and
fear for your child, you will also have to be strong for him/her.

You may consider talking to the counselor of your child to see if s/he can help
you with your emotional and mental wellbeing as well.

In the meantime, be supportive.

Talk to your child openly about stuttering and keep educating yourself on the
complex disorder and the ways you can help your teenage son/daughter.

Teenage Stuttering: How Can Parents Help

Being a millennial has its perks, but access to speech therapy right when we
began stuttering wasn’t one of them. Speech-language pathologists (SLPs) weren’t
very common back in the late 80s and early 90s.

If a child began stuttering, his/her parents either ignored it or tried to treat
it at home. Taking children to the SLP for speech dysfluencies wasn’t common
practice back then.

I grew up in a bustling city, yet my parents never deemed it necessary to seek
the help of an SLP or a cognitive behavioral therapist when I was a child. They
did ask their friends and friends-of-friends who were aware of the ongoing
research on speech dysfluencies and received the advice to ignore my stutter.

So, that’s how it was. My parents and extended family knew I stuttered, but no
one really spoke about it. Since none of my cousins stutter, I often felt like I
was alone in my suffering. Stuttering and fear
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728710/] shared a strong bond in
my mind.

Only when I was in high school and already in my teens, I sought and received
speech therapy [__GHOST_URL__/treatment-for-stuttering/]. I shall always be
thankful for it since it has helped shape who I am today and given me a voice. I
won’t say I don’t stutter. I do stutter, a lot, sometimes, but speech therapy
has taught me that stuttering and shame need not go hand-in-hand.

Breaking the Bond between Stuttering and Fear
You stutter. And that’s alright. It bothers you. And that’s alright too because
you are here to look for a solution.

You can begin your search by locating the right resources. The resources can be
professional SLPs, self-help groups for speech dysfluencies or apps/websites
dedicated to people who stutter (PWS).

Since there are more SLPs available online and in person, you have a better
chance at therapy [__GHOST_URL__/how-to-stop-stuttering/] than I had when I was
young. If someone has told you that speech therapy doesn’t work for adults, this
is your chance to prove them wrong!

Most importantly, now you have apps like Stamurai
[https://ghost.stamurai.com/stamurai-app-to-stop-stuttering/] that provide speech therapy in
the comforts of your home. You can consult professional SLPs and practice your
speech exercises regularly while at home or during your lunch break.

As long as you have a smartphone, you will have access to speech therapy.

Taking Account of the Challenges of Stuttering
The next step is taking stock of your dysfluencies. Stuttering is heterogeneous
[https://www.aau.edu/research-scholarship/featured-research-topics/understanding-mystery-stuttering-0]
. Repetitions, blocks, and prolongations may characterize stuttering, but each
person who stutters has a different list of feared words.

For example, “stuttering” itself was a feared word
[https://www.psychologytoday.com/us/blog/word-less/201904/feared-words-and-free-words] 
for me. While you may say it fluently only to get stuck on “language” or
“pathologist”.

What’s your story? Before we can explore the different ways you can potentially
overcome stuttering-related insecurity
[https://www.stutteringhelp.org/message-stutterer], we need to explore your
story. So, get a journal and begin writing the answers to the following
questions –

 * How has stuttering influenced my life and life choices?
 * What have I given up for stuttering?
 * How much am I willing to spend to get professional help for my stuttering?
 * Who will support my decision to get help from an SLP? Who wouldn’t and why?
 * Have I received help to improve my speech fluency?
 * What has worked in favor of my speech fluency and what hasn’t?
 * Who criticizes my stuttering and why?
 * Am I ready to take the full responsibility of seeking help for my speech
   dysfluency even though I might not become 100% fluent?

Even if the answer to the last question is a “no”, it doesn’t mean you are weak.
It means you possibly need the help of an SLP
[https://speech-language-therapy.com/index.php?option=com_content&view=article&id=114:findslpslt&catid=11:admin&Itemid=122] 
on your journey towards fluency and you are not ready to undertake the
responsibility entirely on your own.

Reducing the Burden of Stuttering and Fear
If your answer’s “yes”, then it’s time to move on to the next step – reducing
the burden.

Just for this step, ignore the feelings and attitudes that come bounding once
you think about stuttering. Try to cover things you actually do, such as –

 * I repeat the first syllable of every hard word at least six times.
 * I always blink when I stutter.
 * I can’t make eye contact with the person I’m talking to.
 * I am terrified of public speaking.
 * I become easily frustrated while talking on the phone.
 * I don’t receive calls or leave voice messages.

It should be a straightforward list of actions you take
[https://www.asha.org/Practice-Portal/Clinical-Topics/Childhood-Fluency-Disorders/Characteristics-of-Typical-Disfluency-and-Stuttering/]] 
while talking. It’s a necessary step towards overcoming your fear and insecurity
stemming from stuttering.

Overcoming the Stuttering Challenges – One Step at a Time
The list should show you exactly what is keeping you from doing things you would
love to do including meeting new people, talking to someone at any time of the
day, and even leaving voice messages.

Initially, it might feel awkward or, even, weird, but it becomes easier with
practice. Here are a few techniques that have helped me despite not receiving
professional therapy for years –

Making eye contact
Most listeners don’t know how to react to your stutter. You may find them to be
fidgety or distracted.

They are simply wary about making eye contact. It is not always a sign of
disrespect.

You can put them at ease by making eye contact.

Stutter on purpose
You should try this one. Begin stuttering on simpler, monosyllabic words. For
example “I cuh-cuh-cuh-cuh-uh-not (real) spuh-uh-uh-speak (fake) without
stu-uh-uh-uh-uh-ttering (real)”

It’s like a game, but one that gives you a sense of control. Instead of focusing
on NOT stuttering, you should focus on trying to stutter deliberately
[https://www.mnsu.edu/comdis/isad8/papers/reitzes8.html]. Repeat this around
20-times per day.

See if listeners can tell the difference between your real and faked stuttering.
Doing this put me at ease with myself. After all, people expected me to stutter,
so I was providing them with a few extra instances of stuttering.

Speak to strangers
Go up to strangers with a simple line, such as “pardon me, what’s the time?” or
“when does the next bus to XYZ leave?”

Tell them explicitly that you stutter. You will be surprised to see how many of
them actually listen to you patiently and don’t mock at all.

Going out and interacting with strangers
[https://stutteringtreatment.org/7-ways-feel-comfortable-talking-stuttering-others/] 
can boost your confidence to say what you want, whenever you want and to
whomever you want!

Challenge yourself
Do things you normally wouldn’t do.

Go to a Starbucks and place your order verbally instead of using the app. Give
an order at a drive-through. Leave a voicemail for your friends. Volunteer at
your workplace or school for giving a presentation.

Transitioning to this step might take weeks if not months, and that is perfectly
fine. Our goal is to NOT overcome stuttering but to embrace it as a part of who
we are and overcome the insecurity that stuttering has imbibed within us.

Change the Way You Stutter
Once you significantly reduce the burden, you will be talking more, socializing
more, and taking more chances. You may even consider making a new career move or
joining a college course that requires you to talk a lot more.

You will find that although you are more outgoing in comparison, you still
stutter significantly. Now, that’s alright too. Stuttering is a part of who we
are.

If you want to become a more effective communicator, you should think about 
changing the way you perceive
[https://ghost.stamurai.com/changing-the-perception-about-stuttering-5-tips-for-talking-to-someone-who-stutters/] 
your stutter instead of looking for a cure for stuttering. The first step to
achieving it is by not trying to NOT stutter.

In our effort to hide our stutter we have picked up habits like blinking, lip
twitching, raising eyebrows, rapid and shallow breathing, and head jerking. It’s
time to say “goodbye” to these habits and adopt a new viewpoint.

Stutter all you like and all you can, but do so smoothly.

Make the prolongations unforced and the repetitions slow. Don’t hold your breath
and don’t try to breathe rapidly and slowly. Take a deep breath and make strange
sounds to overcome a block!

It may sound strange, but it’s not stuttering. You are in complete control of
the sounds you make and the words that leave your mouth. This is what SLPs refer
to as “stuttering more fluently”.

If you are able to stutter more fluently, you will be able to shorten your
stutters and simplify your repetitions.

The Final Few Words on Overcoming Insecurities Related to Stuttering
Stuttering is not a habit. It is a symptom of a neurobiological condition
reinforced by emotional and environmental factors.

However, rapid blinking, twitching, head jerking, and shallow breathing are
habits that we have picked up
[https://speech.steinhardt.nyu.edu/blog/anticipation-stuttering/] over several
years of dedicatedly trying to avert stuttering.

Since old habits die hard, we need you to not give up
[https://ghost.stamurai.com/high-relapse-after-stuttering-speech-therapy-understanding-the-reason/]
.

You should practice deliberate stuttering at least once a day initially, and
once a week after you attain noticeable fluency. You should keep working on your
speech without trying to avoid stuttering.

In the next few years, your goal should be to modify your stuttering so that
speaking is less of a hassle for you.

You are your own master and you are in control of your stutters.

You don’t have to be fluent like the majority of your friends and family.

You need to be you – complete with your blocks, repetitions, and prolongations.

Don’t practice fluency. Practice stuttering. Regularly.

How To Overcome Stuttering Related Insecurity

Hearing Dr. Gerald Maguire talk [https://stuttertalk.com/tag/gerald-maguire/],
it’s almost impossible to guess that he has stuttered since childhood.
Currently, he is one of the leading experts on the medical treatment of
stuttering in the world.

Dr. Maguire is a Professor and Chair of Psychiatry and Neuroscience at the US
Riverside School of Medicine. Along with conducting research on the medical
treatment of stuttering [__GHOST_URL__/stuttering-medicine/] for over two
decades, he has been treating his own stutter with common and not-so-common
antipsychotics.

Psychiatrists may prescribe antipsychotic drugs for the treatment of psychosis,
bipolar disorder and schizophrenia. Some of the antipsychotics that have a
positive impact on stuttering include second-generation antipsychotics
risperidone, asenapine, and olanzapine.

Many of these compounds are not yet approved for the official treatment of
stuttering.

More than 70 million people stutter worldwide. It includes around 1% of the
adults. Several children show tendencies of speech dysfluency while growing up.
While many children outgrow stuttering by the time they are around 6 or 7 years
old, there are exceptions.

These exceptions include US presidential candidate Joe Biden
[https://ghost.stamurai.com/joe-biden-stuttering-journey-and-struggles/], actors James Earl
Jones & Emily Blunt, and singer & songwriter Ed Sheeran.

Could Stuttering Be Entirely Neurological?
It is a popular belief that anxiety and fear cause stuttering
[https://pubs.asha.org/doi/abs/10.1044/jshd.5502.290]. The use of antipsychotics
for the medical treatment of speech dysfluencies begs the question – is
stuttering psychological or biological?

Early research [https://pubs.asha.org/doi/abs/10.1044/jshd.0702.97] has
mistakenly attributed stuttering to anomalies in the vocal cords and voice box,
emotional trauma, anxiety, and even bad parenting! According to J. Scott Yaruss,
some researchers and speech-language pathologists (SLPs) have always suspected
[https://ghost.stamurai.com/what-is-stuttering/] neurological problems to be the underlying
cause of stuttering.

Yaruss, a leading SLP at Michigan State University states that the first proof
that could back up the hunch of their team came from a report
[https://jamanetwork.com/journals/jamaneurology/article-abstract/590851] of
altered blood flow in the brains of people who stuttered.

Thanks to advancements in diagnostics, neuroscientists have observed minute but
important differences in the brain structure and function of those who stutter.

Why Is It Wrong to Attribute Stuttering to Genetics Only?
According to the Stuttering Foundation of America has stated
[https://www.stutteringhelp.org/faq] that there is no “reason to believe that
stuttering is caused by emotional trauma”.

The National Stuttering Association has stated
[https://westutter.org/causes-of-stuttering/] that stuttering is “not caused by
emotional problems or ‘nervous disorders’. Stuttering is not a result of faulty
upbringing.”

Scientific evidence and publications by reputed organizations like the ones
mentioned above suggest that stuttering is an inherited condition
[https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935336&section=Causes] 
with little dependence on emotional state.

According to Peter Wolson, a training, and supervising psychoanalyst,
psychoanalytic psychotherapy may be an option for the treatment of stuttering in
individuals whose speech disfluencies stem from internal conflicts due to
disturbances in their families and relationships.

Focusing exclusively on the biological causes of stuttering rules out the
importance of the emotional trauma or internal conflicts of the person who
stutters. Put simply, calling it entirely biological can be misleading.

Can Psychotherapy Impact the Intensity and Frequency of Stuttering?
In many interviews, David Siedler, the writer-producer of The King’s Speech
speculated that in his real-life Bertie (King George VI) benefited from Lionel
Logue’s “talking cure”.

Siedler, who also stutters
[https://www.latimes.com/archives/la-xpm-2010-dec-09-la-en-seidler-20101209-story.html]
, has an uncle who received speech therapy from Logue. According to his uncle, a
large part of Logue’s therapy included encouraging the client to talk about
their family, friends, and others who may have had a strong impact on their
life.

Seidler has concluded multiple times that Logue must have used Freudian
psychoanalysis on Bertie and his uncle. Although his uncle did call the
psychoanalytic method “utter rubbish”, by the end of his therapy he didn’t
stutter anymore.

Decades later, Jack Welch, CEO of General Electric confided
[http://transcripts.cnn.com/TRANSCRIPTS/1106/11/pmt.01.html] in talk show host
Piers Morgan that he stutters. Although he didn’t have someone like Logue to
listen to him, his mother imbibed confidence and courage in him from a young
age.

His mother reinforced his confidence by stating that his brain worked faster
than his ability to express his thoughts and ideas.

Jack’s mother was instrumental in developing his belief
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/] that whatever
he wanted to say was worth saying.

Is It Possible for Stuttering to have Psychological as well as Physiological
bases?
As Luc F. De Nil, an associate professor and chair of the graduate department of
speech-language pathology at the University of Toronto precisely put it
[https://www.scientificamerican.com/article/what-causes-stuttering/] –
stuttering has biological as well as psychological etiologies.

Children who develop stuttering have a predisposition to the speech dysfluency.

Other factors such as environmental stress, emotional trauma, listeners’
reactions, and anticipatory anxiety play crucial roles in the maintenance of
stuttering.

Over the years, researchers have gathered several facts about how stuttering
develops [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831617/], which
highlight its physiological as well as psychological nature.

 1. 4 males for every 1 female stutter
    [__GHOST_URL__/is-stuttering-gender-specific/].
 2. The male predominance is similar to several genetic (biological) disorders
    including Tourette’s syndrome
    [__GHOST_URL__/tourette-syndrome-and-stuttering/], and Down Syndrome.
 3. 1% of the world’s population stutters.
 4. Acquired stuttering highlights the importance of neural systems
    [__GHOST_URL__/the-unexpected-development-of-stuttering-in-adulthood/] in
    speech fluency.
 5. Several psychoactive compounds such as Ecopipam
    [https://www.sciencedaily.com/releases/2019/08/190828140048.htm] can treat
    stuttering in children and adults.
 6. Psychoanalytic therapy is effective in treating stuttering in both adults
    and children.

What Does Current Genetic Evidence Suggest About the Nature of Stuttering?
In 2001, Dennis Drayna received a strange and interesting email that stated

“I am from Cameroon. My father is a chief. He has had three wives. I have 21
siblings and half-siblings, almost all of us stutter. Could there be something
in the family?”

At that time, he was unprepared to make a journey to West Africa based on an
email. So Drayna, now a world-renowned geneticist, shared the email with Francis
Collins (Director of the National Institute of Health).

Collins encouraged him to travel to West Africa and later to Pakistan.

In Pakistan, marriage between cousins allows recessive genes to be expressed and
the extensive studying of linkage.

Drayna’s dedicated research and data collection finally led to the discovery of
the mutations
[https://www.annualreviews.org/doi/abs/10.1146/annurev-genom-090810-183119] in 4
genes – GNPTAB, GNPTG, and NAGPA from Pakistan and AP4E1 from Cameroon in those
who stutter.

However, none of the genes that Drayna and his team discovered have a direct
connection to speech production or processing. These are genes that encode
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370225/] lysosomal protein and
function in the brain.

An NIH study published in 2019 was finally able to determine the difference
between the brains of those who stutter and those who don’t. In the mice model,
the ones that produce stuttering-like gaps and pauses have fewer astrocytes
[https://ghost.stamurai.com/cellular-causes-of-stuttering-in-adults-and-children/] in their
corpus callosum.

It would be Myopic to Deem Stuttering as Entirely Biological in Nature
It is still unclear if these 4 genes only play a role in controlling lysosomal
functions. Many genes in our bodies have more than one function. Moreover,
scientists are sure that there are more stuttering-related genes
[https://www.stutteringhelp.org/genetics-stuttering-new-developments], yet to be
discovered.

Therefore, calling stuttering purely biological could be short-sighted and
limiting. King George VI discovered that his stuttering had roots in the neglect
and oppression he faced from his father during his formative years. Thousands
are waiting for their Lionel Logue to explore the emotional or psychological
stress at home or school that precipitated their stutter.

It takes a combination of environment, emotions, and genetics to set off
stuttering. Just like one cannot deny the biological bases of stuttering, one
should not deny its psychological etiology as well.

Stuttering: Is It Biological or Psychological?

The beginning of the school year is an exciting and happy time.

For young students who stutter (CWS), however, it can also be a time of anxiety
and fear. It is especially difficult for a child if s/he is the only one who
stutters in their grade.

The information on stuttering is readily available today. Still, only a handful
of teachers know how to support a stuttering student
[https://ghost.stamurai.com/teachers-guide-to-helping-stuttering-student/].

Stuttering is a complex speech disorder and every person stutters differently
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/]. So, you might
think that putting a stuttering kid at ease is difficult.

Well, that’s not the case.

No matter how severe the condition, you CAN work with a stuttering student.

Here in this post, we will shed light on the top nine ways teachers can work
with students who stutter.

1. Let Them Know That “It’s Okay to Stutter”
Sounds pretty basic, right?

Well, when a child refuses to participate in a discussion or oral quiz, simply
telling them that stuttering in class is alright can help allay their fears.

Some stuttering kids will avoid answering questions.

So, they may pretend to not know the answer to avoid speaking in front of the
entire class.

Let them know that it’s the content of their speech that matters and not how
they say it.

2. Foster Good Communication
Set a good example
[https://www.stutteringhelp.org/notes-teacher-child-who-stutters-school] as the
teacher.

Maintain eye contact with a kid who trips on some words or phrases. It should be
comfortable and natural.

Try to speak at a relaxed pace. Good communication includes not rushing the
child.

Do not finish their sentences.

You should also not speak on their behalf. Let them answer questions and
participate in group discussions.

3. Treat Students Who Stutter Like Every Other Kid In Class
You should expect the same level of dedication and performance
[https://ghost.stamurai.com/the-positive-aspects-of-stuttering/] from CWS as you do from your
other students.

Allowing CWS to opt-out of presentations or oral tasks may encourage avoidance
behavior.

You can, by all means, offer help during the preparatory phase.

Before a stuttering student begins speaking, you can request the class to be
quiet and patient.

4. Make Small Changes
Many of us still suffer from anxiety and self-doubt when we have to present in
front of an audience.

Stage fright is something most of us have experienced at some point in our
lives.

For CWS, stuttering or stammering adds an extra layer of the anxiety to stage
fright.

Allow them 5 to 10 minutes of extra to finish their speech.

Encourage voluntary communication and discourage quick call-out answers.

You can adopt a random pattern of turn selection for students to reduce the
anticipation among CWS.

5. Inform Other Students
Talk to the child who stutters in your class first. Find out if it is alright to 
discuss their stuttering
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/] in front of their
classmates.

Tell the class to not be impatient when a child who stutters is speaking. Stop
others from finishing their sentences.

Urge students to support and not mock someone who stutters.

Set up a model wait-time. Make it a practice to wait around 2 seconds to answer
a question. Don’t reward students based on who answers the fastest.

6. Talk About Stuttering And Bullying
Introduce life stories of inspirational personalities
[https://www.stutteringhelp.org/famouspeople] like Charles van Riper, Joe Biden,
Ed Sheeran, and James Earl Jones (the voice of Darth Vader) to normalize speech
disfluencies.

Let your students ask questions freely about stuttering and its effects.

Talking more about stuttering is the only way to destigmatize it.

Let everyone know that stuttering doesn’t make
[https://ghost.stamurai.com/changing-the-perception-about-stuttering-5-tips-for-talking-to-someone-who-stutters/] 
a child any less capable or less intelligent.

Make your class a no-bullying zone. Foster an inclusive environment for all
students.

Every child needs a safe space to be themselves.

Let your class become that safe zone for everyone, including the kid who
stutters.

7. Offer Additional Support
Sometimes, children don’t speak up even when they know the answer. That may be
because they are conscious of how they sound.

It can affect their overall performance.

You can become the source of additional support
[https://www.stutteringhelp.org/faqs-teachers] for CWS.

You don’t have to be a speech therapist or a speech-language pathologist in
order to be a good listener.

Let your actions show that you care.

A word of encouragement and a positive attitude can make a world of difference.

A child who constantly struggles to express what they think and feel needs all
the support they can get.

Seek permission from their parents to introduce them to an anti-stuttering phone
app like Stamurai [https://stamurai.app/0F5N64cpm5].

Children can become more fluent and confident in communicating through exercises
and techniques.

Yes, a speech therapy app [__GHOST_URL__/stamurai-app-to-stop-stuttering/] can
make a real difference.

8. Don’t Offer Unsolicited Advice
For a stuttering student, nothing’s worse than hearing a teacher repeat “slow
down” or “take a deep breath.”

You might think you are being helpful when you offer such advice.

However, it’s beyond annoying
[https://isad.isastutter.org/isad-2018/papers-presented-by/stories-and-experiences-with-stuttering-by-pws/stuttersplaining-nina-g/] 
to someone who has stuttered for as long as they can remember.

They have heard such advice thousands of times.

They already know that such advice does not work.

By offering such advice while a student is talking, you are merely interjecting.
It may distract them from the topic.

Such incorrect and untimely advice can also leave them frustrated if you don’t
let them finish their sentences.

9. Foster a Positive Learning Environment for Stuttering Students
Becoming a good teacher is easy.

Becoming a great teacher, however, is nothing short of a challenge.

Make sure every child in your class gets the same opportunities.

On many occasions, some children will require extra care and attention. Children
who stutter may need your support and encouragement to communicate without fear
and hesitation.

Establishing a no-bullying rule will help CWS regain confidence and be
themselves. It will also help children, who may have other disorders.

Devote extra time to a stuttering student after class if necessary.

On all other occasions, when accommodations aren’t necessary, never treat a
stuttering student any differently from others in the class.

9 Ways to Work with Students Who Stutter

None of us think along the same lines, walk or move similarly. How can we expect
everyone to talk in the same way?

Every child goes through a period of normal disfluency. More than 8% of children
will experience stuttering or stammering.

Speech disfluency is usual between the ages of 2 and 5 years.

Is It Normal For School-Aged Children To Stutter?
Stuttering in children between the ages of 2 and 5 years may begin all of a
sudden.

According to speech-language pathologists (SLPs) like Charles van Riper and
Barry Guitar, the period when children begin stuttering coincides with their
rapid language learning phase.

During this period children learn
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3738062/] new words and begin to
use bigger words to express themselves.



Around 75% of children who stutter at this age will recover
[https://www.stutteringhelp.org/prevalence] and speak fluently. Many will
recover without therapy.

However, there are times when a child may require speech therapy to regain
fluency or find the confidence to speak with reduced frequency and intensity of
stuttering.

When Should You Seek Help A School-Aged Stuttering Kid?
How can you tell when it’s time to take your child to a speech therapist or a
speech-language pathologist?

The symptoms of stuttering [__GHOST_URL__/what-is-stuttering/] vary across
children. If your child is still stuttering after 5-years of age or their
symptoms are getting worse, you should consider talking to a SLP or speech
therapist.

You should consult a specialist if your child –

 1. Tries to avoid talking in social situations
 2. Repeats whole words and/or phrases frequently
 3. Repeats syllables and sounds frequently
 4. Begins a word but changes it in the anticipation of stuttering
 5. Shows facial and/or body movements in an effort to speak
 6. Has sounds that show strain
 7. Has vocal tension and a rise in pitch/loudness while speaking

Every child’s stuttering behavior is different.

If your child is showing one or more of these signs it may be time to consult a
SLP.

What Does Speech Therapy For School-Aged Children Cover?
When children approach school-age, speech disfluency becomes more complicated as
they begin to experience anxiety
[https://ghost.stamurai.com/channel-your-emotions-to-reduce-your-stutter/], shame
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/], and the fear
[https://ghost.stamurai.com/overcome-stuttering-fear-and-insecurity/] of speaking.

The person may develop secondary behaviors to hide stuttering.

Therapy-based stuttering treatment [__GHOST_URL__/treatment-for-stuttering/] for
school-aged children, including adolescents, encompasses several goals such as

 1. Attempting to accept stuttering
 2. Reducing avoidance behaviors
 3. Reducing secondary behaviors
 4. Increasing fluency
 5. Enhancing communication skills
 6. Managing bullying
 7. Improving self-confidence
 8. Minimizing the effects of stuttering on the kid’s life.

According to a study
[https://pubs.asha.org/doi/abs/10.1044/0161-1461%282012/11-0044%29] by Yaruss et
al, as the child experiences more difficulty in communicating, s/he may
experience shame and an aversion towards communication.

Apart from teaching fluency techniques, clinicians need to focus on 
desensitization
[https://www.sciencedirect.com/science/article/abs/pii/S0094730X07000162]
techniques that will help reduce bullying.

SLPs also need to educate the child’s parents and peers about stuttering and the
effects it has on the individual.

What Can A Stuttering Kid Gain From Speech Therapy?
For the older school-aged children, the results of speech therapy will vary.
Some will become fluent after weeks or months of therapy.

Other children might find the confidence to stutter while talking.

Here’s what a parent or the CWS can expect from therapy –

1. Making Changes in Speech
The speech therapist will teach a few techniques, such as pull out,
diaphragmatic breathing, easy onsets, sing-to-start
[https://ghost.stamurai.com/stuttering-and-singing-what-we-understand/], and light
articulatory contact.

These techniques will help children stammer with less tension. CWS can learn to
speak in a relaxed way.

2. Understanding Stuttering
A child will gain an understanding of speaking and stuttering. Gain a better
knowledge of how vocal cords and articulators work.

Children may be able to put the new techniques to work when they anticipate a
stutter.

3. Reduce Avoidance Behavior
Children are more afraid of the reaction of the listeners than their stutter.

Your child will receive complete guidance and encouragement while trying their
feared words. They may get to explore new situations.

Overall, CWS can benefit massively from speech therapy by reducing their 
avoidance behavior
[https://www.stuttering.co.nz/news/avoidance-reduction-therapy/].

4. Acquire Good Communication Skills
Good communication skills are indispensable in every walk of life.

Your child will learn that communication
[https://pubmed.ncbi.nlm.nih.gov/12207276/] doesn’t depend on fluency.

An experienced speech therapist should be able to explain how listening, taking
turns to speak, and holding eye-contact can contribute to communication skills.

A CWS will benefit from learning how to take control of a conversation.

5. Taking About the Emotions of Stuttering
Stuttering is not just about speech disfluency. It often attracts bullying,
condescension, discrimination, and derogatory remarks.

School-aged children are highly impressionable and vulnerable. They should have
someone to talk to about their emotions regarding stuttering.

A therapist, with the help of a cognitive-behavioral therapist (CBT), can help
them navigate their emotions
[https://ghost.stamurai.com/channel-your-emotions-to-reduce-your-stutter/].

Unhelpful thoughts and negative attitudes
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/] are almost
unavoidable. However, a therapist can guide a CWS to cope and be optimistic
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/].

How Can Parents Help Children Who Stutter?
You, as a parent [https://westutter.org/faq-items/what-is-my-role-as-a-parent/],
play a critical role in stuttering therapy for your child.

You can try the following steps to ease your child’s speaking.

They can become more confident and relaxed in their speech once you begin
imposing these changes –

 1.  Avoid correcting them. Don’t criticize CWS when they stutter.
 2.  Don’t ask your child to “slow down” or “breathe” while they are struggling
     to speak.
 3.  Speak slowly and clearly.
 4.  Ask fewer questions.
 5.  Hold regular and informal family conversations, such as over dinner.
 6.  Don’t ask your child to articulate at all times.
 7.  Make talking fun and not a chore.
 8.  Maintain eye contact while addressing your child.
 9.  Maintain a calm atmosphere at home.
 10. Let your child speak for themselves. Don’t finish their sentences, even
     when they are conversing with someone else.

Learn more
[https://ghost.stamurai.com/changing-the-perception-about-stuttering-5-tips-for-talking-to-someone-who-stutters/] 
about stuttering. Inspire your child by providing them examples of successful
people who stutter in real life.

How Can Parents Make Speech Therapy More Successful for Stuttering Kids?
You can make a great deal of difference in how your child perceives stuttering.
Almost every experienced speech therapist involves the parents of CWS.

Changes in how the entire family communicates can help the child with their
fluency. The therapist may even assign “homework” to each member of the family.

The parents should help their CWS during this “homework.”

It is typically in the form of including techniques in informal communication.
It can be in the form of games.

Your child’s therapist may also contact their school with permission. They can
speak with the teachers to ensure that your child gets the necessary support in
class [__GHOST_URL__/teachers-guide-to-helping-stuttering-student/].

Therapy doesn’t promise to cure stuttering for school-aged kids. Some children
do gain fluent speech that they retain for the majority of their life. However,
stuttering therapy aims to give the child confidence to communicate in their
unique way. Therapy also aims to eliminate the shame that often comes with
stuttering in school-aged children.

A Guide to Stuttering Therapy for School-Aged Children

A person who stutters can’t be efficient in communication. People who stutter
(PWS) are nervous and need to relax. PWS cannot be great speakers.

We have heard so many infuriating comments ever since Biden’s “gaffes” went
viral.

We have also received so much unsolicited stuttering advice from people with no
experience of stuttering [__GHOST_URL__/what-is-stuttering] or speech-language
pathology that it prompted us to create a do’s and don’ts list.

It has stuttering guidance for PWS, like us, who needs a boost of confidence
right now.

You Stutter: So What Should You Do?
1. Take Your Time
When we anticipate [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728710/] a
stutter, we often try to rush through what we have to say. We try to complete a
whole sentence before we run out of breath.

Sadly, that doesn’t prevent repetitions, prolongations, or blocks. We put
pressure on ourselves by setting a time limit on our speech.

Instead of rushing yourself, you could try to find a rhythm while talking.
Sticking to a rhythm, speaking at a slow pace, and not putting pressure on
yourself to finish a sentence in one breath will help you stutter less.

2. Use Frequent Pauses
Have you ever felt your stomach in knots? Because it’s not a question of if but
when you are going to stutter.

That’s the anticipation of stuttering getting the better of you.

Several times a day, while speaking, we work ourselves up because we are afraid
that we might stutter.

While it’s completely alright to stutter, we must remember to take a breather,
literally.

Back in 2006, several researchers including Reitzes et al discussed
[https://www.mnsu.edu/comdis/isad12/papers/therapy12/reitzes12.html] pausing as
a ‘rate control strategy’ while speaking.

Pausing can prepare you for an easy initiation.

Right when you anticipate a stutter, you can pause briefly, take a normal
breath, and prepare to stutter differently.

Yes, it’s not avoiding a stutter. Or overcoming it. A short pause can give you a
way to stutter differently.

3. Try Deep (Diaphragmatic) Breathing Techniques
The Starfish Project and McGuire Program both use diaphragmatic or costal
breathing. It’s a physical speaking strategy
[https://www.researchgate.net/publication/26459492_Regulated_Breathing_as_a_Treatment_for_Stuttering_A_Review_of_the_Empirical_Evidence] 
that can help manage stuttering.

Normal or tidal breathing is an involuntary activity. ‘Costal breathing
[https://stuttertalk.com/tag/costal-breathing/]’ is breathing deeply.

You fill your lungs with air and empty your lungs before speaking.

When your lungs are full, the pressure on your vocal folds increases. That makes
it more difficult to talk fluently.

You can try a simple experiment at home.

Try breathing in different volumes of air and try to begin talking with the
different volumes in your lungs.

You will notice that talking with the maximum volume of air in your lungs is
most difficult.

When the lungs contain between 30% and 60% of air (vital capacity), it’s much
easier to begin speaking.

4. Notice The Listener’s Eye Color (Maintain Eye Contact)
Maintaining eye contact is not going to stop stutters. However, it will give you
the confidence to express yourself despite your stutters.

Making direct eye-contact
[https://www.stutteringhelp.org/maintaining-eye-contact] will help you overcome
any shyness or feeling of self-doubt
[https://ghost.stamurai.com/overcome-stuttering-fear-and-insecurity/] you have while talking.

Practice it for a couple of weeks. You will see that making and maintaining eye
contact has become a natural habit while holding a conversation.

Noticing someone’s eye color is a quick-trick that will initially help you
establish eye contact.

Try not to look away when you are stuttering or anticipating a stutter.

We break eye contact or look away during particularly stubborn blocks or
prolongations because we feel embarrassed about how we might sound or look to
our audience.

Well, you will be surprised to see how many people can look beyond how you
sound, and care about what you have to say.

Just go ahead and try to establish eye contact while talking the next time.

5. Challenge Yourself to Step Out Of Your Comfort Zone A Little Every Day
When you have practiced costal breathing, strategic pausing, and maintaining eye
contact for at least a month, it’s time to move to the next step – talking to
strangers.

Yes, we do not like approaching or talking to people we don’t know.

We’d rather carry a list of items we need from the grocer and pay by card than
ask or answer questions.

We’d rather wait for someone else to open the door than greet a visitor.

Phone calls make us break out in cold sweat and we wonder who doesn’t use
texting in 2020!

That’s because we love the comfort bubble we have created for ourselves.

Make a list of tasks to challenge yourself
[https://ghost.stamurai.com/overcome-stuttering-fear-and-insecurity/], such as –

 1. Starting the conversation with 100 new people randomly (asking the time or
    talking about the weather, and introducing yourself as someone who stutters)
    on the streets or at the mall.
 2. Answer every time the phone rings. Tell the caller that you stutter and ask
    them to be patient with you.
 3. Going to shop at the local bodega or grocery store. Chatting up the grocer
    or cashier after disclosing your stutter and your goal of the week.

You will again be surprised to see how many people will remain empathetic and
patient throughout your speech.

An account by Lon L. Emerick says
[https://www.stutteringhelp.org/sites/default/files/Migrate/book0009_may2010.pdf] 
that an exchange student almost got rid of her stutter after confronting almost
950 listeners in a week.

She was visibly tired and her voice was hoarse, but her stutter was almost gone!

6. Smile and Look Relaxed
Anxiety is contagious.

When you look tensed while talking, you risk making your listeners uncomfortable
and tense as well.

You need to ensure that you look relaxed irrespective of the anxiety you are
feeling. Although we don’t recommend it in every aspect, this is one place where
we tell our readers to “fake it till you make it.”

Smiling more and looking relaxed will soon dissipate your anxiety little by
little.

In a couple of weeks, you will feel genuinely relaxed. You will smile almost
effortlessly while holding a face-to-face conversation.

7. Try Mindfulness and Yoga
Heather Kauffman [https://journals.sagepub.com/doi/abs/10.1177/0031512516628987] 
says that yoga can modulate the autonomic nervous system activities.

Yoga or mindfulness won’t cure stuttering or reduce it directly. It will reduce
anxiety [__GHOST_URL__/yoga-and-stuttering/] and stress, which increases the
frequency and intensity of stuttering.

Paul Brocklehurst [http://www.stammeringresearch.org/PaulBrocklehurst_webCV.pdf]
, the Director of the Stammering Self-Empowerment Programme, England, first
tried meditation when he was 21. Mindfulness meditation seemed easy to him
because it didn’t require him to speak!

It turned his life around. Mindfulness meditation allowed him to be more fluent.
He went back to school and got a degree in Speech therapy and a Ph.D. in
Psycholinguistics.

A study [https://pubmed.ncbi.nlm.nih.gov/23218212/] from 2012 shows that
meditation reduced the frequency of stuttering of the participants. It also
reduced the impact of stuttering on a person’s life.

By keeping aside 20-minutes a day for mindfulness meditation or yoga, you too
can make a difference in your life. Change the way YOU perceive your stutter.
Only then you will be able to change the way you stutter.

8. Join Speech Therapy If Your Stuttering Is Severe
Speech therapy [__GHOST_URL__/treatment-for-stuttering/] is an option for anyone
whose stuttering is severe and it causes them to avoid certain situations.

Therapy can decrease avoidance behavior and increase self-confidence.

Stuttering therapy can be costly, irrespective of where you live. And it can be
difficult to access during these trying times.

Nonetheless, therapy can help you find comfort in the way you speak. The goal if
speech therapy isn’t always curing someone’s stutter.

In most cases, an experienced speech-language pathologist (SLP) or speech
therapist will help you stutter confidently or find a new way to stutter.

You can find a list of certified and experienced speech-language pathologists in
your area by running a search on Google. Verify the credentials of any
therapist/SLP you choose with registered stuttering foundations or associations
in your area.

9. Work With DAF Apps
When you are working with your SLP, you can talk about new technologies that can
help your fluency.

Now, you can use your mobile phone to download and try Delayed Auditory Feedback
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2231594/] (DAF).

It’s a technique that introduces a delay between speaking and auditory
perception.

DAF allows anyone who stutters to speak normally by allowing them to hear their
own voice a fraction of a second later. Not everyone experiences the same levels
of fluency.

The effects of DAF can be temporary, but it has an immediate positive effect on
the fluency of PWS without any impact on the naturalness of their speech.

10. Use Speech Therapy Apps
Many people either avoid going to speech therapy or discontinue after a few
initial sessions because SLPs can be expensive. It is one of the leading reasons
of high relapse rates
[https://ghost.stamurai.com/high-relapse-after-stuttering-speech-therapy-understanding-the-reason/] 
among adults who stutter.

You can seek help from highly-rated speech therapy apps like Stamurai to
complement your speech therapy. Or, you can begin your therapeutic journey with
Stamurai’s speech exercises and fluency tools.

Using a speech therapy app [__GHOST_URL__/stamurai-app-to-stop-stuttering/] 
regularly, whether alongside therapy or on its own, can help you find your
rhythm and voice.

The state-of-the-art apps may use a combination of machine learning and AI to
suggest new exercises apt for you. You can check your weekly and monthly
progress.

Stamurai [https://stamurai.com/] currently uses a guided training plan
customized for each user.

The therapy protocol [https://stamurai.com/therapy-protocol] includes fluency
shaping strategies and stuttering modification techniques.

11. Join Stuttering Support Groups
You are not alone!

Several nationally and internationally acclaimed stuttering associations have
local chapters. Many of them have stuttering support groups.

The NSA (National Stuttering Association) in the United States, for instance,
has over 200 local chapters [https://westutter.org/other-programs/] for
children, teens, and adults.

You can find independent, private, and open support groups online. You can
search for communities for PWS and similar forums in your region or country.

Here at Stamurai, we have a dedicated Stuttering support Group
[https://stamurai.com/sessions] for all users. PWS can join in on the scheduled 
group video calls [https://stamurai.com/sessions]. Each call is moderated and
participants from across the world can join in.

What Should You Absolutely NOT do?
1. Worry about What Others Might Think
Life hasn’t been easy on us since we stammer. We have heard jibes, mean
comments, mockery, and even faced bullying
[https://ghost.stamurai.com/reining-in-the-bullies/].

However, people are now becoming more aware of stuttering as a speech fluency
disorder.

Today, there are more empathetic listeners than you can imagine.

We are not mind readers.

So, it’s only logical to give our listeners a chance even though we are afraid
of impatience, and disrespect.

2. Hide Your Stammer
Whenever you need to talk to a new audience, let them know you stutter and that
you are working on your speech.

Saying it upfront without making an effort to hide your stuttering
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/] can work wonders.

Politely request your listeners to be patient while you speak your mind.

Trying to hide your stutter will put undue pressure on you. It will increase
your tendency to circumvent feared words and find replacements.

Anticipation can make upcoming blocks, repetitions, and prolongations much
worse.

Disclosing your stutter, in the beginning, can feel like taking a weight off
your shoulders. Do that and see how effortlessly you can stutter through what
you have to say.

3. Speak Until You Are Ready To Speak
Costal breathing and pausing exercises will help you with your fluency. However,
we have all experienced days when our stuttering is much worse.

On such days, if you want to keep to yourself and avoid group activities, it’s
alright.

Fellow PWS and fluent speakers will understand your predicament. On such days,
talking to your SLP or texting a friend about how you feel can help you.

4. Take Advice from People Who Aren’t Experts on Speech Fluency 
“Slow down,” “take a deep breath,” “you are probably just tired” and “you need a
good night’s sleep” are “advice” we have all received one time or another.

It has often made us think about how many of these advisors have dealt with
stuttering. Or, how many have the qualification to dish out tips to those who
stutter.

Many of these people don’t mean to condescend or criticize.

However, they don’t realize that these words do more harm than good
[https://isad.isastutter.org/isad-2018/papers-presented-by/stories-and-experiences-with-stuttering-by-pws/stuttersplaining-nina-g/]
.

It’s almost impossible to explain that to our listeners who don’t stutter.

So, the only way to deal with such advice is to say “thank you” with as much
stuttering as possible accompanied by a broad grin!

Let’s Stutter Together, With Confidence and Pride
We hope that these do’s and don’ts help you in your journey.

We don’t believe stuttering to be a limitation. It’s simply a different way of
talking.

So, if you stutter, do so with your head held up high. Remember to make eye
contact and introduce yourself with a bright smile. Don’t hide your stutter.

You will find more friends than you have ever hoped for once you embrace your
stutter and find your confidence.

Keep at the exercises, learn controlled breathing, try DAF with the help of your
SLP, and use the Stamurai app to assist your fluency.

The Do's and Dont's Of Stuttering

Megan Washington is a popular name in the genre of jazz, indie pop, and
alternative rock. She’s a brilliant singer and songwriter. Washington recently
appeared on TedTalk
[https://www.ted.com/talks/megan_washington_why_i_live_in_mortal_dread_of_public_speaking/transcript] 
to talk about her stutter.

In her own words, “I spend a lot of my life on the stage. One would assume that
I’m comfortable in the public sphere…but I’ve spent my life…living in mortal
dread of public speaking”

And that’s what happens to many of us. When we were kids and people would tell
us that we’d grow out of our awkward skinny legs, or our acne would disappear
when we grew up. We often dreamt that like the other “problems” that plagued our
lives, our stutter, too, would disappear when we’d become adults.

Only when we either entered high school or college we realized that despite
therapy and spending all those years hoping, our stutter was a part of us
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/].

Many of us already know that we are more than our stutter. Stuttering is only a
small part and it doesn’t define us. However, when we have an audience, we often
face intense fear and anxiety.

Are We Afraid of Our stutter?
Are we afraid of stuttering? Turns out most people who stutter (PWS) are afraid
of their listeners’ reactions than they are of stuttering.

Susannah Parkin [https://www.stutteringhelp.org/content/recipient] gave the
graduation speech at Hamilton College, NY in 2013.

She too stutters and during her speech, she said something that I find
interesting and important for fellow PWS. “…we should do things in spite of our
fear…sometimes we have to go even further. We have to do things because we are
afraid.”

How to Overcome Fear of Stuttering?
Fear is something all of us have experienced. Some of us are afraid of darkness,
others are afraid of the ocean.

Then there are people like us who are afraid of speaking
[https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/fear-of-speaking-chronic-anxiety-and-stammering/3159744DE5296FF7A614C4C8267DEC90] 
in front of people. The thought of addressing an audience causes stress. And
needless to say, stuttering and stress don’t mix well.

Fears
[https://www.smithsonianmag.com/science-nature/what-happens-brain-feel-fear-180966992/] 
and phobias are not easy to overcome. We know that all too well. However, it is
also necessary to not let our fear of speaking overpower us at all times.

Here are a few strategies I have employed to trick my brain into not feeling
fear. It has gradually helped me build my confidence while speaking in front of
people.

I Practice Deep Breathing
I fill my lungs with as much air as possible and then exhale it all out before I
begin speaking.

Don’t try to talk like you swim – with your lungs filled with air.

When our lungs are full, the air pressure inside our thorax is high and our
vocal cords become tense. It becomes difficult to talk
[https://www.mnsu.edu/comdis/isad15/papers/quesal15.html].

Try speaking once you finish exhaling.

Deep breathing relaxes the muscles and the mind. It’s a brilliant way to fight
the stress we often feel before facing an audience.

I have tried several deep breathing or costal breathing techniques.

I have found the following video to be most helpful while learning how to master
it to manage my stuttering.

How to breathe deeply and stutter smoothlyI Pause, Frequently
I owe my understanding of the importance of pausing during speech to Hugo H.
Gregory [https://www.stutteringhelp.org/two-sides-coin].

While reading his works I came across the fact that the more we try to mask our
stuttering, the worse we stutter.

Instead of trying hard to hide it, I started pausing
[https://www.mnsu.edu/comdis/isad12/papers/therapy12/reitzes12.html] every time
I anticipated a block.

According to him, stuttering more fluently is possible only when we accept our
stutter.

Stuttering easily involves relaxed speech beginnings, smoother word transitions,
and adequate pausing time between two phrases.

I Have Stuttered On Purpose
Stuttering on purpose serves two goals – it desensitizes a person to their own
stutter. It also gives them a sense of control.

When I began stuttering on purpose
[https://www.stutteringhelp.org/admitting-you-stutter], I saw that people
couldn’t tell the difference between my actual stutters and faked stutters.

I also began to notice that many of my listeners simply did not care how much I
stuttered. They were interested in what I had to say.

The more I stuttered on purpose, the more I began to understand the mechanics of
my involuntary stutter.

It gave me the confidence to approach more people. And it reduced my fear of 
stuttering publicly [__GHOST_URL__/public-speaking-with-a-stutter/].

Today, I stutter much less frequently and intensely than I used to even a year
before I tried stuttering on purpose.

I Meditate Regularly
If you have never meditated before, feel free to use an app for guidance.

I have used several apps over the years and the result has been astounding.

Meditation has helped me calm my thoughts and channel my emotions
[https://ghost.stamurai.com/channel-your-emotions-to-reduce-your-stutter/] in the right
direction.

Stuttering isn’t stressful. The anxiety and fear preceding every stutter are.

Begin meditating to brown noise if you have a short attention span. Your focus
will improve and so will your control over your thoughts.



You will feel calmer each day. As you feel the stress ebb away, you will find
that you are stuttering with less effort and less fear.

I Have Opted For Speech Therapy
When I was a child, there weren’t too many speech therapists around. Moreover,
they were costly!

So, I began seeing my speech therapist in my early 20s. It’s only been around 2
years and we both believe there is a lot I still have to achieve.

I have come to realize that stuttering therapy isn’t about finding a cure
[https://ghost.stamurai.com/how-to-stop-stuttering/] for my speech disfluencies. It’s about
finding a solution to my fear of stuttering and confidence issues while talking.

Nonetheless, therapy has helped me beyond my imaginations.

To be completely honest. I also go for cognitive behavioral therapy
[https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/] or CBT. The
frequency of our sessions have decreased in the past year, but the positive
impact has been tremendous.

If you have access to CBT or psychological counseling, you should absolutely opt
for it. We all know that the impact of stuttering is long-term
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/].

I Use Speech Therapy Apps
Today, I can confidently introduce myself even though I always stutter on my
first name.

I know that stuttering is a part of my speech. Everyone is different in one way
or another. I am unique because of my speech! And that’s absolutely alright.

Apart from CBT and speech therapy, speech therapy apps
[https://ghost.stamurai.com/stamurai-app-to-stop-stuttering/] have played a huge role in
helping me understand what my feared words are, why anticipation is worse than
stuttering, and how we can control our fluency every time we speak.

Speech therapy apps can complement your SLP sessions or they can work alone to
help you reduce tension while speaking.

In fact, you can also refine your breathing skills, learn how to manage
stuttering through meditation, and monitor your speech improvement on the app.

What I find particularly motivating is that I can track my progress on one
dashboard.

I Introduce Myself as a Stutterer
I stutter and it’s no secret. I may be a writer, thinker, avid blogger, and
animal lover, but I am also a stutterer.

It is a part of who I am, but it’s not all I am.

So, whether I am sitting down for an interview or talking to a crowd, I
introduce myself as a stutterer
[https://ghost.stamurai.com/overcome-stuttering-fear-and-insecurity/].

Once I have done that, I don’t feel the anxiety or tension I used to feel. I
know that people don’t expect me to be fluent. Yet, they are still sitting down
looking at my face because they want to hear what I have to say.

I might take a couple of seconds (minutes on my bad days) more than the fluent
speakers. Nonetheless, what I have to say is important.

That gives me confidence. And that is how I have almost conquered my fear of
public speaking.

Are Stuttering and Stress Related?
The human brain is a mysterious and complex organ. The secrets of stuttering
hide in the brain [__GHOST_URL__/is-stuttering-biological-or-psychological/],
and so does the cause of stress and fear.

Maybe ever since you were a kid, other children and even adults have made fun of
you when you tried to speak. Maybe the last time you tried speaking to a big
audience, you failed.

Now, your brain recognizes certain signs or patterns that precede your stutters.
Your mind makes you believe that if you try again, you will meet with failure.

That is what happens when anticipation kicks in. We already know which words are
difficult. For me, these can be words that begin with “w” or “t.” For you, words
that start with “s” or “d” can be difficult.

Nonetheless, we already know when we are going to stutter. We can feel it at the
back of our throats, tightening our vocal cords. So, we either replace the word
or avoid speaking altogether.

Even so, the fear doesn’t go away. We have learned how to “postpone” our fear
[https://www.say.org/blog/i-know-the-fear-stutterers-face/] of stuttering.

Stress does not cause me/us to stutter. It can definitely make an oncoming
stutter much worse.

It’s Time to Find Our Voices
Stress, anxiety, and fear keep getting the better of us despite months or even
years of therapy.

Along with speech therapy, we need to understand how stuttering works and how
our fear influences our speech.

Stress and fear work hand-in-hand to worsen our stutter. In a way, stuttering
and anxiety share a strong relationship.

The only time I found respite was when I embraced my stutter. I realized it’s
alright to take more time than the person next to me. I don’t have to sound
fluent to deliver my opinion.

I just have to sound confident. And the fear of stuttering can no longer take
that away from me!

How to Overcome Fear and Tension If You Stutter

I have been stuttering for as long as I can remember. For years, I thought that
meant living a life of loneliness because no one would understand my struggles.

During school, I had the best bunch of friends. They helped me out in
particularly “sticky” situations, which sometimes involved boys.

Decades ago, I realized that I was speaking my own tongue. I was both fast
[https://ghost.stamurai.com/what-is-cluttering-and-how-is-it-related-to-stuttering/]while
talking, AND I stuttered. I felt alone
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/] in the world because I
believed no one understood the language I was speaking since my childhood.

It took me over two decades, but I did find a bunch of people from various walks
of life, just like me.

How Did Finding A Stuttering Community Help Me?
I was a smart kid. My parents took me to speech therapy early. I quickly learned
that stuttering is not my fault.

I also learned that around 1% of the world’s population stutters.

However, I was the only kid in middle school with a pronounced stutter. If
others had one, they did a marvelous job of hiding it!

At the end of the day, it was just me. That kept me wondering where all the
other 70 million lived. Surely, none of them went to my school or lived on my
block!

And it kept me thinking if I was ever going to meet anyone else who stutters.
Would we become friends over our shared disfluency
[https://ghost.stamurai.com/overcome-stuttering-fear-and-insecurity/]? Would s/he think that
I’m trying to mock them when I reply to their questions?

Only after I became an active member of not one but several Facebook stuttering
support groups, WhatsApp communities, and local chapters of stuttering
associations did I realize that the bond runs deeper than friendship.

When I first attended a meeting cum gala held by a registered stuttering
association for people who stutter (PWS), it was the first time I found myself
surrounded by hundreds of men, women, teens, and children who spoke my language
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/].

I would be lying if I said that I felt confident immediately. Or that I found a
community where I didn’t feel the need to hide my speech disfluency.

However, finding a community [https://stamurai.com/sessions] told me that I
finally belonged somewhere.

Why Should You Speak To Others Who Stutter?
For many, staying in touch with friends and making virtual friends over social
media apps is no big deal.

For me, it was always a big deal. I always felt like I was deceiving people
because they had no idea what I sound like in real life.

Only after I began attending the stuttering foundation galas and meets did I
realize that I wasn’t the only one
[https://www.huffpost.com/entry/not-alone-because-of-stuttering_b_9933336] who
thought like that.

My feeling comes from a deep-seated sense of guilt and shame
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/].

Even though I know stuttering isn’t something I cannot control, I felt guilty
while “talking” fluently on messengers and text.

Talking to others who stutter has helped me find my identity
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/]. I finally
stopped ignoring everything related to my stuttering.

I began confronting feelings I had been suppressing for decades.

I attend meetings and seminars. Listen to people share their stories and share
when I’m ready to talk.

It is an intense setting, where for the first time in a long time, I saw people 
wait patiently [__GHOST_URL__/the-positive-aspects-of-stuttering/] as a person
who stutters finished speaking.

That once again reminded me that our opinions are important.

You don’t choose [__GHOST_URL__/is-stuttering-biological-or-psychological/] to
stutter. However, you can choose to surround yourself with people who stutter,
understand your speech disfluency, and support you.

You Are Never Alone
You may have felt alone, just like I did while growing up. But, you don’t have
to feel that way forever.

I have learned through years of therapy, attending support group meetings,
stuttering group video calls, and chats that we are as alone as we choose to be.

It is incredibly difficult, especially, if none of your family members or
friends stutter. It feels almost impossible to talk about our daily struggles.

However, that doesn’t have to be your reality forever.

There’s always at least one stuttering support group or community
[https://chat.whatsapp.com/DF2CpqQroAO2ychWM8hcV4] near you, just waiting for
you to find them.

Why You Should Talk to Others Who Stutter

In less than a month, the world’s oldest democracy will exercise their
democratic right to choose their next leader.

Presidential debates are an integral part of the electoral procedures in the
United States of America. On 29th September, more than 70 million people watched
the first [https://www.bbc.com/news/election-us-2020-54331319]of three debates
for the 59th quadrennial presidential election.

However, this debate did not exactly pan out as people expected. Majority of the
population concluded that it was the worst presidential debate of all time.

Some eminent personalities did not hesitate in sharing their honest views. CNN’s
Dana Bash said the debate was a “shitshow”, while a panelist in ABC News said it
was the “worst presidential debate I’ve ever seen,” on air.

Abrupt interruptions, chaotic situations, rhetorical arguments – there was
plenty wrong with the debate. However, beyond all the wrongs was the righteous
fight of a person with stutter (PWS).

Biden, dodging through a series of interruptions, held fast to his ground and
did not let his disability come in the way of what he needed to address.

The Story of Joe Biden’s Stuttering
Around six decades before Joe Biden became the vice-president, he was called
“Joe Impedimenta.”

Biden started stuttering [__GHOST_URL__/joe-bidens-stutter-and-life/] when he
was four years old. “Stutter Boy” to some and “Dash” to others, he was 
mercilessly name-called [__GHOST_URL__/reining-in-the-bullies/].

Not only the class bullies, but even a nun made fun
[https://www.theatlantic.com/magazine/archive/2020/01/joe-biden-stutter-profile/602401/] 
of his speech impediment.

After stuttering on a word during a reading lesson, she called him
“Buh-Buh-Buh-Biden.”

Little Joe darted out of the room
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/].

With an indomitable desire to fight back, Biden promised himself that he will
never let his disfluency define him.

He found solace in the works
[https://ghost.stamurai.com/joe-biden-stuttering-journey-and-struggles/] of great poets like
Ralph Waldo Emerson and William Butler Yeats.

Biden did not receive speech therapy, but on the advice of some nuns, he started
speaking in a rhythm.

Though he still stutters occasionally, the speaking technique worked wonders for
him.

How Biden Fought Against Two Adversaries At Once
During the debate, Biden was not justlooking to win against Donald Trump.

He was also trying to win his fight against his fear of public speaking, which
is a highly feared activity [__GHOST_URL__/public-speaking-with-a-stutter/] 
among PWS.

Various factors curb the fluency of an individual with stutter while speaking.
Abrupt interruptions, sudden change of conversational subject, personal attacks
and bringing up past trauma are all trigger points of stuttering.

On 29th September, not one factor from the list was missing.

Throughout the debate, Biden had to deal with abrupt interruptions.

Such was the frequency of interruptions that moderator Chris Wallace had to
intervene on multiple occasions. The Fox News host lost their patience on one
occasion. He told the President “Frankly, you’ve been doing more interrupting.”

There was no dearth of personal attacks as well. He saw his academic record
[https://asia.nikkei.com/Politics/US-elections-2020/Trump-vs.-Biden-Five-things-we-learned-from-first-debate] 
being ridiculed, as the President said: “You graduated either the lowest or
almost the lowest in your class.”

His intelligence quotient [__GHOST_URL__/stuttering-misconceptions/] was
questioned, as Trump said “There’s nothing smart about you. (sic) 47 years
you’ve done nothing.”

Biden’s family was also brought into the conversation.

The President tried to attack his family by talking about the international
business ventures of Biden’s son, Hunter.

The continuous interruptions and personal attacks are open to interpretation.
Some might feel they were spontaneous. Others might opine they were pre-planned,
to make Biden nervous on stage.

However, that calls for another debate which we don’t fancy. What was the most
important takeaway from the debate was how Biden handled the situation.

Despite being knocked down on multiple occasions, he came back fighting.

As a kid, his parents told him “The measure of a man isn’t how often he is
knocked down but how quickly he gets up.”

Perhaps, amidst the halts and hollering on 29th September, this bit of advice is
what kept him going.

Biden – A Synonym of Hope for PWS
Time will tell whether Biden will become the hope of 332 million Americans.
However, he already has established himself as a hope for 70 million PWS across
the world.

As a kid, little Joe fought with bullies and nuns who bullied him. As a young
adult, he fought with employees who declined him a job because of his
disfluency.

At 77, Joe Biden is still ever-so-stern in his relentless fights against anyone
and everyone who tries to attack his disfluency to bring him down.

His perseverance and unremitting comebacks are bound to inspire many. As he
wrote in a letter [https://www.stutteringhelp.org/content/joe-biden] to
Stuttering Foundation of America –

“When you commit yourself to a goal and when you persevere in the face of
struggle, you will discover new strengths and skills to help you overcome not
only this challenge but future life challenges as well. I promise you – you have 
nothing to be ashamed of
[https://ghost.stamurai.com/overcome-stuttering-fear-and-insecurity/], and you have every
reason to be proud.”

Biden’s performance in the debate may or may not help him gain some votes.
However, he surely did gain a lot of respect and admiration for his valiant
fight against disfluency and demeanour.

Joe Biden’s Performance in Presidential Debate Inspired Millions Who Stutter

Presentations! OMG. The word still sends chills down my spine. Although I have
probably given over a hundred counting my school, college, and office days.

There was something I learned pretty fast during my school days. If I
volunteered to go first, the anticipation was significantly less. It didn’t give 
fear [__GHOST_URL__/how-to-overcome-fear-and-tension-if-you-stutter/] a chance
to take over. I didn’t have to listen to how fluent my classmates were.

I got to stutter as much as I liked, and people were typically more patient
since I was the first speaker.

Volunteering to go first is really a win-win for anyone who stutters.

However, in college, uni, or at the workplace, you may not get to choose when
you get up on the dais. That has happened to me as well. That’s when I employ
the strategies I will now mention.

Hopefully, once you practice and apply these in real life, you will also find
more confidence and freedom from fear while giving presentations –

1. Select a Topic That You Care About
If you are at liberty to pick a topic, choose one that you are passionate about.

I have had to give presentations on the genetic factors and proteomics of
early-onset Alzheimer’s. And holy moly! Was it a disaster?!

Even to date, I cannot go through the first introductory slide without stumbling
and blocking.

The reason? Well, I simply wasn’t interested in it.

Next, I chose to give a presentation on the genetics of Stuttering
[https://ghost.stamurai.com/what-is-stuttering/] and the neurological differences between the
brains of PWS and neurotypicals.

I went first. If I say I didn’t stutter at all, that would be a lie.

I did stutter, but significantly less.

Talk about something that moves you and inspires you
[https://medium.com/speech-language-pathology/tips-on-public-speaking-with-a-stutter-8457a891446]
! It can be the history of hip-hop or the mechanism of a V12 engine.

You will find speaking to be less of a chore. Your passion for the subject will
grab the attention of the audience with much less effort too!

2. Do Your Research
When I did my research for the presentation, I also included my observation of
the presentation space.

I go to the room or auditorium. Check out the acoustics, seating, and light
options.

Pace up and down while rehearsing my speech while including fluency shaping
strategies
[https://medium.com/@stamuraiapp/fluency-strategies-and-techniques-for-stutterers-3905f1b6b92e] 
on the main stage.

On the day of the presentation, I check out the sound equipment.

I consider it important since I already have a speech disability. I don’t want
additional glitches to make it even more difficult for my audience to understand
what I’m saying.

3. Add Some Humor into the Mix
No matter what topic you pick, you should think about adding a couple of
anecdotes.

One of my favorite speakers is a standup comedian. When she’s not performing on
open-mics or for TV, she’s out there talking about stuttering and spreading
awareness.

I love borrowing a quote from her when I find the audience to be particularly
serious and impatient.

Nina G is an icon. She speaks to educate people
[https://ninagcomedian.wordpress.com/2019/01/13/transforming-how-we-think-about-stuttering/] 
on stuttering and dyslexia.

One of her signature catchphrases inspires millions – “I stutter…wait patiently
for all my brilliant ideas.”

You can come up with something similar. It will give you the chance to own your
stutter [__GHOST_URL__/public-speaking-with-a-stutter/].

It will introduce you as someone who stutters. And it tells that you have some
great ideas in store for those who are ready to wait.

Something like this is great for breaking the ice. It tells people that I have a 
speech disfluency
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/]. However, it
also subtly guides them as to how to react to stuttering.

4. Communication Isn’t About Fluency
Think about it! We know hundreds of people who are fluent. Are all of them great
communicators?

Then, why should stutters make you a bad communicator?

Today, we have successful entrepreneurs, politicians
[https://ghost.stamurai.com/joe-bidens-stutter-and-life/], actors, singers
[https://medium.com/@stamuraiapp/do-you-know-about-ed-sheerans-stuttering-journey-40740d8589e5]
, and comedians who stutter.

Addressing the world with a stutterStrong communication includes multiple
factors – confident body language, eye contact, and using the right tone of
voice.

Practice confident delivery of your points in front of family and friends. Ask
for feedback. It is one method I used during the initial days of my preparation.

Practice in front of a mirror or record yourself on video. Go back and check the
different hand gestures, body language, and voices you are using.

Note the changes you need to make.

Remember to use every mode of expression you can, such as visual and auditory
cues.

Do not neglect your presentation (slides or video) while preparing the speech.

5. Channel your nervous energy
The mind is complex and beautiful.

There used to be times when I was so nervous I could barely get a word out
without blocking.

Then I learned to channel
[https://ghost.stamurai.com/channel-your-emotions-to-reduce-your-stutter/] my nervous energy.
It has little to do with control.

A lot of people will tell you to “control” your fear, anxiety, and stress.
However, it makes little sense to me since I never found out concrete
descriptions of how to control the negative energy.

So I found a way to channel them.

If you ever hear someone who stutters and they speak confidently in front of
people, you will notice that they move a lot, and use a lot of hand gestures.

This reminds me of Drew Lynch. He begins slowly without a lot of movement of
hands, but once he’s into his material, he begins using hand gestures.

Although his stuttering may have a different nature
[https://ghost.stamurai.com/the-unexpected-development-of-stuttering-in-adulthood/], it is
quite apparent that he channels the extra energy through body movements.

And boy! Does he do a great job of making every audience member laugh?!

6. Breathe and Then, Breathe Some More
This one isn’t just for right before the presentation.

I have found out that breathing exercises work in favor of my fluency. I
practice them daily for at least 20 minutes.

If you have never practiced deep breathing exercises
[https://ghost.stamurai.com/how-to-overcome-fear-and-tension-if-you-stutter/] before, you can
seek guidance online, on YouTube or from a dedicated stuttering therapy app like 
Stamurai [https://stamurai.com/features].

Deep breathing or costal breathing
[https://www.mnsu.edu/comdis/isad15/papers/quesal15.html] can relax your
articulators. I almost always find it easy to initiate a particularly difficult
word when I empty my lungs completely.

If you can manage to incorporate costal breathing into your daily speaking, you
might be able to employ fluent and easy onset during your presentations and
speeches.

7. Spend Time on Speech Exercises
Speech exercises recommended by speech therapists can work wonders. They can
teach you light articulatory contact, easy onset and super-fluency techniques.

If you have been to speech therapists or speech-language pathologists (SLPs),
you may already know a few exercises.

You can keep at them. Or, you can practice more with Stamurai.

While using Stamurai [http://stamurai.app/uSL8fLtzO4] you will receive a
detailed analysis of your speech improvement and performance.

It is an excellent way to boost your confidence in the long-term.

Stamurai doesn’t offer a short-cut to fluency or a cure for stuttering. However,
you will begin to understand your stuttering much better, like I do with daily
practice.

Final words
In conclusion, you should not aim to stop stuttering at all. Don’t try to hide
it. Don’t feel ashamed of it. You speak in your unique and beautiful way.

Keep the seven points in mind to ace your next presentation or speech.

We have standup comedians who stutter. Their pieces don’t always feature pieces
on stuttering. However, they deliver the joke complete with involuntary stutters
and make us laugh nonetheless.

Then there’s LeRon Baron, Megan Washington, and Joe Biden
[https://ghost.stamurai.com/joe-biden-stuttering-journey-and-struggles/], who all have
commanding stage presence despite their speech disfluencies.

Instead, think about letting it flow out without any difficulty. Aim to stutter
with ease and fluency. Download [http://stamurai.app/uSL8fLtzO4] and use
Stamurai to know more about stuttering with confidence!

It’s about delivering your message to the people. They are here to listen to
you! So, tell them what you have to say, in your unique and beautiful way.

How to Stop Stuttering When You Give Presentations: 7 Tips

Stuttering is not simply biological or completely psychological
[https://ghost.stamurai.com/is-stuttering-biological-or-psychological/]. It is
quite complex, and everyone stutters differently. Hence there is currently no
perfect cure [__GHOST_URL__/stuttering-medicine] for stuttering.
You can, however, learn to manage or significantly overcome your stuttering with
the help of speech therapy. Speech therapy includes several stuttering exercises
for various age groups depending on the intensity of their stutter.

Do you stutter? Did you have no access to formal speech therapy? Haven’t been to
your speech therapist recently?

You can practice exercises to stop stuttering at home. Hundreds and thousands of
others have tried and benefitted from these exercises. You too, can.

[https://stamurai.app/z4HKmlNXigb]Here is our compilation of eleven exercises
for adults who stutter:

1. Diaphragmatic Breathing
Diaphragmatic or costal breathing has been a popular breathing exercise for
stuttering speech-therapists use. Several therapists and speech-language
pathologists (SLPs) now use deep breathing
[https://www.mnsu.edu/comdis/isad15/papers/quesal15.html] as a tool to help
their clients relax their articulators.

[https://stamurai.app/z4HKmlNXigb]How to Do Diaphragmatic Breathing Exercise to
Stop Stuttering at Home?
During costal breathing, the instructor or therapist asks the person to sit or
lie flat on their back. The aim is to achieve relaxation. The person should bend
his knees and get sufficient head support.

The person who stutters should place one hand on their chest and the other on
their belly. They should inhale through their nose slowly and calmly. They need
to feel the air fill up their stomach as the hand rises and moves forward. Their
shoulders and chest should remain immobile.

Next, they should begin exhaling. The hand on their chest should remain still.

It is a simple breathing exercise for stuttering. You can find guide videos on
YouTube as well. We have one right here, so you can practice it for 5 minutes
every day at least thrice.

You will notice that with regular practice, it will help you manage your fear
[https://ghost.stamurai.com/stuttering-treatment-for-adults/] or anticipation of
stuttering. It may even reduce escape and avoidance behaviors.

[https://stamurai.app/z4HKmlNXigb]2. Progressive Relaxation
Stress and anxiety can worsen anyone’s stutter. You may have experienced intense
blocks and repetitions while speaking in front of your class or an audience.

Progressive relaxation
[https://www.medindia.net/patients/patientinfo/relaxation-techniques-for-people-who-stutter.htm] 
technique helps  relax your articulator muscles; it also relieves the symptoms
of anxiety, hypertension, general muscle stress, and tension.

How to Practice Progressive Relaxation Exercise to Reduce Stuttering?
Find a quiet and comfortable place. Play some relaxing music, and remember to
breathe through your nose throughout the exercise.

Either sit on a chair in a relaxed manner or lie down flatly on your back.

Keep your arms relaxed, away from your body with the palms facing upwards.

Keep your legs slightly spread, so your feet are comfortably apart.

Progressive relaxation enables the gradual relaxation of one part of the body at
a timeFocus on every muscle from your toe to head. Slow your breathing down.
Tense the muscles of your feet for 5 seconds and then relax them.

Next, do the same for your thigh muscles. Then move to your hip muscles, stomach
muscles, chest, biceps, neck, and face.

Take a 20-second break between the tightening of the next set of muscles. Don’t
forget to breathe while successively tensing and relaxing the muscles.

This relaxation exercise for stuttering will help you feel in control of your
body and reclaim confidence
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/]. In
stuttering therapy, progressive relaxation aims to help clients relax the
muscles involved in stuttering.

3. Light Articulatory Contact
Light articulatory contact refers to minimal contact between the lips, teeth,
tongue, and hard palate. The technique teaches people who stutter (PWS) to use
light mouth movements like tongue exercise for stuttering to allow a smooth flow
of air while talking.

It enables the speaker to move to the next sound with a smooth movement and an
effortless voice. Consonants typically produce high articulatory pressure, which
is natural.

Learning this particular speech exercise for stuttering will help you reduce the
articulatory pressure.

How to Practice Light Articulatory Contact Exercise?
You can learn light contacts at home from the video.

Your speech therapist will help you practice light articulatory contact on all
consonants. You will learn how to implement it on single-syllable words/sounds.
Gradually, you will learn to apply the technique on initial, medial, and final
positions.

For example – you will learn how to establish light articulatory contact on the
consonant /p/ in pink, poppy, and top.

Soon, you will graduate to phrase level, sentence level, and conversational
level applications of light articulatory contact.

Once you learn this technique from your therapist, you can always practice it at
home alone or with family.

4. Speaking While Exhaling
It is a fluency shaping method. Speaking while you have begun exhaling can
modify your onset of phonation.

How to Practice ‘Speak While Exhaling’ to Stop Stuttering at Home?
You can master this technique
[https://voicefoundation.org/articles/breathe-and-speak-with-ease/] all on your
own. First, inhale with your nose and begin speaking as you start exhaling.

When you exhale, your vocal folds are more relaxed. They cannot come together to
hold the air back. It reduces the laryngeal muscular tension.

The working principle of this method is quite simple, and you can keep
practicing this at home
[https://ghost.stamurai.com/why-dont-we-stutter-when-talking-alone/] whenever
you speak to your family members or friends.

5. Pausing and Phrasing
It is another fluency shaping technique. It lengthens the natural pauses. Or, it
can teach you to insert additional pauses in your speech between the words and
phrases.

You can join a stuttering video calling group [https://stamurai.com/sessions] if
you currently don’t have access to a speech therapist. The right frequency of
pausing and phrasing may help you reduce the rate of your speech and decrease
muscle tension.

You can use this speech therapy exercise for stuttering while reading out loud,
speaking, and in conversations. A person who stutters may have to pause every 2
to 5 syllables while talking.

Pausing and phrasing are one of the most popular exercises to stop stuttering.
Pausing will also give you the time to breathe deeply and begin the next word
with light contact of the articulators.

6. Prolonged Speech
You can best master prolonged speech under the guidance of a speech therapist.
This stuttering exercise can help you achieve fluency by stretching out the
vowels.

It combines the techniques of light articulatory contacts along with gentle
onsets and pausing. This combinatorial technique can enhance fluency, slow your
rate of speech, and reduce articulatory pressure. It will give you a sense of
control while you are speaking.

This combinatorial approach can enhance your fluency by allowing you to stutter
more easily than beforeYou will initially require the guidance of a therapist to
master prolonged speech. You can also practice ‘Prolonged Speech Exercise’ for
stuttering with a verified speech therapy app like Stamurai
[https://ghost.stamurai.com/stamurai-app-to-stop-stuttering/]. Later, you can
practice it and apply it at home.

7. Pull Outs
You can perform pull-outs correctly and with ease at home after a clinician has
shown you the technique.

You can use it when you face an unexpected stutter, and you find yourself stuck.

The therapist will teach you how to stretch the sound you got stuck on and slide
out of it easily and blend into the next sound.

It is a stuttering modification technique that modifies the stuttering while
it’s occurring.

You can practice it regularly on your own to get out of stubborn stutters when
you speak.

This exercise for a stuttering adult can teach you

 1. How to reduce muscular tension?
 2. How to reduce the stress of stuttering
    [__GHOST_URL__/is-stuttering-biological-or-psychological/]?
 3. How to stutter more fluently?

8. Mindfulness and Meditation
A recent 2018 study
[https://journals.sagepub.com/doi/abs/10.1177/1525740118783516?journalCode=cdqc] 
shows that including mindfulness in your daily routine can benefit your speech
fluency.

Just like most of the techniques we have discussed above, you can begin
mindfulness meditation with the help of the Stamurai app.

Mindfulness
[https://ghost.stamurai.com/channel-your-emotions-to-reduce-your-stutter/] will
reduce your mental stress and anxiety while communicating with others. The other
positive results might include a decreased rate of avoidance and improved
control over the negative emotions.

You might be able to reduce anticipation of stuttering by meditating daily with
the help of a guide app.

9. Try Yoga
Yoga is all about finding the right balance between your body and mind. Begin
with the light stuff like upward facing dog, downward-facing dog, the standing
backbend, forward bend, camel, warrior, and pigeon poses.

These yoga [https://www.nytimes.com/guides/well/beginner-yoga] poses are all
light and fairly easy. You can find guides to assume these poses quite easily on
YouTube.

The aim of these poses is to stretch the muscles of your limbs, midriff, and
neck muscles.

According to Kauffman
[https://journals.sagepub.com/doi/abs/10.1177/0031512516628987], studies show
that yoga not only reduces stress but also gives the person a sense of control
and confidence.

You can also manage your breathing better, apply deep breathing techniques, and
feel more in control of your articulators by including pranayamas within your
daily yoga [__GHOST_URL__/yoga-and-stuttering/] routine.

Dedicate 20 minutes every day while you are at home to see a marked difference
in your metabolism, confidence level, mental health, and emotions related to
stuttering.

10. Note Your Daily Accomplishments
Keep a journal. You should note the smallest of the small positive changes you
observe in your speech.

For example, you answered the door with a smile and a “Hi” without stuttering.
Or, you went to the grocers and initiated a conversation.

You can also include stories of how you came in touch with other PWS who have
motivated you. Share your stories in forums and communities
[https://chat.whatsapp.com/DF2CpqQroAO2ychWM8hcV4].

Keep a digital journal to include photos, videos, and screen-grabs. Make your
journey towards fluency memorable and inspiring.

It will help you focus on the positives of stuttering rather than let you dwell
on the drawbacks.

11. Challenge Yourself to Approach and Overcome New Situations
Make a list of things that scare you right now.

For example, answering phone calls, placing an order via phone, talking to a new
guest, or speaking [__GHOST_URL__/public-speaking-with-a-stutter/] 
during a Zoom meeting.

Next, once you begin to see improvements in your speech after you practice your
stuttering exercises, breathing and yoga daily, try to face one challenge at a
time.

At first, you may find it tough to step outside your comfort zone. Joining 
virtual stuttering support groups
[https://ghost.stamurai.com/benefits-of-talking-to-other-people-who-stutter/] 
and attending moderated video calling sessions [https://stamurai.com/sessions] 
with other PWS can help you garner the confidence you need for approaching the
new situations.

Make it a part of your exercise to challenge yourself each day while at home by
stepping out of your comfort zone.

12. Try Aerobic Exercises
Recent studies [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017068/] show that
light aerobic exercising can help improve fluency. 

10 adults who stuttered, participated in a study at the National Institute of
Rehabilitation and medicine (NIRM). They ran on treadmills and rode stationary
cycles for 30-minutes under the supervision of a physical therapist.

They also received speech therapy along with the control group. This continued
for 6-weeks.

Speech-language pathologists then evaluated the stuttering severity of both
groups. Results indicated that the ones doing aerobic exercises regularly
stuttered significantly less than before.

13. The Linklater Voice Progression
Have you noticed how singers and actors do “funny” vocal exercises before each
performance? It is a part of Kristin Linklater’s Voice Progression - a
collection of vocal exercises that ease the tension of the throat muscles and
‘frees’ the voice.

It is an integral part of renowned actor training programs, such as Yale School
of Drama. A recent publication
[https://www.sciencedirect.com/science/article/abs/pii/S0094730X17300013] shows
that the Linklater technique can reduce the impact of stuttering among adults.

The technique focuses on the following -

 1. Physical awareness of the tension building up in and around the throat.
 2. Relaxing the breathing and throat muscles to allow easy flow of sound
 3. Freeing the sound vibrations
 4. Undoing the tensions in the jaw, tongue, lips and throat. 
 5. Providing strength to the voice 

Although it is not a conventional component of any stuttering therapy
[https://stamurai.com/blog/online-speech-therapy-for-stuttering/] or speech
therapy, research findings indicate that the Linklater Voice Progression can
increase fluency by soothing the muscles involved in breathing and speech. 

Few Final Words
These are 13 easy and exciting exercises that can help you become more fluent.
They can also help you retain your fluency long after you have had your session
with your speech therapist.

These are exercises that most speech therapists and SLPs recommend. However, you
can also practice some of these at home regularly to see a noticeable difference
in your stuttering frequency and intensity.

[https://stamurai.app/z4HKmlNXigb]

13 Stuttering Exercises for Adults: Reduce Stuttering At Home

“The world is in your palm” sounded like a clichéd quote until this year. A
global epidemic has forced almost everything to go digital. Education has not
been an exception to this.

There can hardly be any argument on the various benefits of remote learning.
However, there is no rose without thorns.

From technological limitations to connectivity issues, online education has its
fair share of problems. While these are mostly mechanical and universal issues,
there are a few specific & humanitarian problems.

Currently, more than 70 million people stutter worldwide. It is most common in
kids between 2-6 years old. 5-10% of all children are likely to stutter
[https://ghost.stamurai.com/what-is-stuttering/] at some point in their lives.

Children with stuttering (CWS) are not very confident about how people will
react to their stutter. As a result, they often fail to engage in class
discussions.

With classes going digital, CWS neither have adequate time to share their views,
nor are they getting an all-inclusive environment to participate. Subsequently,
the rate of participation has decreased.

It is essential to ensure that a child does not feel left out because of his or
her stuttering. With a few simple steps, we can create a stutter-friendly
environment.

Here, we will look at some of the best ways parents, schools, teachers, and
other institutions can create a stutter-friendly e-learning environment:

1. Letting People Know
Change always starts with one’s self. We will be able to create a
stutter-friendly virtual environment when we are aware of someone’s disfluency.

It does not necessarily mean treating someone specially.

Instead, we need to ensure that the environment is inclusive and the child feels
he or she is a part of it.

As children try to hide their stutter, they evade participation in discussions.
This nolens volens isolate themselves from their classmates. 60% of teenagers
[https://kids.frontiersin.org/article/10.3389/frym.2019.00153] rarely talk about
their stuttering with people.

Hence, Speech-Language Pathologists (SLP) encourage children to open up about
their stutter. It requires courage, but there are various ways of doing it.

One can choose to inform the teacher, who can subsequently convey it to the
class. Others might do it themselves.

A child can use a humorous way of disclosing it. For example –

“I would request the moderator to allow me an extra minute for my debate
argument because I stutter.”

Different people find different options comforting, but the underlying aim
remains the same. Our speech mechanism works in such a way
[https://www.stutteringhelp.org/admitting-you-stutter] that it fails to operate
smoothly under tension.

By letting people know about your disfluency, you are getting the fear of
public
reaction [__GHOST_URL__/how-to-overcome-fear-and-tension-if-you-stutter/] out of
the way. With reduced tension, speaking becomes much smoother.

2. Being a Patient Listener
Once a child has disclosed his or her stuttering, it is up to the teachers to do
their part.

In the times of online education, we might confuse someone’s stuttering as an
internet issue. Some might even think that the speaker does not know what to
say.

In reality, CWS knows perfectly well what to say. Only that they take a bit
longer than usual to say it. To make the classroom environment inclusive, we
should be patient listeners.

The “seven-second rule” is a common practice in use. It says – once you ask a
question to a CWS, wait for seven seconds for the response.

Ensure that your non-verbal cues show you’re interested in what the child has to
say. In this way, we can make the classrooms stutter-friendly
[https://ghost.stamurai.com/work-with-students-who-stutter/].

3. Allow Different Ways of Class Participation
Adherence to rigid rules of physical classes might deter a child’s
participation. The teachers should allow and encourage different ways of
engaging in online class discussions.

For example, if a child is not confident about speaking during an online
session, teachers can let them use the chat function. If someone does not feel
comfortable presenting something to an online audience, teachers can encourage
use of pre-recorded videos.

Not all vases are cast in the same way. By encouraging different ways of
involvement, we take a significant leap towards an all-embracing milieu.

4. Understanding Technological Know-how
In most platforms, the person to feature on the screen is the speaker. This
makes it difficult for a CWS to be on the screen.

Firstly, if a CWS pauses on a word and someone interrupts, the screen will
switch to the new speaker. To prevent this, we need to ensure that we don’t
speak unless the child has finished his statement.

Also, since we will be on-screen only when we speak, it might be difficult for 
a child who stutters to get their points in. The solution to this technological
problem is the technology itself.

The most commonly used platform for hosting online classes, Zoom has a “
hand-raising [https://www.youtube.com/watch?v=UzUZeN2DGKE]” feature. By using
it, we let everyone know that we have something to say.

Every platform has features to make people know someone wants to speak. By using
them, we are ensuring everyone gets a chance to speak.

Inclusion Is the Only Solution
Eminent influencer and social commentator Verna Myers once said –

“Diversity is being invited to the party; inclusion is being asked to dance.”

With online education being the new normal, the feeling of being left out among
CWS has increased. Our solitary goal should be to make our virtual learning
environment stutter-friendly and all-inclusive.

When the children feel they truly belong to the class, they are more likely to
engage in various learning activities.

A teacher’s job isn’t easy in the current times. However, by taking a few steps,
we can ensure that a young mind does what it is meant to – express freely
without any inhibition.Parents, too, can play an important role. Besides
creating a stutter-friendly online learning environment at home, they can
encourage kids to practice stuttering exercises
[https://ghost.stamurai.com/five-stuttering-exercises-to-help-your-child/] to reduce their
stutters.

How to Make eLearning Stutter-Friendly

It’s been a long day working from home. You have had to attend meetings and meet
deadlines. Now, it’s time to place an order at your favorite restaurant – you
can either walk there or place a call.

For fluent speakers, the choice is an easy one. Why walk when one can call? But
we all know, people who stutter (PWS) will sometimes choose to walk for 10
minutes to place an order, wait and carry it back home rather than place the
order over the phone.

Phone calls can be nightmarish for PWS. Making and receiving phone calls can be
dreadful for anyone who stutters.

Some say that in face-to-face conversations, 30% of the communication is verbal,
and 70% is non-verbal. For PWS, that is incredibly good news. We rely majorly on
the non-verbal part of daily communication. A simple nod, head-jerk, or
thumbs-up can save us from saying a few extra words!

However, there’s no escape plan when it comes to telephonic conversations. We
have to talk!

[https://stamurai.app/z4HKmlNXigb]Why Do I Stutter Worse on the Phone?
As adults, we have to make phone calls, sometimes, several, in one day. Here are
some reasons your stutter becomes worse during a phone call –

1. You feel the pressure of responding immediately after the person has stopped
talking, or they have asked a question. You believe that you cannot risk a block
or prolongation during a conversation where the listener cannot see your face.

2. You are afraid of making a bad first impression whether you are calling a
restaurant or a client. You are scared that the person on the other side might
perceive you as “slow” because you take time to talk.

3. Maybe you have had a bad experience in the past. The memory and the negative 
emotions [__GHOST_URL__/stuttering-and-lasting-emotional-effects/] surrounding
stuttering add to the anxiety and make your stuttering worse than it is.

4. You cannot replace a feared word with expressions, hand gestures, or body
movements during a phone call. That can put extra pressure on anyone who has
disfluent speech.

How Do I Stutter Less on the Phone?
Those who stutter employ several tips and tricks while talking on the phone to
stutter less. Some of these tricks stem from pure belief.

For example, one man prefers to take his phone calls at the bottom of the stairs
with his right foot up one step. He believes it helps him articulate.

Other techniques [__GHOST_URL__/how-to-stop-stuttering/] include pausing
strategically, breathing out while speaking, and using a list of topics while
making a call. These are some techniques that are based on stuttering therapy.

Make A List
When on a call, we tend to meander from the topics, especially when our
disfluencies take over.

It will help you tremendously if you can make a list of the topics you want to
discuss. It can be a list of items you want to order, or health concerns you
want to talk about.

This practice will ensure that you don’t have to remember the points while you
are trying hard to not block or prolong.

You will always have a visual cue. While making the list you will also get the
time to think about how to approach each topic by avoiding your trigger words
during the phone conversation.

Practice Making Phone Calls
Have an important call? Make a practice call before that.

A practice call can be a call you make to your local store to enquire if they
stock a particular item. You can call your friend or mum to have a brief chat
about your upcoming call.

You can also call numbers that use a voice-activated system.

Try to be casual about it. The more you practice, the less stressed you will
feel during the actual phone call.

Introduce Yourself as Someone who Stutters
When you are calling a new place or person, tell them that you stutter
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/]. It’s not
something you do voluntarily, so any adult should be empathetic and patient
towards your speech disfluency.

Many of us are already pretty used to being hung up on, especially when
blocking.

So, instead of waiting for someone to hang up on us, we should just go ahead
with a “hello, I’m John, and I stutter. I may take up more time than the average
caller, so please be patient.”

You can frame it any way you like. Avoid your feared words. However, you will be
surprised to see how many people will show patience and not hang up once you
introduce yourself as someone who stutters.

Apply Speech Therapy Techniques
Have you already attended speech therapy? If so, you should be familiar with the
practices of easy onsets, pull-outs, costal breathing, and beginning speech
while starting to exhale.

If not, you can try using a stuttering therapy app like Stamurai
[https://ghost.stamurai.com/stamurai-app-to-stop-stuttering/]. It is a speech therapy app
that can teach you fluency techniques
[https://ghost.stamurai.com/stuttering-fluency-shaping-techniques].

[https://stamurai.app/z4HKmlNXigb]It is not like you stutter only on the phone.
You stutter while talking, and that’s alright. You have applied speech therapy
techniques IRL, so why not try them while you are on a call?

Speech therapy can help make phone calls less intimidating for you. It can also
help you stutter less while on the phone.

Record and Listen To Yourself
It might feel awkward in the initial days, but you need to record yourself while
on the phone. Playing it back, you will be able to understand how your speech is
different from a face-to-face conversation.

A video recording is often more helpful since you will be able to see the
changes in your body language and movements.

Note your rate of speech and blocks. Make a list of words that lead to blocks or
prolongations during each call.

Learn from the recording. Prepare for your next call. It might feel weird
listening or watching yourself talk on the phone, but it will help you beyond
your imagination.

[https://stamurai.app/z4HKmlNXigb]Will You Ever Stutter Less During a Phone
Call?
Practice can make phone calls easier and less scary for you. Once you find a way
to control the negative emotions and bad memories, it can help you stutter less
during a phone call.

Take time to answer a call, but also try to be the person who answers every
call. Those “annoying” sales calls might be the right practicing opportunity for
you.

Give your listener the benefit of the doubt. Always admit that you stutter at
the beginning of a call. It is indeed trying, but you will find a script that
you can stick to while starting a phone call.

Don’t let a piece of tech dominate your fears. It is much better and easier to
use the phone and stutter than avoiding it entirely.

How to Stutter Less While Talking on Phone?

A big part of the daily struggle every person who stutters (PWS) is facing their
anxiety, fear and anticipation of stuttering. A person who stutters needs to
fight the negativity that shrouds their thinking every waking moment. It
requires more than the daily pep talk and inspirational post from Instagram.

Research shows that mindfulness and meditation can manage the negative attitudes
and emotions in people, and it can help the person relax physically.

What Is Mindfulness?
According to Paul Brocklehurst, PhD, Founder and Director of The Stammering
Self-Empowerment Programme, mindfulness is distinct from meditation.
Brocklehurst, who practices Zen, advocates a form of mindfulness that may be
unique to many readers.

Mindfulness is not relaxation
[https://theconversation.com/we-dont-yet-fully-understand-what-mindfulness-is-but-this-is-what-its-not-110698]
. It is about becoming mindful of any state that we are in.

You can be mindful of being happy and relaxed, the same way you can be mindful
of being anxious, afraid or angry. The target of mindfulness is to make one
completely aware of the present and be open to the potential experiences that
may come in that moment.

What Is Mindfulness Meditation?
Meditation can be one way to achieve mindfulness. However, it does not involve
trying to empty one’s mind completely. It is only natural for anyone to have a
nonstop train of thoughts. Stopping that forcibly is not the target since
thoughts are not the obstacle but the tools to achieve mindfulness.

Mindfulness meditation for stuttering enables you  to become more aware of
 thoughts that cross your mind. Over time, you will develop the skill to assess
how much attention you pay to each thought, how different thoughts arise in your
mind and control the importance you give to each thought process.

Meditation can help you slow your thoughts, eliminate the negative thoughts and
calm your mind. If you are trying mindfulness for the first time, meditation can
be of help.

You can try guided meditation techniques for stutterers that include breathing
practice. You can begin with the assistance of apps. Stamurai
[https://ghost.stamurai.com/stamurai-app-to-stop-stuttering/] - a speech therapy app for
people who stutter, offers guided meditation options. This smartphone app also
helps you learn and practice various stuttering exercises and is available for
both Android
[https://play.google.com/store/apps/details?id=com.stamurai.stamurai&hl=en_IE] 
and iOS
[https://apps.apple.com/us/app/stamurai-stuttering-treatment/id1488071175] 
users.

How Can Mindfulness Meditation Influence Stuttering?
Mindfulness Can Tell You What You Do When You Stutter
Researchers have explored the relationship between meditation, mindfulness and
stuttering time and again. Mindfulness meditation aims to make you more aware of
your mental and physical state.

Achieving mindfulness is not easy. You may need to dedicate between twenty
minutes to an hour every day to practice meditation for stuttering to achieve
the mindfulness necessary to assess what you do when you stutter.

Mindfulness can help you delve beyond the verbal description of stuttering
[https://ghost.stamurai.com/causes-of-stuttering-in-adults/]. You can directly realize the
sensory experiences that accompany each stutter. What you do when you stutter
can become the starting point of your cognitive and speech therapy.

Being Mindful Can Improve Your Communication Skills
PWS are often scared of public speaking
[https://ghost.stamurai.com/public-speaking-with-a-stutter/] because of past experiences. How
people have reacted to their speech in the past shroud the reality of how their
listeners are reacting to them in the present.

It is particularly true in case of the bad days when your stutter seems to be
worse than it typically is. In cases of stubborn blocks, prolongations or
repetitions, we often don’t perceive how the listeners are reacting. We are too
engrossed in bad memories
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/] of unpleasant
encounters.

Mindfulness meditation can help you remain in the present to see and assess the
reactions of the listeners. It can also empower you to determine the most
appropriate way to relate to your listeners and react accordingly. It can
improve your communication skills and break the vicious cycle of anticipation
and stuttering.

Mindfulness Can Reduce Secondary Stuttering Behavior
As adults, almost all PWS have well-established secondary behaviors
[https://www.stutteringtherapyresources.com/blogs/blog/even-more-thoughts-about-secondary-characteristics]
. These may include rapid blinking, shrugging of shoulders, clenching of fists
or twisting of lips. People who stutter develop them over the years because they
tend to believe that these behaviors somehow help them “unstick” the words.

Being mindful will make you more aware of such secondary symptoms. The
consciousness extends to the subtler secondary symptoms including delays,
unnatural changes in pitch, and emphasis.

Mindfulness is a wonderful practice since the more conscious you become of these
actions, the more likely you are to overcome them on your own.

Mindfulness Helps Build a Realistic Self-Esteem
A majority of PWS suffer from low self-confidence and self-esteem. Mindfulness
gives you the chance to slow down and look at your life from a different
perspective. You gain an understanding of your core and secondary stuttering
behaviors. You get to understand how your listeners are reacting.

Practicing mindfulness meditation daily gives you the opportunity to be more
forgiving towards yourself. Stuttering is not something
[https://ghost.stamurai.com/cellular-causes-of-stuttering-in-adults-and-children/] that you
can control. It’s something beyond your control, but not beyond your
understanding.

Interestingly, with increasing mindfulness we become more accepting
[https://pubmed.ncbi.nlm.nih.gov/23218212/] of the lack of control we have over
our lives. It is impossible to have complete control over what we do, although
we would like to believe otherwise.

This understanding and acceptance brings a feeling of empathy towards oneself
and the others (including the listeners). With the new understanding you will
slowly gain the self-esteem you thought was only entitled to the fluent
speakers.

Can Meditation Cure Stuttering?
Medical professionals, speech therapists, researchers and PWS have been looking
for the cure of stuttering for almost a century.

Is meditation a cure? Yes, and no.

Meditation can reduce your anxiety and stress. Both of these factors contribute
to pre-existing stuttering. Mindfulness can make you more aware of the emotions
you feel and the movements you carry out while you stutter.

In a way, mindfulness and meditation can help you realize everything you are
doing wrong and the things you are doing right while stuttering.

Self-realization and growing confidence levels can contribute to an increasing
fluency.

However, calling it a complete cure for stuttering would be grossly wrong. It is
a treatment for adults who have been stuttering for years. And it has been shown
to yield positive results in hundreds of case studies.

How Can Meditation Help You Stop Stuttering?

What happens when you alter the speaking environment of a person who stutters?
Research shows that making a few changes including - the introduction of noises
that prevent the speaker from hearing their own voice and manipulating the sound
of their voice before they can hear it - can induce fluency.

Over the years, several types of speech manipulations
[https://www.mnsu.edu/comdis/kuster/TherapyWWW/Electronictechnology/FAQelectron.html] 
have been introduced including –

 * Introduction of a slight delay between speaking and hearing
 * Shifting the frequency (up or down) of the voice of the speaker

Both the delayed auditory feedback stuttering therapy techniques work towards
inducing fluency in a majority of speakers who stutter. Interestingly, the two
techniques mentioned above work for children, teenagers and adults.

How Does DAF Work?
Currently, both prosthetic devices that induce a delay of a few microseconds and
state-of-the-art smartphone apps such as Stamurai [https://stamurai.com/] can
produce similar outcomes in inducing fluency in people who stutter
[https://ghost.stamurai.com/what-is-stuttering/].

Delayed auditory feedback (DAF) devices and software work on the principle of
choral effect. They introduce a delay between speech production and auditory
perception. The delay can be typically customized to be between 50 and 70
milliseconds.

Researchers have observed [https://pubmed.ncbi.nlm.nih.gov/8944848/] that a
delay of 50 to 70 milliseconds can reduce stuttering by around 70%.

Using DAF to reduce speech disfluency doesn’t require any previous training and
conscious effort. It doesn’t lead to abnormal sounding speech. Speakers can
maintain a normal speech rate while using a DAF hardware or software to reduce
their stutters.

Is DAF Stuttering Therapy Effective in Reducing Stuttering Permanently?
One of the most common questions experts hear from people who stutter (PWS) is
“can DAF cure stuttering?” The results of using DAF can vary depending upon the
guidance the user receives while they use the DAF device or software (app), and
the nature of their auditory processing.

Speech experts now use DAF to improve fluency especially by slowing the
speaker’s speech rate up to ten times. Initially, the delay between speech and
auditory perception can be 200 milliseconds.

For best results, anyone who stutters should work with a speech pathologist with
the goal of shaping their speech for higher fluency. A trained speech language
pathologist may gradually reduce the delay from 200 milliseconds to 50
milliseconds.

Alternatively, people who stutter can use Stamurai [https://stamurai.com/] - a
cutting edge speech therapy (with DAF) - for guided stuttering speech therapy
and exercises.

The ultimate goals of guided DAF therapy for stuttering is to increase the
stress the PWS feels during speaking and to reduce their dependence on the
device at the same time.

Multiple studies show
[https://onlinelibrary.wiley.com/doi/abs/10.1080/1368282021000042902]that DAF
reduces stuttering by 70% almost immediately. A combined approach that uses DAF
and FAF (frequency altered feedback) reduces stuttering by around 80%. A
combinatorial approach rarely reduces anyone’s stutter beyond 90% or less than
50%.

Using DAF in conjunction with other conventional stuttering therapies can reduce 
stuttering relapse
[https://ghost.stamurai.com/high-relapse-after-stuttering-speech-therapy-understanding-the-reason/] 
rates, increase the fluency and hasten positive outcomes in adult clients.

What is a DAF Device?
A user can access DAF technology in the form of hardware or software. A hardware
could be a portable altered auditory feedback device that introduces the
necessary delay to induce fluency.

Currently, there are two main types of DAF devices available in the market –

 * A single-component DAF device – it looks and fits similar to a hearing aid.
 * A multi-component DAF device – it consists of an earphone and a box (similar
   to old-school hearing aids). The connection between the box and earphone
   might be wireless. A wireless device makes its presence less prominent akin
   to a single-component DAF device.

A few manufacturers offer try-before-you-buy options for the users. If you have
never tried a DAF anti-stuttering device in therapy before, you should go for a
trial run before investing.

Opting for smartphone-based software
[https://ghost.stamurai.com/stamurai-app-to-stop-stuttering/] that offers DAF through
Bluetooth or wired headphones is also a good option for the novice users.

Can A Mobile App Provide DAF Stuttering Therapy?
A smartphone app can provide DAF services. However, the user needs to be
cautious that they have access to a verified speech therapist who can guide them
properly. Integration of a DAF stuttering app with conventional stuttering
therapy [__GHOST_URL__/stuttering-treatment-for-adults/] can improve speech
fluency at a faster rate.

Depending on the DAF mobile app you are using, you may have access to multiple
features. Some of these features may include –

 1. Recording the user’s voice – you can record your voice while using DAF and
    play it back for yourself to hear how much your speech has improved.
 2. Use it regularly – most Pro apps have a “running in the background” feature
    that allows the user to constantly use the app while conversing, presenting
    and attending meetings. Many apps offer pro/paid versions that work even
    when you lock the phone screen.
 3. Measuring speech rate – several iOS and Android apps have a speech rate
    indicator. The aim of DAF for stuttering is to reduce the speech rate so the
    user’s speech is comparatively relaxed and clearer. A DAF app with this
    feature will notify the user if they speak too fast.
 4. Training sessions – although there is no learning curve for using a DAF
    device successfully, you may want to use a training session or two before
    using your DAF app during an important meeting or career-defining
    presentation.
 5. Speech exercises – not all DAF apps have speech exercises
    [__GHOST_URL__/stuttering-exercises-for-adults/]. You should look for the
    ones that do. Exercises will help you apply the speech techniques you learn
    during stuttering therapy, and give you the chance to couple them with DAF
    to induce higher levels of fluency.

How to Use DAF for Stuttering?
DAF is an effective assistive technology for stuttering even when it is the only
one someone who stutters employs outside a therapeutic environment.

PWS can opt for DAF devices or smartphone apps. If you are using a smartphone
app, you will need to install the app and couple a Bluetooth headphone or a
wired headset to your phone.

DAF works best under the guidance of a professional and experienced speech
therapist or an app that serves a similar purpose. Someone who has the expertise
in DAF devices and DAF mobile apps can help PWS to enhance their fluency.

Speech therapists typically recommend a slow-speaking test to determine the
progress. Any DAF device works perfectly when the user masters slow-speaking.

Only an expert therapist can guide the user based on their improvements in
fluency. With constant guidance the user should be able to reduce the delay from
200 milliseconds to 75 milliseconds and ultimately decrease their dependence on
the DAF device.

Common Mistakes People Make While Using DAF To Reduce Their Stutters
For the best results of DAF, you can couple it with speech therapy. While you
can approach a speech-language pathologist, you can also follow exercises and
receive guidance from speech therapy apps like Stamurai.

Wholesome speech therapy apps can tell you how to use DAF correctly for
achieving speech fluency.

Avoid the following mistakes if you are using DAF for the first time –

 1. Setting a longer delay for higher fluency – if you are using a
    normal-speaking rate, set the delay between 50 milliseconds and 75
    milliseconds. Setting it to a longer delay will make the auditory processing
    worse in those with existing atypical auditory processing.
 2. Expecting speech fluency to increase exponentially – PWS often experience
    50% fluency at a delay of 50 milliseconds. They also experience close to 75%
    fluency at a 75 millisecond delay. However, it does not mean that increasing
    the delay will also increase your speech fluency.
 3. Not speaking at a slower rate – working with a therapist can help you
    achieve a slower rate of speaking. Once you have achieved five to ten times
    slower speaking rate, you can set the DAF delay to 200 milliseconds.
 4. Using DAF only in low stress situations – don’t use DAF in just low stress
    situations like reading aloud
    [__GHOST_URL__/why-dont-we-stutter-when-talking-alone/] or taking in front
    of a mirror. You need to test your DAF induced fluency in high-octane
    situations like in a meeting, during public speaking or live presentations.

Notable Research Findings on DAF and Stuttering
Since stuttering is a heterogeneous disorder not everyone responds to DAF
therapy the same way. For example, the Charles A Dana Foundation reported in a 
NIH study
[https://www.researchgate.net/publication/8187159_Aberrant_auditory_processing_and_atypical_planum_temporale_in_developmental_stuttering] 
that they had found two sub-groups of PWS – one with atypical auditory anatomy
and the other with typical auditory anatomy.

DAF was only helpful in inducing fluency in people with atypical rightward
planum temporale asymmetry (auditory anatomy). The other group didn’t become
fluent with DAF therapy.

Will DAF Work for Me?
The only way to find out if DAF will work to enhance your fluency during speech
therapy is by trying it.

You can either seek help from a SLP or you can rely on a verified speech therapy
app like Stamurai to help you out. Using it at the right time in the correct
manner makes all the difference.

You need to find the delay that suits your speech rate at the moment. You can
use Stamurai to make a list of your feared words and find out how fast you
speak. Both of these factors will help you improve your fluency while using DAF
for stuttering therapy.

DAF & Stuttering: Can DAF Help Reduce Stuttering?

“What stutter? You talk smoothly!” “You definitely don’t stutter. I haven’t
heard you get stuck even once in the last 20 minutes” – these are comments
people who stutter covertly have been hearing everytime they want to advertise
their stutter.

What’s worse than stuttering? No one believing that you actually stutter
[https://pubmed.ncbi.nlm.nih.gov/30347066/] and that you put in immense effort,
every waking moment, to pass yourself off as fluent.

Only 1% of the world stutters. Many of us, in our effort to sound like the
majority, hide our stutters. We may have hidden them since elementary school or
high school, ever since we became conscious of our speech disfluency.

We have avoided saying words that we fear, we have substituted words, and we
have simply chosen to remain quiet in situations that may have triggered our
stutters.

Now, we sound fluent and we pass as fluent seemingly effortlessly.

However, is it truly effortless? We have to deal with the anxiety and
anticipation of stuttering long before we begin speaking. We have to constantly
keep updating our feared words list. Our vocabulary is expansive, and every time
we come face-to-face with a feared word we comb through it for a synonym.

It is time that we speak out about covert stuttering, but before that, let’s
find out a little more about what it is, what causes covert stuttering and what
are the treatments for stuttering covertly.

What Is Covert Stuttering?
Today, research shows that around 1% of the world’s population stutters.
However, some researchers also mention that the number can be significantly
bigger since no one knows how many people hide their stutter.

Some say that the number of people who stutter is a lot more than 70 million,
but we don’t get a fair estimate because many of them don’t stutter openly or
overtly.

So, how do we define covert stuttering?

Well, covert stuttering may refer to the following –

 * Omission – A person may anticipate a stutter and avoid the trigger words
   altogether. There are instances where people have had their names changed
   officially or introduced themselves by their nicknames to avoid stuttering.
 * Substitution – A person who stutters may substitute one word for another. For
   example, instead of saying “big” the person can say “immense” or “ample.”
 * Escape or avoid – A person can entirely avoid situations, or choose actions
   like yawning, coughing, clearing their throat to avoid stuttering overtly.
 * Introversion – A person may appear to be quiet or introverted in social
   situations that demand talking.

Covert stuttering is less studied due to its nature.

A person who stutters covertly
[https://www.mnsu.edu/comdis/kuster/journal/hallen/covert.html] can change words
and avoid people or situations that may trigger their stutter. These serve as
the typical symptoms for covert stuttering.

It’s entirely possible that someone who stutters covertly has never spoken about
stuttering to anyone.

How Does Covert Stuttering Hurt The Speaker?
Stuttering can be a well-kept secret for many covertly disfluent speakers.
Almost every person who stutters has hidden a stutter or avoided saying a
particularly difficult word once in a while.

However, making it a daily practice to hide one’s stuttering from their friends,
colleagues and even family takes a severe toll on mental health. It can increase
fear, shame, and anxiety in someone who has to carefully choose their words and
navigate conversations to hide their stuttering.

According to research [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504509/],
stuttering covertly can have a long-term impact on a person’s mental health
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/]. Anger, frustration,
helplessness, speech anxiety, low confidence levels and low self-esteem are all
problems associated with covert stuttering symptoms .

Personal Accounts Of Covert Stuttering
According to Berit Løkken, someone who stutters covertly, she has never spoken
to anyone about her stuttering other than Hilda Sønsterud. Her doctoral thesis
is on stuttering.

Løkken resorted to covert stuttering after she was bullied at school
[https://ghost.stamurai.com/reining-in-the-bullies/]. Saying her own name
[https://stamuraiapp.medium.com/saying-your-name-4-ways-to-reduce-stutters-71f2371bdd6d] 
was difficult which caused her to withdraw from social introductions. She became
more introverted by the day. Finally, she mastered the skill of hiding her
stutter by avoiding words that trigger her stuttering.

Her struggle to remain fluent goes largely unnoticed. Berit Løkken is one of the
many people who stutter covertly and just like them she has repeatedly been told
that she is not a “stutterer”.

Michael Punzi, another 23-year old male college graduate states that he began 
stuttering covertly
[https://blog.usejournal.com/im-a-covert-stutterer-this-is-my-story-dd011a1622eb] 
after he noticed that his speech was different from the others in elementary
school. His parents assured him that he’d “grow out” of it.

He never grew out [__GHOST_URL__/stuttering-misconceptions/] of it. Instead he
quickly learned how to hide his stutter. It was his firm belief that he could
get rid of his stutter if he tried hard enough. Instead of allowing him to 
accept [__GHOST_URL__/should-you-accept-your-stuttering-yes-absolutely/] and
embrace his stuttering, this pushed him further into denial for more than a
decade.

Even during his college years, he chose to remain quiet in class, avoided asking
questions and minted his words very carefully during presentations.

Only when he had to present [__GHOST_URL__/public-speaking-with-a-stutter/] in
front of a large group he accepted and advertised his stuttering problem. That
was one of the first times he felt relieved and deeply appreciated by his peers
and professor.

Evaluating Covert Stuttering
Not much is known about covert stuttering since people who stutter covertly
typically hide it well. Some studies show that a few factors tend to perpetuate
it.

 * Fear – what’s worse that stuttering? The fear of it. Anticipation and fear of
   sounding different, looking different or a secret being discovered often
   makes people hide their disfluency. Some do it well enough to pass as fluent
   speakers.
 * Guilt – if a child grows up thinking that stuttering is their fault, they can
   develop covert stuttering at an early age. This is typically difficult to
   detect, since the person  often feels guilty of making listeners
   uncomfortable with their disfluencies.
 * Shame – stuttering attracts mockery, stigma and bullying. Sadly, several
   people who stutter are ashamed of how they sound. Embracing one’s stuttering
   isn’t easy, but shame can feed a person’s denial.
 * Denial – a person who stutters may not be ready to accept their speech
   disfluency. In such a situation, they might evade situations that can cause
   them to stutter. They may be in denial of the need for therapy.

Sadly, the evaluation of covert stuttering isn’t easy due to the overlay of the
several psychological factors [__GHOST_URL__/stuttering-depression/] that prompt
PWS to hide their stuttering.

Treatment of Covert Stuttering
Today, the treatment for stuttering is available and accessible to almost anyone
and everyone across the globe, thanks to speech therapy apps like Stamurai
[https://ghost.stamurai.com/stamurai-app-to-stop-stuttering/].

Conventional therapy and stuttering treatment
[https://ghost.stamurai.com/stuttering-treatment-for-adults/] can help adults reduce their
disfluencies over time.

However, the complex psychological factors involved along with the neurological 
causes [__GHOST_URL__/causes-of-stuttering-in-adults/] make covert stuttering
difficult to treat. Traditional speech therapy can become effective only when a
person who stutters covertly, is willing to accept and embrace their stuttering.

Therefore, one of the first tasks for the therapist is to encourage the client
to stutter overtly. Acceptance can come through rigorous exercises
[https://www.sciencedirect.com/science/article/abs/pii/0094730X83900268] like –

 * Talking openly about stuttering and introducing oneself as someone who
   stutters
 * Mentioning one’s stuttering to their friends, colleagues and family in an
   acceptable way
 * Advertise their stuttering via voluntary stuttering
 * Desensitizing oneself towards the negative reactions of the listeners
 * Not substituting or avoiding the feared words, but saying them complete with
   blocks, repetitions or prolongations

An adult may need intensive cognitive behavioural therapy (CBT) to achieve the
self-confidence necessary to accept and advertise their stuttering.

Once the person is able to embrace their stutter, there’s no looking back.

Understanding Covert Stuttering – A Brief Guide

Saying “hi” to someone in the school corridors, picking up the phone to order a
pizza or answering the doorbell to receive a package from UPS shouldn’t be a
difficult task. So, why do we shy away from the simplest and common form of
communication – talking?

I have always been described as a quiet and introverted person in school. My
teachers even commented on my report cards how well behaved and quiet I remained
in class during lessons. Little did they know that there was a talkative child
inside, wanting to pass notes, whisper little jokes, and make my classmates
laugh.

The only thing that kept me from being myself was my stutter.

Now, I kind of identify as a quiet and introverted person. I have come to terms
with the fact that I have very few friends who know and accept my “weird” way of
speaking. I do like loud parties and pubs, because my stutter nearly vanishes in
the chaos.

My acceptance [__GHOST_URL__/should-you-accept-your-stuttering-yes-absolutely/] 
of who I am, complete with the stuttering and all, has come after years of
speech therapy and cognitive behavioral therapy (CBT).

Not being able to speak my mind for decades had wreaked havoc on my
self-confidence, self-worth and happiness [__GHOST_URL__/stuttering-depression/]
.

One day, my therapist asked me about the positive
[https://ghost.stamurai.com/the-positive-aspects-of-stuttering/] lessons I have learnt from
my stuttering.

My first thought was, “Are you kidding? I’m here because of my stutter.”

Then she told me to think a little longer; to look beyond my anxiety, fears,
broken dreams, and frustrations. Finally, it dawned upon me that stuttering has
indeed taught me some very important life lessons.

So, here’s a list of the life lessons stuttering has taught me –

1. Nothing Is More Important Than Empathy and Compassion
Empathy did not come as a “free gift” with my stutter. In fact, it took years of
work to overcome my envy, fear, and tinges of unconscious hatred towards the
fluent speakers to actually feel empathetic towards other people.

Getting the support and therapy I needed helped tremendously in this case. Right
now, I am not just more empathetic towards others who stutter; I am genuinely
sympathetic for people in general.

I find myself standing up for others [__GHOST_URL__/reining-in-the-bullies/] 
with speech disfluencies and other disorders. I can connect with most people I
come across every day, whether they stutter or not. My own struggles have made
me more aware of what other people go through.

2. Everyone’s Time Is Valuable
People are always in a hurry. Stuttering slows everyone down! While it doesn’t
sound like a virtue, it is. Stuttering slows the speaker as well as the
listener.

It takes the listener’s mind off the multiple tasks circling in their head and
their eyes off their phone.

When I begin talking, and stutter, people almost always pay more attention to
what I am saying. They try harder to understand me. It makes them focus. Both
the speaker and the listener
[https://mashable.com/2016/05/09/stuttering-listening-tips/] give up other tasks
to simply sit down and communicate for a while.

I have noticed this only recently after I finished an exercise that involved
‘advertising my stutter and stuttering voluntarily.’ Truth be told, it has
worked superbly in restoring my faith in humanity.

3. What Others Say Is Important Too
When someone has been stuttering for a long time, it can be difficult for them
to see things from a new perspective. For example, it was almost impossible for
me to accept that what others had to say was equally as important as what I had
to say. It wasn’t being fair when I assumed that they had an advantage,  simply
because they were fluent.

Accepting my stutter has made me a better listener.

Now, it’s not because I cannot say what I want to say instantly. I choose to be
a good listener because being the “quiet kid” has taught me to recognize the shy
or introverted ones who need a pair of listening ears.

4. Patience Is a Virtue
Sometimes, saying “Good morning” to my boyfriend can take two extra seconds. He
doesn’t mind and I have come to not care about it either.

Everything good in life comes after a period of waiting. At least that’s how I
see it now.

My own stutter and stuttering treatment has made me a more patient person. I
have learned that it is possible to become fluent even in adulthood, after years
of stuttering, but it takes immense work, daily exercise, often with Stamurai
app [https://stamurai.com/], and loads of patience.

5. Bravery Doesn’t Hide Behind an Armor
Earlier, I would go to Burger King and point at something on their menu. Or,
order off the Starbucks app instead of walking up to the counter.

Now, I take my chances. I smile, tell the person behind the counter that I
stutter
[https://stutteringtreatment.org/3-basic-rules-of-self-advertising-your-stuttering/] 
and although I’m trying, it might take a while. Then, I get on with the order.

I volunteer to give presentations
[https://ghost.stamurai.com/public-speaking-with-a-stutter/], and speak at our support group
[https://stamurai.com/sessions]. I cannot change how I speak, but I can
definitely change how I perceive my stutter. If I can normalize stuttering to
even ten people, I’d like to think I’m making a positive change in the world.

6. Taking Chances Are Easier Than You Think!
Not caring about what others think of my stuttering has made me a braver and
jollier person. I no longer feel the pressure to be perfect while ordering my
cuppa joe or making reservations at a new restaurant for weekend dinner.

I have almost never faced a negative reaction from the person taking the order
or from the people waiting in queue. If anything, they have been superbly 
supportive
[https://ghost.stamurai.com/changing-the-perception-about-stuttering-5-tips-for-talking-to-someone-who-stutters/]
.

Many baristas even remember me and greet me by my name before asking me if I
want my usual. A little meaningful human contact makes a lot of difference in
repairing the dents my own self-doubt has created on my confidence and
self-worth!

7. Honesty Is Refreshing
Joining stuttering support groups and attending virtual stuttering support group
meets has put me in touch with several people who are open about their daily
struggles.

I have also made some genuine friends who have helped me see how stuttering has
shaped my life, my career choices and guided me where I am today.

In the last few years, I have made it a point to state that I struggle with my
speech when I meet someone new. Hiding my stutter only makes it worse
[https://ghost.stamurai.com/channel-your-emotions-to-reduce-your-stutter/] and my friends
have given me the courage to be myself no matter where I am or who I am talking
to.

Stuttering is a part of who I am and there is no way I can avoid it. It is
indeed refreshing to be honest about myself.

8. Stuttering Has Helped Me Grow
Growing up is easy, but growing as a person can be a challenge for many.

Stuttering has helped me become less judgmental, more empathetic and sympathetic
towards others, and more tolerant towards others’ opinions.

Yes, in one way I couldn’t do a lot of activities I wanted as a kid. However, as
an adult, after rounds of speech therapy and CBT, I have come to realize that
stuttering didn’t keep me from participating in quiz club, debate club or music
club. It was me all along! I was too worried about whether other kids would
laugh at my disfluencies.

Well, guess, we’ll never find out if I’d at all fail, because I never tried any
of it.

This has made me see things in a different light. Stuttering has shaped my life
and I am where I am because I sound different from the others.

Everyone has their personal struggles, even if they don’t stutter.

So, I have nothing to be ashamed
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/] of, nothing to
regret or resent right now.

Last but not the least

I am here, sharing my thoughts, with a hint of confidence thanks to everyone who
loves me and supports me. Without my speech therapist and counselor it wouldn’t
have been possible to complete this personal journey and find the state of
quasi-peace I am in.

In fact, who knew this list could be so long! However, I do secretly wish that
with everyone’s help it keeps growing each year as I grow as a person.

8 Great Life Lessons Stuttering Teaches You

Down syndrome is a condition caused by an excess chromosome in one’s genome. It
is NOT a disease.

A person or child with Down syndrome
[https://www.ncbi.nlm.nih.gov/books/NBK526016/] may have an extra chromosome 21
(entirely or partially). It is a genetic disorder that is typically not
hereditary.

According to  the Centers for Disease Control & Prevention (CDC), around 6,000
babies in the US are born with Down syndrome.

What Are The Common Physical Features Of Down Syndrome?
The presence of “excess” genetic material results in traits typically associated
with Down syndrome.

 1. Low muscle tone
 2. Small stature
 3. Upward slant of the eyes
 4. A single deep crease across the palm

Although almost everyone with complete or partial trisomy of Chromosome 21 share
these physical traits, their cognitive and communication skills can vary
significantly.

How Is Stuttering Related To Down Syndrome?
The severity of the syndrome can vary and influence the person’s speech
accordingly. Children with Down syndrome often have disfluent to unintelligible
speech. Speech language pathologists (SLPs) note that children with Down
syndrome exhibit a complex interweave of phonological and motor-speech delay.

There is considerable debate as to whether the characteristic disfluencies in
the speech of children with Down syndrome can be considered stuttering
[https://ghost.stamurai.com/what-is-stuttering/]. However, the studies on disfluencies among
children and adults with Down syndrome prove that stuttering is more persistent
among them as compared to the neurotypicals.

While only 1% of the adults stutter, around 47% of those with Down syndrome
exhibit stuttering or stuttering-like-disfluencies.

Growing research on Down syndrome shows a strong bond between cognitive and
affective factors, and speech planning and production.

That brings us to the Demands and Capacities model. It suggests that those with
Down syndrome may be struggling more than the typical population to balance the
demand of smooth language production and the child’s capability to process
language.

A study
[https://www.sciencedirect.com/science/article/abs/pii/S0021992416301794] by
Kurt Eggers included 26 Dutch-speaking children with Down syndrome between the
ages of 3 and 13 years. It shows that 30% of the observed children have a
stutter. The number is significantly higher than the prevalence of stuttering
among the typically developing children.

A significant percentage of the population with Down syndrome have difficulty in
speech production for life. They can show signs of both stuttering and
cluttering. Their fluency typically wavers between 10% and 45%.

Why Is Traditional Speech Therapy Not Effective For Those with Down Syndrome?
One of the most prominent challenges in treating stuttering in children with
Down syndrome is their short attention span. According to Silverman
[https://onlinelibrary.wiley.com/doi/abs/10.1002/mrdd.20156], 2007, and Hula &
McNeil, 2008, during speech therapy, linguistic and non-linguistic tasks compete
for attention.

Down syndrome has been linked to the loss of hearing for up to 80% of the
population as studied by Sacks and Wood
[https://assets.cdn.down-syndrome.org/pubs/a/dsnu-03-2-038-en-gb.pdf] in 2003.
In such instances, visual cues may take precedence over auditory cues during
therapy. That makes conventional stuttering treatment less effective for them.

Therapists must adjust the course and nature of stuttering therapy for the
special needs of children and adolescents with Down syndrome. They prefer
learning through imitation since their cognitive process “tells” them to avoid
change and new challenges of learning. That significantly contributes to the
reduced efficiency of conventional therapy.

According to a review
[https://www.researchgate.net/profile/Monica_Bray/publication/237406961_Speech_production_in_people_with_Down_syndrome/links/54c6712c0cf2911c7a58d93a.pdf] 
by Monica Bray, Children with Down syndrome may imitate emotions and actions of
their chosen models. Self-awareness remains limited and so does the ability to
assess and process emotions in others.

Individuals with Down syndrome may have a wide range of emotional developments,
awareness and understanding of the self. Each individual may respond differently
to the cues they receive from others.

Therefore, keeping their mental health in check is just as important and
designing new therapeutic methods that can address their speech disfluencies.

How Can A Speech Therapist Help An Individual With Down Syndrome?
Speech therapists and speech-language pathologists (SLPs) must explore the level
of self-esteem and self-awareness in each individual. They should design an
array of activities that include pictorial representation, visual cues, and
action-based methods.

Using picture material may be more useful for the younger population. They must
ensure that the methods put minimal pressure on their language skills.

The SLP can then group the individuals with Down syndrome based on a number of
factors, including the result of activities like –

 * Dividing them into groups depending on the picture material or visual cues
   they like or dislike
 * Self-grouping based on those who are “like me” and “not like me”
 * Ranking self and others on the basis of who’s “the best” at art, making
   friends, talking, and sports

Coding and scoring the activities on the basis of the participants’ response
time can give the SLP a good idea about their cognitive skills, emotional
maturity, and self-awareness.

They must conduct in-depth interviews with the individuals and their
parents/guardians to explore their ability to comprehend specific social and
communication situations.

Next, the therapist must modify stuttering therapy for the individuals with Down
syndrome. Research shows that stuttering therapy can benefit an individual with
any fluency problem in a holistic manner.

Therefore, every speech therapy course should consider the following factors –

Affect
The higher the self-awareness of an individual, the more are the negative
feelings and attitudes associated with speech disfluencies like stuttering.

Speech therapy should focus on the feelings that arise from disfluencies. Apart
from it, programs to develop positive thinking and improve self-esteem should be
core features of any speech therapy program for adults and children with Down
syndrome.

Teaching the parents to praise children with Down syndrome each time they speak
with fluency has proven to be the strongest reinforcer.

One of the positive aspects of children with Down syndrome is that they may show
signs of frustration during disfluency, but they don’t show signs of
internalized shame or guilt. That is one of the traits speech therapists should
explore and strengthen to boost self-esteem.

Behavior
Altering behavior change in speech consists of fluency shaping, speech
modification, or a combination of both.

For adults who stutter, a high cognitive load can impact fluency. It is the same
for children and adults with Down syndrome.`

It is difficult for those with Down syndrome to learn and memorize new speech
patterns, since it may further contribute to their disfluency.

It is necessary for speech therapists to focus on their strengths which may
include –

 * A willingness to communicate
 * The lack of internalized shame and guilt
 * The ability to respond to visual approaches like singing and reading

Focusing on the strengths can help enhance the fluency and communication skills
of those with Down syndrome.

Cognition
Cognitive approach to stuttering therapy emphasizes changing attitudes. However,
due to limited self-awareness of one’s speech pattern and disfluencies, 
traditional speech therapy
[https://ghost.stamurai.com/stuttering-therapy-for-school-aged-children/]and cognitive
behavioral therapy (CBT) has limited efficiency in the case of individuals with
Down syndrome.

It is up to the SLP to develop newer and innovative methods to develop and
maintain positive communication skills like maintaining steady eye contact and a
confident stance. These have shown to be successful on everyone with learning
difficulties including those with ADHD, autism
[https://ghost.stamurai.com/stuttering-and-autism-spectrum-disorder-diagnosis-and-treatment-in-children/]
, and Down syndrome.

What Gives Hope To Speech Therapists And Parents Of Children With DS?
Speech therapy for anyone with a limited attention span, or high preference for
visual cues only may pose an unlimited number of challenges. However, a research
review published by Monica Bray shows that most people with DS have an inherent 
willingness to communicate
[https://ghost.stamurai.com/benefits-of-talking-to-other-people-who-stutter/], high
self-esteem, immunity to guilt and shame related to speech disfluencies and a
general interest in people. These factors provide speech therapists with
multiple scopes to modify traditional speech therapy and improve the
communicative situation.

Down Syndrome & Stuttering: What You Should Know

WHO defines stuttering as disorders in speech rhythm during which the person who
stutters knows what they want to say, but they are unable to do so due to
involuntary blocks, repetitions and prolongations of sounds or words.

How is it that stuttering is common in almost all cultures across the world?
Does language have any impact on stuttering? If someone speaks more than one
language, do they stutter equally and similarly in all of them?

Defining, observing and treating stuttering is comparatively easy when the
speaker is monolingual. When the person speaks and stutters in more than one
language, it results in additional complexity.

What Is Bilingualism?
1% of the world’s population stutters, but more than 60% of the world’s
population is bilingual. There is a high chance that speech-language
pathologists (SLPs) encounter one or more individuals daily, who stutter and
speak more than one language.

There is no universally-accepted definition of bilingualism. The term typically
refers to the simultaneous and alternating use of two languages by an
individual. It can also signify the individual’s fluency in one language and a
limited extent of knowledge in a second language.

In past research, “bilingualism” has been referred to as “the use of two or more
languages” (Borsel et al, 2000).

Manifestation of Stuttering in the Bilingual Population
Over the last few years, attention has shifted to the incidence of stuttering in
the bilingual population. According to a literature review by Borsel et al in
2000, stuttering may be more prevalent in people who speak two or more
languages, as compared to people who speak just one.

According to Nwokah (1988), a bilingual individual may stutter in both
languages, but the disfluencies can manifest differently in each language. The
review further states that the speech disfluencies may affect one or all the
languages equally.

There are rare cases when the individual may experience a higher frequency and
intensity of stuttering in a particular language. At the same time, the
individual may be almost fluent in another language.

Nwokah suggests that in such cases, the individual might be significantly more
proficient in conversing in one language as compared to the other.

What Are the Different Types of Bilingualism?
Everyone who speaks more than one language has picked up the second language
either at a very young age (simultaneously with their first language), during
elementary school (7 to 12 years old) or high school, or later in life (12+
years of age).

Au-Yeung et al (2000) categorized bilinguals into three broad groups that have
helped speech-language pathologists (SLPs) note their observations on the link
between stuttering and bilingualism.

i. The early bilinguals
These are individuals who began learning a second language almost simultaneously
with their first language or mother tongue (simultaneous bilingualism). They
completed acquiring and mastering the second language by the time they were 6
years old.

ii. The middle bilinguals
Individuals who have begun learning the second language between the ages of 7
and 12 years. Travis et al and Mussafia et al have studied and discussed
consecutive bilingualism in their respective work.

iii. The late bilinguals
These are people who have begun the acquisition of the second language after the
age of 12. They may have also chosen to learn the second language later in their
teenage years or in adulthood.

What Is The Prevalence Of Stuttering In Bilinguals?
In one of the earliest studies [https://pubs.asha.org/doi/10.1044/jshd.0203.185] 
on bilingualism and stuttering conducted by Travis, Johnson and Shover (1937),
the stuttering prevalence among 4,827 children surveyed were around 1.80%, 2.80%
and 2.38% for monolingual (English-speaking) kids, children who spoke two, and
more than two languages in addition to English respectively.

The study subjects were between 4 and 17 years old. 2405 participants in the
study were boys and 2,422 were girls. The determination was based on observation
of the subjects’ reading, and conversation fluency in all languages.

An interpreter was present for children who spoke languages other than English.

The results showed that the stuttering prevalence was significantly lower in
monolingual children (1.80%) as compared to those who speak two or more
languages (2.80% and 2.38% respectively).

A similar study by Stern in 1948
[https://sajcd.org.za/index.php/sajcd/article/download/535/647] involved 1861
children from 4 different schools in Johannesburg (South Africa). It showed that
stuttering prevalence was 1.66% in monolingual and 2.16% in bilingual children.

At the same time, the severity rate of stuttering was much higher in bilinguals
who stuttered as compared to monolinguals who stuttered.

However, both studies had one major drawback
[https://www.researchgate.net/publication/7245664_The_Effect_of_Sample_Size_on_the_Assessment_of_Stuttering_Severity]
– the clinical judgments were based on single assessment only. According to
Ingham and Costello (1984) single assessment studies are not enough to report
stuttering like disfluencies.

A working alternative is the introduction of self-reports that can gather data
including age, gender, ethnic background, education levels, occupational
background, age of learning the second language etc.

Except for the research published by Au-Yeung et al (2000), the available data
shows that stuttering prevalence is much higher in people who speak two or more
languages as compared to those who speak only one language. Studies published by
Travis et al indicate a direct link between bilingualism and stuttering.

Factors That Influence Stuttering In A Bilingual Population
A significant percentage of the world’s population is bilingual, but only 1% of
the total population stutters. While there’s not much we know about the
percentage of people who stutter covertly, we do know that not everyone who is
bilingual has or had speech disfluency.

In 1937, Travis et al
[https://www.researchgate.net/publication/344392754_Bilingualism_as_a_Purported_Risk_Factor_for_Stuttering_A_Close_Look_at_a_Seminal_Study_Travis_et_al_1937] 
suggested a direct link between stuttering and bilingualism. For almost 26% of
those who stuttered, there was a relationship between the introduction of a
second language with the onset of their stuttering.

In another study by Pichon and Borel-Maisonny (1964), there was a strong
suggestion that stuttering could be ascribed to bilingualism in 14% of their
subjects.

So, what are the factors that influence the prevalence of stuttering in a
bilingual population?

Synaptic Overload
Karniol [https://journals.sagepub.com/doi/10.1177/014272379201203604] suggested
that in order to determine a direct link between stuttering and bilingualism,
one has to consider the probability of synaptic overload. The 1992 study
referred to a neuroscience model proposed in a 1989 study
[https://www.sciencedirect.com/science/article/abs/pii/0094730X89900284]by
Nudelman et al. The model proposes that speech disfluencies may reflect
instances of instability in the language acquisition, processing and production
loop in the brain.

Demands and Capacities of Language Processing
Another model Karniol and other researchers have considered and dismissed is the 
Demands and Capacities model
[https://www.sciencedirect.com/science/article/abs/pii/0094730X9090015K] by
Starkweather (1987). According to this model, a child shows
stuttering-like-disfluencies when they lack the capacities to meet the fluency
demands of more than one language.

Genetic Predisposition and Environmental Factors
Travis et al [https://pubs.asha.org/doi/10.1044/2020_JSLHR-20-00364] also noted
that 97.2% of the bilinguals who were also a part of the same study, didn’t
stutter at all. Similarly, Mussafia observed in his study that children were
susceptible to speech and language disorders when they have to pick up a second
language suddenly and abruptly.

Other factors Travis et al considered in their research included –

 * The economic insecurity in the homes of migrants whose children typically
   spoke more than one language
 * The stress and confusion of moving from one state or country to another
 * The stress of picking up a new language that is not typically spoken at home
   of migrant children

Possibly, the most important and relevant observation regarding the relationship
between bilingualism and stuttering comes from the studies of Lebrun and Paradis
(1984). They mention that stuttering may be a result of the input of mixed
language utterances around children who are already predisposed to stuttering.

Brain Structures Involved in Language Acquisition and Processing
In 1997, imaging studies [https://www.nature.com/articles/40623] published by
Kim et al on late bilinguals showed that second and native languages were
spatially distinct in the Broca’s area. Whereas, in the case of early and middle
bilinguals the native and second languages are represented in the common frontal
cortical areas.

The same study inspires the discussion that the middle and early bilinguals are
more susceptible to stuttering due to high demands of functioning of the same
brain areas for both languages.

Limitations In The Research On The Link Between Bilingualism And Stuttering
There isn’t enough research to indicate the reason behind the strong link
between stuttering and bilingualism.

Another link that remains to be investigated is the one between the similarities
of the two or more languages spoken by the children who stutter.

The current hypothesis is that two closely related languages may lead to further
confusion and more disfluencies in children who have picked up the second
language later in life.

A contradictory hypothesis is that two unrelated languages may require more
resources and cause more disfluencies in children predisposed to stuttering.

However, one of the most common observations in studies by Au-Yeung et al, and
Travis et al is that disfluencies are less common among middle bilinguals as
compared to early and late bilinguals. Nonetheless, the apparent “immunity” of
adults towards the development of stuttering is unclear.

So, What Can We Tell About Stuttering and Bilingualism?
There is more to bilingualism and stuttering than we currently know. Last six
decades of studies and research show that children (predisposed to stuttering)
who picked up a second language while staying in a vulnerable or new environment
have grown up to retain their stutter.

It is for certain that the middle bilinguals are more susceptible to stuttering
as compared to early and late bilinguals.

There is no saying whether a person will stutter similarly in all the languages
they speak. We must not forget that stuttering is highly heterogeneous. Apart
from genetic predisposition, anomalies in the brain structure and possibilities
of synaptic overload, there might be other factors that scientists and SLPs are
yet to explore.

Understanding the Link between Bilingualism & Stuttering

For adults, who have been stuttering ever since their childhood, the goal for
stuttering treatment isn’t cure. Freedom from stuttering is something every
person who stutters wants. However, in most cases of adults who stutter, it is
impossible to cure their disfluencies completely.

People who stutter (PWS) have spent a majority of their lives trying not to
stutter. They have tried to hide their stutter, they have tried to not talk and
they have also Googled “How do I stop stuttering?” a hundred times hoping for a
quick cure.

Trying to not stutter hasn’t worked. In fact, trying too hard has only made the
stutter worse.

The fact is, if you have stuttered ever since you were a child, you will
probably stutter for the rest of your life
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/]. So why not
make life a little more enjoyable and a lot less tense?

Now, what we are going to tell you might sound a little weird – we are going to
ask you to stutter on purpose.

You may wonder how stuttering more can help you stutter less. Isn’t it
counterintuitive?

Well, according to the stalwarts of speech-language pathology like Charles Van
Riper, Barry Guitar, and Peter Reitzes, voluntary stuttering or clonic pseudo
stuttering can give the control of your speech back to you.

What is Voluntary Stuttering?
Voluntary stuttering or clonic pseudo stuttering is defined as a method that
involves stuttering on purpose. The person who stutters enters into a
conversation with another person with the plan to stutter on every third word.
It is typically a monosyllabic repetition that is similar to organic stuttering.

Wendell Johnson (1959) used the term bouncing to refer to the same method.
Although, in current practice, speech-language pathologists (SLPs) use the term 
bouncing to describe another active process to initiate smooth speech.

How Does Voluntary Stuttering Help the Speaker?
Voluntary stuttering is an active process as opposed to DAF
[https://ghost.stamurai.com/daf-stuttering-guide/], FAF, and choral speaking, which experts
refer to as passive stuttering inhibitors. Active pseudostuttering is one of the
single most powerful tools that an adult can use.

While it has many purposes, the leading one is to get stuttering out in the
open. The person doesn’t have to anticipate a stutter
[https://stamuraiapp.medium.com/understanding-stuttering-anticipation-to-reduce-your-stutters-fea5553bb0ac] 
if they plan to stutter on every third word or the beginning of every sentence
anyway.

By introducing stuttering at the beginning of the very conversation, the speaker
takes control of the narrative. They can control how, where, and when the
repetitions occur. It takes out the fear and anxiety of stuttering
[http://www.mnsu.edu/comdis/cahn_mnsu_edu/8reitzes/_disc29/00000006.html] from
the equation completely.

[https://stamurai.app/z4HKmlNXigb]What Goals Can You Set With the Help of
Voluntary Stuttering?
Voluntary stuttering may have multiple goals and purposes. These typically
depend on the severity of one's stuttering, the age of the person who stutters,
and their mental health status.

Stuttering affects more than a person's speech. It can affect a person's
self-worth, confidence levels, approach behavior, risk-taking attitude, and
personal and professional relationships.

Here are some objectives that stuttering on purpose can meet –

1. Desensitization – You are a good person when you don’t stutter and you are a
good person when you do!
Many of us who stutter and have been doing so for decades often try to hide it.
We try to hide our stuttering.

For example, we have a list of feared words. We avoid words that begin with hard
consonants. Maybe, as a child, we were bullied
[https://ghost.stamurai.com/reining-in-the-bullies/] incessantly because we used to get stuck
on words beginning with /b/. Now, we put in conscious effort to avoid all words
that begin with /b/.

It takes a toll on our communication skills since finding a synonym with the
exact meaning and nuances is not always possible. We often choose to remain
quiet even when we want to speak for the fear of stuttering.

When you take up voluntary stuttering, you may choose to stutter on the first
word of every sentence, whether it starts with /b/ or not. Stutter noticeably,
and boldly. You can couple your pseudostuttering with voluntary eye blinking,
head nodding, or hand movements.

We often feel that we have little control over our speech. After practicing
voluntary stuttering for a while, you may begin to realize that you have control
over your speech after all. Stuttering is a natural part of your speech. There
is no reason to fear it or hide [__GHOST_URL__/guide-to-covert-stuttering/] it.

Voluntary stuttering can help you create a new self-image. The transformation
from a person avoiding and hiding stuttering to proudly brandishing it is
entirely possible.

It may take a month for some, or three months for others, but clonic pseudo
stuttering can give you a taste of freedom from the fear of stuttering like no
other active speech therapy technique.

[https://stamurai.app/z4HKmlNXigb]2. Moving forward with one’s speech – It’s not
important how many times you get stuck; it’s important to keep moving
Easy stuttering can allow you to move past a moment of blocking and intense
repetition. It is a form of stuttering modification that uses voluntary
stuttering to begin a feared word.

For example – you are aware that you will get stuck on the /b/ of “buds”. Speech
therapists recommend easing into the word by prolonging the /b/ sound and
initiating the next vowel to move forward.

However, the struggle is very different for those who stutter. People who
stutter tend to feel confused, angry, and frustrated when they find themselves
stuck. Applying such speech modification techniques becomes almost impossible
when one is unable to think. Hence, applying the common techniques
[https://ghost.stamurai.com/stuttering-exercises-for-adults/] for reducing stuttering may be
challenging during an ongoing repetition.

Voluntary stuttering can prepare you for such situations. Instead of feeling
overwhelmed with anger, frustration, and shame, you may be able to find the
calmness to apply subsequent techniques necessary to get out of the stutter and
move forward with your speech.

Clonic pseudostuttering will help you apply easy onsets, pull-outs, and bouncing
like techniques to your speech for moving smoothly through the moments of
stutter.

3. Building listening skills – Own your stutter to listen to others
During many instances of particularly severe stuttering
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/], we become so
focused on our own speech that we forget to listen to what others are saying.

When you become accustomed to stuttering after stuttering-on-purpose for weeks
or months, your own stutter may bother you less than before. It will allow you
to focus on things other than your own speech disfluencies.

You will not only be able to listen to what others are telling you, but also
find participating in conversations more rewarding.

Your self-doubt will take a backseat. That is when you will truly become aware
of your role and importance in a meeting, group discussion, or a casual
conversation.

4. Overcoming the shame of stuttering – Give yourself the power to control
narratives
Stuttering and shame [__GHOST_URL__/stuttering-in-children-understanding-shame/] 
have shared a strong bond. Whether it’s a teenager or an adult, they know shame
all too well, if they have been stuttering since childhood.

Shame keeps us from achieving our true potential. It stops us from taking
chances in life.

People who stutter rarely maintain eye contact while speaking. We tend to look
away or look at the listener’s hands or feet when a stutter sets in. That also
conveys to the listener that stuttering is something shameful – one should look
away during a moment of disfluency.

Humans mimic each other’s body language to a great extent during a conversation.
Voluntary stuttering gives you the chance to take control of the situation. If
you are not ashamed of stuttering, it shows the listener that they shouldn’t
look away either.

It is a powerful tool that may change how your listener perceives your
stuttering and speech. You can set the comfort level by entering a conversation
to stutter on purpose. That will take away the power of the real stutters when
they occur.

5. Reducing stuttering – The ulterior motive of every stuttering therapy tool
Voluntary stuttering can reduce
[https://link.springer.com/article/10.3758/BF03194876] actual stuttering. One of
the most famous accounts comes from Lon L. Emerick. According to Emerick, the
more one stutters on purpose the less they are likely to hold back. That makes
them unlikely to stutter severely.

His team once worked with an exchange student who almost overcame her stuttering
in less than a week. All she did was meet and greet 947 people in less than
seven days and stuttered all she could. By the end of that week, she was
exhausted, but she could no longer stutter!

While that is a one-of-a-kind incident, it is entirely possible to at least
reduce one’s stutter by engaging in the practice of pseudostuttering.

According to accounts presented by Peter Reitzes, people have reported that
their real stutter became less or almost disappeared when they practiced
voluntary stuttering for weeks. He believes that it is the diminished fear and
apprehension that contributes to a significant reduction in the frequency of
one’s stuttering.

How To Incorporate Voluntary Stuttering in Daily Conversations?
How you stutter voluntarily will have a massive impact on the benefits you
enjoy. Studies by Byrd et al (2016) show
[https://pubs.asha.org/doi/10.1044/2016_AJSLP-15-0018] that clients experience
more benefits from clonic pseudostuttering when they try to match it closely to
their actual stuttering.

At the same time, the clients who enjoyed maximum benefits were the ones who
employed voluntary stuttering outside a clinical environment.

First, decide how you are going to apply the technique. If you have a problem
with your /d/, /b/ and /k/ think about stuttering on every other hard consonant
like /p/, /t/ and /s/.

You can also decide to stutter at the start of every sentence that begins with a
hard consonant.

Here are some situations where you can apply voluntary stuttering –

 * While ordering food – always try to ask a question or inquire about a
   particular dish.
 * During a lecture or a meeting ask pertinent questions.
 * Answer your phone [__GHOST_URL__/phone-calls-stuttering/] at least thrice a
   day. If you don't get calls, call a friend, family member, or a supermarket.
   Talk boldly complete with voluntary stutters.
 * While traveling by bus or the subway, ask a complete stranger what the next
   stop is.
 * While eating out, thank the waiter/waitress for their service.
 * Talk to your family about voluntary stuttering while applying the technique.
 * Meet your friends or make a Zoom call and tell them about your latest
   venture.

[https://stamurai.app/z4HKmlNXigb]Are You Practicing Voluntary Stuttering
Correctly?
The first step to enjoying the benefits of voluntary stuttering is accepting
your stutter. Once you stop putting in the immense effort necessary to hide your
stutter, you will find a sense of liberation and empowerment.

Next, you need to start stuttering boldly, noticeably, and in a manner similar
to your real stutter. Cheating by stuttering softly, or almost inaudibly doesn't
yield favorable results.

Practicing pseudostuttering only in front of the SLP is not enough. You need to
extend your voluntary stuttering practice to real conversations outside your
current comfort zone.

Set short-term goals for yourself. For example – "today I will voluntarily
stutter in front of 5 people". Note down your experience, feelings, and
perceptions from Day #1. You can track your progress in a journal. Or, you can
use an app like Stamurai to monitor your stuttering goals and fluency.

Talk to your SLP and cognitive-behavioral therapist about how your perceptions
about stuttering are gradually changing as you master voluntary stuttering.

For some it takes a mere month, for others, it may take half-a-year.
Nonetheless, the positive impact of voluntary stuttering is inevitable,
especially when you are working with a speech therapist.

Voluntary Stuttering: How Can It Help With Fluency?

Stuttering is a speech disorder, which cannot always be cured. Teens and adults
who have been struggling with stuttering for years face difficulty in attaining
fluent speech.

What Is Fluency Shaping?
Fluency shaping (FS) includes multiple operant techniques that may replace
stuttered speech with fluent stuttering.

In the early days of speech therapy, fluency shaping was used by experts without
the aid of modification techniques. The trend was to provide little attention to
the emotions, attitudes, and feelings of people who stutter (PWS)

According to Barry Guitar, in his 1982 publication
[https://journals.sagepub.com/doi/abs/10.1177/152574018200600106] in the Journal
of Childhood Communication Disorders, fluency shaping works best when Speech
Language Pathologists (SLPs) use it in conjunction with other techniques. It
works most effectively as a part of broader speech therapy programs.

One of the unique features of fluency shaping is that it does not teach people
who stutter to confront their disfluencies for speech modification. SLPs who
advocate stuttering modification techniques teach their clients to confront
their stuttering.

[https://stamurai.app/z4HKmlNXigb]In stark contrast to stuttering modification
techniques, fluency shaping does not delve deeper into the feelings and
attitudes that result from stuttering.

SLPs use a combination of fluency shaping techniques to address a client’s
stuttering. The techniques depend on the age of the client, and the severity of
their stuttering among other factors.

Here in this post, we will shed light on some popular fluency shaping techniques
you may come across during stuttering therapy.

Several speech therapists utilize a variation of the original prolonged speech
technique described by Goldiamond in 1965. Deliberately prolonging one’s speech
can modify stuttering in clients of any age.

An SLP can utilize the following fluency shaping techniques to prolong their
client’s speech –

1. Slowed Speech or Stretched Syllable Technique
The first step to fluency shaping is mastering very deliberate and slow
speaking. The typical rate recommended by an SLP can be around 40 to 60
syllables per minute.

How to Practice Slowed Speech or Stretched Syllable Technique?
 1. Break every word down to its syllables. For example, “Lemon” would be broken
    down to “le” and “mon”.
 2. Try to stretch out every syllable for at least 2 seconds. Make sure to
    stretch the first sound in the syllable.

For example, in “Lemon,” you should stretch out the “L” for a second before
saying “e” for the next 2 seconds. Do the same for “mon”. It should sound like
“Llll (1 second)-eee (2 seconds)” (rest) “mmm (1 second)-ooon (2 seconds).

This rate sounds quite unnatural. Without the guidance of a trained speech
therapist or an interactive speech therapy app [https://stamurai.com/], you may
find it challenging to attain this speech rate.

However, once you master slowed speech, the SLP will introduce you to faster
speaking rates of up to 150 syllables per minute. It is the typical syllable
rate of adults who are fluent.

B, D, G, H, F, K, P, S, T, SH, CH, and TH are unvoiced or stop speech sounds
which you should never stretch. When you encounter these sounds, instead of
stretching them, move through them quickly and stretch the next stretchable
sound, which may include – A, E, I, O, U, J, L, M, N, R, V, W, Y, Z, or a voiced
TH.

[https://stamurai.app/z4HKmlNXigb]2. Diaphragmatic Breathing
People who stutter may develop poor breathing strategies as they struggle with
 blocks and repetitions for many years. Quick and shallow breathing, gulping for
air, or trying to squeeze out air are some practices PWS acquire due to their
struggles with long-term disfluencies.

Costal breathing or diaphragmatic breathing techniques can help you take back
control of your breath and voice.

How to Master Diaphragmatic Breathing?
 1. Place one hand on your chest and one on your belly. Feel your mouth, jaw,
    throat, and neck relax as you breathe out.
 2. Take a deep breath. Feel your belly rise to the fullest extent.
 3. Breathe out all the air. Feel your belly fall. Relax your diaphragm.

Keep following steps 2 and 3 till you feel yourself completely relaxing.
Diaphragmatic breathing is all about relaxing completely. It will also relax
your articulator muscles. You will require diaphragmatic breathing in all the
fluency shaping techniques we discuss subsequently.

3. Light Articulatory Contacts
While pronouncing words like “Put,” “Butter,” or “Pet,” we have to bring our
lips together briefly to produce the initial sound. Similarly, while saying
words that begin with “E,” we need to pull our vocal cords together.

These point-contacts can lead to blocks. Light articulatory contact (LAC) can
help you overcome these blocks and move on with the word.

Steps to Apply  Light Articulatory Contracts (LAC) Fluency Shaping Technique
 1. Your first task is to determine which articulators you use to make a sound.
    For example, to say “ball,” you are primarily using your lips to make the
    /b/ sound.
 2. Next, feel your mouth come into that position to say that sound.
 3. Make the lightest touch of your lips (in this case) to make the /b/ sound
    and continue with the word.

It’s as simple as that! LAC can help you say even the worst-feared-words with
the least bit of stuttering.

4. Gentle Initiation Technique
One of the foremost goals of fluency shaping is to lessen the tension on the
muscles involved in speech production. Excess pressure on the laryngeal muscles
can prevent them from coming together and moving in harmony with one another to
produce smooth speech.

People who stutter face blocks too often due to vocal cords “turning on”
suddenly or abruptly.

In easy phrase initiation, the SLP teaches the client to not apply hard force
while producing the first sound of every word or syllable.

How to Practice Gentle Initiation Technique
 1. Assume a low volume and begin speaking with the lowest vibrations of the
    vocal cords.
 2. Gradually increase the volume, and strength of your voice to a level that
    feels normal for you.
 3. Decrease the strength and volume back gradually to the initial soft level
    once again.

You don’t have to stretch. Apply this technique to each syllable. It may sound
artificial and unnatural at first. However, once you master this fluency-shaping
technique, you can apply it organically for achieving fluent speech sans blocks
and repetitions.

[https://stamurai.app/z4HKmlNXigb]5. Passive Airflow Technique
To master the passive airflow technique, you should already be familiar with
diaphragmatic breathing and stretched syllable techniques discussed above.
Passive airflow technique should ease the beginning of sentences and maintain
fluency.

Follow These Steps to Practice Passive Airflow Technique
 1. Take in a complete breath (like diaphragmatic breathing).
 2. Let out a little bit of air (the passive exhale).
 3. Start speaking using the stretched syllable technique you have already
    learned, once you have let the passive exhale out.

The small volume of air you let out before you begin speaking will keep your
vocal folds relaxed and open. It will prevent blocking while you finish your
sentence.

Just remember not to rush through, but to apply the stretched syllable technique
and LAC wherever necessary.

6. Continuous Phonation
It borrows a leaf from singing to keep your speech smooth and effortless. Think
of it as a way to keep your voice “turned on.”

You will need to practice diaphragmatic breathing, stretched syllables, and
passive airflow techniques to learn and apply continuous phonation.

How to Practice Continuous Phonation
 1. Focus on your articulators once again.
 2. Maintain constant and continuous airflow as you speak.
 3. You should aim at reducing the break between words.

It is important not to rush through. Continuous phonation is a little difficult
to master. You may need the help of an experienced speech therapist. They can
help you get the feel of the continuous vibrations as you keep your voice
“turned on”.

It is imperative for anyone who stutters to master the previous techniques
before they can start with continuous phonation.

[https://stamurai.app/z4HKmlNXigb]What Is the Difference between Fluency
Enhancement & Stuttering Modification?
Fluency shaping or fluency enhancement involves techniques like deep breathing,
slowed speech rate, light articulatory contact, and gentle initiations. These
are all strategies that facilitate more fluent speech.

Fluency shaping strategies aim to help you speak with increased fluency.
Improving your fluency of speech makes you confident and reduces negative
feelings regarding stuttering.

Stuttering modification strategies, on the other hand, involve exercises and
techniques that work directly on one’s stuttering.

These are exercises that help people increase their awareness about how and when
they stutter. They may decrease one's fear of stuttering by facilitating
desensitization and reduction of avoidance behaviors. Stuttering modification
involves predicting and catching one’s stuttering as it’s about to happen. Then,
applying strategies to reduce the struggles
[https://ghost.stamurai.com/overcome-stuttering-blocks/] and allowing stuttering
in a more relaxed manner.

Stuttering modification techniques involve strategies like catching the stutter,
relaxing the stuttering, pulling out, and cancellation.

Long-term Effects of Fluency Shaping Techniques
In recent publications, researchers have demonstrated that practicing fluency
shaping techniques has a long-term impact on the auditory-to-motor pathways
inside the human brain.

It is well-known that fluency-shaping enhances the speech fluency of the person
who stutters. However, the neuroplasticity-related impact of fluency-shaping was
unknown until recently. The new research sheds light on what happens after you
master and practice fluency shaping techniques daily.

According to Korzeczek et. al
[https://www.sciencedirect.com/science/article/pii/S1053811921010089]., it
increases the connectivity within the sensorimotor integration network. The
enhanced fluency comes from a strengthened auditory-to-motor coupling and
enhanced integration of the command-to-execution pathway.

Thus, speech therapy can “rewire” your brain and help you speak more smoothly.

Conclusion
Fluency shaping techniques have helped reduce stuttering and induce fluency in
thousands. However, it is most effective when used with speech modification and
cognitive behavioral therapy on clients.

The success of fluency shaping techniques also depends upon one’s willingness to
practice and apply them to everyday conversations. Tracking one’s progress is
also of utmost importance while implementing these techniques.

You should work with your speech therapist to learn and use fluency shaping
techniques. Or, you can use an app like Stamurai [https://stamurai.com/] to
master fluency shaping techniques discussed in this post and various stuttering
exercises [__GHOST_URL__/stuttering-exercises-for-adults/] that we
have discussed in another post!

Stuttering: 6 Fluency-Shaping Techniques

With new studies on stuttering, it is becoming apparent that it may share more
than one link with neurodevelopmental disorders like Attention Deficit
Hyperactivity Disorder (ADHD). Between 3% and 7% of children in the US are
diagnosed with ADHD each year.

Does ADHD increase a child’s chances of developing a stutter? If your child
stutters, should you get them checked up for ADHD as well?

Come, let’s explore the facts and stats together!

What is Stuttering?
Stuttering or stammering is a speech disorder. It involves disruptions of speech
flow with repetitions, blocks, and prolongations.

Children may begin showing symptoms of stuttering
[https://ghost.stamurai.com/is-stuttering-biological-or-psychological/] as young as 18 months
old. As per research, the incidence of developmental stuttering coincides with
the rapid expansion of a child’s language skills and vocabulary.

Between 5 and 10% of all children [https://www.nidcd.nih.gov/health/stuttering],
either stutter or will do so in their life. The stuttering can last from a
couple of weeks to several years or even their lifetime.

What is ADHD?
Attention deficit hyperactivity disorder (ADHD) is one of the most commonly
diagnosed neurodevelopmental disorders in children in the US and across the
world. Experts typically base their diagnosis of ADHD on three symptoms –

 1. Impulsive behavior
 2. Short attention span
 3. Hyperactivity

Children diagnosed with ADHD often show language and communication disorders.
Reports suggest that 16% to 37% of children with ADHD also show signs of
language impairment.

How Are Stuttering and ADHD Related?
Studies by Baker and Cantwell, 1992, report that children with ADHD also show
articulation disorders. The research findings are in agreement with previous
studies (Zental et al, 1983).  They show that children with ADHD have a higher
incidence of speech disfluencies as compared to those without ADHD.

A survey found that among 109 children who stuttered, 4% had signs of ADHD. A
significant percentage of the children who stutter have ADHD, although it is not
a popular subject of research.

Both stuttering and ADHD arise due to anomalies in the structures of the brain.
Not one but several areas of the brain are involved in the production and
processing of speech. One of them, Broca's area is also involved in ADHD.

Broca’s area is critical in the production and processing of speech.

Those with ADHD have low rates of spontaneous neural activity. People with ADHD
exhibit several functional anomalies in Broca’s area. The study
[https://www.researchgate.net/publication/272145137_Functional_abnormalities_in_Broca's_area_in_adolescents_with_ADHD_A_resting-state_fMRI_study] 
indicates an overall lower level of activity in a particular area of the brain
in the study group.

Recent brain imaging studies have shown that children and even adults with ADHD
may have a smaller Broca's area as compared to those who don't.

Similarly, neuroimaging studies by Chang et al in 2008 show that children who
stutter and those who have recovered from stuttering (after therapy) possess
deficits in the areas of the brain related to the production of speech.

The deficits involve less gray matter volume in the frontal lobe including the
Broca's area. It can affect speech interpretation and processing developed in
the Wernicke's area followed by speech planning and execution in the Broca's
area.

The link between ADHD and stuttering is not merely acquired or behavioral. The
connection lies deep within the frontal lobe of one’s brain.

Recent studies suggest that the treatment of stuttering in those with ADHD is
entirely possible. However, due to short and inconsistent attention spans,
hyperactivity, and/or impulsivity, speech language pathologists (SLPs) need to
modify the stuttering therapy protocols.

Kerianne Druker studied [https://pubmed.ncbi.nlm.nih.gov/30477807/] 185
preschool children who stutter in 2018. She noted that 50% of the study group
exhibited elevated ADHD symptoms. These were also the same children who needed
25% more clinical intervention and attention to achieve the same levels of
fluency as those who didn’t exhibit ADHD symptoms.

Druker’s study showed that ADHD impedes the recovery rate of children who
stutter. The severity of ADHD symptoms directly influences the response time to
therapy and impedes their fluency outcome.

How to Treat Children with ADHD Who Also Stutter?
Treating stuttering in children, who also have ADHD, should account for their
difficulties in focusing, behavioral problems, and communication issues.
Therefore, speech therapy for children with ADHD needs to be modified to adapt
to treatment objectives.

Here are a few ways speech therapists and SLPs modify stuttering treatment for
children with ADHD –

Medication
Although there is no medication for stuttering
[https://ghost.stamurai.com/stuttering-medicine/], there are several compounds that doctors
prescribe for ADHD. One of the most common and popular ones include Ritalin
[https://www.health.harvard.edu/blog/adhd-medication-for-kids-is-it-safe-does-it-help-201603049235] 
(methylphenidate).

It helps children become more receptive to external stimuli. The effects of the
medication peak after 1-hour of consumption. It provides speech therapists with
a roughly 2-hour window to talk to the child, assess their knowledge and
attitude towards stuttering, and teach them fluency techniques.

Modification of the Environment
Environment plays a significant role in how a child with ADHD reacts. For
example, a classroom with a window overlooking a garden or playground may be
overly distracting for the child.

On the other hand, a closed room with muted colors and no artwork on the walls
can help the child focus. Combining medication with a modified environment can
help SLPs reach out to a child with ADHD who also stutters.

Mode of Instruction
Children with ADHD often perform well when placed alone instead of in big
groups. Whenever possible, SLPs should insist on one-on-one therapy with the
child instead of group therapy.

Most importantly, the duration of the instruction should not exceed the
attention span of the child. It is the therapist’s responsibility to keep the
sessions interesting for the child.

Behavior Modification
Increasing positive behavior can be quite challenging initially since children
with ADHD may appear impulsive and hyperactive. However, positive reinforcement
has been shown to be most effective in modifying the behavior of children who
have ADHD.

For example, the SLP can establish a reward system. Each time the child
identifies a disfluency they can receive a token. They can later barter the
tokens for reinforcers like playtime or toys.

SLPs should remember that children with ADHD will require considerable positive
reinforcements. Therefore, they should provide reinforcers quite frequently.

Language Training
ADHD impairs social and communication skills in children. It is up to the SLP to
teach the child to be a good listener while teaching them to identify and reduce
disfluencies.

SLPs should emphasize the importance of steady eye contact, and waiting for
one's turn to speak. That can teach a child to become a good communicator as
well.

Stuttering and ADHD share quite a few neurological factors. Therefore, it is no
surprise that a significant percentage of children who stutter also have ADHD.

ADHD makes treating stuttering in children all the more challenging due to the
short attention spans and hyperactivity. However, it isn't impossible. With
experience and patience, an SLP can have a breakthrough with a child who
stutters who has ADHD.

If you suspect that your child is showing signs of stuttering, speak to a speech
therapist and get them checked up for signs of ADHD. Starting therapy early can
help them learn good communication and social skills. It will help your child
make friends, take chances, and embrace success in life.

ADHD & Stuttering: Are They Related?

Patrick Thornton is a 40-year-old teacher from Huston, Texas. He started feeling
sick back in August 2020 and the same month he tested positive for COVID 19. By
the end of September, he was on his road to recovery. He no longer had a
temperature, headache, shortness of breath, cough, or congestion. His sense of
taste and smell was back. These were obviously good news.

He also had a sore throat which was gradually improving and by mid-September, he
had his voice back! So imagine his surprise when his mom’s call woke him up on
September 25 from a nap and he found himself struggling to get the words out. He
knew right then “some of the words didn’t feel right in” his mouth.

In his own words, “that was terrifying”. As a teacher, he relies on the clarity
of his voice to communicate with his students. But on that fateful day, the
Daily Mail reported
[https://www.dailymail.co.uk/health/article-9186611/Some-COVID-19-survivors-develop-stutters-bizarre-neurological-effects.html]
, he woke up with a stutter that still persists.

By November, Thornton was still fighting the post-COVID19 fatigue. He had
occasional chest pain and dizziness. However, his stutter had also become worse.

COVID 19 and Stuttering: Is There Really a Link?
Studies show that Thornton’s isn’t an isolated case. A recent report
[https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30287-X/fulltext] 
published in The Lancet Psychiatry states that out of the 123 patients with
complete clinical history, 21 patients showed signs of mental health problems.
Six patients show dementia-like (neuro-cognitive) symptoms.

Stuttering is a speech disfluency disorder. Recent research shows that people
who stutter since childhood have anomalous brain structures. Stuttering has its 
roots in genetics [__GHOST_URL__/is-stuttering-biological-or-psychological/] and
the difference in brain structure sometimes contributes to functional changes.
For example, brain imaging studies also show that people who stutter have
deviant sound processing and production processes.

[https://stamurai.app/z4HKmlNXigb]Can Adults Develop Stuttering Out-of-the-Blue?
Rarely, a small fraction of the adult population develop stuttering in their
adulthood. They typically have no history of stuttering in their family. Adult
stuttering is not as common. There can be multiple reasons an otherwise fluent
adult develops stuttering all of a sudden in adulthood
[https://ghost.stamurai.com/causes-of-stuttering-in-adults/].

Neurogenic Stuttering
Neurogenic stuttering [https://www.stutteringhelp.org/neurogenic-stuttering] is
the result of nerve damage or altered nerve functions. It can happen due to
injuries or hemorrhaging in the brain. In rare cases, people who recover from
encephalitis, brain stroke, brain tumor, or cancer can also show signs of speech
disfluency.

Neurodegenerative diseases and some autoimmune diseases may also trigger
disfluent speech in adults. They may talk in a fragmented, staggered, or halting
fashion which sounds just like developmental stuttering.

Sometimes, severe concussions have resulted in stuttering that speech-language
pathologists (SLPs) have categorized as neurogenic.

Psychogenic Stuttering
According to experts, psychogenic stuttering can result from deep-seated
emotional trauma from childhood or even adolescence.

Severe psychological trauma including sudden loss, witnessing violence, or
becoming a victim of violence or abuse can precipitate stuttering
[https://ghost.stamurai.com/neurogenic-stuttering-vs-psychogenic-stuttering] in some
individuals who have no previous history of stuttering.

Pharmacogenic Stuttering
It is drug-induced stuttering. Some people show adverse reactions to clozapine,
risperidone, and buproprion. They begin stuttering either when they start taking
the drug(s) or when they increase the dosage.

Pharmacogenic stuttering is typically reversible. The patient can talk to the
doctor and stop the medication or alter the dosage.

What is The Nature of Stuttering Caused by COVID 19?
The nature of stuttering that many adults are reportedly experiencing after 
recovery from COVID 19
[https://www.scientificamerican.com/article/covid-can-cause-forgetfulness-psychosis-mania-or-a-stutter/] 
may be neurogenic in nature. Although extreme conditions of stress, anxiety, and
fear can trigger stuttering, it is not observed in fluent adults who have not
tested positive for COVID 19.

Adults already struggling with stuttering have witnessed their blocks and
repetitions become worse due to isolation, anxiety, and fear. However, the type
of stuttering noticed in patients who have recovered or are recovering from
COVID 19 has its roots in the nervous system.

The drugs involved in the treatment
[https://www.frontiersin.org/articles/10.3389/fphar.2020.01224/full] of SARS
CoV2 infection do not have a history of inducing stuttering. Therefore, it is
possible to rule out pharmacological causes in the sudden onset of stuttering in
recovering individuals.

On the other hand, autopsies on severe COVID 19 patients indicate the presence
of the whole virus and, sometimes, the viral particles in the brain. Studies
have shown the presence of viral particles in and near the trigeminal nerves of
deceased COVID19 patients.

There is strong evidence that the S1 protein from SARS CoV2 virus can readily
cross the blood-brain barrier. Mouse model studies conducted by Rhea et al
[https://www.nature.com/articles/s41593-020-00771-8] in 2020 show that
intranasally introduced radiolabelled S1 protein from the COVID 19 virus can
cross the blood-brain barrier almost instantly.

Tender and genetic makeup of the mice apparently do not affect the capability of
the S1 protein to cross the blood-brain barrier.

What may be Causing Stuttering in COVID 19 Patients?
Over the past six months, evidence concerning the long-term effects of COVID 19
has been pouring in. These are individuals who have recovered from the disease,
tested negative, but still suffer from the aftermath. The Daily Mail reports
that studies involving 153 patients in the UK show that more than one-third
suffer from brain fog, psychosis (without any history), dementia-like memory
problems, speech problems, and brain swelling.

Soo-Eun Chang
[https://medicine.umich.edu/dept/psychiatry/news/archive/202009/new-neuroscience-stuttering]
, a leading neuroscientist at the University of Michigan, says, “Anxiety and
stress don’t cause stutter, but they can exacerbate it”.

Thornton’s doctors insist that once his stress subsides, his stutter, too, will
subside. In the meantime, he says it has only become worse. Amanda Wood, from
Indianapolis developed a stutter during her recovery period from the novel
Coronavirus infection.

One of the leading theories is that the COVID 19 virus mounts a strong immune
response that produces bulks of cytokines. These cytokines can also cross the
blood-brain barrier and are capable of attacking even healthy tissues. It is
similar to an autoimmune disease, which can lead to an immune-mediated attack on
nerves and parts of the brain.

So, even in milder cases, where the COVID 19 virus or the protein particles
don’t make it to the brain, there is a good chance that cytokines
(autoantibodies) can sneak in and wreak havoc on the brain functions of an
individual.

Is There a Cure For Stuttering Caused by COVID 19 infection?
Currently, there isn’t enough research on the autoimmune response caused by the
COVID 19 infection or the effects of the viral infection on the human brain.
However, it is clear that undoing the damage caused by the infection will take
time, research, and a lot of patience.

Can COVID 19 cause stuttering? Yes! Along with a plethora of other psychological
and physiological issues.

Can stuttering caused by the novel Coronavirus be cured? Guess, we will have to
wait for people like Mr. Thornton to recover to find our ray of hope.

Till then all we can do is stay home, wash and sanitize our hands, wear a mask,
and maintain social distance.

Can COVID-19 Cause Stuttering?

Yoga is an ancient practice that originated over 5,000 years ago in India.
Several asanas (postures), and pranayamas (breathing exercises) comprise
traditional yoga. These asanas and pranayamas can help a person reclaim control
of their own body and mind through regular practice. In our earlier blog posts,
we have discussed whether yoga can help cure stuttering
[https://ghost.stamurai.com/yoga-and-stuttering/] and how mindfulness can be helpful
[https://ghost.stamurai.com/stuttering-and-meditation/] for anyone looking to overcome or
manage their stutters. In this post, we will discuss specific yoga exercises
that can help people who stutter.

Several forms of yoga are practiced in India and elsewhere in the world today.
You can master different asanas or pranayamas from YouTube easily. Daily
practice of yoga can reduce [https://pubmed.ncbi.nlm.nih.gov/2795647/] anxiety,
symptoms of depression, and stress. It can also potentially improve one's
fluency.

[https://stamurai.app/z4HKmlNXigb]Yoga Is The Ultimate Anxiety And Stress Buster
Yoga can enhance a person's posture, muscle strength, and breathing control.
According to Ristuccia and Ristuccia, 2010, asanas and pranayamas can positively
influence the factors that contribute to speech fluency.

Anxiety and stress can affect the functions of the brain’s left hemisphere. The
left hemisphere is also responsible for speech processing and production
[https://www.researchgate.net/publication/303479456_A_Preliminary_Study_Investigating_the_Effects_of_a_Modified_Yoga_Breathing_Program_With_Four_Individuals_Who_Stutter] 
in humans. Therefore, dedicating some time to practice yoga regularly can
improve a person’s speech and language production.

Yoga Increases Muscle Coordination and Control
Yoga aims to increase a person's coordination between their musculature and
respiration through different postures and breathing exercises. It is one of the
few exercises that use diaphragmatic breathing (costal breathing), which is an
integral part of any fluency shaping method
[https://stamuraiapp.medium.com/fluency-strategies-and-techniques-for-stutterers-3905f1b6b92e]
.

According to Gatzonis and Fabus, yoga can combine diaphragmatic breathing
training with muscle control to improve a person’s speech coordination.

At the same time, yoga focuses on mindfulness and meditation. Pranayama teaches
different breathing techniques to calm one’s thoughts. It can increase the
practitioner’s awareness of their breathing.

Sadly, there are no studies that exclusively review the use of specific and
structured breathing techniques to reduce a person's stutter. However, several 
studies [https://journals.sagepub.com/doi/abs/10.1177/0031512516628987] show
specific pranayamas can decrease a person's anxiety, hypertension, and stress.
That can lead to effectively smoother speech with fewer interruptions.

There are hundreds of yoga postures and breathing techniques. Not all of them
help in reducing stuttering. Here are 11 yoga poses and pranayamas that can help
increase your fluency slowly but steadily –

1. Sahaj Shankh Mudra (Easy Conch Shell Pose)
It is one of the easiest mudras or hand poses you can master for smooth
breathing. The result should resemble the folds of a conch.

How to Practice Sahaj Shankh Mudra?
 1. First, sit straight with your hips on your heels (Vajrasana) and regulate
    your breathing. Your breathing should be deep and even.
 2. Raise both your arms evenly, bend your elbows and bring your arms closer to
    your chest.
 3. Grasp the left thumb with all four fingers of your right hand.
 4. Touch the right thumb to the left middle finger.

The literature on yoga suggests that this hand posture is beneficial for throat
muscles, neck muscles, and all disorders related to the throat. Remember to
focus on your breathing to gain the maximum benefit of the posture.

[https://stamurai.app/z4HKmlNXigb]2. Brahma Mudra
The Brahma Mudra invigorates the heart, throat, and crown chakras. It is a
power-filled hastha-mudra that is beneficial for the throat and all
speech-related disorders.

How To Practice Brahma Mudra to Manage Speech-Related Disorders?
 1. Begin by sitting cross-legged. Straighten your back. Put your hands on the
    knees.
 2. Make fists using both hands, with both your thumbs touching the base of your
    little fingers on each hand.
 3. Keep your fists facing upwards and touch the right knuckles to your left.
 4. Maintain the hand pose and move the touching fists towards your navel while
    inhaling.
 5. While exhaling, press the fists against your abdomen and feel the air leave
    your lungs and your tummy deflate completely.
 6. Inhale and release your fists. Let your hands rest on your knees once again.

The Brahma Mudra can increase the strength of your articulator-muscles and give
you more control over your breathing, both of which are necessary for the
production of smooth speech.

3. Simhasana (Lion Pose)
Simhasana or the Lion Pose is a wonderful posture for reducing anxiety, tension,
and stress. It relaxes the body and mind. The forceful exhalation with voluntary
muscle contraction during Simhasana is what releases the tension from the body
and mind.

Steps to Practice the Lion Pose
Kneel on your yoga mat (Vajrasana) with your hands placed on your knees. Make
sure your spine is straight.

 1. Take at least two deep breaths (diaphragmatic) before you assume the pose.
 2. Press your palms on your knees. Keep your fingers open akin to the claws of
    a feline.
 3. Lift your hips and move your body slightly forward.
 4. Inhale deeply through the nose.
 5. Stick your tongue out and exhale forcefully by contracting your abdominal
    muscles as much as possible.
 6. Roll your eyes up and focus on the center between your eyebrows.
 7. Feel the force of your body leaning forward as your press your palms against
    your knees and the momentum of the exhalation.
 8. After complete exhalation, resume your relaxed posture (vajrasana).

The lion pose is a powerful asana that engages the spine, abdominal muscles,
diaphragm, and all the articulators. It is excellent for reducing stuttering.
You will not feel the effect in one day. However, practicing it daily for at
least a month will give you the confidence and strength to speak more fluently.

[https://stamurai.app/z4HKmlNXigb]4. Vrikshasana (Tree Pose)
The Tree Pose or Vrikshasana is a yoga posture that strengthens the muscles of
your legs, back, hands, and neck.

It regulates breathing and aids diaphragmatic breathing practice.

Steps You Should Follow to Assume Tree Pose
 1. To begin, stand straight and tall. Keep your arms by the side of your body.
 2. Fold your right knee and put your right foot on your left thigh.
 3. Keep your left leg straight.
 4. Take a deep breath once you find your balance. Raise your arms slowly above
    your head. Bring your palms together and look ahead.
 5. Keep your spine straight. Maintain deep breathing.
 6. Exhale slowly and bring your hands back to your sides.
 7. Release the right leg gradually and bring it back beside the left leg.
 8. Repeat the same posture with your left leg folded and right leg straight.

Vrikshasana can rejuvenate and re-energize you after a long day. It improves
concentration and control over your articulators. Vrikshasana can reduce speech
disfluency in adults slowly but steadily.

5. Trikonasana (Triangle Pose)
Trikonasana or the triangle pose is ideal for yoga practitioners of every
expertise level and age.

Practicing the Triangle Pose for Reducing Speech Disfluencies
 1. Stand straight with hands by your side. Take one step to the side so your
    feet are 3.5 to 4 feet apart.
 2. Raise both your arms till they are parallel to the floor. Stand in front of
    a mirror if necessary to assume this posture.
 3. Align your right heel to the middle of your left foot. Balance your weight
    on your feet.
 4. Inhale and exhale deeply. Bend towards the right while keeping your knees
    unbent. Keep your waist straight and bring your left hand above your head.
    Stretch towards the ceiling, without bending your elbow.
 5. Turn your head to look at your left palm.
 6. Make sure you are only bending sideways and not towards the front or back.
 7. Take a few deep breaths. Inhale deeply while resuming your initial neutral
    position.
 8. Try the same pose with your left heel aligned to the center of the arch of
    your right foot and your right hand stretched up.

Always warm-up before attempting trikonasana. It is a posture that benefits
almost the entire body. Virabhadrasana is another great posture to try and
master once you have completed the trikonasana.

Yoga experts state that the triangle pose is effective in reducing speech
disfluencies in adults and youngsters who practice it at least once daily.

6. Virabhadrasana (Warrior I Pose)
The Warrior Pose has 3 variations. Here, we will talk about the ‘Warrior I
Pose,’ which is ideal for beginners.

How to Practice the Warrior I Pose at Home?
 1. Stand straight with your legs slightly apart and hands by your side.
 2. As you exhale, move your left foot 3.5 to 4 feet away from the right, and
    raise your arms beside your head.
 3. Your arms should be parallel to each other.
 4. Breathe in. Turn your right foot 90 degrees to the right and left foot 60
    degrees to the right. Keep your right and left heels aligned.
 5. Exhale and turn your torso to the right. Keep your left heel on the floor.
 6. Bend your right knee and bring your shin in a position perpendicular to the
    floor. Try to align your right thigh with the floor.
 7. Stretch as you spread your palms and join them together. Tilt your head to
    look where your thumbs meet.
 8. Take a few deep breaths and return to your initial posture.
 9. Now, try the same with the other leg.

It stretches and strengthens the muscles of your calves, thighs, entire back,
neck, and arms. The deep and controlled breathing helps in invigorating the
articulators. Virabhadrasana is a holistic yogasana that targets physical and
mental wellbeing.

7. Savasana (Corpse Pose)
You should end every yoga posture you practice with the Savasana or the corpse
pose. It is one asana that is meant to provide utmost relaxation to every muscle
in the body.

There are several variations of savasana. Here, we are discussing the simplest
and most common one.

The Corpse Pose - Step By Step
 1. To achieve the posture, lie down straight with your eyes closed.
 2. Keep your hands beside your hips, stretched out, but relaxed. Keep your
    palms turned upwards.
 3. Make sure your legs are straight, but your feet are about a foot apart from
    each other.
 4. Now, exhale deeply and feel the tension leave your limbs.
 5. Stay for at least 2 minutes in savasana. Practice deep or diaphragmatic
    breathing the entire time.
 6. To come out of savasana begin by deepening your breaths. Then begin to
    wiggle your toes and fingers.
 7. Feel the movement in each appendage and limb.
 8. Stretch your arms over your head to stretch your entire body.

Savasana is a simple yet relaxing posture that completes every yoga session.
Always intersperse two postures with 2 minutes of savasana. End the entire
session with at least 5 minutes of savasana.

It is the best asana to release built-up stress and anxiety that can make your
stuttering worse. When you don’t have time for practicing all your asanas, take
out 5 minutes to practice savasana only!

8. Sukshama Vyayama
Shukshama Vyayama translates to ‘subtle exercising.’ It is not one but a set of
subtle workout techniques that stimulates your entire system.

There are three main components of Shukshama Vyayama that you need to pay
attention to –

 * Your breathing
 * A point for concentrating
 * The exercise

Here’s how to do it –
 * Place your hands on either side of your head and massage gently.
 * Begin breathing deeply.
 * Pinch your eyebrows between the index finger and thumb of each hand 5-6
   times.
 * Roll your eyes in the clockwise direction 10 times and the anti-clockwise
   direction 10 times.
 * Blink by squeezing your eyes shut and opening them as wide as you can 10-15
   times.
 * Tug on your ears for 10 seconds.
 * Hold and tug your ears in a clockwise and anticlockwise manner 10 times each.
 * Massage your cheeks using your first three fingers on each hand. Go from your
   jawline to your chin and back.
 * Now, open and close your mouth (jaws) with force 10 times.
 * Begin rotating your neck. While inhaling, tilt your head back. While
   exhaling, tilt your head forward so your chin touches your chest.
 * Rotate your head in the clockwise and anticlockwise directions 5-6 times
   each.
 * Stretch your hands on either side in parallel to the floor. Shake them out
   for 2 minutes.
 * Halt all movement and sit still.

Shukshama Vyayama is all about invigorating all the muscles involved in the
expression. It is one of the finest exercises for those who want to practice
yoga to reduce their stuttering.

9. Nadi Shodhana (Alternate Nostril Breathing)
It is a powerful yet simple tool that can have a profound impact on your nervous
system, circulation, and mind.

The Alternate Nostril Breathing Yoga Exercise Step-By-Step
 * First, sit comfortably with your back straight.
 * Place your hands on your knees with the palms open towards the ceiling.
 * Lift your right hand, place the tips of the index and middle fingers between
   your eyebrows. Place your ring and little finger on your left nostril and
   thumb on the right nostril.
 * Breathe out of the left nostril only by using the thumb to press (block) your
   right nostril.
 * Next, breathe in through the left nostril and breathe out only from the
   right, by blocking the left.
 * Then, breathe in through the right nostril and exhale through the right.

This comprises one round of Nadi Shodhana or alternate nostril breathing
exercise. Complete 10 rounds every day for maximum benefits.

Remember to breathe deeply to the fullest capacity of your lungs each time you
inhale and to breathe out forcefully till your chest is empty while you exhale.

[https://stamurai.app/z4HKmlNXigb]10. Bhastrika (Bellows Breaths)
Always practice Bhastrika or bellows breaths in the morning or the beginning of
your day.

Do not practice this before bedtime as it may make it difficult for you to fall
asleep.

How to Practice the Bellows Breaths Pose to Improve Speech Production?
 1. Begin by sitting straight and relaxing your shoulders.
 2. Take a few deep (diaphragmatic) breaths through your nose.
 3. Now, begin to exhale forcefully through your nose.
 4. Always inhale with force for one second per cycle.
 5. Use your diaphragm to control the air volume. Use your maximum tidal volume
    to breathe in and out.

For the first cycle, complete 10 breaths, take a 15-30 seconds break, and then
follow it up with 20 more Bhastrika breaths. This pranayama increases lung
capacity and tones the muscles involved in speech production. It relaxes and
energizes the brain. It is one of the primary pranayamas you should practice to
reduce the impact of stuttering in your life.

11. Ujjayi Pranayama
Ujjayi breathing or victorious breath calms your mind and silences the negative
thoughts that arise in your head.

Always inhale and exhale through your nose only while performing ujjayi
pranayama.

Steps On How to Practice Ujjayi Pranayama at Home
 1. Remember to sit up straight.
 2. Keep your mouth closed while breathing.
 3. Constrict your throat muscles so that breathing in and out makes a noise
    similar to snoring.
 4. Engage your diaphragm throughout the exercise.
 5. Make sure the duration of your inhalation and exhalation are equal.

You can practice Ujjayi Pranayama in the morning or at night. It releases
tension. It gives you control of your throat muscles. A recent study shows that
yoga breathing or pranayama can relieve symptoms of depression and anxiety
disorder that often arise after decades of stuttering.

What Are The Overall Benefits Of Yoga For Those Who Stutter?
Many yoga postures and breathing exercises are beneficial for stuttering and
other fluency disorders. Several of them don't act directly on the articulators
but help us by boosting our concentration, confidence, and control.

Yoga can relax you, alleviate your anxiety and stress. It can improve your sleep
quality and replenish your nervous system naturally.

Yoga contributes to a positive attitude in life, which is an integral part of
every stuttering therapy. If you are receiving speech therapy for stuttering
whether through traditional speech therapy clinics or a cutting-edge speech
therapy app like Stamurai [https://stamurai.com/],  it is a good idea to  couple
it with these yoga poses and breathing exercises to gain the most from your
sessions. A calm state of mind will help you learn faster and remain motivated
to do your daily speech exercises.

[https://stamurai.app/z4HKmlNXigb]

11 Yoga Exercises That Can Help With Stuttering

Stuttering in children can begin when they are as young as 22 months old. The
incidence of stuttering in preschool-aged children is almost as high as 5%.

More than 76% of the children who begin stuttering at an early age recover
spontaneously.

There are several speech-language pathologists, speech therapists, and
pediatricians who are of the opinion that early childhood stuttering does not
need intervention due to its high probability of natural resolution.

That, however, begs the question, how do we know if the child will recover
spontaneously or they will be a part of the 24% who grow up with a stutter for
life.

Why Should You Seek Early Intervention For Your Child Who Stutters?
As per the research of Anne Smith and Christine Weber, recent studies provide
evidence that children as young as 3 to 5 years old with early-onset stuttering
begin showing atypical patterns of neural connectivity and activity that are
characteristic of stuttering.

In families with a history of stuttering, there’s  high likelihood that children
who begin stuttering as early as 22 months to 3 years may continue to do so as
adults. However, there is no guarantee that they will not spontaneously recover
especially if one parent has no history of stuttering in their family.

Stuttering can become a reason for emotional distress among children soon after
onset.

 1. Other children recognize stuttered speech. They may react negatively to
    speech disfluencies, resulting in isolation and emotional agony of the child
    who stutters.
 2. Researchers have observed and measured negative attitudes among children as
    young as 3 years to 6 years old during communication with those who stutter.
 3. By the time children who stutter are 7 years old, their attitude towards
    communication worsens.
 4. Facing bullying at school and playgrounds can result in severe anxiety
    disorders later in life. School-aged children who stutter often face more
    bullying as compared to their peers.
 5. Recurring negative perceptions concerning communication can make it
    difficult to form  relationships later in life.

Research by Robin Jones, Dahye Choi, Edward Conture, and Tedra Walden shows that
children who stutter exhibit significant differences in overall emotion and
temperament as compared to children who don’t stutter.

Not treating it when the child is young can result in the persistence of
stuttering in adulthood. Stuttering can attract psychological, educational,
occupational, and social problems. Therefore, the management of childhood
stuttering should begin as early as possible.

What Are The Advantages Of Early Intervention Of Stuttering In Children?
Treating stuttering in adolescence and adulthood can be challenging. Apart from
speech therapy, the treatment demands concomitant behavioral therapy or
psychological counseling sessions to address anxiety and stress.

At the same time, speech therapy for adults can be costly, time-consuming, and
prone to relapse.

According to multiple speech-language pathologists and leading researchers in
the field of speech pathology, the Lidcombe Program is one of the most efficient
treatment programs for toddlers and young kids.

The first thing to do if you notice disfluencies in your child’s speech is to
consult a speech-language pathologist.

Only an expert can assess your child’s speech and tell you -

 * Whether immediate intervention is necessary.
 * Or, if you should wait a couple of months before intervening.

If you notice your child stutter, it’s important that you seek professional
help. Finding the right speech therapist is not always easy. You can use a
cutting-edge speech therapy app like Stamurai [https://stamurai.com/] to contact
a speech therapist and gain a preliminary understanding of your child’s
stuttering severity.

What is the Lidcombe Program?
The Lidcombe Program is a behavioral treatment targeted at children who stutter.

The Lidcombe treatment guide is now easily available over the web. Parents and
guardians can easily use operant conditioning principles for guiding their
children towards a stutter-free future.

During this program, parents don’t try to change how their children speak. At
the same time, parents don’t change their pattern of speaking or language
habits. There is no change in family lifestyle.

 1. Operant conditioning principles include praises when the child speaks
    fluently without stuttering. The parent offers verbal contingencies during
    practice sessions and natural conversations with the child.
 2. Occasionally, they may request the child to repeat themselves in case of
    particularly-strong stuttering. However, there should be no criticism. They
    may ask questions like “was that smooth?” or “could you say that for me
    again please?”
 3. Parents should also measure their child’s stuttering severity with a
    severity rating (SR) that ranges from 0 to 9.
 4. The parent(s) or guardian(s) visit the clinician every week for around 45 to
    60 minutes. They learn how to conduct the treatment properly and report the
    outcomes.

The first stage of the Lidcombe program focuses on  training the parent on

 * How to recognize stuttering
 * How to note the severity
 * Organizing the conversations that aid treatment
 * Giving (verbal) positive reinforcement.

Here, the goal is to achieve an SR of 0 or 1.

The second stage involves the goal of ‘no stuttering for a prolonged duration.

How is Early Stuttering Intervention Helpful for Children?
Most children who begin stuttering at an early age outgrow it without any
external help. However, a small percentage of children continue to stutter for
longer than 2 years post-onset. These are the same children who are at high risk
for adulthood stuttering.

During the onset, it is impossible to tell who will recover spontaneously and
who will need speech therapy intervention.

Teaching speech exercises to children is difficult and it may prove to be
counterintuitive to their natural language development.

The Lidcombe Program is one of the best, proven techniques for treating
stuttering in pre-school-aged children. It is an indirect method that uses
verbal positive reinforcement and operant conditioning principles for addressing
early developmental stuttering in children.

Stuttering in Childhood: Early Intervention Is Important

Stuttering consists of involuntary repetitions, prolongations and blocks. Some
people who stutter (PWS) are conscious about their trigger words and they avoid
saying those words to hide their stuttering.

No matter how much we try, those of us who stutter moderately to severely,
almost always fail to hide our stuttering. The pressure of hiding our stutter
often sends us into a spiral of anxiety, fear and anticipation
[https://ghost.stamurai.com/overcome-stuttering-fear-and-insecurity/] that makes our
stuttering worse.

What is Self-advertisement or Self-disclosure of Stuttering?
So, what’s one way to take the power away from stuttering? According to
accomplished clinicians and speech-language pathologists, self-advertising or
self-disclosure is a powerful way. It can be as simple as telling someone that
you stutter.

In many cases, we find ourselves worried about what others might think of the
way we speak. Since there’s nothing wrong with how we speak, it’s just better to
accept and address our stutter before we begin our conversation. Doing so can
help eliminate the fear and anxiety.

Self-disclosure of stuttering takes power away from the anxiety and fear of
stutteringAccording to Michael P. Boyle [https://pubmed.ncbi.nlm.nih.gov/27865229/], there
are three more effective anti-stigma strategies that work for stuttering –

1. Contact (self-advertisement)
This includes hearing stories from a first-person perspective. You can introduce
yourself as someone who stutters at the beginning of an interview
[https://ghost.stamurai.com/what-employers-should-know-about-candidates-who-stutter/],
meeting or presentation [__GHOST_URL__/stop-stuttering-during-presentations/]. A
significant number of college professors, lecturers, and job applicants make a
favorable impression by owning their stutter at the beginning of a crucial
conversation.

2. Education
This method works best for adolescents and young adults. This is when people are
exposed to brochures, books, e-books, online presentations, or videos about
stuttering. The content is directed towards telling people what causes
stuttering and replacing the myths related to stuttering
[https://ghost.stamurai.com/stuttering-misconceptions/] with facts.

3. Protest
It has become a popular tool ever since the Stuttering Foundation
[https://www.stutteringhelp.org/content/stuttering-foundation-snl] stood up
against the 15 September 2015 Saturday Night Live sketch that ridiculed
stuttering. The foundation called  it a “huge step backwards” for the entire
stuttering community. The idea is to discourage discrimination and humiliation
of people who stutter.

Interpersonal contact is a method of self-advertising or self-disclosure. It may
involve someone sharing a personal life-story about living with the speech
disorder. It is one of the most effective methods since it depends on the
grassroots efforts from people who have lived with the disorder to change the
public attitude about the disorder.

When Should You Self-advertise Stuttering?
The next question that almost always follows is “what’s the right time to
disclose stuttering?”

On the effects of self-disclosure of stuttering, E. Charles Healey
[https://www.researchgate.net/publication/6528651_The_effects_of_self-disclosure_and_non-self_disclosure_of_stuttering_on_listeners'_perceptions_of_a_person_who_stutters] 
notes that in order to understand the effectiveness of self-advertising, we need
to first understand the three main scenarios –

 1. The speaker may disclose stuttering at the beginning of the dialogue
 2. The speaker may disclose stuttering at the end of the dialogue
 3. The speaker does not advertise stuttering at all

The moderators played monologues from people who stuttered for the listeners.
Listeners in the Healey study reported that they were equally comfortable
listening to all the recordings with or without disclosure. However, studies
also showed that listeners reacted slightly more positively towards the
monologues of people who self-advertised their stuttering at the beginning.

However, in many real-life interactions, you may find self-advertisement
unnecessary. For example, self-disclosure isn’t needed when you are traveling
and someone asks for directions or asks to borrow your phone. As soon as you
respond, the person might be able to figure out that you stutter. But, does that
matter? Since it is a transient interaction and it will have little to no impact
on your life in the distant future, is it at all necessary to advertise your
stuttering to a stranger?

Balance is important. It’s not always necessary to self-advertise!You will
notice that in several instances like these where you interact with complete
strangers or acquaintances for a short duration, the topic of stuttering will
never come up organically.

Should you volunteer to inject the topic in the conversation? Should you make
stuttering a topic of every conversation you have in the future? Well, that
doesn’t seem very practical or pleasant for the speaker or the listener. More
importantly, you will probably have more interesting things to talk about. So,
why not talk about other things and let the conversation take its course.

If the topic of stuttering or disfluencies and disorders ever come up, you can
always acknowledge
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/] or
self-advertise. It is always about striking a balance – the balance of talking
about other things and discussing stuttering.

Just as Russ Hicks puts it “the world does NOT revolve around stuttering!”

Why Should You Self-advertise Stuttering?
Now, as someone who has stuttered for more than a decade and probably will
stutter in different intensities throughout life, we have the right to ask “Why
should we self-advertise our stutter?”

In many cases, a listener’s negative perception about a speaker who stutters can
stem from the lack of knowledge about the person’s speech disorder. To avoid
confusion, one can always begin a possible conversation by saying “I may take
longer than usual to finish what I have to say because I stutter”.

Acknowledgement and advertising has two main goals
[https://www.sciencedirect.com/science/article/abs/pii/S0094730X18300597] –

 1. To lessen the sensitivity of the listener towards the speaker’s disfluencies
    and  promote acceptance of their stuttering during a speech or conversation.
 2. To reduce the negative biases towards the speaker by eliminating doubts
    about their communication skills and articulatory prowess.

It is untrue that PWS are bad at communication. The act of acknowledgement and
self-advertising can reduce the effects of both tension and anticipation in an
adult who stutters. They don’t feel the need to hide their stuttering while 
addressing the listeners [__GHOST_URL__/public-speaking-with-a-stutter/].

In a 1990 study [https://pubs.asha.org/doi/abs/10.1044/jshd.5501.75] by Collins
and Blood, listeners had to watch video tapes of one out of two adults with
severe and moderate stuttering. The video consisted of adults who stutter
answering questions during a mock job interview.

The acknowledgement of stuttering came at the end of the interview in one video.
Next, they were shown another video that didn’t come with a self-advertisement
of stuttering. When the listeners were quizzed, results showed that a
significant number of the listeners would prefer to interact with people who had
acknowledged their stuttering.

One of the biggest reasons you should self-advertise your stutter at the
beginning of a job interview, presentation or speech is to let people know that
you are comfortable with your stutter and soon they will be too.

How Should You Self-advertise Your Stutter?
Acknowledging and advertising stuttering takes more courage than fluent speakers
think or believe. Since a majority of the society still, sadly, perceives
stuttering to be a “flaw” it takes immense nerve to accept it in front of people
who will probably judge you, employ you and/or give reviews.

So, here are the basics of self-advertising for anyone who has speech
disfluencies like stuttering –

If you stutter, use the word “stutter”
Famous comedian Drew Lynch
[https://leader.pubs.asha.org/do/10.1044/drew-lynch-comedian-with-stutter-is-runner-up-in-americas-got-talent-finale/full/] 
almost always introduces himself as someone who stutters. Although you are
definitely more than a speech disfluency, self-disclosure will help out your
listener(s) by telling them that you are not in denial of it and that you are
comfortable with it. It exhibits a sense of confidence that is necessary for job
interviews, lectures, and presentations.

Do not be apologetic
Don’t begin by saying “I’m sorry for the interruptions, but I stutter”. There’s
nothing to be apologetic about! It’s not your fault that you stutter. You may
need to practice this a little since we have been taught that ‘how we speak’ is
important no matter what we have to say! It becomes a knee-jerk reaction
sometimes.

Don’t complicate it
Don’t put in big words and stats. Simply tell your listeners that you are aware
that you stutter. Stuttering doesn’t diminish your talents, skillset, or
experience. Simply talking in a different way should not influence their
attitude towards you.

What are Some Examples of Self-disclosure?
If you follow Nina G
[https://isad.isastutter.org/isad-2018/papers-presented-by/stories-and-experiences-with-stuttering-by-pws/stutterer-interrupted-on-disrupting-the-interrupting-nina-g/] 
or Drew Lynch, on Twitter or YouTube, you may have come across some great
one-liners on stuttering. Humor is necessary because it reminds us that despite
the discrimination, negative attitudes, and discomfort some of our listeners
throw our way, it’s important to laugh.

You can think about incorporating some humor in your self-disclosure statement
to rope in your listeners and lessen their discomfort.

You can say something like, “Before I begin, I’d like to take this opportunity
to state that I stutter. That means I may take longer to finish what I am
saying, but that doesn’t affect my ability to meet targets, as you can see from
my resume”.

You may have to disclose your stutter over phone calls
[https://ghost.stamurai.com/phone-calls-stuttering/] at times too. For example, if someone
asks about your birthday or address, you can always say, “I stutter, so thanks
in advance for your patience”.

You can be a teacher, professor, dental hygienist, doctor, motivational speaker,
comedian, author, actor, cashier, accountant, or Uber driver. Regardless of the
profession you are in and the kind of people you meet on a daily basis,
 self-disclosure for stuttering shouldn’t be hard or awkward especially when
it’s necessary.

Use the available context to advertise your stutter if that’s necessary.

Understanding Public Reactions to Self-disclosure of Stuttering

We may expect people to be sensitive and supportive when we muster the courage
to acknowledge and advertise our long-term speech disfluency. However, the
reality can be quite different and you need to be prepared.

If you have been stuttering for a while and receiving therapy, there might be
days where your stutter is barely noticeable
[https://ghost.stamurai.com/guide-to-covert-stuttering/]. We have all experienced those
“lucky days”.

After you self-disclose, you may hear comments from your listeners like, “Are
you sure you stutter? Your speech was smooth”. Some of them can be outright rude
like the ones famous comedian Drew Lynch receives. People may accuse you of
faking a stutter!

Well, it’s important to remember that most people do not know what it’s like to
not be in complete control of their words and voice. That also brings us back to
two of the three anti-stigma strategies – education and protest.

In situations where listeners are challenging your self-disclosure you can
choose to enlighten them on what is stuttering
[https://ghost.stamurai.com/is-stuttering-biological-or-psychological/], the different 
severities [__GHOST_URL__/understanding-degrees-of-stuttering-severity/] of
stuttering and why it happens.

Sometimes, education is not enough and we understand that. Days of bullying and
mistreatment can take a toll on mental health and productivity of any adult who
stutters. So, if push comes to shove, you can reach out to WhatsApp support
groups, stuttering foundations and organizations for additional support.

Self Advertising Your Stutter: Benefits, Advice, Examples & Considerations

Stuttering is not just the inability to speak fluently, but it is a speech
disorder that affects roughly 1% of the entire population.

It is heterogeneous in nature. However, most adults who stutter have been
struggling with the speech disorder since childhood. This type is referred to as 
developmental stuttering [__GHOST_URL__/causes-of-stuttering-in-adults/].

Adults who begin stuttering suddenly in their adulthood may do so due to 
neurogenic, psychogenic
[https://ghost.stamurai.com/neurogenic-stuttering-vs-psychogenic-stuttering/], or
drug-induced causes.

Drug-induced stuttering or drug-induced stuttering is when a person develops
speech disfluencies suddenly after starting to take a new medication. Chances
are that the stuttering will reduce or vanish after they reduce the dose or stop
taking the drug.

We already know that there are no FDA-approved drugs
[https://ghost.stamurai.com/stuttering-medicine/] targeted to treat or cure stuttering.
However, some drugs like olanzapine, risperidone, and clozapine have been used
to treat stuttering in adults.

[https://stamurai.app/z4HKmlNXigb]Which Medications Can Induce Stuttering?
Recent research shows that several antipsychotic drugs including those mentioned
above can cause stuttering in adults
[https://ghost.stamurai.com/causes-of-stuttering-in-adults/] who have never shown any signs
of speech disfluency. 

In a recent publication, Trenque and Morel
[https://pubmed.ncbi.nlm.nih.gov/33337944/] list the 22 compounds that increase
the risk of drug-induced stuttering in patients.

Medication for ADHD Can Cause Stuttering
Methylphenidate [https://pubmed.ncbi.nlm.nih.gov/31418914/] is the active
molecule in Concerta, Metadate ER, Methylin, QuilliChew, and Ritalin variants.
It is a compound extensively prescribed by doctors for the treatment of
attention deficit disorders (ADD) and attention deficit hyperactivity disorders
(ADHD).

It belongs to the family of central nervous system (CNS) stimulants. Hence, it
is also used to treat excessive daytime sleepiness and narcolepsy.

Older research indicates the use of methylphenidate for the treatment of
stuttering.

It works via a dopamine/norepinephrine based pathway. It can cause a decrease in
the dopaminergic receptors in the brain due to its amphetamine-like traits.
Methylphenidate-based drugs can increase the levels of dopamine and
norepinephrine.

The excess of dopamine in one’s system can contribute to the sudden onset of 
stuttering in adulthood
[https://ghost.stamurai.com/the-unexpected-development-of-stuttering-in-adulthood/].

The Relation between Stuttering and Anti-Epileptic Drugs
Doctors have been prescribing pregabalin and topiramate to help patients control
convulsions and in the treatment of epilepsy. In the US, pregabalin is the
active ingredient in Lyrica and topiramate is present in Qudexy XR, Topamax,
Topiragen, and Trokendi XR.

Patients who have been taking these drugs in combination with others for
treating epilepsy have reported the unexpected incidence of stuttering
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424827/].

These drugs work by enhancing the activity of gamma-aminobutyric acid (GABA)
receptors. They have an inhibitory effect on the CNS. The disturbances in the
white matter fibers in the areas of the brain responsible for speech production
like the Broca’s area can potentially increase one’s risk for developing
stuttering in adulthood.

Antipsychotic Medication and Stuttering In Adults
Several studies [https://pubmed.ncbi.nlm.nih.gov/15179972/] have previously
described the onset of stuttering in relation to treatment with antipsychotic
drugs. Clozapine, risperidone, and olanzapine have been mentioned extensively in
both treatments and causes of stuttering in adults.

Clozaril, FazaClo, and Versacloz are all brand names of clozapine
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528227/], a medication used to
treat schizophrenia and schizoaffective disorders. One of the potential side
effects of the compound includes stuttering. Experts note that stuttering occurs
predominantly when the dose is increased and ceases when the dose is decreased.

Murphy et al have noted the prevalence of stuttering to be 0.92% in
clozapine-induced cases.

Risperidone is present in Risperdal M-Tab, RisperiDONE M-Tab, and RisperDAL.
Psychiatrists recommend it in cases of bipolar disorder, schizophrenia, and
irritability associated with autism spectrum disorder (ASD).

While risperidone is a highly effective drug for the treatment of dysphoria and
mania related to bipolar disorder, schizophrenia, and acute irritability
associated with ASD, it can cause stuttering in patients.

Olanzapine is a constituent of ZyPREXA. It is also used to treat schizophrenia
and bipolar disorder.

All of these compounds exhibit anticholinergic properties. That is a pathway
implicated in stuttering.

The long-term use of clozapine, risperidone, or olanzapine, or the increase in
dosage can cause stuttering in adults receiving one or more of these
antipsychotics.

Quetiapine is another compound used for the treatment of depression. It has a
strong preference for dopaminergic and serotonergic receptors. It is an atypical
antipsychotic that causes stuttering in rare cases.

Bupropion is an antidepressant, which is used for the treatment of seasonal
affective disorder and atypical depression. It inhibits the reuptake of
norepinephrine and dopamine. It is currently available under the brand names
Aplenzin, Budeprion SR/XL, Buproban, Forfivo XL, WellButrin, and Zyban.

It increases dopaminergic activity in the frontal cortex, which has previously
been implicated in speech disfluencies. Bupropion treatment has resulted in
quite a few cases of stuttering in the past.

Asthma Medication and Stuttering
Theophylline is a common drug used to treat shortness of breath, wheezing, and
chest tightness due to asthma, emphysema, bronchitis, and other lung diseases.

Theophylline is the active component of Phyllocontin, TheoCap, Theochron,
Theo-Due, Uniphyl, and Norphyl. It is a bronchodilator that opens the air
passages and makes it easier to breathe.

Theophylline can cause acquired-stuttering irrespective of the patient’s age.
Theophylline increases the neurotransmitter dopamine by inhibiting adenosine
receptor activity. According to research
[https://pubmed.ncbi.nlm.nih.gov/15607558/], theophylline creates a
hyperdopaminergic microenvironment that mimics the state necessary for
developmental stutters.

[https://stamurai.app/z4HKmlNXigb]Do All People On These Medications Experience
Stuttering?
Medication-induced stuttering is a common occurrence especially among patients
taking psychoactive drugs. Most of the drugs that cause stuttering work via the
neurotransmitter systems. Many tricyclic antidepressants work via the
cholinergic systems. Bupropion, theophylline, methylphenidate, and other
antipsychotics target the dopaminergic systems.

On the other hand, clozapine targets several neurochemical receptors, which can
trigger stuttering in a number of known and unknown ways.

The inherent properties of multiple compounds that are used for treating various
types of depression, bipolar disorders, and schizophrenia lead to
medicine-induced stuttering.

Some people are more at risk for stuttering. They have a higher chance of
developing drug-induced stuttering during their treatment.

Each medication has different prevalence and incidence rates for stuttering. The
under-reporting of stuttering as a side effect of these drugs has made it
difficult to predict what percentage of the population will develop stuttering.

However, almost all active molecules that affect neurotransmission or activate
the dopaminergic system increase the risks of drug-induced stuttering among the
adult patients.

Can Some Medicines Make Stuttering Worse?

Tristan Roeder is a resident of Iowa City. Although American by birth and
upbringing he has chosen an English accent because it helps him speak fluently.

In Tristan’s own words, “I have a stutter. I have some difficulty pronouncing 6
letters of the alphabet.” After he began speaking in an English accent
[https://dailyiowan.com/2015/09/17/student-overcomes-speech-impediment-with-accent/] 
he is more fluent than he ever was as a child.

He chanced upon fluency thanks to his younger brother who is a dedicated Harry
Potter fan. The audiotapes he used to listen to, encouraged him to try the new
and interesting foreign accent. And once he did, he found that he could talk
faster without any stutters.

According to Patricia Zebrowski, professor of communication sciences and
disorders at the University of Iowa, people who stutter have distinct and
anomalous speech processing and production pathways
[https://www.researchgate.net/publication/47383388_Articulation_rate_and_its_relationship_to_disfluency_type_duration_and_temperament_in_preschool_children_who_stutter]
.

Speech-language pathologists (SLPs) have observed numerous instances of
spontaneous fluency when a person's voice changes, they adopt a foreign accent,
or speak in a nasal tone.

What Suppresses Stuttering During Accented Speech?
The mechanics of the phenomenon are little-known. However, some speech
pathologists are of the opinion that people stop stuttering when talking in an
accent because they use their mouth and brain differently.

Some experts compare it to singing
[https://ghost.stamurai.com/stuttering-and-singing-what-we-understand/]. It is quite
impossible to stutter while singing. While speaking in a foreign accent, the
speaker needs to focus on the pronunciation of different words and the emphasis
of different letters.

Speaking in a new accent may reduce the demands from the left hemisphere of the
brain. That is exactly what happens during singing!

Sadly, there is a dearth of research in the area of accent modification to
reduce stuttering. The exact mechanism that works towards reducing a stutter
during accented speech is still not well-explored.

Why SLPs Do Not Recommend Accent Modification To Reduce Stuttering?
Tristan may inspire hundreds of people who stutter to speak in an accent all the
time. However, speech-language pathologists are against it.

Here are the main reasons you shouldn’t assume an accent all the time while
speaking, despite your stuttering.

 1. There is a chance that if you adopt an accent while speaking all the time,
    it will become your "normal" speaking style. As a result, your brain will
    readjust the use of the left and right hemispheres, and you may begin to
    stutter even while talking in aforeign accent. Experts believe that accent
    modification is not a long-term solution to speech disfluency.
 2. Stuttering may be painful. It may seem humiliating and embarrassing to not
    be able to say what you want to say. However, stuttering is a part of who
    you are. Expecting yourself to speak in an accent 24/7 is unreasonable. At
    the same time, it masks your true self.

What’s a Healthy Alternative to Accent Modification to Reduce Stuttering?
Speech-language pathologists have come across several instances where the
reduction of one’s accent or the introduction of a new accent reduces stammering
almost magically. However, disfluencies return once the person is used to their
new accent.On the other hand, accepting
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/] one’s
stammering can open new avenues for stuttering modification and fluency shaping
[https://ghost.stamurai.com/voluntary-stuttering-and-fluency/] techniques. You can speak to a
speech therapist. Or, you can seek help from a speech therapy app like Stamurai
[https://stamurai.com/]. It can help you understand your stuttering,
anticipation, and set fluency goals.

Accent Modification: Can It Reduce Stuttering?

Your phone rings, but as you receive the call, a speech block hits you out of
the blue!

This has happened to almost all of us who stutter. Sometimes, at the exact
moment when we want to speak, we find our words choking and our vocal cords
“paralyzed.” Experts refer to these instances when you cannot utter a word as
speech blocks.

Stuttering blocks are always unwelcome although not unexpected. In reality,
people who have been stuttering for a long time come to fear these blocks. Even
if we don’t know why these blocks occur, we know that they are lurking around,
waiting to jump at our larynx, when we need to speak the most!

Blocking is a core behavior of stuttering. In the event of silent blocks, the
closure is total. They obstruct the flow of speech at one or several locations
(tongue, lips, larynx, etc.)

[https://stamurai.app/z4HKmlNXigb]The only way to defeat these blocks is by
moving through them. Block corrections are a few simple techniques speech
therapists teach to help PWS speak more fluently and easily.

Post-Block Correction
Post-block correction consists of steps you can take to correct your speech
after you have experienced a block. Since you have already experienced blocking
in several instances, you should begin with post-block correction exercises.
These can help you stutter less severely
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/] in the long run.

Cancellation
Cancellation [http://www.stutteringsource.com/blog/-the-411-on-cancellations] is
a unique but simple technique that can help you confront your stuttering. It is
a post-block correction method that you need to implement immediately after a
block.

It should be easier for you to determine what you did wrong and how you can
modify it in the near future.

In cancellation, you begin saying a feared word that tends to induce a block.
Once you are in the block, assess the way your articulators are acting. Pause,
and give yourself a little time to think what might be causing your block.
Release the pent up pressure and try to say the word in a different way.

During post-block corrections, you make overcorrections to your “faulty” speech
muscle movements.

Here’s a step-by-step guide of completing a cancellation –

 1. Say the word on which you block. Say the entire word.
 2. Pause. Understand why you blocked.
 3. Let your articulators relax completely. Feel your tongue and jaws relax.
    Breathe deeply and calmly.
 4. Make a mental note of everything you think you did wrong that may have
    caused the block.
 5. Rehearse or mimic how it would feel to make the corrections as you modify
    the movement and contact of your articulators.
 6. Repeat the word.
 7. This time, stretch out the sound on which you had blocked in step (1).

Revisiting a block is never easy. You may block a second or a third time. You
may need several tries before you can say the word easily without blocking.

Don’t just focus on saying the word smoothly. Concentrate on the movement of
your lips, tongue, jaws, and your breathing while you say the word.

[https://stamurai.app/z4HKmlNXigb]In-Block Correction
Post-block corrections can give you a new insight into the relationship between
muscle coordination and breathing. Post-block corrections teach you how to
cancel your stuttering block once it has already occurred.

In-block corrections can help you cancel a stuttering block once it is already
occurring. Think of it has a systematic process that will help you overcome the
block while you are in the middle of it.

Pull-out
Here’s how in-block correction works –

 1. When you are in the middle of a block, do not stop.
 2. Continue to stutter, but slow it down and let the block complete itself.
 3. Prolong the word. Stretch the sound you are stuttering on.

Doing so will slow the repetition down or change the repetition to a
prolongation or smoothen out a tremor. This will help you come out of a
stuttering block.

The pull-out technique is helpful for people who stutter severely and encounter
multiple blocks a day. Mastering this technique will show you that no one but
you are in control of the duration of a speech block.

Holding the stutter long enough will show you what you need to do, to change the
course of your stutter. Soon, you should be able to voluntarily release yourself
from the block.

In case you are unable to apply the in-block correction technique, you should
revisit post-block correction to explore what you need to change to gain control
of the stutter.

Pre-Block Correction
Several people who stutter can predict the words they will stutter on in their
speech. Once you have mastered the post-block and in-block techniques, it is
time for you to learn and apply the pre-block correction techniques.

Preparatory Set technique
The preparatory set
[http://www.stutteringsource.com/blog/411-on-preparatory-sets-prep-sets] 
technique is a stuttering modification technique that will allow you to ease
through a block without pausing or stopping.

Follow this exact procedure to effectively use a pre-block correction –

 1. As you come up to the feared word halt. The brief pause will give you the
    time to take a deep breath and calm yourself. Make sure that the pause is
    not long. It should be brief enough to sound normal in an ongoing
    conversation.
 2. Feel the tension in your articulators and try to calm them. Feel your tongue
    lying loosely at the bottom of your mouth, your jaws loose and your lips
    relaxed.
 3. Think about what you do that typically creates the block on the particular
    sound.
 4. Reflect on the fluency shaping techniques you have learned so far that you
    can use to avoid stuttering or blocking on the particular word.
 5. Rehearse how it will feel to say the words in your mind. Think about saying
    the whole word with deliberation, in an exaggeratedly slow motion.
 6. As you begin breathing out say the word while applying the corrections.

While saying the word, pay attention to how the word feels rather than how it
sounds. Focus on the movement of your tongue, jaws, and lips.

You should concentrate on the feeling of change as you progress through the
word.

[https://stamurai.app/z4HKmlNXigb]Managing Your Stuttering Blocks
Make a list of your feared words – words on which you stutter or block
repeatedly.

Next, try to apply the post-block corrections to find out how you stutter on
them.

Then, apply the in-block correction. Determine the changes necessary to ease
your way out of the block and apply these changes during the pre-block
corrections.

Continue this entire set of exercises
[https://ghost.stamurai.com/stuttering-exercises-for-adults/] until you can automatically
determine which corrections are necessary for every anticipated block.

Remember, practice makes you perfect. It is possible to master all three
techniques to overcome speech blocks only if you practice daily.

You can make daily practice easy and engaging, and keep track of your progress
with Stamurai [https://stamurai.app/z4HKmlNXigb] - a cutting-edge speech therapy
app.

How to Overcome Stuttering Blocks

Stuttering is a speech disfluency that may have multiple causes. Researchers
associate neurodevelopmental disorder with structural anomalies
[https://ghost.stamurai.com/cellular-causes-of-stuttering-in-adults-and-children/] in
multiple regions of the brain associated with speech processing and production.

A study by CA Kell states that spontaneous recovery from stuttering during
adulthood may be rare, but it opens up the possibilities of brain repair outside
the scope of developmental plasticity.

What Processes Of The Brain Contribute To Stuttering?
Imaging studies
[https://www.stutteringhelp.org/differences-brains-people-who-stutter] of the
brains of people who stutter (PWS) show that the regions responsible for speech
function anomalously.

Two such areas include the left inferior frontal gyrus (IFG) and the left motor
cortex. The left inferior frontal gyrus is responsible for the planning of
speech and the left motor cortex is responsible for executing the speech
movements.

According to Nichole Neef [https://www.cbs.mpg.de/stuttering-in-the-brain], a
leading neuroscientist at the Max Planck Institute for Human Cognitive and Brain
Sciences (MPI CBS),

“when speech movement planning and execution are sporadically interrupted or
inhibited, the person cannot speak fluently.”

MRI studies of the brain activity in adults who stutter show significant
hyperactivity in the right hemisphere of their brains.

As per studies [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731627/] by Chang
et al 2008, children who stutter show anomalies in the Broca's area and
noticeable disorganization in the white matter in the region of the left
rolandic operculum.

These structural anomalies persist in the brains of adults who stutter. In
adults who stutter, neural activity is higher in the right frontoparietal
regions of the brain and the basal ganglia.

Who Can Recover Spontaneously From Stuttering?
Publications on the research work conducted by Ambrose and Dworzynski
respectively show that, just like stuttering, spontaneous recovery can be
heritable.

It is impossible to predict who will recover without assistance and who won’t.
Therefore, almost all speech-language pathologists (SLPs) recommend early
intervention for children who have been stuttering for more than 2 months.

The heritable nature of an individual’s ability to recover without assistance
makes room for the hypothesis that spontaneous recovery must engage strong,
reproducible neural mechanisms in the brain.

What Brain Structure Changes Are Key To Stuttering Recovery?
Data from the study [https://pubmed.ncbi.nlm.nih.gov/19710179/] by CA Kell et al
shows that unassisted recovery is accompanied by the activation of the part of
the orbitofrontal cortex of the brain. It is adjacent to the area where an
anomaly of white matter distribution is noted in the case of people who stutter.
However, the same area is normalized in subjects who recover without assistance.

The structural differences between the brains of adults who stutter and those
with fluent speech show that stuttering depends on the anomalies in the left
inferior frontal region. The recovery process depends significantly on the
posterior orbitofrontal site.

In the cases of adults who stutter, hyperactivity was noticeable in the right
hemisphere. The regions of hyperactivity were contralateral to the structural
anomalies. The over-activation of the right hemisphere is inversely related to
the stuttering severity
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/].

Behavioral and speech therapy can abolish the over-activations in the right
prefrontal and parietal regions. Fluency shaping shifts the hyperactivations to
the corresponding regions in the left hemisphere.

Therapy can reduce the compensation attempt by the adult brain and prevent the
over-activation of the right hemisphere. Therapy can normalize the function of
the perisylvian regions.

Can You Induce Changes In The Brain Structure and Function?
The brain has high plasticity. Even in adults, the brain undergoes changes in
neural connections, depending on external factors including habits, daily
practices, lifestyle, medication, and more.

It is hard to believe, but it is possible to  train your brain to revert the
anomalies in structure and function that may contribute to your stuttering.

A new study published by the American Academy of Neurology (AAN) proposes
[https://www.aan.com/PressRoom/Home/PressRelease/1095] that one week of speech
therapy can reorganize the structures of the brain responsible for stuttering.
The reorganization of brain structure can reduce stuttering.

The researchers conducted the study on 28 adults and 13 people who don’t
stutter. Out of the 28 adults, 15 received a week of therapy with three sessions
per day. The control population and the remaining 13 people who stuttered didn’t
receive any therapy.

The team used brain scans to measure the thickness of the cerebral cortex at the
beginning and end of the study. The team measured the interactions between the
different areas of the brain while at rest for all participants.

For those who stutter, the interactions within the cerebellum were stronger as
compared to the fluent speakers.

After a week, the PWS who received therapy exhibited the same level of
functional connectivity in the cerebellum as those who don’t stutter.

The author of the study, Chunming Lu, Ph.D. states

"therapy can prompt the brain to reorganize itself even in the cases of adults
who stutter. The changes in the interactions of the cerebellum show that the
brain compensates for stuttering".

Research also proves that differences in the structure and function of several
regions of the brain contribute to stuttering and stuttering severity.

CA Kell, MD, Goethe University, Frankfurt states that these findings should help
speech therapists and speech-language pathologists (SLPs) in their work. They
can further gain an insight into how speech therapy works in reorganizing the
structure of the brain.

Neuroplasticity Is Good News for PWS
These studies are proof that it is never too late to begin speech therapy
[https://ghost.stamurai.com/stuttering-treatment-for-adults/].

It is important that you find the right speech therapist who can provide you
with the correct exercises [__GHOST_URL__/stuttering-exercises-for-adults/] and
speech therapy tools that can help stimulate your brain.

If you have never thought about or opted for speech therapy, you can start right
now with Stamurai. Give this state-of-the-art speech therapy a try.

A good speech therapist or speech therapy app can help you master fluency
shaping strategies and stuttering modification and apply them effortlessly while
you are speaking.

However, you need to be patient. If you have been stuttering for years, you need
to give speech therapy at least a couple of months before you can sense a
significant difference in your speech.

How the Brain Repairs Stuttering

We refrain from using the term “stutterer” for multiple reasons. Labeling
someone is reductive and limiting. The particular term implies that a person who
stutters is defined by their speech disfluency. It is a stereotype that we aim
to break.

A person who stutters can be a speech-language pathologist, speech therapist,
researcher, scientist, pilot, author, marketing expert, entrepreneur, sports
person, actor, and whoever they want to be.

The imposition and assumption of listeners who don’t stutter tend to limit the
choices, and possibilities for those who do. People who stutter (PWS) often feel
a lack of confidence, self-esteem, and courage to do something they desire due
to repeated negative reactions from their listeners.

The fear of rejection drives PWS into a shell and keeps them from taking on new
challenges in life.

Yes, speech therapy or stuttering treatment is definitely an option for
children, teens, and adults who stutter. However, there is a significant
percentage of the population that does NOT have access to speech therapy for one
reason or another.

Self-therapy for stuttering is one of the best options for them to usher a
change in their life.

What is Self-therapy for Adults who Stutter?
Self-therapy is ideal for adult clients who have chosen to become their own
clinician. The person has to engage in intense self-study, observation, and
noting down their emotions, and behaviors when studying.

Malcolm Fraser, published the very first book
[https://www.stutteringhelp.org/self-therapy-stutterer] on self-therapy for
adults who stutter. Over the last couple of decades, several stuttering
organizations and reputed speech-language pathologists have further simplified,
elaborated and built upon his work. Now, we have a set of guidelines that adults
without formal training in speech pathology can follow in the absence of
clinical intervention.

What are the Steps of Self-therapy for Adults who Stutter?
If you are considering self-therapy for stuttering, you can follow this short
guide.

How Do You Identify Yourself?
Is stuttering truly limiting you? Sadly, repeated interactions with listeners,
opinions of our parents, negative reactions from our friends make us believe
that we are “stutterers.”

Years of avoiding conversations and social situations take a toll on
self-confidence, self-esteem, and self-image.

Labels can be overwhelming. They can make us believe that we are bad
communicators [__GHOST_URL__/stuttering-misconceptions/], inept decision makers,
or even incapable of living independently.

It is easy to believe that stuttering limits our abilities. However, in most
instances, we are limiting ourselves.

Let us begin our fight against these labels and restrictions by listing the
instances when you have fought back against the label.

 1. Write about situations in which you have felt different, dependent,
    independent, insecure, and secure.
 2. Share 3 instances where you struggled to express who you are. Don’t forget
    to write what you felt during these times.
 3. Share 3 responses people have made about your stutter. How did you respond
    to them?
 4. What are the adjectives you believe people use to describe you and your
    stuttering. Do you agree or disagree with these adjectives? Why?

Overcoming the Loneliness of Stuttering
Stuttering can be a lonely affair. Oftentimes, our blocks keep us from sharing
our feelings and at other times, we keep ourselves from speaking. Speech
disfluencies may make us feel isolated and alone.

Anyone who stutters is well aware of the frustration of not being able to
express their desires, discomforts, likes, dislikes and so much more. We have
learned to anticipate the reactions of our listeners before we speak.

It paves the way for depression and long-term emotional turmoil
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/] that may impact our
life choices. All in all, stuttering is an isolating journey.

It is time to take the power of stuttering away. Here’s how we can do it -

 1. Make a list of 5 statements people have made regarding your limitations
    because of stuttering. Discuss what hurt you the most and why.
 2. What are some of the negative statements you have made to yourself in the
    following situations –

 * Job interview
 * Placing an order at a restaurant
 * Social gatherings
 * Class presentations

What were the emotions and feelings behind these comments each time?

 1. How do you feel when people focus on your stutter rather than what you have
    to say?
 2. Make a short timeline of memories of events, situations, and interactions
    that are relevant to your stuttering. Describe them and note the emotions
    you felt in each instance.

Accepting Your Stutter
Speech therapy and counseling may help you accept your stutter
[https://ghost.stamurai.com/should-you-accept-your-stuttering-yes-absolutely/] as a part of
who you are. It is important to remember that you can stutter and still be
anyone you want to be in life.

Stuttering should not define who you are, what you do, and the decisions you
make. A person who stutters feels the need to reduce their expectations, tailor
their dreams, and check their aspirations.

The problem begins when we give up the control of our lives to stuttering and
tell ourselves that “I could have done so and so, had I not stuttered”.

Here are a few exercises that will help you realize how much stuttering affects
your identity and its influence on life choices.

 1. Write a narrative on “Life with a Stutter”
 2. Make a list of 5 experiences that have made you feel like a “stutterer”
 3. List 5 people who have made you feel reduced to just a “stutterer”
 4. What do you expect from personal relationships, education, jobs, and
    marriage?
 5. What are your perceptions of yourself, people in speech therapy, successful
    individuals, and people having fun?

Owning Your Stutter
Owning one’s stuttering isn’t as easy as many expect it to be. Most of us have
struggled silently for years against our self-perceived inferiority.

Owning our stuttering involves two levels –

 * Acknowledgement – This is where we begin to learn more about stuttering. We
   learn about the causes, potential treatment options, emotional effects, and
   psychological impacts of stuttering.
 * Admission – We admit to our stuttering instead of blaming it on situations or
   denying it. This is a key step for anyone who is looking for a “stuttering
   cure”. Before we can go to a speech therapist and demand a cure, we have to
   accept that we stutter.

Here are a few exercises that can help you own your stuttering and the effect it
has had on your life –

 1. What have you never disclosed about your stuttering?
 2. Define and cite examples of the following: passive, assertive, powerless,
    and empower.
 3. Maintain a journal for a week. Note how you perceive your stuttering in
    different situations in this format –

Day/Time

What Happened

My activity

Reactions of the listener(s)

My feelings and emotions

What were the consequences


Letting Go of the Negativity

Learning to let go of negative
[https://ghost.stamurai.com/overcome-stuttering-fear-and-insecurity/] images and thoughts
from our minds is incredibly challenging. Negative self-images keep us from
achieving our true potential.

To truly let go of the negative voices in our mind, here’s what we need to do –

 * Recognize when we stop ourselves from participating in social situations.
 * Understand when we stop ourselves from communicating with others.
 * Admit it when we anticipate someone’s reaction to our stuttering.
 * Let go of the negative ideas that limit our interactions with our
   environment.

To effectively let go, here’s what you need to do –

 1. Maintain a journal for 7 days. Write about every instance that triggers a
    negative monologue in your mind.
 2. Note 3 conversations you have had in the recent past. Write down what you
    think the listener was thinking/feeling and why.
 3. What bothers you about your stuttering? Next, write about the different
    strengths you have developed because of your stuttering.
 4. Make a list of 10 activities that you have always wanted to do but you blame
    your stutter for not being able to do them. Pick any 3 and complete them.

A New Perspective
Gaining a new perspective of your stuttering is the ultimate goal of
self-therapy for stuttering adults.

The first stages of self-therapy should help you understand how others truly
view you and your stuttering, what factors have limited your potential and how
you can bring about a positive change in your life.

To consider a new perspective towards your stuttering, you need to –

 * Understand all the previous steps
 * Accept and own your stuttering
 * Disavow the stigma that comes with the “Stutterer” label
 * Understand that a larger part of the society will interact with you as a
   “stutterer” and it is up to you to deal with the feelings this evokes.
 * Own your feelings and be the master of your responses.

It sounds like a herculean task and it will take some time. however, here are a
few self-therapy exercises that might help –

 1.  Discuss your thoughts on personal values, self-respect, stereotypes, and
     self-image.
 2.  Write the Ten Commandments that would sum up your rules, ideas, taboos, and
     thoughts about stuttering.
 3.  What are the 3 goals you want to accomplish in your lifetime?
 4.  Choose 3 challenges and complete them during the next two weeks –
 5.  Introduce yourself [__GHOST_URL__/voluntary-stuttering-and-fluency/] as a
     person who stutters to a new person/group
 6.  Invite someone or ask someone out for coffee/dinner without hiding your
     stutter
 7.  Ask 3 strangers for directions
 8.  Go somewhere alone
 9.  Answer the phone
 10. Call a supermarket to ask if a particular item is in stock
 11. Chat with someone on video call
 12. Make a list of 10 situations that make you feel powerless.
 13. Write a powerful piece titled “I am a Person”. Include everything you have
     achieved despite your stuttering.

The Last Words on Self-therapy for Adults who Stutter
Self therapy for adults is especially effective since adults are capable of
assuming responsibility for the course of therapy.

During self-therapy remember to be honest to yourself. Self-therapy isn’t just
about speech exercises [__GHOST_URL__/stuttering-exercises-for-adults/] and 
fluency shaping [__GHOST_URL__/stuttering-fluency-shaping-techniques/] 
techniques. When you undertake self-therapy for stuttering, you need to invest
time in self-study. Note your emotions as well as attitudes, behavior patterns
associated with stuttering.

Self-therapy for stuttering may help you overcome the fear and anxiety
[https://ghost.stamurai.com/how-to-overcome-fear-and-tension-if-you-stutter/] of stuttering
anticipation. However, the success of self-therapy depends on your readiness to
commit and ability to accept stuttering as a part of your life.

What Is Self-Therapy For Adults Who Stutter?

Watching your child grow up is one of the best gifts ever. Their first attempts
to roll over, their cute smiles, and their babble bring heaven to the earth. As
they grow up their language and vocabulary typically expand as well. They go
from saying single words to constructing full sentences.

Very soon “Mommy juice” and “Daddy candy” turns to “Mommy, I want some juice”
and “Can I please have some candy?”

Understandably, children struggle when they first learn to speak and try to form
complete sentences. Sometimes, children mispronounce words and have trouble with
the bigger words too. These can be genuinely concerning. Asking “is my child
stuttering” is not at all uncommon during these instances.

Fortunately, some disfluencies go away on their own. As children get a good
grasp of language skills, they begin to form sentences more boldly, show fewer
moments of hesitation, and pronounce words correctly.

Most parents learn to accept small instances of stuttering as a natural part of
speech & language development in their child. Disfluency is a popular term, used
to describe the normal disfluencies that occur during speech.

However, in the case of childhood-onset fluency disorder, stuttering treatment
[https://ghost.stamurai.com/stuttering-in-childhood-early-intervention/] may be necessary
even for children.

What Are Normal Disfluencies in a Child’s Speech?
Normal disfluencies are very typical for young children or toddlers.

They should not raise a red flag since almost all children go through a phase of
disfluency irrespective of their mother-tongue.

It is especially common in children who grow up in multilingual homes and are
learning multiple languages simultaneously.

 * Interjections – It may be when children insert additional sounds within a
   sentence. For example, “I ummm want pizza.”
 * Hesitations – This is when children include additional sounds of hesitation
   in a sentence. For example, “I want to … see gramma.”
 * Multisyllabic (whole) word repetitions – This is where children repeat a
   whole word. For example, “You you are pretty.”
 * Phrase repetitions – This is where a child may repeat the entire phrase or
   part of a sentence. For example, “Jack is Jack is Jack is my new friend.”
 * Phrase revisions – These can be in the form of abandoned sentences or
   incomplete utterances. For example, “I want…can I have some juice?”

According to some pediatricians and researchers, children may go through normal
disfluency because they are learning or acquiring multiple skills at the time.

Disfluency is very common in younger children. They may appear particularly
disfluent when excited, tired, upset, or speaking fast. Typical childhood
disfluencies may increase and decrease without any external influence.
Eventually, they disappear after a few weeks or months.

In the cases of normal disfluencies, children are hardly aware of them. They
exhibit no signs of frustration or surprise.

Understanding Early-Onset Developmental Stuttering
Telling normal disfluency apart from childhood-onset of stuttering is indeed
tricky. Stuttering is a fluency disorder that makes it difficult for a person to
produce smooth speech.

If you are asking yourself - is my child stuttering?-  the following information
will help you understand whether the disfluency you have been observing is
normal or points towards childhood stuttering
[https://ghost.stamurai.com/stuttering-in-preschool-kids/].

 * Monosyllabic word repetitions – Children repeat words that consist of one
   syllable only. For example, “I-I-I-I want to go out.”
 * Syllable or sound repetitions – Children repeat a particular sound or
   syllable from a multisyllabic word. For example, “a story be-be-be-before
   bed.”
 * Prolongation – The child may prolong a particular sound. For example, “Iiiiii
   want a ball.”
 * Blocks – Silent prolongations or vocal blocks are instances when no sound
   comes out. It’s common for a child to block before hard consonants like /b/,
   /k/, /p/, /c/, /g/, /d/, and so on.

Almost 5 out of 100 children go through a period of stuttering that persists for
about 6 months or longer. Around 75% of them will recover spontaneously without
any stuttering treatment. However, approximately 25% will go into adulthood with
mild to severe speech disfluencies.

When you are wondering whether your child is stuttering, you need to look for
the signs of mild and severe stuttering in children.

Is My Child Stuttering? Look for these Signs of Mild Stuttering In Children
Children who stutter mildly
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/] will exhibit
disfluencies that are similar to typical disfluencies in children. However, they
will have a higher frequency of repetitions. They may also have more repetitions
each time they stutter.

A telltale sign of childhood-onset disfluency or stuttering is the persistence
of stuttering. In the case of mild stuttering, the disfluencies appear to be
more regular as compared to normal or typical speech disfluencies in kids.

The child who stutters mildly may not be concerned about the problem, but they
may show signs of discontent, frustration, or embarrassment due to stuttering.

Is My Child Stuttering? Look for these Signs of Severe Stuttering In Children
In the case of severe stuttering in children, you may even see some physical
tension associated with the repetitions, prolongations, and blocks.

It can begin anywhere between the ages of 18 months and 7 years.

When the speech disfluencies are noticeable in almost every sentence or phrase,
it may be characterized as severe stuttering. 
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/]

Secondary behaviors [__GHOST_URL__/stuttering-in-children-understanding-shame/] 
associated with severe stuttering in kids may be uncommon, but your child may
blink rapidly, close their eyes, look away, or exhibit physical tension during
stuttering.

When Should Parents Seek The Help From A Speech Therapist?
If you have noticed some signs of stuttering but are still asking yourself - is
my child stuttering - you should consult a speech-language pathologist.

Mild to severe stuttering in children may persist especially if they have been
stuttering for 18 months or longer.

Parents of a child may seek counsel from a speech therapist if –

 * They have a family history of stuttering
 * The age of onset is late (after 3 years)
 * The stuttering has persisted for longer than 6 months
 * There is a high frequency of disfluencies in speech
 * The child is showing secondary behaviors associated with stuttering
 * The child is male (stuttering is more common
   [__GHOST_URL__/is-stuttering-gender-specific/] in males than females)
 * The child has co-existing speech-language disorders
   [__GHOST_URL__/stuttering-and-autism-spectrum-disorder-diagnosis-and-treatment-in-children/]

A speech therapist may recommend indirect therapy methods or pursue the Lidcombe
Program for addressing your child’s stuttering.

Research shows that early intervention
[https://ghost.stamurai.com/stuttering-in-childhood-early-intervention/] is helpful in
restoring a child’s fluency. If stuttering is not treated properly and on time,
a child may continue to stutter as an adolescent and adult. Stuttering treatment
for adults typically takes more time.

If you are concerned about your child’s speech, you should consult a
speech-language pathologist immediately.

Typical Disfluencies vs. Stuttering in Children

Talking and sharing can be incredibly challenging for anyone who stutters. It
may feel like waging a war with oneself at all times.

If you have a family member or dear friend who stutters, you may want to
introduce them to books that talk about speech disfluency in a way that’s
uplifting and informative.

Many people who have stuttered since childhood have sought comfort in reading.
Books have not only fueled their imagination, but they have also helped them
learn. These books may make learning speech exercises for adult
[https://ghost.stamurai.com/stuttering-exercises-for-adults/]s or kids
[https://ghost.stamurai.com/five-stuttering-exercises-to-help-your-child/] to reduce
stammering [__GHOST_URL__/how-to-stop-stuttering/] both interesting and easy.

If you want to pick a book for someone you know or you want to read more about
stuttering, these are a few books that may help.

For Preschoolers
Santa Stutters
[https://books.google.co.in/books/about/Santa_Stutters_Too.html?id=EHrCzAEACAAJ&redir_esc=y] 
Too By Regan Espinosa
Our beloved Santa always says “Ho ho ho”. However, what if he had more to say
like “Ho-ho-hold that sleigh”?

It is the ideal book for toddlers and preschoolers who are just beginning to
show signs of stuttering. It is a great bedtime read for parent-child activity
advocated by the Lidcombe program.

Your child will gain a new perspective about stuttering. Regan Espinosa
normalizes stuttering by making children believe that even Santa Claus may
stutter.

The Adventures of Phil & Dotty
[https://static1.squarespace.com/static/583ec3aae6f2e18631f608e0/t/5fa90b2f64a757513a0c4dc6/1604914004828/Michael+Sugarman+-+The+Adventures+of+Phil+and+Dotty+%28spreads%29.pdf] 
By Michael Sugarman and Kim Swain
It is an incredible book that fuels positive fantasy in children. Kim Swain
paints a mesmerizing picture of fantastic creatures and how Phil comes to find
his own voice through adventure.

Phil is a kid who doesn’t like going to school. However, one fateful school
morning he saves and befriends a ladybug named Dotty, and their adventures
begin.

‘The Adventures of Phil and Dotty’ is about accepting, standing up for, and
believing in oneself.

I Talk Like a River [https://www.youtube.com/watch?v=uWN3knjJgxw] by Jordan
Scott
‘I Talk like a River’ is a beautifully illustrated picture book that tells the
story of a young boy who struggles to speak. It portrays his frustration and
loneliness, and it shows how support and kindness go a long way to help a child
reconnect.

‘I talk like a River’ is based on Jordan Scott’s personal experience. It is an
impactful book for young children who are struggling with difficult emotions
like loneliness or self-doubt.

Hooray for Aidan [https://www.mnsu.edu/comdis/isad13/papers/hollett13.html] by
Karen Hollet
‘Hooray for Aidan’ by Karen Hollet is an illustrated storybook for children. If
your child is just beginning to show signs of secondary stuttering behavior like
avoidance and fear of talking, getting this book may be a good idea.

This book draws heavily from the personal experiences of Karen, who has
stuttered most of her life. It tells the story of Aiden, a little girl, who
stutters. She moves to a new neighborhood and she’s afraid to speak at her new
school.

It is a story of personal battles and how they are won even by children.

It’s a book highly recommended by the Canadian Stuttering Association and Cherry
Hughes, the Education Officer at the British Stammering Association.

For School Aged Children
A Boy and a Jaguar [https://www.youtube.com/watch?v=W-p0Un_1TOo] by Alan
Rabinowitz
Alan Rabinowitz was an American Zoologist. Apart from working as a
conservationist and zoologist, he also served as a spokesperson for the
Stuttering Foundation (SFA).

‘A Boy and a Jaguar’ is a largely biographical book (illustrated) where the
author writes “Animals were the only things I could talk to as a child.”

It is a story of how Rabinowitz turned a perceived weakness into a personal
strength. He writes about how he grew up from being someone who stuttered
severely into a spokesperson for the safety and conservation of jaguars.

It is an interesting and easy read for school-aged children who are coming to
terms with their stuttering, and struggling with feelings of isolation and
dejection.

The Adventures of Abigail
[https://books.google.co.in/books/about/The_Adventures_of_Abigail.html?id=-bupywEACAAJ&redir_esc=y] 
by Yolanda Boone
Yolanda Boone has 16 years of experience as a Speech-language pathologist (SLP).
Yolanda has been stuttering ever since she was a young child. Her personal
experience and professional expertise lends an accurate insight into the mind of
Abigail, a young girl, who stutters.

She not only narrates the story of Abigail, but each child who stutters across
the world. This coming-of-age account of a 14-year-old girl who has just begun
attending high school resonates with the thousands of teens who are currently
struggling with self-doubt, self-confidence, fear and identity.

Greenhorn [https://www.olswanger.com/greenhorn.php] by Anna Olswanger
Greenhorn is a story of human relationships and dreams. A quiet young boy, who
is also a holocaust survivor, arrives at a yeshiva with only one possession, a
mystery box. Set in 1946, Greenhorn explores the dynamics between the new boy,
his classmates and the narrator, who stutters.

The narrator finds a friend in the new boy, Daniel. Daniel never lets the box
out of his sight. The mystery of Daniel’s box spirits Anna’s story, while
navigating the complex relationship the children share with stuttering and their
dreams.

Paperboy [https://www.goodreads.com/book/show/15797693-paperboy] by Vince Vawter
Paperboy is less of a work of fiction and more of an autobiographical novel. It
is Vince Vawter’s memoir about his early teens and his struggle with a speech
disorder.

Paperboy takes place in 1959. It narrates the experiences of Victor, a boy who
stutters. As Victor takes over his friend’s paper route, he encounters new
people in the neighborhood and faces new challenges.

It is an inspiring account of a young boy’s journey from speech disfluency to
fluency. Paperboy is a must read for teens and tweens who are struggling with
stuttering.

For Teenagers and Young Adults
Stuttering: Inspiring Stories and Professional Wisdom
[http://stuttertalk.com/wp-content/uploads/2012/08/StutterBookcontents.pdf] 
Edited By Peter Reitzes and David Reitzes
It is a collection of short stories and accounts from people who stutter from
across the world, and professionals.

The first section of the book contains inspiring accounts from people who
stutter. Ideal for teenagers and young adults, this book provides a much-needed
boost of motivation and positivity.

In this book, you will find topics like fluency, stuttering, stuttering related
fears, covert stuttering, avoidance, tools for stuttering treatment and
productive changes.

It is the most wholesome book for readers who want to learn about stuttering and
its impacts in a concise and interesting way.

The Gift of Stuttering - Confronting Life's Challenges: A Personal Journey
[https://www.goodreads.com/book/show/29441977-the-gift-of-stuttering] by Moe
Mernick (2016)
Moe Mernick describes the challenges he has faced throughout life as a person
who stutters. It is an exceptional book that takes us through Mernick’s quest
for the meaning and purpose of his stuttering and suffering.

Read this book to find out how Mernick overcomes his loneliness and suffering
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/] to find an exceptional
life of purpose and meaning [__GHOST_URL__/stuttering-life-lessons/]. Find out
what drives him to embrace hope even when uttering his own name seems like a
challenge on some days.

The Gift of Stuttering can help someone who stutters by giving them inspiration
and hope!

Stuttering Is Cool [http://stutteringiscool.com/stuttering-is-cool-book/]. A
Guide to Stuttering In a Fast Talking World, By Daniele Rossi
Are you an adult or teen who enjoys reading comic books more than novels and
short stories? Well,this book by Daniele Rossi is for you!

This super fun, simple, yet informative book tells the story of Banky. Franky
Banky struggles with stuttering and loneliness. ‘Stuttering is Cool’ captures
Banky’s journey from shame, discomfort and embarrassment to confidence, 
voluntary stuttering [__GHOST_URL__/voluntary-stuttering-and-fluency/] and 
advertising their stutter [__GHOST_URL__/self-advertising-stutter-or-stammer/].

It is an excellent guidebook for people who want to master new tools and
techniques that can help them cope with stuttering. It is an interesting read
for anyone who wants to learn about stuttering without keeping a thesaurus
handy!

Stammering Pride & Prejudice: Difference Not Defect
[https://stamma.org/news-features/stammering-pride-and-prejudice-book] Edited By
Patrick Campbell, Christopher Constantino, and Sam Simpson
‘Stammering Pride and Prejudice’ is an engaging read, which aims to change the
way we think about stuttering or stammering. It is a must-read if you are
thinking about pursuing self-therapy for stuttering
[https://ghost.stamurai.com/stuttering-self-therapy/].

While many view stuttering as a character flaw, the authors present stuttering
as a unique way of talking that needs to be heeded and respected. It presents a
combination of personal narratives, statistics, disability theory and art to
demonstrate how society has turned stuttering into a disability.

This book will give you a new perspective about stuttering and an understanding
of the negative emotions associated with it. It will give you the validation you
need to deal with your shame, embarrassment, anxiety and fear of stammering.

12 Books for People Who Stutter

Is fluency enough? Everyone who stutters has the goal of being more fluent one
day, but they don’t want to stop at that. They dream of freedom from stuttering.

Is it tough? Yes! Is it an impossible dream? Apparently, not.

It takes a lot of work to be fluent and it takes even more work to achieve
freedom from stuttering. However, it is an attainable dream that begins with a
lot of work on oneself.

If you too have the dream of becoming free from stuttering, you should begin
with these 4 simple steps –

 1. Identification – The first step is the identification of the specific nature
    of your stuttering
 2. Development – Next, you should work on developing an effective therapy
    program
 3. Implementation –The third step should be implementing the therapy program
 4. Maintenance – The final step should be maintaining the new stuttering
    modification and speech production methods till they become habitual

Identifying Your Stuttering
Everyone who stutters may not have the same type of stuttering. Stuttering
severity [__GHOST_URL__/understanding-degrees-of-stuttering-severity/] along
with type may vary significantly between two individuals. So, simply knowing
that you stutter may not be enough.

Begin self-diagnosis with what you do when you stutter. 

For example – when you try to say a word and stutter, examine the feelings,
articulator movements, and actions that occur. 

You may notice that you hold your breath before making a /h/ sound at the
beginning of a word. 

Or, your tongue "gets stuck" behind your teeth when you are trying to make a /d/
sound.

You should also make a note of what you do when you anticipate a block.
Sometimes, you may avoid the word entirely and substitute it. 

Or, you may articulate the feared word with more effort to overcome the block.

You may want to divide these observations into three categories –

1. Speech-flow blocks
Blocks are interruptions to the regular flow of speech. These are silent phases
during which a person who stutters tries to speak. You may have felt your throat
close up, chest tighten, jaws clench, or tongue getting stuck when no sound
comes out. That may have been a speech block. We have more details on blocks and
how to overcome them right here.

2. Coping methods
Many adults who have been stuttering since childhood learn block coping
[https://www.mnsu.edu/comdis/kuster/Infostuttering/Harrison/block.html] 
mechanisms in speech therapy or from trusted sources like Stamurai. However,
many opt for patterns that may make blocks worse. Some block-coping methods may
even worsen stuttering including pushing oneself to complete a word, adding a
head nod or hand movement to release a block, or avoid a particular word and
replacing it with another.

3. Stuttering not associated with a block
Some stuttering behaviors aren't associated with blocks. For example, when
someone who stutters tries to rush through a sentence in a high-strung situation
they might end up repeating a few syllables or part-words in the sentence.
However, it isn't the same as blocking, since the speaker can vocalize during
their stutter. The same is true for prolongations.

Development of a Therapy Program
Not everyone stutters in the same way. Therefore, not every therapy program is
equally effective for everyone who stutters. 

One way to understand which stuttering treatment
[https://ghost.stamurai.com/stuttering-treatment-for-adults/] methods will be effective for
you is by assessing the severity
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/]of your stuttering.

Your speech therapist can help or you can use a trusted app like Stamurai
[https://ghost.stamurai.com/stamurai-app-to-stop-stuttering/] to determine your stuttering
severity. Either way, the goal is to get more acquainted with your blocks.

Stuttering blocks seem unpredictable. They appear when you are least expecting
them; this makes it extremely difficult for someone who stutters to manage and
reduce their stuttering blocks.

Currently, there are several techniques speech pathologists recommend to
effectively overcome speech blocks [__GHOST_URL__/overcome-stuttering-blocks/].
Here are some of the techniques that may work for you –

Cancellation
Cancellation is a post-block correction technique that you need to use
immediately after you experience a block.

Immediately after you experience a block, try to understand what you did wrong
and what you can do to rectify it in the future.

During cancellation, you begin to make your way through a feared word, and as
you approach the block, pay attention to the movement of your lips, tongue,
throat muscles, and jaws.

Pause a little and give yourself the time to think about what may be
contributing to your block. Next, release the pressure and try saying the word
differently.

Pull-out
It is an in-block correction technique that can give you a fresh insight into
the relationship breathing and muscle coordination share.

Post-block corrections aim to teach you how to cancel the block once it has
begun.

The in-block corrections demand that you don’t stop when you are in the middle
of a block. Next, slow it down and let the block run its course. Try to prolong
the word you are blocking on and stretch the sound. The pull-out technique is
incredibly useful for people with a high stuttering severity who experience a
high frequency of blocks.

Preparatory set technique
It is a pre-block correction that will enable you to move through a block
without breaking flow.

As you approach your feared word, pause. Take a deep breath (look at coastal
breathing for a clear idea) and feel your articulators relax.

Recollect the fluency shaping techniques
[https://ghost.stamurai.com/stuttering-fluency-shaping-techniques/]you have learned so far
and apply one that can help you ease through the word without breaking the flow
of the conversation.

Imagine how it would feel to say the word with deliberation. Now, try to say the
word out loud in the same manner while applying your newly learned block
correction techniques and fluency shaping techniques.

Implementing the Therapy Program
Devising a therapy program or receiving a personalized stuttering treatment from
a speech therapist isn't enough. You need to follow through with daily
practices, exercises [__GHOST_URL__/stuttering-exercises-for-adults/], receive
feedback and track your improvement.

Stuttering therapy is a lot of hard work! Sadly, it isn’t the magical cure most
of us hope for.

Stuttering therapy for freedom from stuttering requires significant amount of
unlearning. Over the years, we have learned secondary responses to our
stuttering, including avoidance and escape behaviors. These pose obstacles in
the path of acquiring fluency.

You will need patience, tenacity, and dedication to see the first signs of
fluency. Sometimes, it takes days, but at other times, it may take weeks or even
months. Therefore, it is important to set tangible, daily goals.

If you are experiencing a lack of progress for days at a stretch, then you may
need to revise your stuttering therapy plan.

Maintaining and Persisting
Normal speech requires thousands of muscles and nerves working in sync to
produce smooth speech. It may seem effortless, but that isn’t always the case
for people who are learning to overcome their stuttering.

For people who stutter, producing fluent speech requires a learning curve. 

This learning curve demands that you master the speech therapy techniques and
apply them whenever you speak with little effort. They must become a habit.

And that takes a lot of work! Self-therapy for stuttering
[https://ghost.stamurai.com/stuttering-self-therapy/] is entirely possible for adults who
stutter. 

You just have to remember that fluency doesn't come in one day. 

You will have to spend several hours mastering the techniques and subsequently
applying them every time you feel a repetition, prolongation or block come up.

On Your Way to Freedom
Recent research shows that people who stutter benefit from flexible stuttering
treatments [__GHOST_URL__/stuttering-treatment-for-adults/]that cater to their
specific needs. 

A majority of the adults who stutter expect
[https://pubmed.ncbi.nlm.nih.gov/18695024/] greater fluency and better control
over their speech rather than complete freedom from stuttering.

100% freedom from stuttering isn't a far-fetched dream if you are ready to put
in some elbow grease. 

It will take considerable time and you will have to apply the fluency shaping
techniques every time you speak. 

However, it is indeed possible as long as you are ready to identify your
stuttering, make a therapy plan, and implement the therapy
[https://stamurai.com/therapy-protocol] and follow-through.

4 Essential Steps to Freedom From Stuttering

Does your child often block or repeat while talking? Is your child between the
ages of 18 months and 6 years? Has s/he been doing it for over 8 weeks? Then,
your child may have childhood onset fluency disorder or stuttering.

Adults may stutter [__GHOST_URL__/causes-of-stuttering-in-adults/] too. Some
adults stutter since their childhood and are said to have developmental
stuttering. Others may develop stuttering suddenly, which experts refer to as
acquired stuttering.

What Do You Do If You Notice Your Loved One Stuttering?
Speech therapy is one of the most effective stuttering treatments that is ideal
for children and adults [__GHOST_URL__/stuttering-treatment-for-adults/].

Early intervention [__GHOST_URL__/stuttering-in-childhood-early-intervention/] 
in the case of developmental stuttering
[https://ghost.stamurai.com/causes-of-stuttering-in-adults] in children can reduce the 
intensity of stuttering
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/] and even prevent
it from becoming a lifelong problem.

The frequency of sessions, types of exercises and duration of speech therapy
will depend on the severity of stuttering.

Beginning Speech Therapy
Case studies show that speech therapy is most effective for children up to the
age of 7. Stuttering treatment for older kids
[https://ghost.stamurai.com/parental-guide-to-teenage-stuttering/] works as well. However, it
may take longer and the child may require more frequent sessions with the SLP.

Therefore, early intervention is of utmost importance for childhood-onset or
developmental stuttering.

It may be difficult for a parent or a doctor (pediatrician) to tell the
difference between normal disfluency in children and childhood onset fluency
disorder.

SLPs are responsible for the screening, assessment and intervention of
communication disorders in all ages. However, the role of an SLP is most crucial
in the screening and detection of communication disorders in toddlers and
children.

How Can A SLP Help You And Your Child?
An SLP looks after the holistic development and wellbeing of the child besides
treating their stuttering.

SLP services adhere to 4 basic guidelines that aid in the effective and early
interventions for children.

SLPs Provide Family-Centered and Culturally Responsive Services
The SLP aims to provide early and effective intervention that addresses the
family’s concern regarding the child’s needs and learning ability. An
experienced SLP is able to individualize his/her service for the family
according to their culture, unique situation, priorities, resources and
preferences.

It is important to note that the entire family, and not the individual child, is
the recipient of the SLP’s services. Family-centered services offer the family
members a more active role in planning, implementing and decision making during
stuttering treatment.

These are all integral components of indirect therapy
[https://ghost.stamurai.com/five-stuttering-exercises-to-help-your-child/] for toddlers and
preschoolers, who may benefit from the Lidcombe program.

An SLP Provides Services That Are Developmentally Supportive
Simply treating stuttering isn’t the ultimate goal of any stuttering treatment
[https://ghost.stamurai.com/treatment-for-stuttering/] plan. Stuttering may result in a
reduction of self-esteem and confidence in a child.

It is the responsibility of the SLP to take the emotions associated with
stuttering [https://www.stutteringhelp.org/new-look-stuttering-and-emotions] 
into consideration before they proceed with treatment.

The SLP proceeds with the hypothesis that the acquisition of communication
skills occurs based on a child’s social and cultural framework. The early
intervention practices include active exploration of experiences, cognitive
abilities, interests, interactive participation appropriate for the child’s age
and the family’s concerns.

The optimal early intervention practices for childhood-onset fluency disorder is
provided in a natural setup (such as the child’s home). It also offers realistic
learning experiences that the child can apply during their daily interactions.

SLPs Provide Comprehensive and Coordinated Services
SLPs may act as the first point of contact for families who may need expert
interventions for their children’s speech.

In the case of developmental stuttering [__GHOST_URL__/what-is-stuttering/],
SLPs often provide the complete guidance necessary for primary intervention and
maintenance therapy.

However, if the SLP deems that your child may have auditory disabilities,
anomalies in behavior or congenital conditions that imply developmental delay,
he/she may refer you to the necessary medical expert.

SLPs Provide Services That Meet the Unique Needs of a Child and Their Family
An SLP has the qualification, training and experience to provide tailored
services that meet the unique needs of the child and the family in need.

SLPs provide uniquely personalized services to their clients for the following –

Prevention
Not all communication disorders and fluency disorders can be prevented. However,
an early intervention may mitigate the risks on the child’s development.

SLPs can even help a few children, who are predisposed to stuttering
[https://ghost.stamurai.com/cellular-causes-of-stuttering-in-adults-and-children/] (genetics
and family history), reduce the symptoms of their stuttering. SLPs can promote
the positive communication interactions between the toddlers and their
caregivers as a part of primary prevention.

As a part of secondary prevention, they can also mitigate the negative emotional
effects of stuttering in children. Finally, they can address an existing or
long-term stuttering problem by providing intervention services to prevent
future complications as a part of tertiary prevention.

Screening and Assessment
An SLP can screen for the communication needs of a toddler or child. They are
responsible for the identification of children who are at risk for stuttering
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6154780/].

Based on their observation, a team of speech-language experts and medical
professionals can evaluate and assess what intervention program a child may
require.

Planning and Implementing Therapy Plans
When a child is at risk and the SLP tailors a stuttering treatment program that
suits the needs of the child and the family, the SLP coordinates with other
members of the team including audiologists, special educators, and home trainers
to provide services and support.

Consultation With and Education of Family Members
One of the crucial responsibilities of the SLP is to inform and educate the
family members about their child’s speech problem. This includes the causes of
stuttering, potential treatment options, stuttering treatment goals and what to
expect at the end of speech therapy.

In the cases of stuttering in preschool-aged children, the SLP assumes an
indirect or consultant role only. He/she communicates with only the parents and
guides them to modify their communication with the child. He/she takes feedback
on the progress of the child’s speech.

Providing Up-To-Date Information
Research on stuttering [https://www.stutteringhelp.org/basic-research] is still
continuing. Several new factors, and models for stuttering treatment are coming
to light.

The SLP always informs the family of the advancement in research on stuttering
and their options.

The SLP has the best interest of the family and child in their mind, and they
inform the families regarding the new treatment methods that may suit the unique
needs of their child.

Wrapping It Up
Speech-language pathologists aim to prevent, evaluate, assess, reduce, diagnose
and treat speech disorders including stuttering. However, you can expect much
more than traditional speech therapy or stuttering exercises from SLPs once you
step into their office.

SLPs not only treat toddlers and children, but they also address speech issues,
social communication, cognitive communication and language disorders in
teenagers and adults.

Stuttering Treatment: How Can A Speech-Language Pathologist Help?

Stuttering treatment may consist of fluency shaping
[https://ghost.stamurai.com/stuttering-fluency-shaping-techniques/] and stuttering
modification methods. These are approaches that can teach someone to stutter
more fluently. However, these methods only address the surface components or
physical symptoms of stuttering – repetition, prolongation, and blocking.

Why Should We Focus On The Mental Health Of Anyone Who Stutters?
Stuttering is a multi-dimensional, speech-motor disorder. Several decades of
research has shed light on the causes of stuttering
[https://ghost.stamurai.com/what-is-stuttering/], the signs and symptoms, and the ways to
reduce its severity
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/]. Nonetheless,
there's not a lot of research on the less-obvious symptoms and effects of speech
disfluency.

The less-obvious symptoms may include anxiety, stress, panic, embarrassment,
frustration, and confusion. It is indeed common for adolescents and adults to go
through intense self-doubt and self-criticism as a result of their stuttering.

Anxiety May Come From Stuttering
Social anxiety, generalized anxiety, and stress are common among people who
stutter. However, social anxiety disorder (SAD) and general anxiety disorder
(GAD) aren't formally diagnosed unless the symptoms contribute to diminishing
quality of life.

In the case of people who stutter (PWS), the fear of being judged for their
disfluency, embarrassment and shame
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/] worsen persisting
anxieties [https://pubmed.ncbi.nlm.nih.gov/15178129/] about social interactions.
The common symptoms of SAD may include –

 * Rapid heartbeat
 * Muscle tension
 * Shortness of breath
 * Dizziness or light-headedness

These symptoms may also worsen the stuttering, which can further contribute to
the symptoms of anxiety.

The Progress of Depression among the PWS
Stuttering may not cause depression. However, the inability to express oneself
over the years, the recurring instances of social anxiety, withdrawal from
social life, and the self-imposed restrictions may contribute to morbid feelings
that make depression [__GHOST_URL__/stuttering-depression/] worse.

The most common symptoms of depression may include –

 * General lack of interest in everyday activities
 * Increased sleep and fatigue
 * Problems falling asleep
 * Irritability
 * Changes in appetite and fluctuations in weight
 * Sudden outbursts and uncontrollable emotions
 * Feeling of hopelessness.

Currently, the jury is still out on what exactly causes depression. There are
several theories regarding its pathophysiology. However, it is quite common
among the PWS.

Stuttering and Perception of the Self
People who stutter are not just afraid of their stutter, but they are anxious
about the way their listeners might perceive them as a result of the way they
speak.

While stuttering is quite common, many have faced negative reactions from our
listeners. It has contributed to negative feelings and attitudes about speaking
and social situations.

Negative attitudes from parents, friends, and close acquaintances may contribute
to poor self-esteem
[https://www.oatext.com/self-esteem-and-anxiety-in-stuttering-children-and-attitude-of-their-parents.php]
. The precipitation of poor self-esteem may begin when the individual is a child
and may continue well into adulthood.

According to Boyle (2009), the negative judgments may be the result of the
innate belief that PWS can control their core stuttering behavior. Stuttering is
completely involuntary and PWS are in no way to blame for their speech
disfluency.

Boyle proceeded to show that PWS prefer not talking at all rather than
exhibiting their stuttering. PWS are highly self-conscious and may even have
decreased self-esteem.

The Effect of Stuttering On Intimate Relationships
A study
[https://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1061&context=gs_rp] in
1969 showed that only 7% of the participants felt that PWS is acceptable for
marriage. Stuttering is a negative attribute when adolescents and young adults
are looking for romantic relationships.

Collins and Blood [https://pubmed.ncbi.nlm.nih.gov/2299842/] (1990) show that
there are several ways to mitigate the problems or negative effects stuttering
has on relationships. They may include going out in a group, virtual courtships,
or choosing a casual environment that aids fluency.

Sadly, a majority of people avoid relationships with PWS as is shown by the
studies conducted by Shears (1969) and Boberg (1990).

Many PWS choose to stay single due to their social anxieties and the fear of
being judged by their romantic interest.

Stuttering Affects Career Choices
Adolescence is the time when individuals delve into positive fantasies about
their future. Some dream of becoming pilots and engineers, while others may
dream of becoming successful chefs or actors.

Research shows that years of feeling rejected takes a toll on the positive
imagination of PWS. Children [__GHOST_URL__/stuttering-in-preschool-kids/] and
adolescents who stutter begin to restrict their dreams and censor their goals.

Misconceptions [__GHOST_URL__/stuttering-misconceptions/] like “those who
stutter are bad at communication” diminish the self-confidence and aspiration of
adolescents with speech disfluencies.

Their weakened confidence coupled with a dwindling self-image often finds them
holding back during job applications and interviews
[https://ghost.stamurai.com/stuttering-and-job/].

Stuttering Therapy and Counseling for Better Mental Health
Stuttering is not a completely psychological phenomenon. Depression and anxiety
may make stuttering worse, but it is a multi-dimensional disorder. Genetics,
neural functions, and cellular factors contribute to speech disfluency in
people.

Stuttering has a significant impact on the mental health of the person who
stutters. Going through life sounding different from other people isn't easy.
The years of bullying, rejection, and shame take a toll on one's mental health.

Therefore, addressing stuttering with speech therapy isn't enough. Speech 
therapy [__GHOST_URL__/stuttering-therapy-for-school-aged-children/] may help
you increase your fluency and reclaim control of your speech, but it can't undo
the years of abuse your mental health has gone through.

Research shows that psychological counseling
[https://ct.counseling.org/2018/04/counseling-people-who-stutter/] or simple
talk therapy can have a huge positive impact on a person's self-image.
Counseling is a holistic approach that addresses negative emotions and
attitudes.

Stuttering counseling deals with both the behavior and feelings of the client.
Clinicians address the guilt, shame, and fear that PWS go through in their
everyday life during therapy.

Adolescents who stutter can learn to navigate their fears, anxieties, shame, and
embarrassment with the support of a certified counselor while working on speech
techniques with their speech therapists.

The Psychological Impact of Stuttering on Adolescents

As parents, when you notice your child stuttering, you may feel helpless,
guilty, and even anxious. You worry about their future, social life, career
options and so much more.

Parents begin to wonder what they can do to help their children. There are few
verified resources that can guide you. Most importantly, they assure you that
you don't have to face stuttering alone.

Here are 20 things you can do to help your child who stutters –

1. Learn About Stuttering
Learning more about childhood fluency disorders like stuttering will not only
help you, but it will also help your child. You can give the correct information
to your child and encourage them whenever necessary.

You can find verified information on stuttering causes, symptoms, and stuttering
treatment right here at Stamurai Blog [__GHOST_URL__/].

The more you know about stuttering, the more you can help your child.

2. Discuss Stuttering
Stuttering is not shameful and it shouldn’t be. It is time to talk openly about
stuttering with your child and the rest of your family.

Some children are unaware of their stuttering problem. If that's the case, you
may want to wait a while until they begin asking you questions about their
speech.

If your child seems perturbed by their uncommon talking style, make sure that
he/she can come to you with their questions. Create a safe space for your kid to
talk about stuttering and the feelings that come with it.

It will help your child to know that they don’t have to deal with it alone.

3. Establish Clear Communication
Take time off from working and social commitments to spend an hour with your
child. Establish an open line of communication, which is unhurried and
comfortable for the both of you.

A child who stutters needs parental support in every way possible. Be there for
your child physically and emotionally.

4. Talk To a Professional
Thankfully, the 21st century has made speech therapy options and stuttering
treatments [__GHOST_URL__/treatment/] accessible for children with stuttering.
Going to a clinic may not be an option for many parents or children out there.
However, you can always use Stamurai [https://stamurai.com/] from the comfort of
your home.

While most children under the age of 6 may gain fluency with the Lidcombe
Program, it is the responsibility of the parent to find the right therapist for
their child.

Therefore, consult a speech-language pathologist or speech therapist who
specializes in treating children with speech disorders. Find out all the
necessary details about the therapy your child may need.

5. Take Time to Listen
Research shows that paying attention to what your child has to say can boost
their confidence and self-esteem. What your child has to say is important. It is
more important than how s/he says it!

Don’t try to finish their sentences. Don’t say things like “relax,” “just
breathe,” “slow down,” or “you are talking too fast”.

Following these simple steps can help you encourage your child to develop
healthy communication skills.

6. Reduce Your Demands
If you are demanding too much from your child verbally, it’s time to reconsider.

Asking too many questions or telling them things like, “tell grandma what
happened during Jane’s birthday party” may demand too much from their speaking
abilities. It may lead to anxiety and a fear of speaking.

Reducing these demands may allow your child to relax and even enjoy speaking.
Decrease the pressures to see your child develop prudent communication skills,
even when they stutter.

7. Decrease the Time Pressure
There’s nothing worse than making your child feel that their speech is being
timed.

Always speak slowly and enunciate your words while talking to your child.
Moreover, make it a practice at home to take turns while talking. Minimizing the
interruptions while your child talks can help your child feel important,
confident and encouraged.

Make room for pauses in your own speech. Use your speech as a model for your
child. Your child will soon understand that they don’t have to rush, and ‘taking
a pause while talking’ is absolutely fine.

This will foster a healthy and supportive communication environment at home for
your child who stutters.

8. Empower Your Child
Accepting and trusting your child unconditionally may be challenging, but that
is exactly what they need when their speech is suddenly changing.

When you believe in your child and accept them for who they are, they will find
the courage to accept themselves, complete with their stuttering.

Your choices can empower your child to become independent thinkers. They can
live their lives with confidence despite their speech disfluency.

9. Become Supportive
We know that you are already doing a lot for your child. However, we urge you to
take one step further and stand up for him/her too.

You are best qualified to be your child's advocate. As you learn about the
stammering causes, stuttering treatments, and stuttering behaviors, you can also
tell others about it.

You can inform other parents and their class teachers about stuttering. You can
help make others more supportive and understanding about stuttering as well.

You will set a stellar example for your child in the process. They will learn to
stand up for themselves in the long run.

10. Stay Involved
Learning more about stuttering may not be enough. You need to be a part of your
child’s life.

Share their experiences, ask about school, and inquire about their friends. Talk
about how stuttering is impacting their life, friendships, classroom activities,
and academics.

Remember, your child knows best about how stuttering is affecting their lives.
So, be a good listener. Just knowing that you are there, taking interest in
their lives, will serve as an encouragement for your child.

11. Be Accepting
The most important fact for a parent to remember is that stuttering is only a
small part of who your child is. Stuttering doesn’t define or limit your child.

Your child may overcome stuttering with patience, exercise, and acceptance. Show
your child that your love and acceptance aren't conditional. You will love and
accept them irrespective of their fluency or disfluency.

12. Cut Yourself Some Slack
You and your family will require time to cope with the stuttering diagnosis and
its treatment. Stuttering treatment and therapy take time and effort. It is
alright to crave a break sometimes.

After a week of working hard, if you want to skip 20 minutes of speech exercises
on a Sunday to go have ice cream with your little one, that’s alright!

You must remember that you will have to take an uncountable number of small
steps with your child towards fluency.

13. Let Go
Your child understands their speech and disfluencies. As they grow older, they
will have to take responsibility for the way they speak.

It may be possible that your child understands that s/he sounds different from
other children, but s/he is happy with their speech. They may choose not to
continue their search for fluency.

If they are comfortable with their stuttering, it is not up to you to “perfect”
their speech. All you can do is be supportive of their decision.

14. Be Open to Changes
Changes can be difficult for you and your child. As the adult in the situation,
you must not forget that as your child goes through their tweens into their
teens [__GHOST_URL__/parental-guide-to-teenage-stuttering/] the purview of
stuttering may change.

Their motivation and goals will change too. Talking to their speech therapist
and staying in touch with their psychological counselor may help. However, be
sure to remain their companion in their journey.

Embrace the changes and be their support during times of transition.

15. Be Flexible
As your child edges towards adolescence, your role as a parent will change. Your
child will demand more space to make independent decisions. It is important to
respect their wishes while expressing your concern.

Establish yourself as their well-wisher, and advisor. You cannot expect them to
follow through with speech therapy simply because you want them to. You can only
share your opinion and advice.

It is up to you to foster an atmosphere of trust and mutual respect at home as
the parent of a teenager who stutters.

16. Take Small Steps
Stuttering treatment will take time. Determining what constitutes success will
require teamwork and tons of patience. After that, chalking a plan and following
it through will be a long haul.

Stuttering therapy isn’t a magic cure. You will receive considerable speech
training as the parent of a child who stutters. Learning and executing the
exercises with your child may take longer than you expect.

It may be a steep learning curve for some parents. Partnering with a speech
therapist who specializes in stuttering may be helpful for you and your child.

17. Make Stuttering Exercises Fun
Speech exercises may seem trite after a few days or weeks especially if your
child is young. School-aged children may benefit from a gamified experience of
stuttering therapy.

You may work with the speech therapist to create a fun therapy/exercise plan for
your child. Or, you can opt for personalizable and customizable stuttering
therapy apps that can encourage your child.

18. Follow the Progress
As a parent, keeping tabs on how your child is performing during speech
exercises [__GHOST_URL__/five-stuttering-exercises-to-help-your-child/] and how
their speech is improving every week is of paramount importance.

However, it may be difficult if you are new to this. Apps like Stamurai
[https://play.google.com/store/apps/details?id=com.stamurai.stamurai&hl=en_IN&gl=US] 
can help keep track of your child's improvements. You can check their progress
easily in the form of charts and consult the speech therapist based on the
reports.

Following their improvements will give you and your child the necessary impetus
to practice and reach fluency.

19. Stay In Touch With the Speech Therapist
If your child has a mild or severe stutter, it is your responsibility to take
feedback from their therapist frequently.

Depending on the age of your child, you can moderate your involvement. However,
make sure you are not intruding in their sessions.

Stay in touch to learn about their progress, and changing attitudes. Talk to the
speech therapist and counselor to learn more about your role as a supportive
parent of a child who stutters.

20. Stay Connected
While there are several groups for people who stutter, there are a few that
cater to parents and guardians of children who stutter as well.

You can get pertinent information regarding similar support groups
[https://ghost.stamurai.com/benefits-of-talking-to-other-people-who-stutter/] in your area
that operate virtually right now.

Participating and listening to other parents who have similar experiences may
present new opportunities for therapy for you and your child. It can also add to
your perspective about stuttering and individuals who grow up with a stutter.


These are the 20 steps every parent of a child who stutters should follow. These
are 20 simple changes that may change how you and your child view stuttering.

For Parents: 20 Steps to Help A Child Who Stutters

"I don't stutter when there's a lot of noise," "I speak without stuttering when
I can't hear myself speak" – no matter how bizarre these situations sound, it is
true that people who stutter (PWS) can indeed speak fluently when they can't
hear themselves speak.

Scientists believe that inadequate or faulty auditory feedback monitoring may be
responsible for the precipitation of stuttering. Alterations in auditory
feedback like delayed auditory feedback [__GHOST_URL__/daf-stuttering-guide/] 
(DAF), and frequency altered feedback (FAF) have been used to treat stuttering
for quite a few years.

Recognized speech therapists and researchers agree that blocking auditory
feedback may reduce or completely remove stuttering.

Sadly, the neuroscience behind the cessation of stuttering as a result of
auditory feedback blocking remains unknown.

According to Dr. Paul Sowman from Macquarie University, Australia, "anything
masking the sound of one's own voice can induce fluency temporarily."

What's The Link between Auditory Feedback and Stuttering?

A recent study
[https://www.sciencedirect.com/science/article/pii/S1808869419301120#aep-article-footnote-id1] 
by Fiorin M, Marconato E, Palharini TA, Picoloto LA, Frizzo AC, Cardoso AC, et
al. shows that stuttering has a strong link to the deficit in the modulation of
the cortical auditory system. Inefficient auditory feedback monitoring results
in neurodevelopmental stuttering.

The test results showed that people with severe and moderate stuttering
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/] benefited from
masked auditory feedback.

Masking the sound of their own voice reduced the number of stuttering-like
disfluencies in both groups.

Why Don't I Stutter When I Can't Hear Myself SpeakQuote: Masking auditory
feedback can reduce the disfluencies in one’s speech

Masking auditory feedback significantly reduced the disfluencies of the people
who stutter severely
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/]. Masking also
reduced the flows of syllables and words-per-minute among the group of
individuals who stutter moderately.

In 2015, Adam Jacks and Katarina L. Haley published a study
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4987030/] on the auditory masking
effects on speech fluency among people with apraxia of speech (AOS) and aphasia
(APH). They conducted a study on 10 neurotypical individuals and 10 individuals
with AOS/APH.

Both AOS and APH impair an individual's ability to produce smooth speech. AOS
and APH may result in injuries or neurodevelopmental causes similar to 
stuttering [__GHOST_URL__/is-stuttering-biological-or-psychological/]. In many
cases, both conditions co-exist.

Disfluent speech is a characteristic of AOS and APH. Darley
[https://ci.nii.ac.jp/naid/10029832855/] (1968) described AOS as a disorder that
"sounds much like stuttering." Repetition is a common disfluency among
individuals with apraxia of speech.

The results of this study prove that masking auditory feedback induces and
increases fluency among individuals with AOS and APH.

Any condition overriding the affected individual's auditory feedback monitoring
may induce fluency.

How Does Masking Auditory Feedback Reduce Stuttering?

Although the exact reason for the temporarily induced fluency is largely
unknown, experts have stated that stuttering is associated with a faulty
auditory feedback process. When a person hears themselves stutter, their brains
automatically try [__GHOST_URL__/how-brain-repairs-stuttering/] to correct the
speech by increasing the rate of syllables/words produced per minute.

Masking the auditory feedback helps in overriding the auditory feedback. Masking
can be by wearing noise-canceling headphones and playing music to drown out
one's voice.

One can try speaking with headphones on when they have to give a presentation or
speech. We can see a popular rendering of the concept in The King's Speech
[https://ghost.stamurai.com/cultural-awareness-of-stuttering-through-the-kings-speech/] where
Colin Firth is urged by Geoffrey Rush to read Shakespeare out loud while
listening to music on headphones.

However, masking is not always a practical option, especially when conversing
with people. Masking auditory feedback is a temporary solution to stuttering
since it induces fluency as long as the person is unable to hear their own
voice.

Why Masking Auditory Feedback Isn't The Ideal Solution For Speech Disfluency?

Stuttering is a neurodevelopmental condition. It does not have a permanent cure.
Currently, there is no medication [__GHOST_URL__/stuttering-medicine/] for
specifically treating stuttering.

Stuttering can make you feel helpless and angry. It might make you believe that
you are losing control of your speech. Even though there's no magic pill that
can remove your repetitions, prolongations, and blocks, you can gain control of
your speech back.

Masking auditory feedback is a technique that you can use for specific
situations like giving online lectures, or speaking to a large audience. In
social situations, you need to hear what your listeners are saying. Putting on
 headphones to mask the sound will create a communication barrier. Instead, you
can try DAF along with a combination of different speech exercises
[https://ghost.stamurai.com/stuttering-exercises-for-adults/] to reduce your stuttering in
the long-run. Currently, there are several apps like Stamurai
[https://stamurai.app/z4HKmlNXigb] that offer speech exercises and DAF tools
that you can access while sitting in the safety and comfort of your home.

Why Don't I Stutter When I Can't Hear Myself Speak?

What happens when you stutter?

During a repetition, block, or prolongation, you may feel embarrassed, tense up
and break eye contact. It's common for anyone who stutters.

However, these reactions to your stuttering prompt the listener to react in a
similar fashion. Your listeners will react to your stuttering the same way you
do.

If you are anxious, tense, and apprehensive, they will also feel anxious, tense,
and apprehensive. They will mirror your emotions and body language. That is one
of the primary reasons you may find it difficult to hold a conversation or
communicate successfully.

Whether you are receiving speech therapy from a qualified speech-language
pathologist or using a cutting-edge speech therapy app such as Stamurai
[https://stamurai.app/z4HKmlNXigb] to learn how to stutter less, it's important
that you focus on achieving some basic goals.

Here in this post, we will shed light on the four basic goals that you should
try to achieve.

Goal #1: To Rediscover Confidence
As someone who stutters, one of your basic goals should be to find the
confidence to speak without any sign of tension, anxiety, and hurriedness. That
will eventually make it possible for you to converse better in social and
professional settings.

Stuttering with less tension may not always mean speaking more fluently. The
goal is not to avoid stuttering entirely, but to speak with less physical
tension and anxiety. The idea is to speak at a normal rate. However, when you
feel a block coming, you should slow down, and take your time to say the word.

You should not avoid or replace a feared word. Instead, relax and keep going.
Take a deep breath. Feel your jaws, tongue, lips, and throat muscles relax as
you approach the word. Begin saying the word after you exhale a little bit.
Remember that there's no rush. Keep moving forward till you know that the block
is behind you.

Several techniques can help you overcome stuttering blocks. You can find all of
them right here [__GHOST_URL__/overcome-stuttering-blocks/]. Begin with step 1
and progress to the subsequent steps only after mastering the previous ones.

Goal #2: To Defeat the Embarrassment of Stuttering
You need to learn voluntary stuttering
[https://ghost.stamurai.com/voluntary-stuttering-and-fluency/]. The main objective is to find
confidence in the way you talk and overcome the embarrassment stuttering
incites.

One way to overcome the feeling of embarrassment is by repeating the sounds or
syllables on which you stutter. Make deliberate repetitions before even trying
to say the whole word out loud.

Voluntary stuttering is a part of multiple stuttering treatments for adults.
When you are struggling to say a word, you may feel out of control. Deliberate
repetitions can help restore the sense of control in someone who has been
struggling with stuttering for years.

While the listener may think that you are stuttering all through these words,
you know that you are in control of the majority of the deliberately stuttered
words.

The technique is useful in dissolving the fear of stuttering and it offers a
sense of freedom that many people who stutter haven’t enjoyed while speaking in
a long time!

Goal #3: To Get In Touch With Others Who Stutter
Another basic goal should be to find and get in touch with others who stutter
[https://ghost.stamurai.com/benefits-of-talking-to-other-people-who-stutter/]. Meeting and
speaking with people going through similar struggles in life can help you find a
new perspective for your life problems that may not be limited to stuttering.

Stuttering is not just a speech disfluency. It can be the cause of depression,
anxiety disorders, and social withdrawal in adults. You may be limiting yourself
in your social life and workplace because you believe that society has defined
you as a "stutterer."

Stuttering may create multiple crises in a person's life; it can affect their
quest for love and performance in the workplace. Attending group sessions with
others who stutter can help you find new solutions and explore lesser-known
methods that may alleviate your emotional anguish.

Goal #4: To Overcome the Fear of Stuttering
The fear of stuttering is sometimes worse than the stuttering itself. Fear gives
rise to physical tension and worsens secondary stuttering behavior. It also sows
the seeds of self-doubt like "Are people going to laugh at me", "Do people think
I'm stupid", and "Maybe my communication skills are subpar."

Reducing the fear of stuttering
[https://ghost.stamurai.com/how-to-overcome-fear-and-tension-if-you-stutter/] is not as easy
as it may sound. Fear is a strong negative emotion that has become a part of
your life. While you don’t always stutter, the fear of stuttering rarely leaves
your side.

That is the primary reason, stuttering treatment for adults
[https://ghost.stamurai.com/stuttering-treatment-for-adults] isn’t complete without
psychological counseling and cognitive behavioral therapy (CBT). It takes
considerable time and numerous sessions to free a person of their fear of
stuttering and help them rediscover their self-confidence.

It should be a long-term goal for anyone who stutters to overcome their fear of
stuttering. At the same time, one must work towards revisiting their self-image
and boosting their self-esteem with the help of a trained therapist. A
professional counselor may be able to help you align your view with reality as
you undergo stuttering treatment.

What Are The Standard Goals For Stuttering Therapy?
The basic goals for each individual who stutters may be different. However,
during stuttering therapy, the basic goals for an adult client tend to focus on
the three Fs –

Fluency – Your stuttering severity should decrease over time. Your speech
therapist may help you monitor and record stuttering severity
[https://ghost.stamurai.com/understanding-degrees-of-stuttering-severity/] using SSI or
Fluency 5-point scale scores.

Feelings – The individual should aim to improve their positive feelings and
attitudes about stuttering. They should be able to overcome the impact of
negative reactions that they may have gathered from their listeners, and focus
on building their confidence and self-esteem.

Functional impact – It is the overall effect of stuttering on your performance
[https://www.asha.org/siteassets/uploadedfiles/ICF-Adult-Stuttering.pdf] in the
different spheres of life. It can extend to your performance as an employee or a
student, in your extracurricular activities and socializing abilities.

What Are The Most Common Goals For People Who Stutter?
Multiple factors may contribute to what a person expects to gain out of
stuttering therapy. These may include the person's current perception of
stuttering, their speaking ability, and their satisfaction levels associated
with communication in professional and social settings. However, a majority of
these goals include the individual's aspirations for coping in the real world. 
Studies [https://www.sciencedirect.com/science/article/pii/S0021992418302314] 
confirm that adults who stutter want to focus on both the psychological and
physiological aspects of stuttering treatment. More than 95% of the individuals
who participate in stuttering treatment want to gain “control over their
stuttering” rather than look for a cure.

4 Basic Goals for People Who Stutter

Psychotherapy is an umbrella term that covers talking to a mental health
professional about one's challenges, fears, insecurities, thoughts, and ideas.
Psychotherapy may be in the form of psychoanalysis, cognitive therapy, behavior
therapy, or humanistic therapy.

During psychotherapy [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6929220/] for
stuttering, a person gets to learn more about their own feelings, emotions,
moods, and stuttering behaviors.

Just like stuttering treatments [__GHOST_URL__/stuttering-treatment-for-adults/]
, psychological counselors and therapists use a combination of multiple
techniques for psychotherapy. Cognitive-behavioral therapy (CBT) is one of the
most common and effective approaches used to address stuttering in children and
adults.

Do People Who Stutter Need Psychotherapy or Psychological Counseling?
People who stutter (PWS) may feel apprehensive about speaking in public. This
may happen due to the negative emotions [__GHOST_URL__/stuttering-depression/] 
associated with memories of stuttering in public.

Similar situations may evoke unpleasant memories and trigger anxiety, fear
[https://ghost.stamurai.com/how-to-overcome-fear-and-tension-if-you-stutter/], and, even,
shame.

“People will laugh at me”, “people will think less of me”, “they’ll think I’m
stupid”…thoughts like these can cross your mind quite often if you stutter.

Stuttering results in more emotional tumult and physical tension in the speaker,
which makes them more likely to stutter.

Alternatively, they might compensate by acting introverted, trying not to speak,
or avoiding social gatherings.

PWS often find themselves in a vicious cycle of negative self-talk, unhelpful
coping methods, and emotional turmoil that reinforces one's anxiety of speaking
rather than diminishing it. Psychotherapy or psychological counseling can help
help a person who stutters deal with such challenges.

How Can CBT Help Someone Who Stutters?
In therapy, the professional helps the client explore the possible link(s)
between their actions, thoughts, feelings, behavioral responses, and
physiological reactions. The clients may find it easier to identify which coping
mechanisms are unhealthy and develop new skills to manage their stuttering
behaviors.

Therapists may also encourage the client to “experiment” with their assumptions
and predictions to see how accurate they are. For example, the therapist may
suggest ways of advertising stuttering
[https://ghost.stamurai.com/self-advertising-stutter-or-stammer/] to the client and give them
ways to note their listeners’ reactions.

A good therapist will never decide for the client or judge them. They will only
provide empathetic listening and emotional validation, so that the client can
form their own conclusions.

Cognitive-behavioral therapy
[https://www.simplypsychology.org/cognitive-therapy.html] aims to work
coordinately and collaboratively with the client. The idea is to avoid
arguments, debates, and instructions. Instead, a mental health professional
encourages the client to ask questions like –

 * What are the pieces of evidence that support my assumption and prediction?
 * Can there be another way of looking at the incident?
 * Is there a reason for my prediction to be inaccurate?
 * Are my listeners truly trying to belittle me, or are they simply feeling
   awkward or insecure due to my stuttering?

How Can CBT Help Break Unhelpful Thoughts & Beliefs About Stuttering?
Throughout our lives, we find ourselves in multiple "thinking traps." These are
unhelpful patterns that we have developed to find meaning in our struggle.

For example, you may believe that stuttering is completely in your control, and
you stutter when you are afraid or anxious.

These unhelpful thoughts and beliefs about stuttering not only
[https://www.uts.edu.au/asrc/resources/utbas] arise from the anticipatory fear
of stuttering but also feed the social anxiety that makes stuttering worse.

Cognitive-behavioral therapy may help you break free from this unhelpful pattern
of thoughts. With every session, you may be able to identify, check and,
eventually, stop the thinking trap from taking over your confidence.

Here are some of the unhelpful patterns of thinking that adolescent and adults
who stutter have recognized during therapy –

Mind Reading
It is quite common for PWS to assume that they know that other people are
thinking. We are quick to believe that people will think less of us if we
stutter while speaking.

In truth, it is impossible for us to read someone's mind. You may be able to
read their expressions and gestures. However, your judgment of a person may be
clouded by your emotions related to similar circumstances in the past.

CBT can help you distinguish between the presumed reactions and the real
reactions of your listeners.

Catastrophizing
There are times when you feel that the world is coming to an end or the worst is
going to happen if you stutter.

It happens when other possibilities seem too far-fetched. It may also be
possible that you catastrophize because you believe that you no longer deserve
good things in life.

Psychotherapy can help you explore various other positive fantasies and
possibilities that you may not be able to see on your own right now.

Selective Filtering
You tend to dwell on the words you repeated or blocked on, but you forget about
the others you said smoothly. It is easier to remember the negatives and magnify
them, but focusing on the positives at all times isn't as easy.

A good psychological counselor or therapist will help you build your resilience
and explore the positive qualities you already have inside. With a little help,
you should be able to focus on the positive aspects of your speech, regain
confidence and reinforce the fluency shaping skills you are learning at speech
therapy [https://stamurai.com/].

Over Generalization
You may make sweeping conclusions based on one event. For example, when looking
at a situation, you may perceive it to be an “utter failure” because you
stuttered twice.

However, that is far from the truth. You may have been fluent for 90% of the
conversation and stuttered on only 8 to 12 words. Your disfluency doesn’t
determine the success or failure of a conversation.

Maybe you are unable to perceive that right here, right now. Nonetheless, with
regular therapy, your counselor may be able to help you gain a new perspective
on similar situations in the future.

What Does Psychotherapy (CBT) Not Do?
Therapists using the CBT approach don’t “teach” their clients to think more
positively or be rational. It is not the therapist’s responsibility to judge
their client’s behaviors or thoughts.

Therapists are not here to provide their clients with ready solutions to their
problems. They are here to enhance the client’s problem-solving skills and
resilience towards life’s hurdles.

Therapists do not make the decisions for their clients. Psychotherapy focuses on
helping the client cope with daily struggles. Continuing CBT may help a client
assume a new point of view so that conflicts appear as challenges.

CBT is concerned with helping the clients lead a more productive and happy life.
Counselors may provide empathetic listening, unconditional support, and
emotional validation to help their clients make their own decisions.

Psychological counselors, therapists, or psychotherapists do not teach fluency
[https://ghost.stamurai.com/stuttering-fluency-shaping-techniques/] skills, exercises
[https://ghost.stamurai.com/stuttering-exercises-for-adults/] and stuttering modification
techniques to clients. Clients may undergo psychotherapy alongside their speech
therapy sessions to gain a better understanding of the secondary behaviors of
stuttering.

Can Psychotherapy Help in Stuttering Treatment?

When an individual knows what to say, but their speech is interrupted by
involuntary repetitions, prolongations and blocks, they might have a childhood
onset speech fluency disorder or stutter.

Early intervention [__GHOST_URL__/stuttering-in-childhood-early-intervention/] 
of stuttering in childhood may improve a person's fluency and ease of speaking.

Most children who stutter do not receive timely therapy and they grow up into
teens and adults with anxiety and fear of stuttering. In such cases, stutter has
profound negative impacts on the mental health of the person.

What Does Cognitive Behavioral Therapy Address?
Negative psychological impacts of untreated stuttering (mild and severe) may
lead to anxiety, self-doubt, fear, frustration, avoidance, anger, and a negative
attitude towards speaking in public
[https://ghost.stamurai.com/public-speaking-with-a-stutter] in adulthood.

A relapse after stuttering treatment [__GHOST_URL__/treatment-for-stuttering/] 
may cause severe demotivation, anxiety disorder, and depression.

Negative emotions and attitudes may interfere with the individual’s ability to
participate in daily activities. It may even diminish their overall quality of
life.

Therefore, treating stuttering [__GHOST_URL__/stuttering-treatment-for-adults/] 
with speech therapy and exercises may not be enough to motivate a person towards
fluency. A teen or adult who has been stuttering for years requires more than
conventional speech therapy to accept stuttering or work towards better mental
health.

Cognitive behavior therapy (CBT) targets the biopsychosocial
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/] crises experienced by
those who stutter. It is a multi-disciplinary approach that focuses on the
behavioral, cognitive, and emotional aspects of stuttering.

It is important to note that CBT is not a cure for stuttering. It is a form of
talking therapy under the guidance of a professional and qualified psychological
counselor or psychotherapist. It can help
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137813/] an individual deal with
the effects of stuttering in their life.

What to Expect During the First Days of Cognitive Behavioral Therapy?
Receiving pertinent information about stuttering is part of CBT for the client
and their family. The psychotherapist addresses the client’s avoidance behaviors
and unhelpful thoughts.

The next step typically involves helping the client face their feared
[https://ghost.stamurai.com/how-to-overcome-fear-and-tension-if-you-stutter/] and avoided
situations. The therapists chalk out behavioral experiments that enable the
client to face these situations, such as speaking in public.

Based on their interactions with those involved in the experiment, the therapist
may guide them to modify their stuttering-related behaviors. It facilitates a
slow but steady modification of the client’s self-focused behavior over the
sessions.

How Can CBT Help You?
The therapist analyzes the cognitive errors
[https://www.healthline.com/health/cognitive-distortions] and their observer’s
perspectives. Both of these are crucial for the modification of behaviors
associated with stuttering.

While cognitive therapists refrain from labeling behaviors as “right” or
“wrong”, they also encourage their clients to think –

 * What are the reasons behind the negative emotions that they are feeling
   during or after an interaction?
 * Is there another perspective? Will another way of looking at the interaction
   give their actions and emotions a new meaning?
 * Is there evidence that what they are feeling may not be entirely true?
 * Can there be another version of the truth that they can explore by
   themselves?

Often, people jump to conclusions and predict the worst outcomes based on past
unpleasant interactions that bear resemblance to the current ones. CBT can help
them reduce these cognitive errors by adopting a different point of view and
equipping them with skills that may help them respond differently.

Anxiety, negative thinking, and withdrawal from social interactions result in a
thinking trap. The vicious cycle can be broken by adopting this line of
self-inquiry. With CBT, the clients can learn to challenge their fear of
negative interactions. They may acquire the necessary skills that can help them
deal with similar issues in the future.

How does CBT Address Stuttering Related Issues?
The common components of CBT that may help in managing anxiety include
attentional training, cognitive restructuring, and behavioral experiments.

 * Attentional training – Working on the skills that help the client focus on
   their actions, words, emotions, and surroundings at a given time.
 * Cognitive restructuring – Developing the skills necessary for recognizing the
   cognitive errors, analyzing them, and taking appropriate action accordingly.
 * Behavioral experiments – Learn strategies that help the individuals deal with
   situations that evoke negative feelings associated with stuttering.

The CBT approach may include one or more methods of cognitive interventions and
a dysfunctional thought record scheme.

A dysfunctional thought record scheme works through self-monitoring. It focuses
on the identification and analysis of the dysfunctional thoughts of the client.
The therapist helps the client replace these dysfunctional or negative thoughts
[https://benevolenthealth.co.uk/12-ways-to-recognise-negative-thoughts/] with
positive, functional, and more realistic ones.

The goal of a dysfunctional thought record scheme is to help the client practice
alternate patterns of behavior that may change their cognitive distortion.

Cognitive interventions include sessions for the identification and modification
of cognitive distortions, examination of facts, listing the alternatives, and
enlargement of one's perspectives.

Can Mindfulness Work With CBT During Stuttering Treatment?
Studies show that CBT works best when coupled with mindfulness techniques. Some
of the more popular mindfulness approaches leveraged in stuttering management
including mindfulness-based stress reduction (MBSR), acceptance and commitment
therapy (ACT), and mindfulness-based cognitive therapy (MBCT).

Combining CBT with mindfulness techniques
[https://ghost.stamurai.com/stuttering-and-meditation/] can help a person become more aware
of their speech and develop a positive attitude towards communication and social
interactions. In addition to reducing the negative emotions and attitudes
associated with stuttering, these therapeutic strategies may help the clients
improve their quality of life, self-esteem, and control over their emotions.

How Long Does CBT For Stuttering Take To Work?
The duration of CBT depends upon the severity of one’s symptoms. Typically, it
may range from 3 months to 3 years.

The goal of therapy is to restore the client’s resilience and enable them to
think with a new perspective. The therapist tries to empower the client to set
new goals and achieve them too. Therefore, the duration of therapy depends
greatly on the individual needs of the client.

The client may require frequent sessions during the beginning of CBT. The
frequency of sessions may reduce as they begin to show significant improvement.
The client may also require booster sessions during follow-ups to maintain their
positive outcomes or talk about new issues.

How Can CBT Help People Who Stutter?

When we are alone, we often revisit the interactions that caused us
embarrassment. For people who stutter, these interactions are quite frequent.

You think of the times you blocked while speaking to a teller at the bank. Or
the times you blocked while placing your order at your favorite restaurant and
now you try hard to avoid the place.

You think of all the fun you could have had if you went to the party this
weekend, but then you decide against it because avoiding the trigger words is
too much work anyway.

Even hanging out with friends seems exhausting because you have to rehearse
every word in your mind multiple times before you can speak.

Do you see a pattern?

You are tired from the unwanted advice, looks of pity, and interjections. Many
of us who have been stuttering for a long time find it easier to avoid the
emotions [__GHOST_URL__/stuttering-and-lasting-emotional-effects/], situations,
and conversations that may trigger our stuttering than facing them head-on.

Make Room for Positive Thinking
We should begin our journey towards fluency by altering our thought patterns.
Avoidance is the most harmful habit. It deprives the speaker of positive
experiences that could have been, had they taken a chance. Avoidance worsens
[https://www.stuttering.co.nz/news/avoidance-reduction-therapy/] the fear and
anticipation of stuttering.

If you have been stuttering for years, there is a good chance that you have
already faced all types of listeners possible. You have met with the genuinely
supportive ones and the critical ones. You already know what types of reactions
you will receive while speaking in front of friends and strangers, and how to
respond to them.

As a matter of fact, the constant vigilance is quite tiring. Keeping a mental
note of all the words that make your stuttering worse and avoiding or replacing
them may be extremely taxing if you have developmental stuttering
[https://ghost.stamurai.com/what-is-stuttering/].

It is much easier to just say what you want to say and stutter throughout your
speech. It is a temporary discomfort that is a welcome relief from the
continuous alertness you have been exercising so far.

Take Steps to Face Your Fear
Instead of avoiding all the situations and people that might make your
repetitions or blocks worse, you should try to face them. You may believe that
facing these situations contributes to anxiety, but that anxiety is temporary.
Imagining all the things that could have gone wrong and subsequent avoidance
starts a vicious cycle
[https://www.goodtherapy.org/blog/can-anxiety-cause-stuttering-a-look-at-speech-and-mental-health-1130189] 
of anxiety that makes it incredibly challenging for the PWS to face their fears.

How can you start confronting your fears?
You can take the first step even if you haven’t started speech therapy formally.
Here’s what you need to do –

 1. Begin by making a list of the words and situations that you fear most.
 2. If you stutter on a particular word, begin using that word deliberately and
    repeatedly in conversations.
 3. You can use one or more of the fluency shaping
    [__GHOST_URL__/stuttering-fluency-shaping-techniques/] and block reduction
    [__GHOST_URL__/overcome-stuttering-blocks/] techniques while saying a
    feared-word.
 4. Keep saying the word every day until you can say it smoothly and with ease.
 5. Then start practicing with the next word.

Continue this exercise until your fear of each word is gone.

Yes. It is a time-consuming process. You may fail the first five times. But,
there is nothing to lose. Imagine yourself saying the words without fear and
hesitation. Exercise the confidence you gain from that mental image.

If you are afraid of certain situations, try to go back to similar situations.

Don’t avoid your feared words. Instead, search for ways to reduce that fear
[https://ghost.stamurai.com/how-to-overcome-fear-and-tension-if-you-stutter/] and discomfort.

That also means bearing temporary embarrassment at times. However, for most of
us who have stuttered for a long time, embarrassment or shame is not a new
feeling. The only difference, in this case, is that we are in control and, this
time, we will ride it out towards fluency.

Explore the Depths of the Unknown
Our fear keeps us from exploring the unknown.

Stuttering has never left your side when you were introducing yourself in
primary school, presenting middle school projects, doing projects in college,
and speaking during office meetings. You have learned to be afraid of the
unpredictable nature of your stuttering. So, when you are stuttering, your
natural instinct is to get out of the block or repetition as soon as possible.

In the hustle, you rarely pay attention to what your lips, tongue, jaws, and
throat muscles are doing. Sometimes, you may blink rapidly, scrunch up your lips
or tense up your jaws to get out of a block. These are all secondary behaviors
of stuttering that don't help you get out of a block but may make it worse.

You may have engaged in similar behavior almost involuntarily in the past.
However, paying close attention to what you are doing while blocking, repeating,
or prolonging can not only help you recover from a block but even prevent it.

You may not have realized this in the past but most of these behaviors are
controllable. You need to make small changes to the things you are doing while
stuttering. Focus on the actions that seem to interfere with your fluency. To do
that you will need to explore the areas of your stuttering that may seem
daunting right now.

Once you find the courage to explore these areas, you will realize that
stuttering is not a negative magical force. It is simply something you do while
speaking. And soon you will also discover that you are able to exercise control
over your stuttering and the fear of stuttering.

A good speech therapist and a psychological counselor may help provide you with
the tools necessary to explore the roots of your fear and anxiety related to
stuttering.

Celebrate the Small Victories
Setting achievable goals [__GHOST_URL__/goals-for-people-who-stutter/] is one of
the most crucial parts of recovering from stuttering. You cannot aim to achieve
absolute perfection the moment you begin exploring fluency shaping and
stuttering modification techniques.

You must remember that it is not an all-or-nothing process. Even the best-spoken
public figures struggle with some level of disfluency in their speech.
Therefore, if you start speech therapy today and notice that you are stuttering
on half of your feared words by the end of the week, it’s not a sign of failure.

In fact, it shows that you are a person with tremendous willpower and dedication
who has overcome the fear of saying some of their feared words.

Gunning for absolute fluency with zero stutters should never be your goal. That
is an unachievable target even for professional speakers. You have lived with
stuttering for years. So, expecting to rid yourself of it completely is not only
unrealistic but also unhealthy for your self-confidence and self-image.

Instead, you should focus on the small gains that bring you great satisfaction.
For example, saying “good morning” with a smile and lowered anxiety at the
checkout of a mall. Or, receiving a phone from an unknown caller and introducing
yourself as someone who stutters.

In place of hoping for complete fluency, set realistic goals like working on
your breathing and lessening the tension on your lips during therapy.

Remember That Relapse Isn’t a Failure
Relapse is always a real threat during stuttering therapy. You should not quit
practicing once you see improvements in your speech. That typically happens
because you have learned and relearned stuttering and associated behaviors over
time. Discontinuing therapy or personal practice allows the acquired stuttering
behaviors to return.

A relapse
[https://ghost.stamurai.com/high-relapse-after-stuttering-speech-therapy-understanding-the-reason/] 
can make you feel demoralized, but there’s always a different way to look at it!

If you are experiencing a relapse or you are afraid of relapsing, instead of
courting failure you can think about the arsenal of fluency shaping and
stuttering modification techniques that you already know.

You already know the particular exercises that can help you defeat your fear and
anticipation of stuttering. You have already found ways to deal with
embarrassment and anxiety.

Therefore, a relapse simply gives you the chance to exercise the techniques you
have already internalized over the past few weeks or months.

You may consider taking your time to complete the three stages of learning –

 1. Establishing the new habit
 2. Transferring the habit to new and different situations
    [__GHOST_URL__/public-speaking-with-a-stutter/]
 3. Maintaining the new behavior

Reduce the Importance of Stuttering In Your Life
Take every chance you get to reduce the importance of stuttering in your life.

Put yourself out there. Go to parties, dinners and speak up at meetings. At
first, it may seem terrifying, but soon, you will begin to enjoy the relief you
get from facing your stuttering rather than circumventing every feared word and
situation to avoid it.

You can attend group stuttering therapy. In stuttering groups, you will meet
other adults who share similar feelings and attitudes about stuttering. You can
explore the different aspects of speech disfluency and explore the various ways
in which you are working on your speech.

Group sessions can be incredibly helpful in boosting your self-confidence and
restoring your self-image.

Never forget the truth about stuttering
Stuttering is only a part of your speech. It need not define you or limit you.
The truth is that you can do most of the things you want to do in life even if
you stutter. A trip to Paris, applying to culinary school, playing pro-football
or bungee jumping from the Burj Khalifa – your stuttering won’t come in your
way!

Speech Therapy for Stuttering: 5 Attitudes for Better Results

Sandra Merlo, a speech therapist from Brazil, observed that her speech became
worse after a few consecutive nights of poor sleep.

She is someone who has been stuttering since childhood. As she attended sessions
and learned more about speech therapy, she has better control over her
involuntary repetitions and blocks. Nonetheless, Merlo
[https://www.sciencedirect.com/science/article/abs/pii/S0021992419301303] notes
that without proper rest, she sees a spike in her stuttering the next day.

Next, she began asking her clients if they have noticed a similar relationship
between their sleep quality and stuttering. Most of their clients stated that
they had not noticed any link. However, after observing for a couple of weeks,
the same people reported that their stuttering did indeed become worse after a
poor night’s sleep.

Poor sleep hygiene may keep the brain from its ability to repair stuttering
[https://ghost.stamurai.com/how-brain-repairs-stuttering/].

So What Constitutes A Bad Night Of Sleep?
Several factors may contribute to poor quality of sleep, but how can you
understand if you had a good night’s sleep?

You Are Sleeping For Fewer Hours than Necessary
It is the most common cause of a poor night’s sleep in this era. We keep busy
schedules that demand late nights of work and early mornings as well. In
between, we can only squeeze in around 6 hours of sleep.

While for some people, 6 hours may be more than enough, for the average adult
population, it may be 2 hours too few.

Here’s how much sleep you should get each night –

 * Preschoolers – 14 hours
 * School-aged children and early teens – 10 hours
 * Teenagers and adults – 8 hours

If your child or you aren’t getting enough hours of shuteye, it is important to
consider rearranging your schedule and limiting screen time. Research shows that
using a blue light filter on your screens in the evening can help you fall
asleep at night.

You Are Sleeping Out Of Phase
Some people are early sleepers and some stay up till late at night. When the
same people have to stay up later or go to bed earlier than usual, they may not
feel equally rested the next day.

That happens because their sleep cycle is not in the usual phase as their
biological clock. Deviating from one’s biological clock can disrupt their sleep
phase
[https://my.clevelandclinic.org/health/diseases/12115-circadian-rhythm-disorders]
.

If you go to bed at a fixed hour, you should try to stick to that. It is
probably your natural circadian rhythm and your body is tuned to it by now.

If you need to change your sleeping hours due to work-related demands, you may
consider gradually changing it to the new hours.

People involved in shift-work, typically complain of feeling jet-lagged and
excessively sleepy during the day, for similar reasons.

People who stutter, report experiencing worse blocks, prolongations, and
repetitions when they experience sudden changes in their sleep schedule.

You Have an Irregular Sleep Schedule
You might be in deep trouble if you have an irregular sleep schedule. This is
more common among teenagers and young adults.

An irregular sleep schedule may mean that on certain nights, you are going to
bed at 10 PM and waking up at 6 AM, while on other nights, you are going to
sleep at 2 AM and waking up at 10 AM.

Irregular sleep schedules create pressure on the brain areas involved in the
processing and production of speech. Moreover, several studies
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3493205/] have linked it to mental
health diseases including depression and anxiety disorders.

You Have Signs of Sleep Apnea
Inadequate breathing may also contribute to poor quality of sleep. While it may
be temporary, there are pieces of evidence of sleep apnea in the teen and young
adult population as well.

Temporary causes may include upper respiratory tract infections and allergies.
Long-term causes of sleep apnea may include disorders like nasal septum
deviation, asthma, sleep apnea, and mouth breathing.

Not breathing properly while asleep may cause a person to wake up several times.
Waking up several times disrupts the sleep cycles and causes the person to feel
tired and sleep-deprived the next morning.

Can Insomnia Cause Brain Damage?
In 2010, Altena et. al. analyzed the brain images of adults with and without
chronic insomnia. There were 24 adults in the group who had insomnia. They were
between 52 and 74 years old. Results showed a significant reduction of grey
matter [https://pubmed.ncbi.nlm.nih.gov/19782344/] in the precuneus and
orbitofrontal cortex of the brain.

Research shows that lesions in the precuneus may have a negative impact on 
speech therapy [__GHOST_URL__/stuttering-fluency-shaping-techniques/]. The
orbitofrontal cortex connects to the entire brain and is responsible for
assigning emotional values to experiences.

That would explain why some people (insomniacs) who stutter experience such 
intense negative emotions
[https://ghost.stamurai.com/stuttering-and-lasting-emotional-effects/] associated with social
interactions.

Damage to both the precuneus and orbitofrontal cortex from persistent sleep
deprivation may make recovery from stuttering extremely difficult. It may
contribute to a quick relapse in stuttering
[https://ghost.stamurai.com/high-relapse-after-stuttering-speech-therapy-understanding-the-reason/] 
after recovery.

How Does Sleep Deprivation Affect Speech-Related Behaviors?
While we sleep, our brain undergoes a deep detoxification process. Not getting
enough or good quality sleep can cause our brains to retain the harmful free
radicals.

Free radicals can cause oxidative stress. It can damage the cells irrespective
of their function. It may result in structural damage of the neurons. Neuron
damage is the first consequence of oxidative stress in the brain.

Persistent insomnia or poor quality of sleep may also alter the gene expression
inside the brain. These genes may be responsible for the production, and control
enzymes related to the speech pathways.

In 2002, Macey et al analyzed the brain morphology
[https://pubmed.ncbi.nlm.nih.gov/12421746/] of 21 men with and 21 men without
sleep apnea. The imaging study revealed multiple lesions in various parts of the
brain of the group who had sleep apnea.

One of the unilateral lesions was in the Broca’s area, which is linked to speech
production. The researchers also discovered that 8 of the 21 participants with
sleep apnea also had a history of stuttering.

Another set of bilateral lesions, which may be consequences of sleep apnea, was
visible in the posterior parietal cortex. Damage to the integrity of the
posterior parietal cortex may affect speech rehabilitation.

Studies [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3134324/] show that in
mouse models wakefulness and sleep affected the function of over 2000 genes.
Merlo's published work shows that there is a significant chance that sleep
disorders disrupt the on/off function of the genes related to speech and
stuttering in children with sleep disorders.

So What’s the Link between Poor Sleeping Habits and Stuttering?
Sandra Merlo's research reveals a vicious cycle of sleep deprivation and
stuttering. On one hand, people with inherent brain damage may develop sleep
apnea and insomnia. On the other hand, the brain anomalies caused by sleep
deprivation may worsen stuttering and pose challenges in speech therapy.

While getting 8 hours of sound sleep may not prevent stuttering, it may help
those who stutter learn and practice speech exercise techniques
[https://ghost.stamurai.com/stuttering-fluency-shaping-techniques/] during therapy. Getting
enough rest may also reduce the stress on your muscles and allow you to relax
your jaws, neck and throat muscles while you speak.

There is really no good reason to not squeeze 8 hours of sleep at night. If you
are unable to sleep due to physical discomfort, anxiety or depression, you
should not neglect it. Consult a doctor, sleep specialist or clinical
psychologist as soon as possible.

Sleep & Stuttering: Is There A Link?

What Causes Speech Delay in Children?

Parents of some toddlers often ask experts, "Is my child a late talker?" Some
children learn to talk later than others. Many of the late-talking children
catch up with their peers by the time they are in kindergarten. But, there’s
more to it.

Defining Late Talking - Who Is a Late-Talker?
Almost all children go through the same stages of speech and language
development as they grow up. SLPs (Speech Language Pathologists) who specialize
in speech and language disorders in children often state that the range of
"normal" for children is quite broad when they are learning and growing.

It is only natural for parents to worry about their child's speech and language
development. However, an 18-month old saying fewer than 50-words may be a
late-talker.

The average 24-month old can master around 300 words and use the newly learned
words to form very short sentences. So, you can expect your 2-year old to say
short sentences like "more cookie" or "mommy walk."

Speech delay in children should be a concern and you should consult with your
pediatrician to rule out the physiological causes of speech delay
[https://ghost.stamurai.com/causes-of-speech-delay-in-children/] in your child.

Is Late-Talking A Genetic Problem?
There are currently no studies that provide a genetic basis for late-talking.
However, experts do share the observation that late-talking may cluster in
families.

It is only typical for a late-talking child to have a parent, cousin, uncle, or
grandparent who was also a late-talker. A late-talker may even have a relative
who has had a speech or language disorder.

Is Speech Delay A Disorder?
‘Speech delay’ is when a child doesn't reach the age-appropriate milestones in
time.

A speech delay is NOT a disorder. However, it can be
[https://www.aafp.org/afp/1999/0601/p3121.html] a sign or symptom of many
disorders. Children with Autism Spectrum Disorder (ASD), cerebral palsy (CP),
Down's syndrome, childhood apraxia of speech, aphasia, or hearing loss may
exhibit a significant language delay.

More than 50% of the children with language and speech delays catch up to their
peers on their own. By the time they enter kindergarten, their speech and
language skills may average out.

Nonetheless, the other 50% are at risk of experiencing language and speech
problems for the remainder of their life. So, even though speech delay isn't
always a disorder, it warrants the attention of SLPs, ENTs, neurologists, and
pediatricians.

How to Tell If Your Child Is a Late Talker?
When you ask - is my child a late talker?- you will find it hard to answer this
question objectively. Therefore, it is best to observe and note what your child
says, how often they speak, and how much they understand your speech.

You can compare your child’s speech and language to the developmental milestones
according to their age. Be careful to use a trusted and verified source like
ASHA for the reference charts
[https://www.asha.org/public/speech/development/chart/].

A baby should ideally say their first words by the time they are 12-months old.
They should be babbling long strings of sounds like ba-ba-ba, or ma-ma-mama.
They may even be able to say a few words like "dada," "mama," "dog," or "bye."
However, there is no reason to worry if the sounds aren't clear.

By 18-months, they should be able to use around 50 words. 18-month old children
are typically able to say at least 20 words. These may be nouns (cookie, juice,
'nana), verbs (go, eat), adjectives (cold, up), prepositions (up, down), and
other words (hi and bye).

Is your 2-year-old child not talking?
By the time children are 2-years old, they should begin putting two words
together to form short sentences. 24-month old children should be able to use
"p," "w," "b," "h," and "m" in words. You can also expect them to ask questions
like "where's mommy?" and "who's that?"

Is your child not speaking clearly at 3?
By their third birthday, children are able to understand and learn new words
quite quickly. So, you can expect them to use prepositions in their sentences.
They should also be able to form 3 and 4-word sentences to describe objects,
events and ask questions. They can also understand opposites and follow two-part
directions.

Is your 4-year old kid not talking at all?
By the time they are 4-years old, your child should be able to respond when you
call them from another room, understand the names for some colors and shapes,
and understand words for the family. They should also be able to answer simple
questions like "who," "what," and "where?"

A 4-year old should be able to use pronouns, use plural words and talk about
what happened during the day. They should also be able to put together 4-word
sentences. People should be able to understand most of what they say. So, a
child not talking at 4 should be a serious concern for all parents.

These are some of the speech and language milestones you can refer to while
evaluating your child’s speech and language development. Or, you can book a
consultation with an SLP in your locality, if you are concerned that your child
is a late bloomer.

Common Reasons Why a Child May Talk Late
Speech delay is prevalent in toddlers. The reported language delay
[https://www.aafp.org/afp/2011/0515/p1183.html#sec-2] in toddlers ranges from
2.3% to 19%. Studies show that severe language delays in children can lead to
difficulty reading in their elementary school years. Some children also
experience attention and social difficulties in their adolescence.

Exploring the reasons for speech delay in children can give you an insight into
why an otherwise active toddler not talking can be risky.

Expressive and receptive language disorders - Primary speech delay can be caused
by expressive and/or receptive language disorders. These disorders are not
self-correcting. Whether your child is a late bloomer due to expressive or
receptive language disorder, you will need to work with a speech-language
pathologist to help your child's speech-language development.

Hearing loss
Children who lose their hearing
[https://www.asha.org/siteassets/uploadedFiles/AIS-Hearing-Loss-Development-Effects.pdf] 
due to injuries or infections before learning to speak can experience severe
speech delays. Medical interventions and sessions with an SLP can help make up
for deficits in their speech and language.

Intellectual Disability
Delayed speech can be a sign of intellectual disability in children. There can
be one or more genetic causes of intellectual disability (ID). Since ID isn't
curable, children who talk late as an effect of ID typically benefit from
attending speech therapy sessions with SLPs and special educators.

Developmental Disorders And Disabilities
Down syndrome, Autism Spectrum Disorder [__GHOST_URL__/speech-and-autism/] 
(ASD), and fetal alcohol syndrome can cause speech delay in a child. Experts
refer to this type of speech delay as secondary. Speech therapy can help a
late-talker child with developmental disorders or disabilities but to a limited
extent.

Cerebral Palsy
Children with cerebral palsy may struggle with their speech. They may have slow
and slurred speech that’s difficult to understand. Children with athetoid
cerebral palsy find it difficult to control their facial and tongue muscles.
Physical therapy alongside speech therapy can help a child with cerebral palsy,
although the condition is congenital and incurable.

Epilepsy or Seizure Disorders
Epilepsy becomes evident in early childhood. Studies
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826845/] show that seizures may
interfere with the function and development of the language areas of the brain.
It's common in children with absent seizures and epilepsy arising in the left
side of the brain.

Anomalies In The Brain Structure/Function
Injury to the language centers in the brain can lead to speech and language
problems in children. While asphyxia is now a rarity with hospital births
gaining popularity, other issues like in-utero brain trauma and traumatic brain
injuries after birth can lead to irreversible speech delay in toddlers.

Risk Factors to Watch for With Late Talking Children
Children can begin talking late for a variety of reasons. It is often difficult
to predict who is at more risk of speech delays and language problems. Parents
who are worried about their children's speech delay should consider the
following factors to weigh the risks associated with late talking –

Is He/She A Twin?
Studies [http://www.mit.edu/~mittwins/delaylit.html] show that twins are at a
greater risk of developing speech delays. A combination of social and biological
factors is at play. However, twins are likely to catch up to their singleton
peers by the time they are of preschool-age. It is only true if the twins do not
have any congenital or developmental disorders.

Is He/She A Late Child?
Advanced maternal age has been linked to severe speech delay in 2-year olds. 
Research [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380823/] shows that the
advanced age of the mother during birth is not associated with morbidities and
long-term neurodevelopmental impairment. These children typically respond well
to early speech exercises at home and increased attention from parents.

What's Their Family Socioeconomic Status?
Multiple studies corroborate that family socioeconomic status has a crucial role
in the language development of the child. A child from a lower socioeconomic
home may show lower levels of language development and speech skills in
comparison to a child of the same age from a high socioeconomic home.

Current research
[https://www.researchgate.net/publication/304194754_Language_Development_Influence_of_Socio-Economic_Status] 
cites a child's language experience at home as the source of their language
difference. Exposing a child to new experiences, environments, and people from
different socioeconomic backgrounds can somewhat compensate for the delay in the
long run.

Is Your Child Getting Enough Attention?
Parenting skills have a minor role to play in the speech and language
development of a child. However, we should not neglect the influence of
parenting since it is controllable and adjustable to a great extent.

Studies [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214906/] show that
spending quality time with the child, talking to the child, and using gestures
while talking about a person or object can influence the child’s speech and
language development.

Promoting child-centered play, increasing home-based playtime between child and
parent, and following the child’s lead during activities can encourage the child
to interact positively. It can contribute to enhanced language skills as well.

Is There A History Of Late-talkers In The Family?
Although there's no genetic basis for speech delay, research
[https://www.sciencedaily.com/releases/2014/02/140217085246.htm] has shown that
speech and language development may be influenced by family history. If there's
a record of the child's parent(s), grandparent(s), uncle(s), aunt(s), or cousin
(s) talking late, there is an increased risk that the child might also be a
late-talker.

In such cases, it is common to enquire, "Can a child with speech delays catch up
with other children?" Well, there is a good chance that they might unless they
have neurodevelopmental disorders, congenital disorders, and related disorders
that affect their speech-motor system.

So, it is prudent to get your child checked up by a pediatrician, ENT, and SLP
even if they have a healthy and neurotypical relative who was a late bloomer.

When Is the Right Time to Seek Help?
Parents and caregivers should understand at least 50% of a child's speech when
they are 2-years old. By their fourth birthday, almost everyone should be able
to understand the child's speech.

If you find yourself asking, "why is my child not talking at 4 years?" or "why
is his/her speech still not understandable?" then it is probably time for you
and your child to see a specialist.

Unless you can determine the source of the speech delay, it is difficult to
predict whether your child will catch up to their peers. It is safer to consult
an SLP if you are worried about your child's speech and language development.

Early interventions can boost your child’s speech and language skills.
Identifying and treating speech-language delays is the best approach.

How Can Speech-Language Therapy Help A Late Talker?
Depending on the age and severity of the delay, a speech-language pathologist
can suggest therapy methods that will best benefit your child. Speech-language
therapy can boost a child's speech and language skills. However, the level of
improvement will depend upon the cause or source of their speech delay.

A speech-language pathologist (SLP) can also tell parents how to enhance the
quality of the time they spend with their children. You may receive advice and
instructions on how to communicate with your child to improve their
speech-language skills.

To know more about how speech-language therapy can help you and your child, you
can refer to the post on the role of SLPs in treating speech and language
disorders.

Is My Child A Late Talker?

Living with stuttering is frustrating.

On some days, saying your own name feels like a challenge. On other days,
sharing with the support group seems like a walk in the park.

When living with stuttering, people begin to accept its unpredictable nature and
roll with it. Very few people stop and think about what may have influenced a
good or bad day of stuttering.

Those who do consider the factors find themselves in a sea of fads and 
misinformation [__GHOST_URL__/stuttering-misconceptions/].

You may have already seen several blogs and articles stating the link between
diet and stuttering. There’s quite a bit on gluten-free food and placebo diets
and their effects on speech disfluencies in children.

However, it is difficult to find scientific proof backing up these claims.

Minerals and Stuttering: What’s there to Be Anxious About?
There isn’t a significant volume of research on the relationship between diet
and stuttering. Back in 2017, Hum, Rietveld, Wiedijk, and Lieshout published a 
pilot study [https://pubmed.ncbi.nlm.nih.gov/28576291/] on the possible
relationship between the two. The team believed that there are empirical and
theoretical reasons to consider how copper metabolism in the brain may influence
stuttering.

Their online survey found that there is no discernible effect of copper or
thiamine on the frequency and severity of stuttering of the participants. There
was modest evidence to support the link between thiamine and copper consumption
via food and self-perceived anxiety.

Anxiety or stress does not cause stuttering
[https://ghost.stamurai.com/causes-of-stuttering-in-adults/]. Hence, there is no reason to
believe that an excess of minerals and amino acids in the diet can cause
stuttering in children or adults. Additionally, you can relieve your anxiety by
indulging in mindfulness meditation [__GHOST_URL__/stuttering-and-meditation/] 
and yoga [__GHOST_URL__/yoga-exercises-for-people-who-stutter/], both of which
have proven to be excellent for treating stuttering
[https://ghost.stamurai.com/stuttering-treatment-for-adults/].

Gut Bacteria and Stuttering: A Potentially New Dimension in Stuttering Treatment
There is no direct evidence that supports the claim that diet impacts
stuttering. However, we have to consider that stuttering is a multifactorial
disorder.

A number of neurotransmitters (chemicals) in the brain impact stuttering
including dopamine.

A study [https://pubmed.ncbi.nlm.nih.gov/16246409/] on the impact of medications
that directly affect the dopaminergic and serotonergic mechanisms shows that 
medication [__GHOST_URL__/stuttering-medicine/], which downregulates the release
of dopamine may help reduce stuttering.

This shows that dopamine is one of the key factors that influence
childhood-onset fluency disorders like stuttering.

Groundbreaking research
[https://www.google.co.in/books/edition/_/PxwvEAAAQBAJ?hl=en&gbpv=1&pg=PA125&dq=dopamine+serotonin+diet] 
by Dinan, Butler and Cryan on gut bacteria highlights their ability to influence
the levels of neurotransmitters in the brain. Psychobiotics or the study of
micro-organisms with the ability to influence behavior may pave a new path for
the treatment of several disorders including stuttering.

It is indeed possible to increase or decrease the levels of “good” gut bacteria
by controlling the food one consumes. Who knows - following a particular diet to
increase the population of helpful bacteria and reduce the secretion of dopamine
in the brain may soon be one way to control one’s stuttering.

However, at this moment, the research is still at a nascent phase, and taking
control over stuttering via dietary modifications is still a hypothesis, albeit,
a highly realistic one.

What Food Should You Avoid To Prevent Worse Stutters?
There is evidence to establish  that if you consume a food you are allergic to,
it can make your stutters worse. However, there may not be a direct
relationship.

Allergens that irritate the airway can cause breathing difficulty and distress
in the person. It may mimic or even cause anxiety. It can further cause
gastrointestinal distress. All of these factors can make already existing
stuttering [__GHOST_URL__/is-stuttering-biological-or-psychological/] much
worse.

Similarly, consuming food that you are intolerant to can make you feel bloated
(For example, drinking milk or milk products if you are lactose intolerant). 
Excessive bloating [https://www.medicalnewstoday.com/articles/327057] creates
pressure on your diaphragm, trachea, and larynx. It can prevent you from
breathing deeply and comfortably. Shallow and fast breaths can cause one's
stuttering to worsen.

Patients with gastrointestinal acid reflux have reported feeling breathless and
compression around their throats. If you eat food that may cause digestive
issues, especially, severe acid reflux, it may be responsible for particularly
and unusually stubborn blocks in the mornings and post-meal meetings.

I Stutter - Which  Food Should I Eat?
As the research on psychobiotics progresses, we may find out what food groups or
diets are good or bad for stuttering. Until then, there is no way to confirm if
gluten-free food, casein-free diet, and no-carbohydrate diets have any direct or
indirect influence on the persistence and intensity of stuttering.

Having said that, it is very important that we eat from all the food groups. No
matter what type of diet you are following, you should ensure that you are
consuming all the necessary nutrients including essential proteins, good fats,
fiber, and enough carbohydrates.

There is a lack of evidence to clearly establish or completely deny the
relationship between a particular type of food and stuttering. So apart from
practicing your speech exercises
[https://ghost.stamurai.com/stuttering-exercises-for-adults/] regularly, eat what keeps you
happy (but in moderation) and healthy!

Unless you have a deficiency disease or a disorder, you should consider having a
balanced diet daily.

Diet & Stuttering: Is There A Possible Cure?

The signs and symptoms of autism spectrum disorder may be evident in a child
before they turn three (3-years-old). Sometimes, it is possible to notice 
language delays
[https://stamurai.com/blog/best-online-speech-therapy-for-language-disorders/] 
and speech problems in children with autism
[https://stamurai.com/blog/autism-common-speech-communication-problems-in-children/] 
as early as 18-months of age.

In such cases, early intervention is necessary. Speech therapy for autism can
equip them with the skills necessary for communication and building social
connections.

Autism spectrum disorder (ASD) is a broad term that may include varying degrees
of problems with social interactions and communication. The challenges one child
on the spectrum faces can vary significantly from another child or individual on
the autism spectrum.

Why Is Speech Therapy Necessary For Autism?
Autism Spectrum Disorder is a neurodevelopmental disorder. Consequently, it has
no cure. Treatment includes intensive therapy such as speech therapy for ASD
[https://stamurai.com/blog/online-speech-therapy-for-autism-spectrum-disorder/] 
to make up for any communication deficits that the child has.

Someone with autism may face the following challenges –

 * They may be non-verbal
 * They may only communicate via cries, grunts, shrieks, or throaty sounds
 * They may talk with an inexpressive tone or monotone
 * They may use foreign-sounding words and produce robotic-sounding speech
 * They may only speak in a sing-song voice or hum
 * They may babble and produce word-like sounds
 * They may have trouble with social interactions, and conversational skills
   (maintaining eye contact and using gestures)
 * They may face problems understanding social and communication cues
 * Trouble understanding the meaning of phrases
 * They may not be able to understand the meaning of common words when used in a
   new context

Speech therapy is one of the most effective ways to improve communication
skills, and it should begin as early as possible when it has the most impact. 

Preschoolers on the spectrum show significant improvement in communication
skills after attending autism speech therapy activities.

What Roles Do Speech-Language Pathologists Play In The Treatment Of Autism?
Speech-language pathologists (SLPs) specialize in the treatment of speech and
language disorders. Sometimes, SLPs assist in the diagnosis of autism in
preschool-aged children and help make referrals to specialists.

SLPs aid in the early and timely identification of autism. Post diagnosis,
speech therapists can assess the child’s ability to communicate. They also
suggest speech therapy techniques
[https://stamurai.com/blog/speech-therapy-exercises-for-children-with-autism/] 
for autism that may enhance their quality of life.

SLPs work closely with the client and their family, as well as the other
professionals. It is their responsibility to inform and teach the parents and
caregivers of the child by teaching them techniques of speech therapy for autism
at home.

In case the child is entirely non-verbal, the therapist can introduce or suggest
viable alternatives to speech. Speech therapy for non-verbal autism may include
the use of alternative augmentative communication such as software or devices
that convert text to speech.

What Are The Benefits Of Speech Therapy For  Autism?

Speech therapy for autism can help improve the overall communication skills of
the child. It may give the child the skills necessary to establish
relationships, hold social interactions, and function in everyday life.

Speech therapists and SLPs can work with an individual on the spectrum to help
them with the following –

Speech Fluency
Research shows that children on the autism spectrum are predisposed to
stuttering [__GHOST_URL__/speech-and-autism/]. 

Stuttering [__GHOST_URL__/what-is-stuttering] may involve
repetitions, blocks, and prolongations in spoken language.

Speech therapy for autism
[https://stamurai.com/blog/online-speech-therapy-for-autism-spectrum-disorder/] 
can help an individual who stutters speak comparatively effortlessly and
smoothly. It can enhance fluency with the help of easy fluency shaping
techniques.

A child who suffers frequent blocks in speech may find relief after attending
speech therapy. SLPs can help a child master speech modification techniques
[https://ghost.stamurai.com/overcome-stuttering-blocks/] to improve their
speech.

Articulation Skills
An SLP can help an individual gain an understanding of how their tongue, palate,
jaw, and lips function to produce speech sounds. The control over the physical
movement of the articulators decides how smooth one's speech is going to be.

If a child has trouble speaking due to a lack of coordination between their
articulators, a therapist can help them learn new techniques
[https://ghost.stamurai.com/stuttering-fluency-shaping-techniques/] to produce
certain sounds or sound patterns. It can enable them to be more intelligible
during conversations.

Expressive Language Skills
We use gestures to express ourselves. We wave our hands, shrug our shoulders and
point at objects. These are part of the repertoire of expressive language skills
that neurotypicals possess as well.

At the same time, facial expressions tell a lot about how a person is feeling.
It is also a part of the expressive language skills that a child on the spectrum
may not be able to understand or use.

An SLP can help them understand what these gestures and expressions mean. Speech
therapy may help a child understand these gestures and facial expressions. It
may make social interactions easier for the child in the future.

What Are The Goals Of Speech Therapy For Individuals With Autism Spectrum
Disorder?
Speech therapy from a qualified and experienced SLP can have a profound impact
on the quality of life of someone living with autism. Learning new skills can
help individuals communicate their needs, likes, and dislikes. They may even be
able to form relationships and take part in social activities.

Speech therapy may have specific goals, including –

 * Helping the individuals articulate better than before
 * Adding to their verbal and non-verbal communication skills, including sign
   language
 * Boosting their ability to initiate conversations without prompting
 * Helping them understand verbal and non-verbal communication, as well as,
   social cues
 * Helping them enjoy communication, playtime, and interactions with others
 * Teaching them self-regulation
 * Improving their ability to pay focused attention

Since autism is not a disease and it has no cure. One should focus on offering
those living on the spectrum as much support as possible. This support can come
in the form of speech therapy, cognitive behavioral therapy, and behavior
management therapy.

Top Benefits of Speech Therapy for Autism

Speech problems are common among preschool-aged children. Speech delay, when
left unaddressed, can be a serious problem in children.

Significant speech delays may be directly related to neurodevelopmental or
health disorders. Although not all speech delays signify autism spectrum
disorder [__GHOST_URL__/speech-and-autism/], Tourette's
[https://ghost.stamurai.com/tourette-syndrome-and-stuttering/], or stuttering
[https://ghost.stamurai.com/stuttering-in-preschool-kids/], sometimes they may be results of
underlying neurodevelopmental disorders or health conditions.

Myth #1 About Speech Delay in Kids: Children Will Grow Out Of Speech Problems On
Their Own
Yes. Sometimes children indeed outgrow their speech problems. Children who begin
stuttering by the age of 18 months may speak smoothly once more without any
intervention.

However, children who are showing a delay in speech development may not recover
on their own. All late-talkers may not be able to catch up on speech development
without expert help.

Speech delay in toddlers may also be a sign of disorders such as autism
spectrum
disorder
[https://ghost.stamurai.com/stuttering-and-autism-spectrum-disorder-diagnosis-and-treatment-in-children/] 
(ASD), expressive language disorder, hearing loss, selective mutism
[https://ghost.stamurai.com/selective-mutism-guide-parents/], cerebral palsy (CP), and
receptive aphasia.

Saying things like "my child will grow out of his speech delay" may be harmful
to their emotional wellbeing and physical & mental health in the long run. If
your toddler is a late-talker [__GHOST_URL__/is-my-child-a-late-talker/] or you
have trouble understanding what s/he says, it may be time to consult a 
speech-language pathologist
[https://ghost.stamurai.com/stuttering-treatment-how-can-a-speech-language-pathologist-help/] 
(SLP).

Myth #2 About Speech Delay in Kids: My Child Doesn’t Speak Clearly Because S/He
Is Lazy
Let us consider the example of Steve, he says "bus" clearly as "bus". However,
instead of saying "sun", he says "tun".

If your child does something similar, you may think ‘oh, s/he can say “s” in
“bus”, but s/he’s just being lazy when s/he isn’t saying the “s” in “sun”.’

Well, that's not true. Your child isn't being lazy, since Steve isn't lazy
either. He has a phonological disorder.

Phonological disorder
[https://www.asha.org/practice-portal/clinical-topics/articulation-and-phonology/] 
is very common in preschoolers. It happens when they struggle to learn the new
rules of a language and the manner in which sounds combine to form words.

As children begin talking, they automatically make certain rule-based changes to
simplify their speech. This makes complicated words like ‘spaghetti’ and
‘hospital’ simpler for them to process and say. They may pronounce them as
‘pagetti’ and ‘hopital’ respectively by applying their own rule-based changes.

Phonological disorders become prominent in toddlers when these rules to simplify
words do not disappear by the time they are 4 years old. It has nothing to do
with laziness. Phonological disorders in children respond well to intervention
by a speech-language pathologist (SLP).

Myth #3 About Speech Delay in Kids: It’s Normal For Boys To Talk Late
Research shows that it is indeed common for girls to mature faster than boys. A
girl child may learn to babble and talk earlier than a boy child. However, this
difference in development should even out by the time they are ready for
preschool.

Sadly, boys are also at a higher risk of language delay and autism spectrum
disorder (ASD). Boys are also more likely to develop a stutter
[https://ghost.stamurai.com/is-stuttering-gender-specific/] as compared to girls. If you have
trouble understanding what your 4-year-old child is saying, you should consider
visiting an SLP.

An SLP can assess and evaluate your child's speech and language skills. They can
tell you whether your child is at a high risk of ASD and can refer you to
experts, if necessary.

Myth #4 About Speech Delay in Kids: It Runs In The Family. His Dad/Uncle/Grandpa
Didn’t Talk Until He Was 5 Years Old
Speech delays that “run in the family” need thorough investigation. Since boys
are more likely to develop language and speech disorders as compared to girls
their age, any sign of speech delay warrants an SLP visit.

There may be a history [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1569819/] 
of a family member who turned out fine without intervention despite their speech
delay. It does not guarantee that your son or daughter will recover on their own
as well.

If speech disorders including stuttering
[https://ghost.stamurai.com/cellular-causes-of-stuttering-in-adults-and-children/] run in the
family, your child may benefit from an early intervention
[https://ghost.stamurai.com/stuttering-in-childhood-early-intervention/] and speech therapy.

Myth #5 About Speech Delay in Kids: Their Older Sibling Or Parent Talks For
Them, SoThey Don’t Need To
Children talk spontaneously. If you, your spouse, or an older child is talking
for the toddler in question, there may be a chance you are all compensating for
their speech delay. Sometimes, parents, older siblings and even grandparents,
may unknowingly, compensate for the speech delay of a child.

Research shows [https://www.jstor.org/stable/1131836?seq=1]that the speech and
language development for first, second and last-born children progress at the
same rate. Interestingly, second-born children, sometimes, show superior
language and conversational skills as compared to their older siblings.

While older siblings or a parent may take charge of a conversation, it should
have no negative impact on the speech development of the younger child.

Myth #6 About Speech Delay in Kids: S/he Talks Fine At Home But S/he Is Shy At
School
When a child speaks confidently at home but refuses to talk in school, it may be
a sign [https://www.nhs.uk/mental-health/conditions/selective-mutism/]of
selective mutism. A child with selective mutism may refuse to talk in front of
strangers, at daycare, or in other lesser-known environments.

Currently, experts define selective mutism as a severe anxiety disorder. It can
affect children of any age. However, a child with selective mutism
[https://ghost.stamurai.com/selective-mutism-guide-parents/] typically has their speech and
language development on track.

One of the telltale signs is that your child will talk fluently and confidently
at home, but they may be unable to speak in specific situations like in front of
distant relatives, classmates, or new people.

Anyone with selective mutism requires the help of a counselor or therapist to
cope with the high levels of anxiety that keeps them from speaking.

Myth #7 About Speech Delay in Kids: My Child Can Understand But Chooses Not To
Talk
Are you sure your child can understand you? It is typically evident when they
can follow simple instructions like “finish the juice”, “don’t go there” or
“call daddy”.

If your child can understand you, but cannot speak clearly, then it may be a
sign of expressive language delay or disorder. When a child is unable to
communicate verbally, it may be a sign of expressive language disorder.

Developmental expressive language disorder (DELD
[https://www.healthline.com/health/expressive-language-disorder-developmental])
typically only affects expressive language. Therefore, it doesn’t affect a
child’s ability to understand, listen, read or produce sounds.

A toddler with DLED may only speak in short, 2 or 3-word sentences. When you ask
them a question, they may not be able to answer since they cannot find the right
words.

Myth #8 About Speech Delay in Kids: My Child Has Delayed Speech Because Of Our
Strict Parenting Style
If you blame or hold yourself responsible for your child’s delayed speech, it’s
time to learn the truth.

It is only natural for parents to love their children and feel guilty if their
children begin to show speech problems. There is no evidence to support the myth
that parenting styles influence speech development in a child.

While strict parenting styles have been related to behavior problems in children
[https://www.ahaparenting.com/parenting-tools/positive-discipline/strict-parenting]
, they do not contribute to speech delays in toddlers.

Personality traits like impulsiveness, calmness, stubbornness, and spontaneity,
which may be direct or indirect results of parenting styles, do not influence
speech and language development in children.

Myth #9 About Speech Delay in Kids: S/He Has A Speech Delay Because S/he Is
Bilingual
Do you speak two or more languages at home? Then, it may be normal for your
child to confuse languages and use words from multiple languages to express
themselves early on. However, it should not hinder their speaking abilities.

As a toddler, your child’s complex language development should continue at par
in each language they hear and speak at home. Being bilingual gives children the
advantage of learning at least two languages, cultures and thus form strong ties
with multiple communities.

Although bilingualism has been blamed for stuttering
[https://ghost.stamurai.com/bilingualism-and-stuttering/] and speech delays in children,
there is no research to support the claim.

Myth #10 About Speech Delay in Kids: Speech Therapy Can’t Help A Child
Early intervention [__GHOST_URL__/stuttering-in-childhood-early-intervention/] 
is of utmost importance for the holistic wellbeing of a child who shows signs of
speech and language disorders.

Speech-language pathologists have the diagnostic tools for the assessment and
evaluation of your child’s speech. There is a wide spectrum of speech disorders
out there that have potential therapy and treatment.

The right help from a speech pathologist is all your toddler needs to be able to
speak clearly, confidently, and effortlessly. Speech therapy can address
selective mutism, expressive language disorder, and stuttering in children. The
earliest interventions tend to have the best results.

When it comes to our children's speech, we must be able to tell the myths apart
from the facts. It is possible to improve a child's speech development with the
help of a certified and experienced speech-language pathologist.

10 Myths About Speech Delay in Children

Signs of speech delay [__GHOST_URL__/is-my-child-a-late-talker/] 
are not always obvious in children under 18 months of age. When you approach
doctors, they may tell you not to worry and wait until your toddler is of school
age. And in most cases, the doctors are right.

But, the questions and doubts about your child’s speech development are not easy
to ignore. So, this is what you should know.

By the time your child is around 2-years (24 months) old, they should be able to
communicate with you using a combination of small words, gestures, and one or
two-word questions.

Here’s what a child of 2-years should be able to do –

 * Use simple phrases to communicate their needs or demands. Most of these
   phrases come as requests like "more milk," "mommy cookie," "banana," etc.
 * They may be able to use one or two words to ask questions like "Go out?",
   "Mommy?", "Daddy go?” etc.
 * They should be able to use about 50 or more words daily.
 * They can follow simple instructions, commands and understand questions.
 * Parents and caregivers should be able to understand what they say.

By the time children are 3-years old, they can –

 * Say two and three-word phrases. Some even speak short and complete sentences.
 * They can use over 200 words and as many as 1000 words daily.
 * Toddlers can typically say their name by this age.
 * They can use simple pronouns like I, My, and Me to refer to themselves.
 * Parents and caregivers should be able to understand them clearly.

Are you currently asking questions like "Is my child not talking enough?",
"Should my child be using more words?" or "Does my toddler need an SLP
[https://stamurai.com/blog/signs-your-child-needs-speech-therapy/]?".

If your toddler isn’t meeting the speech development benchmark
[https://ghost.stamurai.com/children-speech-checklists/] for their age, you may
need to consider speech therapy.

Sometimes, helping children at home with speech therapy can aid their speech
development. Exercises for speech delay in toddlers
[https://ghost.stamurai.com/exercises-speech-delay-toddlers/] can motivate them
to learn and use more words in their daily interactions. 

So, how can you help your child develop their speech and vocabulary? Here are
seven exercises for speech delay in toddlers that can help improve their speech
and expand their vocabulary –

Exercise #1 for Speech Delay: Read To Your Child
Several parents believe that leaving the TV on or giving an iPad to their
toddlers will encourage them to speak. However, research shows that it may not
be the case.

Children require interaction with a human to develop their speech. The best way
to do this is to read to them every chance you get.

When a parent reads to a child, they listen to how you are saying these words.
They are learning new words, and the use of words they hear every day.

Find picture books with short stories that will intrigue your child. Read to
them before naptime and bedtime. Look at our list of books
[https://ghost.stamurai.com/books-for-people-who-stutter/] for preschoolers that
your child will enjoy no matter how many times you read these out to them.

Exercise #2 for Speech Delay: Use Self-Talk
Your grandparents and parents probably used this strategy cum exercise to boost
your vocabulary when you were young. And now, it's your turn.

Talk about what you are doing around your child. If you are playing with blocks,
point to the blocks, and say "blocks" throughout the playtime. Point to the ball
and say, "ball. Throw ball" as you throw the ball.

Don’t be afraid of being repetitive. Children learn through repetition. The more
you repeat the simple words or two-word phrases, the more are your child’s
chances of learning those words and phrases.

Exercise #3 for Speech Delay: Use Parallel Talk
This exercise is similar to self-talk, but instead of describing your own
actions, you will be labeling your child's actions.

One way to assist this process is to label the things your child is using. For
example, you can use hand-made, color-coded labels for their toys. Or, you can
say the name of the things they are using like a chair, table, spoon, bowl, etc.

Always be sure to use phrases or sentences that are slightly longer than the
sentences your child is using. For example, if your child says, "juice." Be sure
to say "juice. You want more juice?" back to them.

Exercise #4 for Speech Delay: Build On Your Child’s Speech
As a part of this exercise, you will build on what your child says or gestures.
Try repeating whatever they say and add one or two meaningful words to it.

For example, if your child says "ball." You can say "want ball" or "throw ball"
or "my ball" back to your child. You can also name the object your child is
pointing at or reaching for.

You can use more than one word to refer to the same object to boost your child’s
vocabulary. Make sure you don’t use words that are too big or complex for your
child.

Exercise #5 for Speech Delay: Sing to Your Child
You don't have to be a great singer, and the songs don't need to be ballads. You
can sing simple nursery rhymes to your child.

Years of research shows that singing to your child can enhance
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6558368/] their ability to speak.
Interestingly, the centers for singing and speaking are different in the brain.

There have been instances where a child was able to sing a nursery rhyme long
before they could form complete sentences.

Exercise #6 for Speech Delay: Boost Receptive Vocabulary
Receptive vocabulary may include all the words that your child understands, even
though they may not use these words.

Just like us, children must first understand the meaning and then use the words.
To help them understand the meanings of new words, you can try using them in
conjunction with words they already know.

For example, when they point at your spouse or partner, you can say, "where's
daddy?" or "where's mommy?”. When they point at food, you can specify the name
of the food like chips, cookie, candy, apple, etc.

You can then move to the next step by asking your child to point to specific
objects like “where’s the book?”, “where’s the fruit” or “show me the dog”.

Exercise #7 for Speech Delay: Praise Their Efforts
No matter how small the improvement, you need to make sure that it doesn't go
unrecognized. If they have learned or used a new word, be sure to praise them.

Verbal positive reinforcement can go a long way in shaping their personality as
an adult. So, even if they fumble a little while using a new word or forming a
whole sentence, be sure to praise them for their efforts.

Wrapping Things Up
It is imperative to spend time with your toddler. Quality time is of utmost
importance if you want to help your child overcome speech delays. Apart from the
usual playing, try to incorporate these 7 simple exercises into your child’s
daily routine. 

Speech delay may not always [__GHOST_URL__/speech-and-autism/] be a
sign of autism and other neurodevelopmental disorders, and auditory disorders. 

However, you should always consult a pediatrician, as well as a speech-language
pathologist, if your child is showing delays in speech development. Besides
helping your child practice the above-mentioned exercises at home, you can also
opt for online speech therapy for speech delay
[https://stamurai.com/blog/online-speech-therapy-for-speech-delay/] for the best
results. 

At the same time, it is important to avoid falling for common myths about
speech
delay in children [__GHOST_URL__/myths-speech-delay-children/].

7 Exercises for Speech Delay in Toddlers

Are you worried that your 2-year-old child isn’t talking? Does your 4-year-old
only say single words instead of complete sentences? Are you afraid that your
child might have a developmental delay?

All children develop speech and language skills at their own pace. Diagnosing
developmental and speech delays in children isn’t always easy since many catch
up to their peers by the time they are ready for preschool.

Speech-language pathologists and pediatricians refer to milestone checklists in
speech and language developments for 2, 3, and 4-year-olds. Comparison with a
standardized checklist helps the professionals, as well as the parents,
understand the type and possible causes of their child’s speech delay
[https://ghost.stamurai.com/causes-of-speech-delay-in-children/].

If you are worried about the rate of speech and language development of your
child and are wondering if your child is a late-talker
[https://ghost.stamurai.com/is-my-child-a-late-talker/], you can refer to this
exhaustive checklist of speech and language milestones.

2-year Old Speech Checklist
What should a 2-year-old child be able to do? Let’s find out.

Talking Skills
 1. The child may say the names of their favorite cartoons, celebrity, or game
    characters.
 2. Children may know and say the names of different body parts like nose, ear,
    eye, mouth, feet, and hands.
 3. A 2-year-old should be able to form short sentences with 2 to 4 words.
 4. They can ask simple questions like “who’s that?” and “where’s daddy?”
 5. They can use words that contain b, h, m, p, and w.

Comprehension And Cognition
 1. A child can point to photos, picture cards, or things when you mention them
    by name.
 2. They are also able to follow simple 1-part instructions.
 3. They are able to answer simple questions like “who’s that,” and “where’s
    mommy”
 4. They show eagerness in listening to stories, rhymes, and songs.

By their second birthday, a child typically copies adults and other children.
They are happy and excited to interact with other children and begin showing
interest in including other children in their games.

A 2-year-old reaches developmental milestones like sorting things according to
shapes and colors. They play make-believe games and indulge in fantasies. They
are also able to learn and repeat new words after hearing a conversation between
adults.

How Can You Help If Your 2-year-Old Doesn't Talk?
 1. Narrate what you are doing, and where you are going. Use simple sentences.
    For example, you can say “I see kitty. Kitty is white. Kitty says meow.
    Kitty drinks milk”
 2. Always use small words and short sentences that your child can mimic. Be
    sure to use correct grammar.
 3. Try to add words to whatever your child says. For example, if your child
    says “dog”, try to say, “yes. That’s a big dog. The dog is black”
 4. Try to read to your child every day before naptime and bedtime. Books with
    large photos or illustrations and fewer words on each page capture a child’s
    attention.
 5. Use picture cards and ask your child to name the familiar ones. It may be
    difficult at first. In that case, name the photos/pictures for them. Soon,
    they will begin to name the pictures all by themselves.

If your child has crossed their second birthday, and yet they have not reached
many of the speech, comprehension, and cognition milestones, you should consult
a pediatrician, and speech-language pathologist immediately.

3-year Old Speech Checklist
What should your 3-year-old child be able to do?

If you observe your 3-year-old not talking much, you can refer to the following
speech checklist.

Talking Skills of a 3-year-Old Child
 1. A 3-year-old child can say their own name and age.
 2. They can name their friends.
 3. They can use the plural of common words like cats, dogs, cars, and shoes.
 4. They can name familiar things including things in their bedroom, the
    children’s park, and the classroom.
 5. They can name things that are not in their sight.
 6. They can use two to three words to ask for things.
 7. They can use words with d, g, f, k, n, and t in them.
 8. Even strangers can understand around 50% of their speech on most occasions.

Comprehension And Cognition Skills
 1. A 3-year-old is able to understand and use pronouns like “I,” “my,” “his,”
    “her” and “you”.
 2. They can follow 2 and 3-step instructions.
 3. They can continue a conversation using 2 or 3 sentences.
 4. They understand simple prepositions like “on,” “in,” and “under”.

A 3-year-old without any developmental delays
[https://stamurai.com/blog/online-speech-therapy-for-early-childhood-development/] 
can play with toys that have levers, buttons, and moving parts. They can also
solve small puzzles with 4 to 6 pieces, play with building blocks and flip
through a book. They may even be able to turn door handles and screw/unscrew jar
lids.

The neurotypical and healthy 3-year-old toddler tries to copy the adults and
their friends. They show affection and empathy for their friends by hugging them
or pecking them on their cheeks. They are able to participate in group
activities with children their age and take turns to play games.

What Should Parents Do If Their 3-year-Old Isn’t Talking Much?
 1. Speak clearly around them. Use short and crisp sentences.
 2. Repeat after your child and add to their words. If your child says, “tasty
    candy”, you can say, “yes. The candy is tasty. Do you want to give daddy
    some candy?”
 3. Ask your 3-year-old to repeat themselves if you don’t understand what they
    are saying. You can say something like, “Yes. You want the toy. Can you tell
    me which one you want?”
 4. Talk about objects around you, colors, shapes, and family members. It is one
    effective way of teaching kids the names of things and the people around
    them.
 5. Give more than one choice to your child. For example, instead of asking if
    they want juice, you can ask them “do you want juice or milk?”
 6. Play simple interactive games that involve naming body parts.
 7. Sing fun songs and nursery rhymes with your child.

If your 3-year-old isn’t talking much and not showing the behaviors discussed in
the above section, it is time to talk to a specialist
[https://stamurai.com/blog/online-speech-therapy-for-speech-delay/] who can
diagnose if your child is a late-talker

4-year Old Speech Checklist
What should your 4-year-old child be able to do? Let’s look at the speech
checklist.

Talking Skills
 1. They are able to name their favorite toys, games, books, and movies.
 2. A 4-year-old knows basic grammar and can use “he,” “she,” and “they”
    correctly.
 3. They can sing a song or recite a short poem from memory such as, “Wheels on
    the Bus” and “Twinkle Twinkle Little Stars”.
 4. They are able to say their first and last name.
 5. They can name colors, numbers, and some shapes.
 6. They can answer “who, where and what” type of questions.
 7. A 4-year-old child should be able to make 4-word sentences. Although they
    may make mistakes sometimes.
 8. They can narrate the events of the day in simple sentences.
 9. Some 4-year-olds can tell stories too.

Comprehension And Cognition
 1. A 4-year-old should respond when you call their name from another part of
    the house.
 2. They should be able to understand the names of some colors and shapes.
 3. They are also able to understand names for family members like a brother,
    sister, grandma, and grandpa.

Apart from these speech and language milestones, children can draw complex
shapes, use scissors, and play board games appropriate for their age. They can
play catch, and hop up on one leg.

By their fourth birthday, a child is able to enjoy new activities and become
more creative with make-believe play. They also show more interest in playing
with other children than by themselves.

What Can You Do To Help Your 4-year-old Child’s Speech And Language?
 1. Play simple sorting games with your child using photos and picture cutouts.
    Take photos of fruits, animals, birds, and shapes. Ask them to find photos
    that are similar. They might need some guidance in the beginning, but soon
    they should be able to catch up.
 2. Read and sing to your 4-year-old kid. Talk about what you are doing, where
    you are going, and what you are eating. It is an effective way to teach them
    new words.
 3. Read simple stories from picture books. Talk about the characters and
    encourage your child to retell the story.
 4. Look at family photos and ask simple questions like “where’s grandma” or
    “who’s that”.
 5. If they have an iPad, encourage them to play games that require matching, or
    identifying photos of everyday objects, colors, and shapes.

If your 4-year-old isn't talking much and isn’t engaging in the activities
mentioned in the above section, you should consult a speech-language pathologist
and pediatrician. These can be signs of developmental delays in children. 

Depending upon the diagnosis, you can opt for online speech therapy for speech
delay [https://stamurai.com/blog/online-speech-therapy-for-speech-delay/], 
language disorders
[https://stamurai.com/blog/best-online-speech-therapy-for-language-disorders/], 
early childhood development
[https://stamurai.com/blog/online-speech-therapy-for-early-childhood-development/]
, and speech-sound disorders
[https://stamurai.com/blog/online-speech-therapy-for-speech-sound-disorders/].

Speech Checklists for 2, 3, and 4 Years Old Children

Many preschool-aged children stutter. They may repeat whole or part words, use
interjections like “uh” and “um”, or show difficulty in finding the right word.

For more than 75% of the preschoolers (children between the ages of 2 and 6
years), the stuttering will go away on its own without any intervention
[https://ghost.stamurai.com/stuttering-in-childhood-early-intervention/]. About 25% of
preschoolers who stutter will continue to stutter till adulthood or require
speech therapy for recovery of fluent speech.

What Are The Warning Signs Of Persistent Stuttering?
Stuttering [__GHOST_URL__/what-is-stuttering/] can become a serious problem if
parents leave the recovery to chance. Parents/guardians should seek the counsel
of a speech therapist or speech-language pathologist (SLP) if –

 * The child has another family member who stutters
 * The stuttering has begun after the age of 3 years
 * The child has been stuttering for longer than 6 months
 * The child is male
 * The kid has other speech/sound disorders
 * Their language skills are delayed or advanced for their age

Natural recovery for a child who has begun stuttering should take no longer than
6 months. So, if your child has been stuttering for longer, you should consult
an SLP or speech therapist immediately.

The course and method of stuttering therapy
[https://ghost.stamurai.com/treatment-for-stuttering/] can vary depending on the age of the
individual who stutters. However, for preschoolers, speech therapists &
speech-language pathologists (SLPs) use a few tried and tested programs.

Indirect Approaches for Treating Stuttering In Preschool-Aged Children
Indirect approaches include modifying the child’s environment. The method avoids
direct interaction with the child. Indirect therapy is recommended for children
who are unaware of their stuttering or do not show any frustration due to their
speech disfluencies.

Indirect therapy focuses on teaching the parents/caregivers the intricacies of
stuttering and therapyIndirect methods of the stuttering treatment target the
children's shame [__GHOST_URL__/stuttering-in-children-understanding-shame/],
fears, language, and feelings during daily interactions.

It also targets the parents’ speaking patterns and aims to reduce the speaking
rate of the child.

Several clinicians prefer the indirect approach since it puts less pressure on
the child.

Direct Approaches for the Treatment of Stuttering In Preschoolers
Direct approaches target the preschooler’s speech behaviors. It is especially
effective when the child is aware of their stuttering and shows discontent with
the speech disfluency.

Speech therapists opt for direct approaches when children begin exhibiting
secondary behaviors of stuttering like rapid blinking, quivering of lips, or
nodding of the head.

An SLP or a parent can provide direct treatment for stuttering. Some direct
approaches include modeling reduced speaking rates, allowing the preschooler to
finish speaking without any interruptions, taking turns while talking,
increasing pauses during speaking, and relaxed breathing.

Some of the most popular direct treatment approaches include the Lidcombe
program and the Gradual Increase in Length of Complexity of Utterance (GILCU).

However, one should remember that direct methods like Lidcombe and GILCU begin
losing effectiveness if the client is above 5 years of age.

Family-Focused Treatment and Client Counseling
Parental intervention is preferred [https://pubmed.ncbi.nlm.nih.gov/16646215/]
for the treatment of stuttering of preschool-aged children. The two major
components of the parental intervention are –

 * Their feelings about stuttering, the child who stutters, and themselves.
 * The parents’ behavior towards the child when they are stuttering and when
   they aren’t stuttering.

It is important that during family-focused treatment, the parents don't
criticize the child, scold them or ask them to slow down repeatedly.

Charles Van Riper also suggested that reducing the pressure, the number of
interruptions, high rate of speech, punishments for stuttering instances, and
completing the child's speech can contribute towards the child's fluency.

As per the family-focused treatment, parents need to learn about speech
disfluencies. They need to gather knowledge about what they can contribute to
the child's fluent speech and communication.

This treatment typically includes strategies to help the parents reduce their
anxiety towards stuttering and modify their speaking patterns.

Counseling is an integral aspect of stuttering treatment for preschoolers. It
can help both parents and children. Psychological counseling
[https://pubmed.ncbi.nlm.nih.gov/28576289/] can help everyone involved in the
dynamics make emotional adjustments.

Counseling young children can be challenging. It is the SLP's responsibility to
listen to their narrative to understand the child's anxiety, fear, and tension.
The aim of counseling provided by an SLP or speech therapist is to ensure that
it doesn't become an internal trait.

Counseling for parents should target emotional adjustments necessary for fear,
anxiety, guilt, depression, or isolation they might be feeling due to the
child's core and secondary behaviors.

Support Groups for Stuttering
Support groups for stuttering are instrumental in helping parents of children
who stutter.

Connecting with people
[https://ghost.stamurai.com/benefits-of-talking-to-other-people-who-stutter/] who are
experiencing similar situations and emotions can help the parents gain new
perspectives on stuttering and stuttering therapy.

Members of support groups [https://stamurai.com/sessions] may also gain
information regarding state-of-the-art stuttering treatment programs. They may
find new literature on the causes, effects, and treatment of stuttering.

The Lidcombe Program
The Lidcombe Program [__GHOST_URL__/stuttering-in-childhood-early-intervention/] 
is a parent-directed behavior modification program that is highly effective for
toddlers and young children.

The SLP teaches and guides the parent(s) as they deliver stuttering therapy to
the child. The parents have to learn how to measure the severity of their
child’s stuttering in their everyday environment.

The parents learn how to provide stuttering treatment to their children during
their weekly visits with the clinician. It is an indirect treatment method, so
the parents are required to learn how to provide feedback.

The program has two stages –

 * Stage 1 – The parent conducts treatment and checks in with the SLP once a
   week. This phase continues till the stuttering goes away or reaches an
   insignificant level.
 * Stage 2 – This stage is all about maintaining the child’s fluency. It can
   last around a year or more. The parent(s)’s clinic visits become infrequent
   during this time and the frequency of feedback also becomes scarce. Since
   stuttering may reappear, maintenance is an important part of the Lidcombe
   program.

A majority of the SLPs across the world recommend the Lidcombe program for
children who stutter since it is non-intrusive. The child can receive treatment
while remaining in a non-stressful, familiar environment.

The Monterey Fluency Program
The Monterey fluency program is targeted at preschool and school-aged children.
According to Dalton, combining this program with a token economy system can be
beneficial for the child’s progress.

The MFP offers two alternative pathways
[https://pubmed.ncbi.nlm.nih.gov/7731220/] to fluency – the gradual increase in
length and complexity of utterances (GILCU) and delayed auditory feedback (DAF).

DAF is more effective for older children. GILCU depends on operant conditioning
principles, and it is more effective for younger kids.

You can learn more about DAF here [__GHOST_URL__/daf-stuttering-guide/].

Fluency Rules Program
The Fluency Rules Program (FLP) has helped preschool and school-aged children.
It has 10 fluency rules.

It has 3 sets of rules – universal, primary, and secondary. CWS follows the
universal rules. These include the slow rate of speech, saying a word only once,
and saying it short. These rules aim at reducing anxiety, repetitions, and
prolongations.

Primary rules are only enforced if the child has laryngeal difficulties during
talking. Secondary rules come into play when secondary stuttering behaviors are
present in the children.

Comprehensive Stuttering Program for School-Age Children
The Comprehensive Stuttering Program for School-Age Children (CSP-SC) has four
main targets –

 1. Speech-related goals
 2. Self-management goals
 3. Attitudinal-emotional goals
 4. Environmental goals

CSP-SC aims to integrate the family and the children to enhance fluency skills,
address emotions and attitudes related to stuttering.

The SLP teaches fluency enhancement skills in various environments with a normal
rate of speaking. The clinician also teaches skills to manage residual
stuttering and improve communication skills.

Synergistic Stuttering Therapy
The Synergistic Stuttering Therapy (SST) model was developed by Bloom and
Cooperman in 1999 for CWS. It considers the physiological factors, attitudes,
feelings, and communication environment of children who stutter.

The SST model [https://www.mnsu.edu/comdis/isad4/papers/cooperman.html] of
intervention focuses on the importance of teaching how the mechanics of normal
speech production work. It aims to teach all clients the mechanics of phonation,
respiration, and articulation using visual devices during therapy.

The SLPs or speech therapists then utilize various activities to help the CWS
increase their awareness about their speech disfluency. It works in four phases
–

 1. Identification phase
 2. Modification and establishment phase
 3. Stabilization phase
 4. Transfer and maintenance phase

The methodology devised by Cooperman and Bloom accounts for three main areas -
self-esteem, assertiveness, and locus of control. The final domain is the
environmental aspect of speech disfluency.

Which Stuttering Therapy Is Ideal For Preschool-Aged Children?
For children who are 6 years or younger, indirect methods of stuttering
treatment seem to be most effective. Approaches that address stuttering
immediately after it occurs can reduce stuttering in natural environments.

To date, the Lidcombe program has the most positive feedback for treating
stuttering in preschool-aged children. Children also show improved emotional
intelligence and psychological progress after completing the Lidcombe program.

Indirect treatment of stuttering provided by a parent or caregiver may help
children who stutter. This can improve a child's speech efficiency,
communication skills, and emotional wellbeing.

Offering psychological counseling or teaching fluency skills directly to a
toddler or preschooler may be difficult or impossible. Hence, speech therapists
prefer indirect methods over direct methods due to low recurrence of stuttering,
and high instances of recovery.

Different Approaches for Treating Preschool Kids Who Stutter

Teachers of preschool-aged and school-aged children often report to the parents
that their child isn't talking in class. The concerned parents approach an SLP
(Speech Language Pathologist) saying "my child talks fine at home, he doesn't
talk at all in class."

It is a telltale sign of selective mutism.

What Is Selective Mutism?
Selective mutism is a childhood anxiety disorder that is usually diagnosed in
children.

It is a rare childhood anxiety disorder that occurs among only 1% of children.
One of the first reported cases dates back to 1877 when Dr. Adolph Kussmaul
referred to children with selective mutism as having "aphasia voluntaria."

DSM-5 states that since it is not a matter of choice of a child, it is not an
elective behavior. Selective mutism (SM) was classified as an anxiety disorder
back in 2013 in the fifth edition of the Diagnostic and Statistical Manual of
Mental Disorders (DSM-5).

Diagnosis – The Signs and Symptoms of Selective Mutism
The primary diagnostic criterion is the failure of the individual (child) to
speak in certain social situations. These situations may include a classroom,
playground/playgroup, or daycare, where there's pressure on the child to speak
and interact. However, the child can talk and communicate in other situations,
such as at home.

Is your child shy or is it selective mutism? A child with selective mutism
typically meets the typical rate of speech development
[https://ghost.stamurai.com/children-speech-checklists/] for children their age, at home.
Nonetheless, they are silent in school and other public settings.

Here’s a checklist for selective mutism in children that you may consider if you
think your child is exhibiting selective mutism -

 * The child understands spoken language.
 * S/he can speak and communicate in some situations. For example – in familiar
   environments (home).
 * Their lack of speech interferes with the child’s education and/or social
   functioning.
 * The child talks to one or two people/friends freely without any signs of
   selective mutism.

A child who has moved to a new country or experienced a jarring event will NOT
be diagnosed with selective mutism. However, in both cases, the child may need
the help of a counselor to be able to integrate into the normal flow of life.

What Causes Selective Mutism?
Recent studies show that some children may have a genetic predisposition towards
anxiety. However, like all mental health problems, selective mutism likely has
multiple causes.

Children who develop selective mutism are generally –

 * Very shy
 * Anxious
 * Prone to embarrassment

Psychiatrists and speech-language pathologists (SLPs) note that selective mutism
occurs with other disorders such as –

 * Depression
 * Developmental delays
 * Anxiety
 * Obsessive-compulsive disorder (OCD)
 * Language disorders
 * Panic disorder

What is the Treatment of Selective Mutism?
Treatment for selective mutism is most successful when it's detected early. Is
your child silent at school? Has your child not spoken for two months in class?
In such cases, it is of utmost importance to begin selective mutism treatment
[https://www.asha.org/public/speech/disorders/selective-mutism/#treatment] as
soon as possible.

Since selective mutism may have multiple causes, treatment usually consists of
two or more approaches.

Psychotherapy For Selective Mutism
The most common and effective approach for treating selective mutism in kids
includes behavior management programs or psychotherapy.

Sessions may include techniques, such as positive reinforcement and
desensitization exercises at home and school.

The child needs to be under the supervision of the psychologist. The parents
need to communicate with the psychologist to provide regular feedback.

Medication for Selective Mutism
Some children with chronic anxiety disorders require medication. However,
children must be evaluated by a child psychologist or psychiatrist before they
can begin anxiolytics.

Parents should also consult the child’s pediatrician before beginning medication
for selective mutism.

The choice of medication should depend on the child's health, medical history,
and history of anxiety.

How can parents Help A School-Going Child with Selective Mutism?
Psychotherapy and medication are indispensable to treat selective mutism.
Nonetheless, parents can help the child cope in different social situations that
may reduce anxiety and symptoms of selective mutism.

Here’s how to help a child with selective mutism –

Inform Their Teachers and Peers
When a child "refuses" to talk in class or playgroups, the adults involved and
their peers may become frustrated, irritated, or angry.

It is imperative to understand and explain that the child in question isn't
actually refusing to talk. S/he is unable to speak in social situations.

As a parent, it is your responsibility to ensure that your child’s teachers know
that they have selective mutism. Their silence is not intentional.

Discuss positive reinforcement with the child’s teachers with help from their
psychologist. You can work with their teachers to offer your child a comfortable
and positive environment, where they feel encouraged to express themselves.

Pick Activities They Like or Enjoy
Children typically feel more confident if they engage in activities that exhibit
their skills. Instead of forcing your child to engage in social situations, you
can choose activities like solving puzzles, art, and craft, or building blocks.

Pick activities that do not require verbal communication. Strengthen your
child’s confidence and self-worth. It is one way to help a little one who has
social anxiety.

Avoid Negative Reinforcement
Conditioning is a significant portion of the treatment of selective mutism in
children. The psychologist will guide the parents and the child. Parents will
learn how to offer positive reinforcement.

Parents should also learn what constitutes negative reinforcement so as to
 avoid it at all costs while interacting with their child who has selective
mutism.

Parents must remember that their child cannot overcome social anxiety or
selective mutism through punishment or pressure.

Can selective mutism be cured? Well, selective mutism is a treatable disorder
that requires understanding, compassion, and patience. Parents should not
pressurize  their children if they are not making significant progress.

Instead, speak to their psychologist and speech-language pathologist (SLP). They
may suggest minor changes in your child's activities and play therapy for a
better outcome.

Does Bilingualism Cause Selective Mutism?
Selective mutism occurs more commonly in children who speak two languages than
those who speak just one.

Although bilingualism and selective mutism share
[https://leader.pubs.asha.org/doi/full/10.1044/leader.FTR1.19112014.34] a direct
relationship, the former does not cause the latter. However, children who are
already prone to anxiety may experience selective mutism, when they are expected
to speak in a language they are less comfortable with.

In some cases, bilingual children may exhibit mutism when they are expected to
speak only in their second language. In other cases, the social anxiety and fear
of speaking may not be restricted to language. So, bilingual children may remain
silent even when expected to speak in their native language.

Bilingual children demand careful observation and analysis of their mutism. If
they can't converse due to the lack of understanding of a second language, then
it's not a case of selective mutism.

Sometimes, children learning the lexicons of multiple languages have a "silent
period." These are intervals where they are acquiring or learning a new
language. So, parents and clinicians must be careful not to interpret these
learning intervals as a sign of selective mutism.

How Can Speech Therapy Help Children With Selective Mutism?
If you think your child is showing signs of selective mutism, it's necessary to
consult their pediatrician and look for a child psychologist and 
speech-language
pathologist
[https://ghost.stamurai.com/stuttering-treatment-how-can-a-speech-language-pathologist-help/]
.

A speech therapist will play an integral role in the treatment of selective
mutism. Speech therapists can assist your child’s selective mutism diagnosis by
providing them with evaluations and assessing their speaking skills.

After diagnosis, a speech therapist can design personalized therapy ideal for
your child. Therapy typically addresses the complexity of the language used and
the purpose of the same. Therefore, the speech therapist can help your child
understand and learn new vocabulary, types of responses, appropriate responses
in social situations, social cues, and pragmatic language.

Selective mutism speech therapy activities also teach children how to ask
questions, take turns in conversations, and communicate non-verbally.

A speech therapist also provides much-necessary encouragement during sessions.
They also teach parents different ways to offer reinforcement to their children
and boost their confidence.

Speech therapists should work with the child psychologist or psychiatrist to
determine the best route for selective mutism treatment. Most importantly, they
should provide pertinent information to the parents regarding diagnosis, therapy
methods, prognosis, and progress.

Parents’ Guide to Selective Mutism

You have noticed that your child isn’t speaking as much as their peers. It may
be possible that your 2-year old hasn’t said their first words yet. This begs
the question: is it autism or speech delay?

A speech delay may be a sign of autism. However, it is not always the case. So,
how do you understand autism vs speech delay?

What Is Speech Delay?
Speech delay or alalia is the delay in the development of speech
[https://ghost.stamurai.com/causes-of-speech-delay-in-children/] or delay in the use of
articulators to produce speech.

Speech is a part of the language. It is the process of making sounds using the
lungs, voice box, vocal cords, tongue, lips, and teeth.

Experts consider a child to have delayed speech if the rate of development of
their speech is slower than the normal rate of children their age.

What is Normal Speech Development in Children?
The rate of speech development is measured against age-related milestones. These
milestones can act as references for determining the normal rate of speech
development [https://www.nidcd.nih.gov/health/speech-and-language] in a child.

Between 1 month and 6 months

 * A child should be able to coo in response to voice.

Between 6 months and 9 months

 * A child should begin to babble in response to voice and on their own.

By 12 months

 * By their first birthday, children should be able to say "mama/dada" with
   meaning. Some children often begin to imitate two- and three-syllable words
   that they hear the adults saying repeatedly.

Between 13 to 15 months

 * Children typically acquire a vocabulary of four to seven words. Around 20% of
   their speech should be understood by strangers as well.

Between 16 to 18 months

 * An 18-month old should have a vocabulary of at least ten words. You should
   expect some echolalia (repetition of what you are saying) and extensive use
   of jargon.

Between 19 and 21 months

 * By the time your child is between 19 months and 21 months old, their
   vocabulary should expand to twenty words. Strangers should be able to
   understand around 50% of their speech.

By 24 months (2 years)

 * By their second birthday, children should have a vocabulary of at least fifty
   words. A 24-month old should be able to use two-word phrases. Strangers
   should be able to understand around 70% of their speech.

By 36 months (3 years)

 * By the time they are 3, children begin to use plurals and past tenses in
   their sentences. 3-year olds should be able to count at least three objects
   correctly. They should use three to five-word sentences. Strangers should be
   able to understand around 80% to 90% of what your 36-month old is saying.

Between 3 and 4 years

 * Children between 3 and 4-years old should be able to form 3 and 6-word
   sentences. They should be able to ask questions, relate experiences, narrate
   stories, and hold conversations. Strangers should understand almost 100% of
   their speech.

If your child hasn't reached these milestones at the right age, then you have
every right to be worried and anxious. Speech delay and autism share an
intricate relationship.

However, instead of worrying alone, you should take the help of a speech
therapist [__GHOST_URL__/exercises-speech-delay-toddlers/] or speech-language
pathologist to determine if  it is autism or speech delay.

What Is Autism?
Autism or autism spectrum disorder is a developmental disorder.

The estimated prevalence
[https://www.cdc.gov/mmwr/volumes/69/ss/ss6904a1.htm?s_cid=ss6904a1_w] of autism
spectrum disorder is 1 in 54 children as of 2016 in the US population. Genetics
plays a significant role in the cause of autism. However, it is a heterogeneous
disorder and multiple mutations, linkages, and variations have been associated
[https://pubmed.ncbi.nlm.nih.gov/22463983/]with autism in the last few years.

Autism spectrum disorder (ASD) is an umbrella term that includes a wide range of
early-appearing social communication deficits. Repetitive sensory-motor
behaviors often characterize autism spectrum disorder.

Speech Related Signs Of Autism
Speech delays are common among children. Nonetheless, speech delays may also
indicate autism. Thankfully, it is possible to tell the difference between
speech delay and autism.

Here are the telltale signs of autism-related speech delays –
 * The child is typically slow in responding or shows no response to parents or
   caregivers calling their name.
 * The toddler may not gesture (point) towards objects or people.
 * They may show a slower rate of language development. A one-year-old may coo
   and babble during the first year and then stop entirely.
 * There may be signs of repeated words and phrases (echolalia).
 * Most of the time, the child may be speaking in single words only.
 * They tend to use words and phrases that seem out of place or have meaning
   only the child and their caregivers understand.

Why Do People Confuse Speech Delay with Autism?
Speech delays characterize autism spectrum disorder. Some toddlers with ASD who
develop speech at a normal rate often face challenges using spoken language as
they grow older.

It is easy to confuse the signs of speech delay
[https://ghost.stamurai.com/is-my-child-a-late-talker/] and autism. With speech delays,
children may reach the age-related speech and language milestones at a slower
rate as compared to other kids their age.

Parents of toddlers with ASD report delays in their children’s speech
development. Yes. Speech delay is an early indicator of autism in young kids,
but it is NOT the only signifier.

Children with ASD may use
[https://onlinelibrary.wiley.com/doi/full/10.1002/aur.1483] varying vocal
patterns, have a tough time using gestures and reading expressions. Experts note
that some children also use repeated sounds and words for self-stimulation.

Symptoms of Autistic Speech Delay
Let us consider the cases of Charlie and Jaimie.

Charlie is currently 2-years old. He isn't talking at all. While he is a quiet
child, he grabs his mother's fingers, tugs at daddy's sleeve, and cups his
mother's face when he wants attention. He engages with his parents and interacts
with other children his age during playdates. He dislikes naps because his
parents leave him alone in his room.

Jaime, on the other hand, does speak a few words. Interestingly, he doesn't use
these words to communicate. He repeats those few words and cannot use or
understand gestures. He doesn't point towards something he wants or needs. Jaime
doesn't engage with other children his age. However, he is quite content when
his parents leave him alone. His parents find it difficult to capture his
attention for longer than a few seconds.

If you think your child is more similar to Jaime than Charlie, it may be wise to
consider having them evaluated
[https://link.springer.com/article/10.1007/s10803-020-04853-1] for ASD.

Some children with ASD who are on the high functioning end of the spectrum may
be more social compared to children with severe ASD.

Almost all children with autism face social communication challenges. However,
with extended speech therapy [__GHOST_URL__/speech-therapy-benefits-for-autism/] 
and behavioral therapy, social communications may become somewhat easier for
children with autism.

Autism vs. Speech Delay
Children learn pretty quickly that they need to communicate to receive what they
want. In the cases of neurotypical
[https://www.healthline.com/health/neurotypical/] children, they learn to make
eye contact, babble, point, and tug on fingers or sleeves to communicate their
needs long before they learn to speak.

Neurotypical children learn spoken language over time because they receive
positive results from using it. While neurotypical children may experience
speech delays, they exhibit the following behaviors –

 * Children are motivated by smiles, hugs, and other social responses.
 * Kids are naturally prone to imitate the actions of grown-ups around them.
 * Children are more likely to observe people than inanimate objects.
 * Neurotypical children prefer the company of people. They may tend to get
   lonely and bored when left alone.
 * A child with autism has social communication challenges. These act as
   hindrances in establishing meaningful social communication.
 * A child with ASD may be more motivated by their own interests as compared to
   social interactions.
 * They may not imitate others' actions or rarely do so.
 * Children with autism may show more interest in things rather than people.
 * They may even be content when left alone.

Any child may face some level of speech development delay in their life.
However, a child with autism will exhibit additional signs like difficulty in
understanding non-verbal communication.

Hearing Problems Can Cause Autism-Like Symptoms
Sometimes, repeated infections in the ear and other factors can cause hearing
loss in children before acquiring speech. In such cases, the symptoms of speech
delay may mimic the early signs of autism spectrum disorder in toddlers. So, you
may confuse speech delay with autism in this case.

If your child is showing signs of speech delay, you should book an appointment
with an ENT(ear, nose, throat) doctor. Children with compromised hearing often
make up with increased visual engagement.

Children with hearing disorders and no ASD typically have no problems
understanding non-verbal communication and following social cues.

Vision Problems Can Look like Early Signs of Autism
Neurotypical babies should be able to follow their parents’ gaze or look where
their parents are pointing.

The only exception is when the child's eyesight is impaired, or their vision
isn't developing correctly. While it can mimic some signs of autism in children,
a visit with the pediatrician and a simple vision test may resolve the parents'
doubts.

What Should We Remember As Parents?
No two children with autism have identical signs and symptoms. Every child is
unique. Kids with autism tend to experience speech and language development that
is slower than neurotypical children. Special educators and speech-language
pathologists can help children with ASD to explore their true potential.

Most importantly, ASD is not a psychological disorder. There is no cure for
autism. With the right help and guidance, many children with mild to moderate
ASD can manage their symptoms and become independent and functioning members of
society.

Speech Delay vs Autism: How to Differentiate

Developmental or Childhood apraxia of speech (CAS) is a motor speech disorder.

Signals need to go from the brain to the mouth for producing speech. These
signals tell the muscles of and around our mouth how to move to make sounds.

A child who has apraxia of speech experiences disruptions in the relaying of
these signals. In most cases, children with childhood apraxia of speech can
understand language but cannot use it efficiently. It happens due to their
inability to move their lips or tongues correctly.

The characteristics of apraxia of speech in early childhood may include limited
vocalization and sound play, distortion of sounds and vowel errors, limited
consonant sounds and groping movements of the mouth.

CAS is a motor speech disorder that affects around 1 to 2 in 1000 children.
Individuals with developmental apraxia of speech (AOS) do not have weak muscles.
Therefore, exercises that aim to strengthen muscles of the mouth and jaws are
not very effective in treating the signs and symptoms of apraxia of speech in
children.

What Are The Causes Of Childhood Apraxia of Speech?
Childhood apraxia of speech is present from birth. Experts sometimes refer to it
as developmental apraxia of speech, articulatory apraxia, or developmental
verbal apraxia.

It is not to be confused with developmental delays in speech.

There can be several potential causes of childhood apraxia of speech.
Interestingly, brain imaging studies rarely show any anomalies in individuals
with CAS. Hence, in most cases, the causes of CAS cannot be determined.

However, here are some of the most commonly observed potential causes of apraxia
of speech in children–

1. Brain injury and neurological conditions such as a stroke, traumatic brain
injury, and infections may cause CAS.

2. A genetic disorder, metabolic or mitochondrial disorder may also be the cause
of CAS. Speech pathologists and neurologists have seen that galactosemia in
children often co-occurs with CAS.

3. Children with mutated FOXP2 gene
[https://www.sciencedirect.com/science/article/pii/B978012407794200002X] 
experience a higher risk of developing CAS as compared to others.

What Are The Complications of Childhood Apraxia of Speech?
Children with apraxia of speech have multiple problems that influence their
ability to communicate. The disorder does not necessarily cause these issues.
However, these conditions are common in children who have childhood apraxia of
speech.

1. Delayed speech and language development – Children with developmental apraxia
of speech have limited vocabulary, trouble understanding speech, and using the
correct grammar.

2. Intellectual and motor delays – Children with CAS may experience problems in
reading, writing, and spelling.

3. Hypersensitivity – Some children with CAS show dislike or aversion towards
certain textures, foods, and clothing. It is a trait common in children with
speech apraxia and autism.

Is There A Way To Prevent Childhood Apraxia of Speech?
It is difficult to predict which children will develop apraxia of speech. Since
the causes of childhood apraxia of speech are still not well-established, it is
indeed challenging to prevent it.

However, it is possible to diagnose childhood apraxia of speech in young
children. Starting the correct treatment as early as possible reduces the
long-term severity of the disorder.

What Are The Signs And Symptoms of Childhood Apraxia of Speech?
Not all children exhibit the same signs and symptoms of childhood apraxia of
speech. Your child may show one or more early signs of childhood apraxia of
speech mentioned below.

 1. Your child does not always say the same words, in the same way, every time.
 2. S/he may distort or change the sounds while saying a word
 3. They may be able to say shorter words more clearly as compared to longer
    words
 4. Children with apraxia of speech may grope for sounds – they repeat the same
    word/phrase multiple times till they can say it correctly
 5. Your child may stress the wrong syllable or word while speaking
 6. They may have difficulties with fine motor skills
 7. Children with CAS may experience delayed language development
 8. Some children with CAS also exhibit problems with reading, writing, and
    spelling

In most cases, children with apraxia of speech can understand language. However,
some of them have additional speech problems like expressive language disorders.

What Is The Treatment for Childhood Apraxia of Speech?
Your child’s speech-language pathologist (SLP) may suggest multiple therapies
for the treatment for childhood apraxia of speech.

Some of the more common and most effective therapies have been discussed here –

1. Speech Therapy
Children with apraxia of speech benefit from personalized and individual
therapy. It allows children more time with the speech therapist or SLP to
practice.

During each session, children get to practice common phrases and words. Since
learning words and phrases for children with apraxia of speech (AOS) takes a
long time, SLPs and parents need to be consistent and patient.

It is not uncommon for the SLP to touch your child’s face to help them make
certain shapes with their lips to produce the correct sound.

Some of the general principles of speech therapy for children include –

 * Speech drills – The SLP will emphasize speech drills. It includes asking your
   child to say particular words or phrases multiple times during a session.
 * Speaking practice – The SLP will guide your child through saying multiple
   syllables, words, and phrases. Your child will slowly master moving from one
   sound to the next during these sessions.
 * Sound and movement practice – The SLP will ask your child to watch their
   mouth as they say a particular word or phrase. Next, they will ask your child
   to mimic the movement while trying to produce the same word or phrase.
 * Vowel practice – Many children with AOS distort vowel sounds. Your child’s
   speech therapist will focus on words with vowels in different syllable types.
   Some common words include “hi,” “out,” “bite,” and “house.”
 * Paced learning – In cases of children with severe CAS, the SLP will use small
   sets of practice words. The number of words will gradually increase as your
   child begins to improve.

2. At-Home Speech Practice
Practice is most important in any speech therapy. You will have to work with
your child at home [https://www.childapraxiatreatment.org/home-practice/] on the
particular speech exercises the SLP recommends.

The SLP may give you words and/or phrases to practice with your child. They will
show you how to properly guide your child.

Remember that at-home sessions can be short, but they can be frustrating for a
parent. Children with apraxia of speech can take a long time to say a word or
phrase correctly.

Simple exercises like encouraging your child to say "Hi dad" or "Hi mom" every
time you enter the room can help their speech.

3. Therapies for Coexisting Problems
Many children with CAS also experience delays in language development. Some may
even have problems with expressive language.

Their SLP should note the complications and coexisting problems that a child
with apraxia of speech may have.

Some children may have an additional medical condition along with childhood
apraxia of speech. The treatment of that condition may improve the prognosis of
CAS for the child.

4. Alternative Communication Methods
If your child's CAS is particularly severe, they may require alternative
communication methods
[https://en.wikipedia.org/wiki/Augmentative_and_alternative_communication].

In addition to speech therapy guided by the SLP, your child may benefit from
learning sign language. Teaching them how to use PECS or communication boards
may also help them express themselves and communicate more efficiently.

Teaching your child alternative communication methods can be beneficial for
their mental health and wellbeing. They can efficiently communicate when they
want or need something.

Children with severe apraxia of speech who know sign language often become less
frustrated while trying to communicate with others.

Speech Therapy Activities for Childhood Apraxia of Speech
Your child’s SLP should show, recommend and list the speech therapy activities
that they can practice.

Here are some activities SLPs use during speech therapy of a child with apraxia
of speech –

1. Make Animal Sound Puppets
You can buy sock puppets or make them. Turn your old socks and mittens into cow,
goat, dog, cat, or chicken puppets.

Use them to encourage your child to mimic animal sounds. For example, during
play therapy you can say, "a cow goes moo." Allow your child to repeat "moo"
after you.

Do the same for each animal puppet.

You can also play animal games and puzzles together. Discuss the respective
animal and the sound it makes while playing with your child.

2. Make Short Movies
Work with your child to make short movies or videos about daily activities like
going to the park, feeding the cat, talking the dog out for a walk, or waiting
for the school bus.

Encourage your child to imitate the sounds you hear and name the things around
you.

Allow your child to be the cameraperson, and you be the star of these short
movies. Later, encourage your child to re-enact the scenes they particularly
like.

3. Sing a Song
Now, your child may already know one or two lines of a rhyme or popular song.
Sing with your child.

Repeat the lines if your child doesn't get the pronunciation correct on the
first go.

Individuals with childhood apraxia of speech often struggle to maintain
phonation and rhythm while speaking. Therefore, singing a song or rhyme is a
particularly effective speech therapy technique for apraxia of speech since it
has rhythm.

Differentiating Developmental Apraxia of Speech from Other Speech Disorders
Telling childhood apraxia of speech apart from other speech disorders can be
challenging for laypersons.

Two children with apraxia of speech may present different sets of symptoms of
the disorder. Some of these symptoms may overlap with other disorders as well.

It is always a wise decision to consult an experienced speech-language
pathologist for a differential diagnosis
[https://pubs.asha.org/doi/full/10.1044/1058-0360%282003/083%29].

How Can Parents Help?
Childhood apraxia of speech (CAS) undoubtedly requires the attention of a
professional for confirmed diagnosis and treatment. However, since a child
interacts with their parents most at home, it is the responsibility of the
parents to ensure that the child feels motivated enough to practice at home.

At-home care, attention, and practice are of paramount importance for treating a
child with AOS. Children who receive parental guidance and support show faster
improvement rates than children who only practice their speech exercises in the
clinic.

Here’s how to help a child with speech apraxia –

1. Fostering a Positive Environment
The child who has apraxia of speech may experience frustration, anger, and
disappointment every day when s/h tries and fails to communicate. Therefore,
parents must remember to be supportive no matter how severe the apraxia.

Depending on the severity of AOS the child may have to attend consecutive
therapy sessions every day of the week for a month or longer.

Parental support is of utmost importance, so the child retains a positive
attitude towards speech therapy and speaking.

It’s up to the parents to foster a supportive environment at home. They should
not ask too many questions, but at the same time, encourage their child(ren) to
speak spontaneously.

If your child has severe apraxia, you may want to consider an alternate
communication language. It may include picture boards, sign language, or
gestures. It is equally important for a parent to acknowledge these
communication efforts.

2. Practicing at Home
Firstly, you should acknowledge your child's efforts to communicate. Secondly,
you should correct your child's speech only a few times per day. Correct only
those words that your child has been learning at therapy.

Always pick a particular time to practice and keep it short. Make sure that the
practice is enjoyable for the child as well.

If, one day, your child does not feel like talking, don't force them to talk.
Engage in bonding activities that both of you can enjoy. Work on puzzles,
building blocks, or crafts – pick something your child likes. It will engage
their fine motor skills as well as creativity without seeming like a therapy
activity.

3. Helping Them Move Forward
There are times when a child with apraxia of speech may get stuck on a word or
phrase. As a parent, you have to be patient and not show frustration.

Bring the difficult words up with their speech-language pathologist (SLP) and
discuss constructive ways to help your child through their speech.

If your child is old enough to communicate which part they find the most
challenging, you can talk to them about it.

Your child may be tired or bored after days of practicing the same words and
phrases. In such a case, talk to the speech-language pathologist and find new
ways to engage your child in their daily home speech practice for childhood
apraxia of speech.

Childhood Apraxia of Speech - Causes, Symptoms & Treatment

‘Expressive language disorder’ is a developmental communication disorder.
Children with expressive language disorder have problems using language. They
can't express how they are feeling and what they are thinking. They also face
difficulty in expressing themselves while using written or sign language.

Some kids develop speech and language skills a little later than their peers.
However, they catch up to the others eventually. Experts refer to this as 
speech
delay [__GHOST_URL__/causes-of-speech-delay-in-children/]. 

Parents may refer to their late-talking children
[https://ghost.stamurai.com/is-my-child-a-late-talker/] as “late bloomers.”

Nonetheless, some have pervasive difficulty in expressing themselves verbally.
Children with expressive language disorder typically construct very short
sentences or phrases.

What Are The Signs Of Expressive Language Disorders?
Here are some signs or symptoms which may indicate that child has an expressive
language disorder –

 * The child struggles to put words together to form sentences to express their
   ideas and thoughts.
 * They have trouble recalling words.
 * They cannot use language appropriately with different people in different
   settings.

Here are some case studies of individuals with an expressive language disorder –

Case 1 - Example of a 3-years Old Child with Expressive Language Disorder
Chris is 3-years old. He is a happy child who likes ice cream, candies, and
walks in the park. However, when it's time to go to the park, he uses 2-word
phrases like "mummy park."

He does not have the typical vocabulary of a 3-year old, and he cannot produce
3- or 4-word sentences like his peers.

Case 2 - Example of a 7-years Old Child with Expressive Language Disorder
Eric is 7-years old. He is unable to form compound sentences. He can't join
sentences by using "but," "and," or "if." Instead of saying, "We went to the zoo
and saw a tiger," he says, "We went to zoo. We saw tiger."

He often makes grammatical errors and fails to use the different forms of verbs.
He also knows and uses fewer words. Eric is a quiet child who sounds hesitant
when trying to start a conversation.

Case 3 - 12-years old Has Expressive Language Disorder
Jessica is 12 years old. She avoids interacting with her peers and teachers.
She's not talkative at all, and her classmates believe her to be introverted.

She has a limited vocabulary and offers overly simplified answers to complex
questions. Her teachers report that she often jumbles up tenses and drops words.

Case 4 - Example of Expressive Language Disorder In A Teenager
Jacob is 16 years old, yet he can't narrate experiences logically and compactly.
He often leaves out verbs and pronouns in his assignments.

He seems withdrawn since he avoids all social interactions. Jacob doesn't attend
parties like his peers, and he doesn't enjoy video chats either. He avoids group
conversations altogether.

Case 5 - Expressive Language Disorder in Young Adults
Jaime is almost 23 years old. He can't make small talk at work and doesn't
interact with colleagues.

His performance review states that he is repetitive and curt. Jaime only uses
short sentences and phrases to answer questions at work and home.

Jamie’s supervisor is worried since Jaime is prone to anxiety during meetings,
can’t answer direct questions, or present company reports.

What Causes An Expressive Language Disorder?
The causes
[https://www.sciencedirect.com/science/article/abs/pii/S1476179308000785]of
expressive language disorders are unknown for most children. It is not a
disorder of speech. Hence its cause does not involve the pathophysiology of the
articulators.

In several cases, an expressive language disorder is associated with
developmental disorders and diseases such as Autism Spectrum Disorder
[https://ghost.stamurai.com/stuttering-and-autism-spectrum-disorder-diagnosis-and-treatment-in-children/] 
(ASD), Down syndrome [__GHOST_URL__/down-syndrome-and-stuttering/], and hearing
loss.

Sometimes, an expressive language disorder is often accompanied by receptive
language disorder. In the case of receptive language disorder, the child has
difficulty in understanding spoken language as well.

In most cases, receptive and expressive language disorders are developmental
conditions. The child has had it since birth. In rare cases, a child may acquire
a language disorder. That may happen due to injury to the head (brain), stroke,
or a tumor.

Recent research also suggests that expressive language disorders may cluster in
a family across multiple generations.

How is Expressive Language Disorder Diagnosed?
If your child has difficulty using language to express their thoughts and ideas,
you must –

 1. Consult a speech-language pathologist (SLP) who can assess their speech and
    language skills.
 2. Consult an audiologist or ENT (ear-nose-throat doctor) to have their hearing
    tested.

The specialists will evaluate your child's hearing, learning abilities,
cognitive function, speaking skills, and language development before offering a
confirmed diagnosis.

Individuals with expressive language disorders can receive their diagnosis at
any age. However, since it is a developmental disorder, the signs become
apparent at a young age. It is typical for children to receive a diagnosis from
a speech-language pathologist when they are preschool-aged.

An early diagnosis and intervention increase a child's chances of improving
their language skills.

What Is The Treatment For Expressive Language Disorder?
The treatment options of an expressive language disorder depend upon its
severity. Standard treatment for expressive language disorders includes speech
therapy, behavior modification therapy or cognitive behavior therapy, and
psychological counseling.

The intensity of treatment and number of sessions depends upon the individual's
age, co-existing disorders, medical history, and mental health.

Here are some components almost every standard treatment for expressive language
disorder includes –

Speech and Language Therapy
One-on-one sessions with professional speech therapists may help your child.
Speech therapy sessions can help them form longer sentences and communicate more
efficiently.

Such sessions aim at equipping the child with new words. An SLP can teach
communication skills in a way that's easy to understand.

Home Care for Expressive Language Disorder
No matter how many sessions your child attends with the speech therapist, their
treatment won’t be complete unless you guide and support them at home.

Remember to work with your child at home. Follow these tips if your child has
been diagnosed with expressive language disorder–

 * Always speak slowly and clearly.
 * Ask your child concise questions with definite answers.
 * Remain patient while your child is trying to answer your question.
 * Reduce the anticipation and anxiety at home. If your child doesn’t want to
   talk at a point, don’t force them.
 * Read them stories from picture books. Ask them to narrate these short stories
   in their own words.
 * Talk to the teachers about their diagnosis, signs, and ongoing therapy.

Being supportive and trying to understand the frustrations of a child
experiencing developmental expressive language disorder is as important as
speech and language therapy. Speak to a child psychologist or psychiatrist as
soon as possible if your child shows signs of emotional or behavioral issues.

Is Expressive Language Disorder Curable?
Expressive language disorder is a developmental condition. The signs and
symptoms of language disorders typically begin to show in early childhood.

Sadly, even with early diagnosis and intervention, many language disorders are
not curable. Depending on their cause and severity, some language disorders are
highly treatable.

Children may expand their vocabulary with extensive therapy. Regular speech
therapy may also contribute to their communication skills. Most importantly,
speech therapy may also help a person acquire language skills appropriate for
their age. Nonetheless, the symptoms of expressive language disorder persist
through adulthood.

Does Your Child Have Expressive Language Disorder?

Well-meaning friends & parents of other children often offer advice and
suggestions to parents in need. You may have heard hundreds of tales about the
symptoms, causes, and treatment of speech delay in children.

When you are unsure whether your child has a speech delay
[https://ghost.stamurai.com/is-my-child-a-late-talker/], it may be difficult for you to tell
the facts apart from myths.

So, here are the 14 most common myths about speech impairment in children and
the truth behind each of them.

Speech Delay Myth #1: Telegraphic Speech Helps Toddlers Learn To Talk
Telegraphic speech means talking in a simplified language that typically lacks
action verbs, prepositions, and correct grammar. For example, instead of "he is
eating candy," you may say, "yumm...candy."

While it sounds simple to the adult ears, it may be confusing for a child who is
just learning to speak. When you want a child's speech and language skills to
develop, you should speak grammatically correctly.

Telegraphic speech can limit
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4987034/] a child’s speech and
language development since it is a poor model of speech.

Speech Delay Myth #2: Children Grow Out Of Speech Delays With Time, On Their Own
Some children grow out of speech delays eventually. Many of them don’t require
any help from professionals. However, it is difficult to predict which children
will grow out and who will experience speech delays for life.

Leaving speech delay in the hands of time is not a wise decision especially if
your family has a history of speech delays and disfluencies. Getting the opinion
of a speech-language pathologist
[https://ghost.stamurai.com/stuttering-treatment-how-can-a-speech-language-pathologist-help/] 
(SLP) and beginning at-home speech exercises with your children is the best way
to handle speech delays in a toddler.

Speech Delay Myth #3: Pacifiers Are Bad For Speech Development In A Child
It is common for many 1 and 2-year-old children to use pacifiers or dummies. No
research states [https://neurosciencenews.com/pacifiers-speech-9999/] that the
prolonged use of pacifiers or thumb sucking can cause speech delays in
2-year-old and 3-year-old children.

If you notice unclear speech in 4-years old child
[https://ghost.stamurai.com/children-speech-checklists/], it’s likely not linked to their
extensive dependence on pacifiers. You should consult a speech-language
pathologist (SLP) in such cases.

However, if your child uses a pacifier most of the time, they won't get too many
opportunities to babble or talk. It may be wise to restrict the use of pacifiers
immediately after they get out of bed or before their naptime.

Speech Delay Myth #4: Baby-talk Hinders A Child’s Development
Studies show that using baby-talk can help your child’s speech and language
development. Baby-talk closely mimics how babies babble and talk. It is often
more interesting than “normal” adult-talk to babies.

Using grammatically correct sentences, but talking in a high-pitched voice
comprises baby-talk. Research shows that making funny faces with exaggerated
expressions stimulates infants to follow the speaker’s voice.

There is a chance that your baby will pay more attention to you if you are
baby-talking. So, be sure to be grammatically correct!

Speech Delay Myth #5: Boys Are Late-talkers
Boys are late-bloomers is a common myth related to speech delay. Boys do tend to
speak around 1 or 2 months later than girls. However, they catch up to girls
within 18 months or so.

However, researchers say that you should still pay attention to the nature of
speech and language delays in your boy child.

If your child isn’t babbling by the time he is 6 to 11 months old and not saying
2-3 words by the time they are 15-months old, you should consult a
speech-language pathologist (SLP). Timely speech therapy can boost your child’s
speech and language development.

Speech Delay Myth #6: Twins Have Delayed Language Development
A study [https://www.sciencedaily.com/releases/2014/07/140721095957.htm] 
involving 473 sets of twins in the US showed that late speech and language
emergence was twice as prevalent among twins as compared to single-born
children.

The twinning effect is more common in the case of identical twins in comparison
to fraternal twins.

However, if your twins don't say their first word by their first birthday, it's
cause for concern. You should consult your pediatrician and an SLP immediately
for their evaluation and assessment.

Speech Delay Myth #7: Younger Siblings Experience Speech Delays Because Older
Siblings Talk For Them
This is one of the top myths about speech delay in children. It is common for
the older children in the family to act as a communication bridge between the
youngest child and their parents.

Younger children may initially rely on their older siblings to communicate with
their parents and other family members. In reality, having an older sibling
should not cause any significant speech delays.

It is untrue that having one or more older siblings can delay the lastborn’s
speech.

Speech Delay Myth #8: Learning More Than One Language At A Time Causes Speech
And Language Delays In Children
Studies show that children from bilingual homes may show a slight delay in
saying their first word. Most importantly, they may mix up words from two or
more languages until they are about 4-years-old.

However, if your 4-year-old isn’t talking, it is a serious cause for concern
irrespective of how many languages you speak at home.

Children who grow up in multilingual homes do not have difficulty learning to
speak, read and write. They have a good chance of mastering all the languages
they hear at home, at a very early age.

Speech Delay Myth #9: A 3-year Old Child May Not Talk Because They Are Lazy
A 3-year-old should be able to say 3-word sentences and use simple pronouns.
Some 3 to 4-year olds can also use descriptive words such as "happy," "sad,"
"big," "small," and "cold."

They can repeat words said by their parents and peers. They can also use most of
the speech sounds. Listeners should be able to understand almost all of the
child’s speech by their fourth birthday.

Speech delay [__GHOST_URL__/is-my-child-a-late-talker/] in 3-years-old children
can be a sign of selective mutism
[https://ghost.stamurai.com/selective-mutism-guide-parents/], severe and repeated ear
infections, childhood apraxia of speech
[https://ghost.stamurai.com/childhood-apraxia-of-speech-causes-symptoms-treatment/], autism,
intellectual disability and/or hearing loss.

Always consult a pediatrician before you blame your child’s mutism on their
laziness!

Speech Delay Myth #10: Speech And Language Delays Run In Your Family
There is some truth in the heredity of speech
[https://www.sciencedaily.com/releases/2014/02/140217085246.htm] and language
problems. The child’s dad or granddad may have been a late-bloomer, but there is
no guarantee that your child will catch up with his peers’ speech development in
the future.

There may have been a family member who turned out fine without any
intervention. That does not imply that they wouldn’t have benefited from
professional help.

Therefore, if there’s evidence that speech delay runs in the family, you should
take your child to the speech-language pathologist (SLP) immediately.

Speech Delay Myth #11: Your Child Talks Fine At Home; S/He Doesn’t Talk At
School At All Because S/He Is Shy
If your 3-years old doesn't talk at all at school, the playground, or daycare,
but talks normally at home, your child may have selective mutism
[https://ghost.stamurai.com/selective-mutism-guide-parents/].

Some children can be shyer than others. They typically speak less in front of
unknown or lesser-known people. However, they talk at school and daycare with
their friends.

Selective mutism is a form of anxiety disorder
[https://ghost.stamurai.com/selective-mutism-guide-parents/] in children. Children who
exhibit signs of selective mutism may require counseling and behavior therapy.
It is a treatable disorder. However, it is imperative to get early intervention
for a child experiencing selective mutism.

Speech Delay Myth #12: You Are Working Parents. That's Why Your 2-years-old
Child Isn't Talking
Parents often blame their busy schedules for speech delays in their children.
“Did I cause speech delay in my child?” is one of the most common questions
concerned parents ask their child’s speech therapist.

While it is easy to blame yourself, here are a few facts that can relieve your
guilt!

Spend quality time with your child whenever you can. Direct interactions boost a
child’s speech and language skills.

Most babies have the innate ability to pick up a language and say their first
words around 6 to 8 months of age. They learn to speak whether they are actively
taught language or not.

If your child has a speech and language delay, an SLP can help you find out why.
However, blaming yourself or thinking about quitting your day job definitely
won't help your child's speech development.

Speech Delay Myth #13: You Are Too Strict/Lenient At Home. That’s Why Your Child
Isn’t Talking Yet
When children experience speech delay, parents tend to feel guilty. Research
shows that parenting style has nothing to do with the development rate of speech
and language in children.

However, if a parent is constantly rebuking or criticizing the child for their 
speech problem [__GHOST_URL__/stuttering-in-children-understanding-shame/], it
may become a barrier in their way of speech and language development.

Repeatedly correcting a child's pronunciation and using negative reinforcement
may make it challenging for young kids to overcome their speech disorders.

Speech Delay Myth #14: A Child Has Speech Delays Because S/He Has An
Intellectual Disability Or Low IQ
While some developmental disorders (DD) and intellectual disabilities (ID)
produce speech and language delays, not all speech delays are signs of DDs or
IDs.

Nonetheless, diagnosing ID
[https://www.psychiatry.org/patients-families/intellectual-disability/what-is-intellectual-disability] 
in very young children isn’t always easy. So, if you notice that your child is
not meeting the age-related speech and language milestones, you should consult
your pediatrician and an SLP without wasting time.

Most home remedies for speech delay do not address the complex issues that the
child may face as a result of ID or developmental disorders.

In Conclusion
When deciding what’s best for your child, it’s always important to consider the
myths vs. facts of speech delays in children. Use a verified age-related speech
and language milestone [__GHOST_URL__/children-speech-checklists/] to weigh your
child’s speech development. If you notice a delay, consult an SLP, pediatrician,
and ENT (ear-nose-throat doctor) without waiting for them to catch up with their
peers on their own.

14 Leading Myths about Speech Delay in Children

Have you ever met a person who finds it difficult to talk to others? Maybe they
find grasping the rules of spoken communication particularly challenging.

You may have met someone who keeps interrupting a conversation or veers off
topic.

These are potential signs that the person has social communication disorder
(SCD). This condition makes it difficult for individuals to understand and
follow the general rules of communication.

It is NOT a speech and language disorder. These individuals can pronounce words
and use the correct grammar.

Typical social communication skills include the ability of a person to vary how
they speak in different situations. They can also consider others' perspectives
and correctly use language syntax, vocabulary, and phonology.

Social communication is necessary for comprehension and expression in both
spoken and written forms of language.

What Are the Symptoms of Social Communication Disorder (SCD)?
Individuals with SCD have trouble communicating in everyday social situations.
The signs and symptoms of social communication disorder may vary between two
individuals.

Here are some of the common signs of social communication disorder –

 * They don't understand sarcasm and maybe overly literal.
 * Individuals with SCD may not provide background information to unfamiliar
   people when talking.
 * They may have trouble understanding meanings that are not stated but implied
   in a conversation.
 * People with SCD may have difficulty following facial expressions and social
   cues.
 * They may fail to use proper greetings.
 * Individuals with SCD may face difficulty in understanding and narrating
   stories.
 * They may not be able to use verbal and non-verbal gestures.
 * Often, individuals with SCD have problems maintaining close friendships.

These signs of social communication disorder may occur irrespective of the age
of the individual in question.

However, young children may have some delays in achieving social communication
milestones, such as using gestures and sounds to greet their peers. They may
even show reluctance in pursuing social interaction.

Typically, the signs of social communication disorder typically show up early,
but teachers and parents may have trouble recognizing them. The diagnosis of
this condition is often delayed due to the lack of understanding of these
behaviors as potential signs of a communication disorder.

What Causes Social Communication Disorder (SCD)?
The causes of social communication disorder are not clear. Researchers have not
yet identified the factors that cause social communication disorder. However,
several studies show that it occurs with other developmental disorders and
conditions such as autism spectrum disorder
[https://ghost.stamurai.com/stuttering-and-autism-spectrum-disorder-diagnosis-and-treatment-in-children/] 
(ASD), attention deficit hyperactivity disorder
[https://ghost.stamurai.com/adhd-and-stuttering/] (ADHD), developmental disabilities,
traumatic brain injury, aphasia
[https://ghost.stamurai.com/childhood-apraxia-of-speech-causes-symptoms-treatment/], spoken
and written language disorders, and learning disorders.

Social communication problems are a defining feature of autism spectrum disorder
[https://ghost.stamurai.com/speech-delay-vs-autism/] (ASD). Along with SCD, an individual
with ASD may also exhibit restricted-repetitive behaviors.

You must remember that social communication disorder has no relation with the
intelligence of a person. Most people who have SCD may face challenges at school
and work, but, generally they are as intelligent and capable as those without
the disorder.

How Is Social Communication Disorder Diagnosed?
Diagnosis of social communication disorder depends on several rounds of
screening for speech and language problems, auditory challenges, comorbidities,
and physiological conditions.

1. Speech and Language
Screening of SCD is a part of speech and language evaluation for any individual
at risk of communication disorders.

The screening process typically depends upon competency-based tools such as
personal interviews, observations, and self-report questionnaires.

The speech-language pathologist should also consult the parents, teachers, and
other caregivers.

2. Hearing
The parents of a child with a possible social communication disorder (SCD)
should consult an ENT (ear-nose-throat doctor) to rule out auditory problems.
Loss of hearing can be a potential cause of social communication deficits in
children.

If the individual wears hearing aids an audiologist must inspect them, and
ensure that the hearing aids are working.

Loss of hearing
[https://www.asha.org/public/hearing/effects-of-hearing-loss-on-development/] or
malfunctioning of one’s hearing aid can create symptoms that may mimic a
communication disorder.

3. Comprehensive Assessment
The speech-language pathologist
[https://ghost.stamurai.com/stuttering-treatment-how-can-a-speech-language-pathologist-help/] 
(SLP) may refer the individual for a thorough speech and language assessment if
they have reason to believe that a person has social communication disorder
after their preliminary screening.

In case the individual has a coexisting condition, then the SLP is responsible
for determining the overlapping signs and symptoms. It is also the
responsibility of the SLP to conduct the assessment of the individual in
question in a culturally sensitive manner.

The assessment should involve the individual's parents, teachers, and
psychologists. The SLP should consult other professionals, such as special
educators and audiologists when necessary.

The comprehensive assessment should also include the following –

 * Family history of speech and language pathologies.
 * Impairments of body structure and functions, including anomalies of the
   person’s articulators.
 * Notes on contextual factors that may serve as hindrances to the proper
   development of social communication skills.
 * The effect of the communication impairments on the person’s quality of life.
 * Existence of co-morbidities and co-existing conditions.

More specifically, an SLP assesses the person’s –

 * Ability to engage in successful verbal and non-verbal communication.
 * Comprehensive and interpretive abilities.
 * Ability to begin and sustain a conversation.
 * The capability of manipulating and navigating topics of conversations.
 * Skills of understanding verbal and nonverbal cues in social, academic, and
   community settings.
 * Aptitude for catching and following figurative or ambiguous language in
   conversations.
 * Ability to form friendships and relationships based on their communication
   skills.

An SLP may use traditional and informal tools to assess the person's social
skills. They may give the person tasks appropriate for their age to understand
how the child may react in real-world situations.

The assessment is necessary for –

 * The diagnosis of social communication disorder
 * Understanding the severity of the disorder
 * Describing the characteristics of SCD
 * Depicting how social communication disorder affects the person’s social and
   personal wellbeing
 * Outlining the possible treatment and interventions that improve the prognosis

What Is the Treatment for Social Communication Disorder (SCD)?
Early diagnosis and treatment improve the prognosis of social communication
disorder. Speech-language therapy
[https://ghost.stamurai.com/speech-therapy-benefits-for-autism/] plays a significant role in
the treatment of kids with SCD.

Intervention for social communication disorder should –

 * Emphasize the strengths and address the weaknesses concerning the disorder.
 * Improve the person's social skills that allow them to participate in social
   interactions and form social relationships.
 * Address and change the factors that act as hindrances to successful
   communication and participation.

While chalking out the treatment plan, the SLP should involve the family
members, consider the preference and need of the client, focus on the functional
outcomes, and tailor the goals according to the individual's potentials.

The SLP may implement one or more treatment strategies depending on the
individual’s needs. Here are some available treatment options for those
diagnosed with SCD –

1. Behavioral Interventions
Behavior modification techniques can change existing behavior as well as teach
new behavior to children and adults. Behavioral interventions depend upon the
principles of learning including social skills (desired behavior) through 
operant conditioning
[https://www.verywellmind.com/operant-conditioning-a2-2794863].

Behavioral approaches are particularly effective in teaching desired social
skills in one-on-one or naturalistic settings. Sessions may include just the
client, their friends, or family members depending upon the context.

2. Peer-Mediated Interventions
Peer-mediated interventions are typically efficient if the client is a little
older and the peers are of age to take responsibility.

In peer-mediated interventions, the SLP teaches different strategies to modify
the social skills of the person.

In a manner similar to the Lidcombe Program
[https://ghost.stamurai.com/stuttering-treatment-preschool-kids/], peer-mediated
interventions may also involve parents and other immediate care providers. The
SLP instructs them to facilitate play therapy and social interactions with
children diagnosed with social communication disorder.

Various Modalities for the Treatment of Social Communication Disorder
SLPs may choose one of the multiple treatment modalities for social
communication disorder. Currently, the most popular treatment modalities include
–

1. Augmentative and Alternative Communication (AAC)
Children with SCD may utilize augmentative and alternative communication (AAC
[https://www.asha.org/public/speech/disorders/aac/]) methods for replacing or
supplementing natural speech with various symbols. These may be in the form of
picture cards, manual signs, gestures, and line drawings.

2. Computer-Based Methods
Individuals with SCD may utilize computer technology like iPads and specialized
software programs to communicate. The SLP may use the same technology to teach
the children the necessary language and social skills. Children can develop
social skills, social understanding, and social problem solving using
computer-based methods.

3. Video-Based Instructions
The SLP may choose video modeling to provide a “model behavior” that children
can emulate. This form of teaching uses video recordings of desired behaviors.

Older children may respond to self-modeling techniques similar to the ones used
in stuttering treatment.

Children may receive therapy for SCD in multiple possible settings. You may
choose a one-on-one clinical setup for your child to interact with their SLP.
 Your child may also receive treatment from school/district-employed
speech-language pathologists (SLPs).

It is not necessary for all kids with SCD to participate in special education
programs. However, those with autism and/or ADHD may benefit from the attention
of a special educator.

What more should you know about SCD?
It isn’t possible for children to overcome social communication disorder without
professional help and guidance.

If you suspect that your child has trouble communicating or using language in
social contexts, then you should reach out to a SLP as soon as possible.

Social Communication Disorder: Symptoms, Causes & Treatment

Are you having trouble understanding what your child is saying? Does s/he
frequently say, “wabbit” instead of “rabbit”? Does s/he say, “bub” instead of
“bus” frequently?

Then, your child may have an articulation disorder.
[https://www.asha.org/public/speech/disorders/speech-sound-disorders/]

Most children exhibit at least one consistent error pattern in speech. It is
what speech therapists and speech-language pathologists (SLPs) refer to as the
phonological process.

It is common for children to replace or substitute sounds. They should grow out
of them by the time they are 5 to 6 years old. If your child continues to
mispronounce common words, then s/he may require speech therapy.

What Are The Common Articulation Problems That Speech Therapy Exercises Address?
1. Substitutions
Children often replace one sound with another. You may hear your child say,
"wun" in place of "run" or "foon" instead of "spoon." It is one of the most
common articulation problems in children.

2. Omissions
Some children omit or leave out sounds. For example, they may say "nana" instead
of "banana," "unny" in place of "bunny" or "pane" instead of "plane."

3. Distortions
Children may say the word almost correctly but include distortions. The word may
sound similar to how it should, since the child may incorporate error sounds
like s, l, and r in the word. For example, your child may say "shlip" in place
of "ship."

4. Additions
Additions or epenthesis is when the child adds a sound within the word. Your
child may be adding a sound between two consonants. For example, s/he may be
saying “bu-lue” instead of “blue.”

How Can You Help Your Child Overcome Articulation Disorder at Home?
Articulation disorder in children can be successfully treated with speech
therapy. The duration of therapy depends upon the nature of a child's
misarticulations. The speech-language pathologist (SLP) you choose to consult
will give you a list of words your child needs to master. They will also provide
you with sets of speech therapy exercises that you can practice at home with
your child.

Here are a few things you can do at home to help your child overcome their
articulation disorder.

1. Practice the Targeted Sounds
The SLP will give you a list of different sounds that your child needs to work
on. They will update or change the list every couple of weeks. You can help your
child practice these sounds for 5 to 10 minutes every day to help them overcome
the articulation disorder.

You can incorporate activities like memory match, coloring pages, scavenger
hunts, word searches, and picture/photo matching in your daily practice. If your
child is interested in apps and games, download different apps that target
articulation in children.

2. Request Correction
Remember to use gentle requests for correcting pronunciations while you are
having a conversation with your child. Do not force them if they seem agitated,
frustrated, or unwilling.

Only focus on the sounds that the SLP is targeting during the week’s speech
therapy practice for articulation disorder.

Before reminding them to correct their articulation, do not forget to praise
your child’s correct articulations and efforts!

3. Read to Your Child
Reading may be one of the oldest yet most effective ways to introduce your child
to correct articulations. Choose simple, short stories with small words for
bedtime. Make sure you know the correct pronunciation of each word before you
read it to your child.

Emphasize the sounds that your child is currently working on during speech
therapy. If your child is a reader, praise their efforts, and encourage them to
read a couple of lines out loud at least once per day.

Here is a list of books [__GHOST_URL__/books-for-people-who-stutter/] we
recommend for children of all ages. If your child is attending speech therapy
for fluency and speech sound disorders, these books might inspire them.

4. Include the Target Sound
When talking to your child or playing with them, try to include the target sound
in your dialog. Model the sound in your speech. For example, if the target sound
of the week is /g/, try to include words like "dog," "fog," "hug," "jug," "mug,"
and "rug" in sentences.

Make stories up as you go. For example, "The doG drank water out of the juG and
fell asleep on the ruG." Enunciate the final G sound in your speech. Encourage
your child to make up silly stories that include the target sounds as well.

5. Describe the Articulation Process
If your child is old enough to understand how we produce sounds using our lips,
teeth, and tongue, you can try saying something along the lines of, "that was
such a good try. The next time we say /p/, let's try to put our lips together.

Touch your own lips while saying words like “pop,” “pulp,” or “pup” to help your
child mimic the movements of your articulators.

A Word to the Parents
Try this at home only if you have already spoken to your child's 
speech-language
pathologist
[https://ghost.stamurai.com/stuttering-treatment-how-can-a-speech-language-pathologist-help/]
(SLP) . You may need to learn a little more about the articulation process
before you can implement various speech therapy exercises at home to help a
child struggling with articulation problems

While practicing with your child, remind them that what they have to say is
important to you. You want to understand them each time they speak. Don’t miss
an opportunity to praise their correct pronunciation and correct them only a few
times throughout the day.

How to Practice Speech Therapy Exercises for Articulation Disorder at Home with
Your Child?
When you are practicing the articulation or speech therapy exercises with your
child, you must have a working knowledge of the process of articulation therapy.
The SLP will teach the target sounds to your child. Nonetheless, you can consult
the SLP and continue practicing the target sounds as described below.

1. In Isolation
You can practice the target sound at home with your child. Begin by practicing
the target sounds in isolation. That means uttering the sound by itself without
adding vowels or consonants.

For example, if they are working on the sound /p/, try saying /p/ multiple times
in a row without adding vowels to it like "op" or "pa."

If you are unsure about the correct nature of the target sound, refer to a 
Speech Sound Development chart [__GHOST_URL__/children-speech-checklists/] or
consult your child's SLP. Always teach your child the precise way to articulate
and pronounce a word.

2. Add Syllables
You can practice the target sounds by adding syllables to them. There are
different ways to do this. You can add the syllable before or after the sound,
or sandwich it between two syllables.

For example, you can add a syllable before the /p/ sound to say "op." Or, you
can add a syllable after the /p/ sound to say "pa." Or, you can add a syllable
on each side of the /p/ sound to say something like "apa."

Practice the target sound(s) with all forms of vowel variations before you begin
practicing words that contain these sounds like “top” or “pat.”

3. Practice Words
You can select a list of words. Or you can request the SLP to pick out a set of
words that contain the target sound. If you are picking the list of words for
home speech therapy exercise, determine the position of the target sound in the
word.

Choose a target sound that your child produced with the most accuracy at the
syllable level. When did your child articulate the target sound more accurately?
Was it when it was in the initial, medial or final position of the syllable?

Let's say your child articulated the target sound correctly more than 85% of the
time when it was in the initial position. So, choose a word that begins with the
target sound. For example, the target sound is /p/, so select a word like "pen"
or "pot" that has the /p/ sound at the beginning.

Practice this target sound at the beginning of words, sentences, and stories
before switching positions and adding vowels before it.

4. Construct Sentences
Make speech therapy for articulation disorder fun for your child. Make up funny
and interesting sentences using the target words.

It's always less stressful for the parent to begin with carrier phrases or
sentences. These are rotating sentences where the sentence stays the same, only
the word changes.

For example, you may say, "Papa made the peas in a pan" or "Papa made the peas
in a pot."

When you see that your child can articulate the target words correctly 80% of
the time, it's time to move to stories.

5. Tell Stories
Select a story that features the target sound frequently. Read it aloud with
your child. Keep reading the story till your child articulates the target sound
correctly 80% of the time.

After that, encourage them to retell the tale in their own words. Encourage
their imagination and let them create alternate endings for their favorite
characters.

Once they master articulating the target sound in almost all the positions, move
on to the conversation.

6. Hold a Conversation
Holding a conversation will take time, practice, and creativity. Try to steer
the discussion, so it contains the target words and sounds they have already
practiced.

During the conversation ask a few questions and encourage your child to share
voluntarily. Correct inaccurate articulations during the chat with polite
requests.

Once your child has mastered the articulation of the target sound in a
conversation as well, it's time for you to observe as your child uses the target
sounds in everyday contexts and conversations. If they face difficulties in
doing so, you may revisit practicing words, sentences, and stories using the
target sound once again.

Remember, children can overcome articulation disorder with the daily revision of
successful words, reading and conversing. Spend quality time with your child and
try not to imitate their mistakes. Speak clearly and pronounce all words
correctly for them to model.

Articulation Disorder: Speech Therapy Exercises for Kids at Home

Childhood Apraxia of Speech or CAS is a motor speech disorder that affects the
movements of the articulators. A child with CAS has difficulty producing the
words even though they know what they want to say.

A kid with childhood apraxia of speech
[https://ghost.stamurai.com/childhood-apraxia-of-speech-causes-symptoms-treatment/] may not
be able to move their lips or tongue precisely to produce a sound even though
they have no weakness in their lips and tongue muscles.

Sadly, it is not a problem that children can outgrow on their own as they grow
older. However, their speech may improve with lots of work and therapy.

Fast Facts about Childhood Apraxia of Speech -
Parents can support their children and contribute to their progress by adhering
to a few do's and don'ts. But before we delve into what you should and shouldn't
do, here are a few facts every parent should know and remember about childhood
apraxia of speech –

 * Childhood apraxia of speech is a rare disorder. It affects only around 1 out
   of 1,000 children.
 * CAS is a complex motor speech disorder. It is characterized by inconsistency.
   Therefore, there is no one-size-fits-all treatment for children. Speech
   therapists and Speech-language pathologists (SLPs) need to customize the
   treatment plan for each child with apraxia of speech.
 * The diagnosis of CAS should always be done by a speech-language pathologist
   (SLP).
 * A child’s speech may not improve with traditional speech therapy if they have
   CAS. They may require treatments based on the principles of motor learning.
 * There is no definite cause of childhood apraxia of speech. Traumatic brain
   injury, stroke, brain tumor, or a genetic disorder may cause apraxia of
   speech in children.
 * Children with CAS may need to learn sign language or picture boards to
   communicate. These are augmentative and alternative communication (AAC)
   methods that complement traditional speech.

The Do’s for Parents of Children with Apraxia of Speech
Here are a few things you can do as parents that will help your child if they
have apraxia of speech.

1. Respond To Their Efforts of Communication
It is important to listen to your child. They may use a combination of different
forms of communication such as signs, picture boards, computers, and gestures.
Remember to pay attention to their efforts of communication.

Respond to all the forms of communication they use at home. Motivate them to
share using AAC methods.

2. Teach Other Forms of Communication to Your Child
A child with apraxia of speech may benefit from communicating via sign language,
and picture boards. These augmentative and alternative communication (AAC
[https://www.asha.org/njc/aac/]) methods allow children with CAS to express
themselves.

Some parents believe that using AAC hinders their child’s speech development.
However, there is no research to corroborate this belief.

On the contrary, children who are able to express their feelings, thoughts, and
ideas using AAC enjoy better relationships with their family members and
healthier emotional development.

3. Talk To Your Child
Talk to your child whenever you can. It's one of the best things parents can do
to help a child with childhood apraxia of speech. You may be working from home
right now, so take time between calls and meetings to interact with your child
and speak about things that may interest them.

Children with CAS may not be able to respond verbally all the time, but pay
attention to the different gestures or signs they are using. Recognize their
efforts to communicate and build your narrative based on their responses.

You must talk to them throughout the day and request other members of your
family to do the same.

4. Use the Words/Phrases Targeted During Therapy
Your child's speech-language pathologist (SLP) may give you a list of words they
are working on each week. You can try to incorporate them in your dialog at
home.

Don’t force your child to repeat after you or use the targeted words. You can
help them by using the listed words while you talk to them.

You may want to make up bedtime stories that include the targeted words
frequently. Or, recite silly rhymes that your child seems to enjoy using the
targeted words.

5. Request Your Child to Correct Their Speech Once In A While
Your child's speech-language pathologist (SLP) will tell you which words or
phrases you can use during home practice. Remember to not put undue pressure on
your child and ask them to repeat or correct only those words or phrases.

You can do this only a couple of times per day. Let them talk freely and praise
their efforts throughout the day.

If you have praised your child's efforts ten times already, only then ask your
child to repeat or correct their speech only once. Make sure they feel
positively about speaking to you.

6. Communicate and Build Trust
Establish an open line of communication with your child irrespective of their
age. If they are feeling frustrated, irritated, angry, or hopeless, they should
be able to talk to you about it.

Even children will go through difficult emotions when they feel stuck with words
or phrases during therapy or at home. You should learn to talk about their
feelings and emotions. For example, you can say, "I can see that this word is
making you feel angry/frustrated. Let us take a break from it."

You can take up the issue later with their SLP and devise a new way to help them
say a particular word or phrase.

The Don'ts for Parents of Children with Apraxia of Speech
There are a few things parents must NEVER do. These are actions that aren’t
helpful and even harmful for a child with CAS.

1. Don't Correct Your Child's Speech Frequently
When your child is trying to tell you something, listen to what they are saying
rather than how they are saying it.

Yes. Correcting targeted words and phrases is an integral part of home therapy
for childhood apraxia of speech. However, remember to provide at least ten
positive reinforcements to your child for every correction.

Correcting their speech over and over will compound their frustration. That may
make them more reluctant to speak at home.

2. Don’t Ask Too Many Questions
Asking questions repeatedly to your child may overwhelm them. Avoid demanding
too many answers from them at all times. Only ask questions when absolutely
necessary.

Similarly, don’t request them to repeat words or speak throughout the day. It
can quickly become tiring and irritating for a child to repeat the same sets of
words at request.

3. Don’t Ask Your Child to Repeat a Word Incorrectly
Repeating a word incorrectly is negative practice. It can be detrimental to your
child’s progress.

If your child is saying a word incorrectly, and you cannot help them correct it,
talk to the SLP. They can help your child when you cannot.

You can learn how to help your child say a word better from their SLP as well.

For Parents: What Should You Do When You Don’t Know What to do
Whenever you are in doubt about your child's progress, improvement, and speech
therapy exercises talk to the SLP
[https://ghost.stamurai.com/stuttering-treatment-how-can-a-speech-language-pathologist-help/] 
about it. Demanding too much from your child in too little time can hamper their
self-confidence and increase their frustration.

A child with childhood apraxia of speech will exhibit inconsistencies in saying
a word even if they have said it perfectly in the past. It is a part of CAS, and
you should not see this as a failure. Instead, you can politely ask them to
repeat it and see if they can say it correctly the next time.

Every child with CAS progresses at a different rate. Childhood apraxia of speech
demands a lot of patience and practice from the child and their parents. As a
parent, you should not lose hope or give up after a couple of weeks of therapy.

Remember the do’s and don'ts to aid your child’s progress during speech therapy
for apraxia of speech.

Childhood Apraxia of Speech: Dos & Don’ts for Parents

Children with autism put forth a unique challenge, including communication
problems
[https://stamurai.com/blog/autism-common-speech-communication-problems-in-children/]
, for their parents, caregivers, and therapists. Many children on the spectrum
don't like interacting with new faces. They don't like being exposed to unknown
environments and new situations.

Speech therapy exercises for children with autism can continue at home under the
supervision of a parent and guidance of an SLP (speech-language pathologist).
Either parent can mediate online speech therapy for ASD
[https://stamurai.com/blog/online-speech-therapy-for-autism-spectrum-disorder/] 
in the form of interactive exercises and activities within the comfort of their
home.

Early interventions like autism speech therapy activities and behavior
modification exercises can benefit a child on the spectrum. Research shows that
some children who receive behavior and speech therapy early in life have higher
chances of overcoming the signs and symptoms of autism as adults.

Most of these therapy techniques don't involve the parent and child in a
clinical setup. These consist of activities, which can be parts of daily
interactions, playtime, storytime, lunch, or dinner with the child.

Parents can add 5 to 10 minutes of such exercises and activities to their
child's daily routine. Remember to keep these "sessions" short and engaging for
the child.

If your child has a speech delay and other signs of autism, you can try numerous
speech therapy exercises at home to aid their speech and language development.

Speech Therapy Exercises for Early Childhood ASD

It is now possible for child psychologists and SLPs to determine if a child is
showing signs of autism spectrum disorder (ASD) in their early childhood. 

Speech therapy strategies for autism spectrum disorder in very young children
should aim to boost their communication skills. 

Here are some exercises you can do at home with your child –

1. Make Animal noises
Research shows that children with ASD often love animals and respond better to
animal noises. You can use this information to set up toy barns, animal trains,
and make-believe farms.

Mimic animal noises as your child picks up each animal. Soon, they may try to
recreate these noises.

It is one exercise that SLPs recommend for nonverbal children with ASD
[https://stamurai.com/blog/ways-to-help-nonverbal-child-with-autism-speak/] as
well.

2. Teach Them The Essential Words
Learning to use a few essential words like “more,” “help,” and "stop" can help
your child in the long run. Many children with autism struggle to use known
words in a new context. So, teaching your child to use the same word in
different setups can be helpful.

Children with autism often have limited vocabulary, or they don't talk a lot.
However, they may learn new words
[https://www.sciencedaily.com/releases/2016/05/160503132018.htm] just like their
neurotypical counterparts.

You can work with your child in familiar and ordinary environments to teach them
the use of a few easy-but-necessary words. For example, during lunch or dinner,
once they have finished eating a portion of the food they like, you can gesture
towards their plate and say "more." Be sure to accompany "more" with a sign.

It may take some time for your child to respond and eventually say the words. It
is important to not lose hope. Patience and regularity are imperative when you
are working with someone on the spectrum.

3. Use their Favorite Toys and Snacks
You can use your child’s favorite toy and snacks for this activity. Keep the
items out of their reach but within their line of sight.

It may take them a while, but your child can learn to gesture or signal for it.
You can help them by pointing and saying the word, “toy” or “snack” for the
first few days.

The next step is the child leading the adult by either gestures, signs, or looks
towards the item they want. A child with mild to moderate signs of ASD may also
learn the name of the items and use the names to ask for them.

4. Provide Positive Reinforcement
Many children with autism, especially those with mild to moderate autism,
respond well to positive reinforcement. Positive reinforcement is an integral
part of various speech therapy exercises experts recommend for children with
autism.

The concept is simple – you provide a desirable reward
[https://www.verywellhealth.com/pros-and-cons-of-rewarding-behaviors-259921] 
every time they respond to their name, use an essential word or follow your
instructions. It can be a piece of chocolate, one scoop of ice cream, extra time
with the toys they like, or 30-minutes of additional screen time. The reward
should be something that the child enjoys and likes.

Children with autism often struggle to respond to their own names, follow
multi-step instructions, or hold conversations. This autism speech therapy
exercise for kids may encourage the child to engage in behavior you deem
desirable.

Next, we discuss Speech Therapy Strategies for Autism Spectrum Disorder In
Preschool-Aged Children –

5. Present Them With Multiple Choices
You can teach children with ASD to make their own choices by offering them more
than one option in everyday situations. You can begin this exercise as soon as
your child is old enough to talk. It is an essential autism speech therapy
exercise for kids that encourages them to make their own choices.

While dressing them, you can hold up more than one pair of socks. Name the
colors while holding each pair up like "red," "blue," or "yellow," and wait till
they pick one. You can do the same when it's playtime. Ask them what they want
to play with and mention the toys by name while pointing at them.

It may take weeks or even months before your child responds with a gesture
towards the desired item or names one of them. Remember to not give up. These
exercises will encourage your child to select an item and point at the object in
response to your query.

6. Play Sorting Games
Studies show that children with autism may show interest in sorting
[https://www.verywellhealth.com/autistic-child-form-of-play-259884] or arranging
their toys. The goal of this exercise is to leverage their interest and teach
them the purpose of commonplace objects.

You can use real-life objects or picture cards for this game-cum-exercise. For
example, you can use fruits and veggies from your kitchen or use picture cards
with their photos. Encourage your child to group fruits and veggies according to
color or taste.

Let them sort photos according to similarities in sizes and shapes. Mix several
picture cards and let your child identify the different foods we eat, clothes we
wear, and places we visit. It is an interesting and stimulating autism speech
therapy exercise for kids of preschool age.

Let your child sort the different picture cards in a way that makes sense to
them. It will encourage independent thinking, problem-solving and analytical
skills.

7. Read Short Stories With Your Kid
Your child may have delayed speech, or they may be non-verbal. These are common
speech-language disorders associated with autism. Reading with them
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892026/] and even singing rhymes
may be a good exercise that encourages them to speak.

Choose an interactive book that comes with photos, pictures, and pull-outs. As
you are reading, try to point at every illustration and describe what you are
seeing.

Depending on how old your child is, you can ask them to describe what they are
seeing. For example, you can point at the photo of a dog and ask what color it
is. Or you can ask your child to gesture at the white bird in the illustration.

Try to engage in conversation about the story, the subjects, and the pictures.
Ask simple Yes or No questions to your child about the story and its characters
if your child shows interest in the book you are reading together.

8. Engage In Sensory Activities
Many children with ASD have sensory processing disorder
[https://www.spectrumnews.org/features/deep-dive/talking-sense-what-sensory-processing-disorder-says-about-autism]
. It can influence how their brains receive, process, and interpret the signals
coming from their environment. Sensory activities can harness the communication
skills your child has already learned. Improvement of their communication and
cooperation skills is one of the many benefits of speech therapy for autism.

Some of the more common and effective sensory activities for children with ASD
include homemade musical instruments, footprint painting, silly putty or
cornflour slime, and scented play-dough. The idea is to help your kids get an
experience of different textures, smells, and sensations. It may help your child
to open up to new sensations.

A large percentage of children with ASD are averse to particular smells and
textures. Be sure to consider their likes and dislikes while setting up their
sensory activity tables.

The next set includes Speech Therapy Exercises for Elementary School aged
children with ASD –

9. Use Communication Boards
Communication boards are an essential part of autism speech therapy activities
[https://stamurai.com/blog/online-speech-therapy-for-autism-spectrum-disorder/] 
and speech therapy for children with an autism spectrum disorder. You can use
handmade boards or the digital ones you get for smartphones and iPads. Your
choice should depend upon which format your child likes more.

Communication boards are part of an augmentative or alternative communication
device for children with an autism spectrum disorder. You can begin using them
at home, especially if your child is nonverbal or speaks very little.

Communication boards typically have one set of cards with a variety of images
related to an event, for example, "play." And the other set comes with a range
of emotions like a happy face, sad or angry face. The child can point at how
they feel in response to an event or action you pick.

You can encourage your child to use the communication board for simple messages
like "I'm hungry," "I need to go to the bathroom," and "I want to play." You can
slowly advance their communication skills using the boards to make choices and
ask questions.

10. Teach Them Facial Expressions
Children with autism often find it difficult to understand facial expressions
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781897/]. They may struggle to
understand what the smile or frown on your face means.

It is possible to teach them the meaning of each expression and its importance
in the social sphere. You can use picture cards or communication boards for this
exercise as well. Say the name and describe each feeling or expression.

If your child is a little older than a preschooler, you can play a similar game
using apps or digital facial expression cards. Make sure they have multiple
choice answers along with a description of the emotions, so your kid can pick
the correct one.

11. Teach Them to Ask Questions
You can begin this exercise using one of your child’s favorite toys. Hide it in
an opaque bag and prompt your child to ask, “what’s in the bag?”

Encourage your child to ask more questions throughout the day like, “Where did
doggy go?” or “Can I watch TV?”

Once they are familiar with how questioning and answering works, you can expand
the activity by veering into social questions. Prompt your child to ask simple
questions, such as, “How are you?” Make a list of similar simple social
questions that your child can practice at home.

12. Utilize their Interests
Children on the spectrum typically have intense interests on specific objects.
These may include Legos, art, automobiles, animals, music, and gadgets.

You can leverage their intense interest to explore conversations on the topic.
Introduce your child to new material on the topic from the Internet. Ask them
questions, encourage them to ask questions, engage in non-verbal communication,
and practice turn-taking using the objects.

Speech Therapy Exercises For Children With Autism Spectrum Disorder In Middle
School And High School –

13. Encourage Socialization
Find support groups and students' groups for children with ASD. If there’s one
at their school, nothing like it. 

Encourage your adolescent child to sit with them. Even if they are not ready to
talk and share, they should have a safe place where they feel comfortable.

Gradually, once your child is interacting actively with their peers, take them
out for lunch or dinner. If they are willing, encourage them to place the
orders.

14. Teach Your Child about Sensory Overload
Many children and adolescents with ASD experience sensory overload. It can
happen when their sight, smell, touch, hearing and taste absorb more information
than they can process. An individual with ASD may react “unnaturally” to sensory
overloads.

Identify how your child reacts to such situations. Identify their triggers.

You can teach them how to cope with feeling overwhelmed by introducing them to
noise-canceling headphones, earplugs, soft lighting, and/or nature-sound videos.

15. Help your Child Behave Appropriately
What is appropriate for one individual may not be for another. Appropriate
interactions and behavior can change according to situations, culture, and
relationships. It may be extremely challenging for an adolescent with ASD to
understand the proper etiquette of social interaction.

You can talk to their behavior therapist, psychologist, and SLP. They can give
you culture-appropriate exercises and activities to teach your child how to
behave in classrooms, public places, and at home.

When Is the Best Time to Start Speech Therapy for Autism?
Diagnosing autism in children younger than 3 years of age can be challenging.
However, in some cases, parents and specialists can recognize speech and
language delays in children as young as 18 months of age.

Some telltale signs like repetitive activities, echolalia, resistance to changes
in routines, and the inability to interact socially with others belonging to the
same age group may confirm autism diagnosis in younger children.

Parents of children with autism can begin speech therapy for autism at home as
soon as they receive a formal diagnosis from a speech-language pathologist,
psychologist, or pediatrician.

Although it’s a life-long condition, some individuals show the ability to
improve and acquire social communication skills as they grow older.

Can Your Child “Grow Out” of Autism?
The likely answer is “no”. However, there is a possibility of improvement
[https://www.psychiatry.org/patients-families/autism/expert-q-and-a] through the
correct therapy and exercises. It is impossible to predict which children will
“grow out” of ASD. Nonetheless, early diagnosis and intervention increase a
child’s chances of becoming a healthy, functional, and independent adult.

Children on the autism spectrum face varying degrees of difficulty in
communicating. Speech therapy can help
[https://stamurai.com/blog/speech-therapy-benefits-for-autism/]! Above-mentioned
15 speech therapy exercises & strategies for children on the spectrum can
strengthen your child's logical and analytical thinking, problem-solving
attitude, and social communication skills.

Your child may be entirely non-verbal or shows severe aversion toward ordinary
sounds, lighting, and textures. In such cases, it may be necessary to consult
with a behavioral therapist and special educator immediately.

15 Speech Therapy Exercises for Children with Autism

An accent is not a speech or language disorder. It is the manner of
pronunciation that is typical of a particular individual, location, or nation.
Every spoken language has a specific accent. Nonetheless, an accent can present
itself as a communication barrier. A thick accent often makes the most common
words sound foreign. Hence, many choose to opt for accent modification or accent
reduction to make themselves easily understandable.

 1. What is an Accent?
 2. What Are The Different Types of Accents?
 3. Why is Accent Modification Necessary?
 4. Can You Modify Your Accent?
 5. Can Speech Therapy Help with Accent Modification?
 6. What Are Accent Evaluation and Assessment?
 7. Why Should You Work with A Licensed Speech Therapist for Accent
    Modification?
 8. What Does Accent Modification Training Look Like?
 9. What Are The Advantages of Stamurai Speech Therapy for Accent Modification?

1. What is an Accent?
An accent is a distinctive way of speaking that may be particular to a group of
people, location, or nation. Everyone has an accent! The nature of the accent
varies from one region to another, and one country to another.

When you travel to a new country or a different part of your country, you may
notice that the locals sound different. There is always a difference in how
people pronounce the same words, vowel, and consonant combinations even when
they are from different regions of the same country.

People sound different from one another for a variety of reasons including
locality, ethnicity (ethnolect), socioeconomic status, social class, and their
first language. While our accents tell others about our unique social, cultural,
and linguistic backgrounds, they may also become a barrier to effective
communication.

Having a thick foreign accent can reduce one's clarity of speech. The troubles
can range from disruptions in the natural flow of conversations to the complete
inability to communicate with a native speaker during an emergency. Accents are
NEVER a communication disorder, but accents can become hindrances to effective
communication.

Here's a quick and accurate guide to help you understand accent modification,
accent modification assessments, online accent modification techniques, and how
speech therapy can help.

2. What Are The Different Types of Accents?
When people learn new languages or move from one country to another, they always
carry their accents with them. It’s like carrying a little part of home!

A person’s accent depends on several factors, but the two most common groups of
accents are –

 * Regional Accents – Have you noticed how people from Portland, Oregon sound
   different from people from Manhattan, New York? They are from the same
   country and speak the same language, but they sound very different. This is
   known as a regional accent.
 * National Origin Accents – When you learn English as a second or third
   language in your adulthood, it is natural for you to speak the language with
   an accent. It’s nothing bad or shameful at all! However, it may make it
   difficult for the English-speaking natives to understand you.

As you can see, accents are natural and part of every spoken language. No accent
is better or worse than another. Modifying an accent or reducing it is your
choice.

3. Why Accent Modification May Be Necessary?
Accents can tell people where you are from and the language you speak at home.
Nonetheless, your unique rhythm of speech and intonation can make it difficult
for others to understand you. People may have a difficult time grasping the gist
of your speech. You may even feel frustrated because you have to repeat yourself
while talking.

Here’s why a number of our clients seek accent modification –

 * They face difficulty being understood by the native speakers
 * They have to repeat themselves quite often
 * People pay more attention to the accent than their message
 * They face unfair attitudes from listeners due to their accents
 * They have faced or continue to face bias/barriers due to their accent in
   social, work, and/or educational environments

The communication challenges posed by thick accents can affect your self-esteem,
professional/educational advancement, social life, and personal life. If you
feel the need to modify or neutralize your accent, it’s completely alright.
Begin by contacting a licensed and experienced speech therapist. You can find
online speech therapy for accent modification right here at Stamurai.

4. Can You Modify Your Accent?
Accent modification or accent neutralization is completely possible for an
adult. It may include simple accent modification treatment protocols that
consist of accent modification exercises and activities for adults.

While it can be difficult to change an accent completely, you can consult a
qualified speech-language pathologist for an accent modification assessment. An
experienced professional can tell you how much change your accent needs to make
you more understandable to your listeners.

5. Can Speech Therapy Help with Accent Modification?
Speech therapy is a significant part of accent modification treatment. Therapy
can include accent modification activities, and exercises suited for various
ages and professions.

Speech therapy can help you identify the phrases, sounds, rhythms, and
intonations that set you apart from the native speaker. Accent modification
techniques aim to enable you to modify these speech patterns and make your
accent less conspicuous.

Speech therapists are professionals who can evaluate your accent, help you
identify the areas that need work, and provide you with instructions that can
reduce or modify your accent.

If you are an adult who has learned English as a second language in their
adulthood, it may not be realistic to expect that your accent will vanish
completely. You may not sound identical to a native English speaker. However,
accent modification techniques mastered with the help of skilled speech
therapists can help you speak more intelligibly and confidently.

6. What Are Accent Evaluation and Assessment?
When you opt for accent modification therapy, speech therapists will first take
a close look at the nature of your accent and speech patterns. Since each person
may have a unique accent, a professional will ask you to repeat specific words,
sounds, and phrases.

Accent evaluation consists of –

 * Understanding how you produce different sounds
 * Capturing the rhythms and intonation in your speech
 * Measuring your intelligibility
 * Determining how you sound in a conversation
 * Determining the impact of your accent on your daily life

Your speech therapist will also ask you questions about –

 * The language(s) you speak at home
 * The details about second language acquirement
 * The method of learning these languages (school, or community)
 * The language(s) you commonly use at home, school/work, or in social
   situations
 * The extent of the use of each language in daily life

The uniqueness of each language calls for bespoke accent modification therapy
ideas for adults. Consulting a professional speech therapist will arm you with
tailored accent modification goals best suited for your age, profession, and
social life. These plans and goals are based on the unique cultural and
linguistic background of each individual. Therefore, you can expect
pronunciation training, at-home accent modification exercises, daily practice
activities, and short-term objectives to be a part of your personal accent
training plan.

7. Why Should You Work with A Licensed Speech Therapist for Accent Modification?
A licensed SLP or speech therapist will first assess the impact of your accent
on your communication and life. Second, they will provide you with the accent
modification resources you need to begin the modification journey.

The roles of a speech therapist can include –

 * Giving the necessary and relevant information regarding accents and accent
   modification
 * Educating the client about the entire process of accent modification and the
   possible outcomes
 * Providing counsel regarding the communication-related problems the client
   currently faces
 * Determining the necessity and applicability of various accent modification
   exercises
 * Chalking out a therapy plan comprising of multiple sessions and achievable
   goals for the client

8. What Does Accent Modification Training Look Like?
The training plan and basic accent modification exercises can look different for
each person. Different speech therapists use different accent modification
training approaches.

Some of the common strategies that you may come across during accent
modification training include –

 * Listening and imitating – the client has to repeat a model given by the
   therapist
 * Minimal pair and contextualized minimal pair drills – the client is shown the
   contrast between similar sounds while the therapist provides a discernable
   context
 * Using visual aids – the client is given pictures, mirrors, sound-color
   charts, and the vowel quadrilateral to assist the production of sounds
 * Tongue twisters – the therapist helps the client navigate through sentences
   that are difficult to say correctly due to the repetition of consonantal
   sounds (e.g. she sells sea shells on the seashore)
 * Phonetic training – the client receives exclusive training in phonemics
   through detailed descriptions and the use of articulatory position diagrams
   of the phonetic alphabet
 * Practicing vowel production and altering the stress patterns in spoken
   language
 * Providing visual feedback
 * Building awareness around the production and linking of consonants in speech

Recording the client’s speech production for providing accurate feedback and
review.

9. What Are The Advantages of Stamurai Speech Therapy for Accent Modification?
Stamurai [https://stamurai.com/] provides online speech therapy for accent
modification. Opting for online speech therapy with Stamurai means bypassing the
need for traveling or searching for expert speech therapists in your locality.
You can connect with our trained and certified speech therapists online from the
comfort of your home.

You will continue to receive exclusive and personalized accent modification
therapy plans, progress reports, and daily/weekly therapy goals from our team of
specialists. You can access our repertoire of speech therapy tools and follow
your progress using your smartphone or laptop. You can book and attend a session
at the click of a button.

The convenience and easy access make online speech therapy for accent
modification in adults the #1 choice across the globe.

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