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

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

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

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?

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

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

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

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

Stuttering is a childhood-onset fluency disorder that is NOT caused by the
weakness of facial muscles. So, how can exercises aimed at strengthening facial
muscles be beneficial for a child who stutters?

Certain exercises for reducing stuttering may be counterproductive; the more a
child tries to push through a particularly rough stutter, the worse their
disfluency becomes!

Actual stuttering exercises
[https://ghost.stamurai.com/five-stuttering-exercises-to-help-your-child/] recommended by
certified speech language pathologists (SLPs) and validated by research studies
are quite different from traditional fitness workouts. They do not aim to
strengthen muscles. A child who practices stuttering exercises appropriate for
their age finds new ways to embrace and overcome their stutter.

However, some exercises do not help children who stutter. In fact, they can do
more harm than good!

Exercises That Are NOT Good Stuttering Treatments
By now, you may have already learned about the stuttering exercises that help
children who stutter
[https://ghost.stamurai.com/five-stuttering-exercises-to-help-your-child/]. It is time to
find out which speech exercises you must avoid while working with your kid who
stutters.

1. Drinking Through a Straw
Drinking through a straw does not help with fluency. Currently, no studies
corroborate the claim that using straws to drink helps with the strength and
mobility of one’s tongue.

Irrespective of the material, shape, and size of the straw, you should not
expect your child who stutters to benefit from this technique.

The only upside may be less of a mess for you to clean up later!

2.  Jaw Strengthening Exercises
Several facial exercises and “face yoga” claim to boost speech fluency in
children. These exercises target brain-tongue coordination, and jaw flexibility.

Nonetheless, unlike yoga for stuttering [__GHOST_URL__/yoga-and-stuttering/],
these exercises may not have a profound effect on stress, anxiety, or the
central nervous system (CNS).

Since stuttering is not a problem of jaw movement, tongue-lip coordination, or
jaw flexibility, face yoga or jaw exercises cannot help your child with their
stuttering.

3. AEIOU Technique
A preschool-aged child won't typically know what vowels are. Asking them to
repeat 5-letters of the alphabet throughout the day can be both annoying and
frustrating for the child.

Speech-language pathologists (SLPs) request parents to not force their young
children to perform speech exercises. In fact, if your child has been stuttering
severely, repeating the vowels with a stutter can compound their negative
feelings about speech.

It is prudent to consult an SLP or speech therapist to know more about speech
exercises appropriate for your child if they have begun stuttering recently.

4. Requesting Corrections
Very young children who stutter typically do not harbor negative emotions and
attitudes towards stuttering. Primarily, because they are not unaware of how
they speak. Children typically don't associate shame
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/] or embarrassment
with their speech.

Repeatedly asking them to repeat after they stutter can make them conscious of
their speech disfluencies. It can discourage them from talking and expressing
themselves altogether.

Moreover, if they are stuttering on a particular word, asking them to repeat it
may harm their self-confidence.

5. Asking Them To Slow Down
For older children and adults in speech therapy, slowing down may reduce the
frequency and intensity of stuttering. However, for younger children, asking
them to slow down [__GHOST_URL__/stuttering-misconceptions/], or take a breather
every time they stutter will send a negative message.

Being interrupted
[https://ghost.stamurai.com/changing-the-perception-about-stuttering-5-tips-for-talking-to-someone-who-stutters/] 
each time someone stutters can be incredibly irritating and infuriating.

If your child is unusually excited and talking rapidly, instead of stopping them
on their tracks and asking them to slow down, let them finish speaking. You can
repeat what they said back to them calmly. Introduce more pauses in your speech
and break longer words down to syllables.

Instead of asking them to slow down, make sure your speech serves as a model for
your child.

6. Teaching Them Syllable-Timed Or Rhythmic Speech
Noted SLPs will tell you that syllable-timed and similar fluency-enhancing
techniques are great for older children, and they are correct. However, younger
children are just learning to communicate. They are still acquiring expressive
language skills.

Teaching them fluency enhancing techniques
[https://ghost.stamurai.com/stuttering-fluency-shaping-techniques/] such as rhythmic talking,
syllable-timed speech, or reduced rate technique can hamper their natural flow
of speech.

Parents can try adopting these techniques to model for their kids, but asking
the kids to adopt one of these speaking techniques without the help or guidance
of an SLP may not help their speech fluency.

Using a cutting-edge speech therapy app like Stamurai can help you understand
what changes you need to implement to your speech.

7. Instructing Them To Avoid Words
Certain words may trigger high-intensity stuttering in kids. These may be simple
words like “banana” or new and complex ones like “medicine.”

However, teaching them to avoid these problem words conveys the wrong message to
the children. By instructing them to avoid problem words, you can quickly turn
them into feared words
[https://ghost.stamurai.com/how-to-overcome-fear-and-tension-if-you-stutter/].

You will also be teaching your child that stuttering is a “problem” that needs
to be avoided and not faced.

Instead, each time your child stutters on such a word, try to repeat it slowly
and break it down to constituent syllables for them.

8. Trying to Calm Them Down
Excitement, joy, sadness, anger, and surprise are all genuine emotions. A
typically developing child should be able to feel and express the entire
spectrum of emotions.

However, if your child is prone to stuttering, they may stutter more frequently
when surprised, excited or angry.

Asking them to calm down at the time sends the wrong message. It may make them
feel that they should not feel the emotion in question or express them. It may
cause your child to withdraw.

Let them stutter through their speech. If you are unable to understand a part of
it, you may request them to repeat it for you a little later.

However, if your child’s anger or agitation is about their stuttering, you
should consult an SLP and a child psychologist or behaviorist
[https://ghost.stamurai.com/stuttering-and-cognitive-behavioral-therapy-cbt/] immediately.

What Should You Do If Your Child Begins Stuttering?
Stuttering in preschool-aged children is common. The incidence of stuttering in
preschoolers may be as high as 11%. However, more than 75% of them recover on
their own.

As a result, SLPs do not recommend direct speech therapy or at-home speech
exercises for children who have just begun stuttering.

According to stalwarts of speech pathology like Barry Guitar, the early
treatment of stuttering
[https://ghost.stamurai.com/stuttering-in-childhood-early-intervention/] in younger
preschool-aged children should be indirect. Direct treatment such as the speech
exercises discussed aims at changing their speech.

Children between the ages of 2 and 3.5 years who have just begun stuttering may
benefit from the involvement of their parents and caregivers in their therapy.
The clinician should counsel the parents, who can then monitor the progress of
the child.

If your child is younger than 3.5 years, try to encourage interaction and
communication at home. Refrain from teaching them speech exercises or trying
at-home tricks that claim to reduce stuttering.

If you have a history of stuttering in your family, speak to a speech-language
pathologist. Ensure that they have the experience of dealing with stuttering in
preschool-aged children.

Speech Exercises NOT to do With Kids Who Stutter

Stuttering is a fluency disorder that can affect children as young as 2-years
old. If your child has stuttering or childhood-onset fluency disorder, then it
may be crucial to open a dialog about it with your child first.

School-aged children with stuttering often feel frustrated, angry, and secluded
due to the inability to express [__GHOST_URL__/stuttering-depression/] their
thoughts and desires.

It is imperative to talk to your child about stuttering first. The goal of such
a discussion should be to present the facts and motivate the child. Your child
should not view stuttering as some mysterious entity or scary obstacle. Everyday
discussions should help you normalize stuttering. After all, it is just a
less-common way of talking! And over 70 million people in the world stutter.
Your child should know and believe that they are not alone.

Does Your Child Stutter? What Should You Tell Their Siblings About Stuttering?
When you talk to your child about stuttering, you can invite their siblings to
sit in. Answer their questions about stuttering and speech with facts they can
understand. Use simple analogies to explain how words can “get stuck.”

You can tell their brothers and sisters to remain calm when they are struggling
with their speech. Explain why interrupting or finishing their sentence isn't
helpful.

You can work towards setting up a few ground rules
[https://ghost.stamurai.com/dos-and-donts-of-stuttering/] of communication in your home for
everyone –

 1. Do not talk when someone is already talking
 2. Everyone must wait their turn while having a discussion
 3. There will be no mocking of stuttered speech
 4. No one will speak for another person

What Should You Tell Friends of A Child Who Stutters?
Children are curious by nature. You may face questions like “why does s/he talk
like that?” or “what is a stutter [__GHOST_URL__/what-is-stuttering/]?”

It is important to remember that children are mostly open-minded and willing to
learn new facts. Talk to them like you would talk to your child. Tell them why
your child faces problems talking sometimes and how it affects them.

Answer them correctly, in the most matter-of-fact way possible. If possible, 
answer these questions [https://stamurai.com/faq/] related to stuttering or
stammering in front of your child and ask for their opinions too. It will help
boost their self-worth and confidence.

Explaining stuttering to your child's friends in front of your child may also
help you handle any teasing from their peers.

What Should You Tell Teachers of Children Who Stutter?
It is always a good idea to set up a prior appointment with their classroom
teacher whether the topic of your child’s stuttering has come up during class or
not!

Most teachers should welcome an open discussion about one of their student's
well-being.

Relay the daily struggles your child faces while talking at home and in other
situations. If your child is showing signs of physical tension or social
withdrawal due to their stuttering, you should mention that to their teacher
[https://ghost.stamurai.com/teachers-guide-to-helping-stuttering-student/].

A teacher typically understands how upset a child can become when they have to
face disfluencies every day.

At the same time, the teacher may want to know what measures you take at home
[https://ghost.stamurai.com/five-stuttering-exercises-to-help-your-child/] to encourage your
child's communication skills. Tell them about the positive reinforcements
[https://ghost.stamurai.com/parents-guide-to-help-child-who-stutters/] you practice at home
and the communication ground rules you have set up for everyone.

If you have received any particular instructions from your child’s speech
therapist regarding classroom communication, share that with the teacher. These
can be simple do's and don’ts during oral presentations
[https://ghost.stamurai.com/stop-stuttering-during-presentations/], classroom quizzes, 
storytelling sessions [__GHOST_URL__/public-speaking-with-a-stutter/], or oral
examinations.

It is important to remember that the same rules apply to all children at school
despite their speech disfluencies. Your child may need some additional
motivation at times, but they should also participate in classroom activities
that involve speaking in front of their peers and teachers.

What Should You Tell The Babysitter of A Child Who Stutters?
Whether your child has a sitter or goes to a daycare facility, you should speak
to the person responsible for the wellbeing of your child during those few
hours.

Explain to them that your child stutters
[https://ghost.stamurai.com/stuttering-in-preschool-kids/]. You are aware of it, and they are
receiving therapy for the same. Make it clear that you do not want them to scold
or criticize your child for stuttering.

Emphasize the fact that you want your child to communicate with them freely.
Your child should feel encouraged to share his ideas.

Moreover, help them understand that your child is aware of these “disruptions.”
Your child already knows what they want to say, but they need some additional
time to finish their sentences. Their care providers should not rush them or
interject.

However, your child should receive the same discipline practices as other
children.

What You Should Tell Your Family Members about Your Child's Stuttering
During family dinners, the child's uncles, aunts, and grandparents may show
concern or ask questions about their stuttering.

Try to explain the basics of stuttering as simply as you can. If your child is
seeing a speech therapist, mention that too.

It always helps to say, "We have noticed him/her struggle with his/her speech.
However, after speech therapy
[https://ghost.stamurai.com/stuttering-therapy-for-school-aged-children/]and speech exercises
[https://ghost.stamurai.com/five-stuttering-exercises-to-help-your-child/] it has improved
considerably."

Don't forget to mention that you do not use negative comments, criticisms, or
reprimands to correct their speech. Insist that no one finishes their sentences
and exercises enough patience to let your child talk when it's their turn.

This approach may encourage the entire family to share a common idea about your
child’s stuttering.

What Should You Tell a Stranger about Your Child’s Stuttering?
When your child is talking at the park or playground, it may attract the
attention of a stranger. When they mention your child’s stuttering to you or ask
you about it, begin by thanking them for noticing.

Yes, it is indeed difficult to talk to a stranger about your child's speech.
However, if they want to know why your child speaks differently, don't
discourage them. Tell them what stuttering is, how it's treated
[https://ghost.stamurai.com/stuttering-treatment-faq/], and how it affects your child's
communication.

It is important to remember that your child is trying to express themselves
while braving stuttering. Be respectful towards your child while discussing
their disfluencies with a stranger. Do not get distracted by comments from
unknown folks. Pay attention to what your child is saying rather than how he’s
saying it!

Why Do Others Need to Know about Your Child’s Stuttering?
From the outside, stuttering may seem like just a speech issue. Nonetheless, it
affects a child’s emotional development
[https://ghost.stamurai.com/stuttering-in-children-understanding-shame/].

Receiving constant criticism, corrections and interruptions can disrupt a
child’s confidence and make them question their self-worth.

People who come in contact with your child and have an influence on their life
should know how stuttering impacts your child's daily activities, feelings, and
emotions. They should be able to understand your child's struggles.

Spreading awareness about stuttering can curb bullying from other kids as well
as adults!

Stuttering in Kids: How to Tell Others about it?

For those who now speak smoothly, it may seem quite straightforward. You think
of something, and you can say it. You do not need to consider the multiple
signaling pathways to and from your brain that make speaking possible!

In reality, the production of speech is a complex process. It not only involves
your mouth and larynx but several parts of your brain as well.

One such lesser-known part of the brain that supports the production of spoken
language [https://www.youtube.com/watch?v=ee586DCHe_4] is the basal ganglia.

How Did Researchers Learn About The Relationship Of Basal Ganglia With Speech?
When three patients with injuries to the basal ganglia were observed,
researchers noted some anomalies in their speech. Two of the subjects were
disfluent. One subject spoke fluently, but all three produced agrammatic
sentences with semantic errors!

Voila! If injuries to the basal ganglia prevent the production of grammatically
correct sentences and fluent speech, then its proper function must be crucial
for the production of speech as well.

So, what’s New with Basal Ganglia and Speech?
Developmental stuttering
[https://stamurai.com/blog/causes-of-stuttering-in-adults/] affects around 8% of
children around the globe. Recent stats show that approximately 1% of the total
population stutters [https://stamurai.com/blog/what-is-stuttering/].

Existing theoretical evidence states that the dysfunction of the basal ganglia
is associated with developmental stuttering. This theory originates from
observing similarities between Parkinson's disease and dystonia (disorders
involving the basal ganglia) and the changes in fluency upon deep brain
stimulation (TMI). The use of dopaminergic medication elicits similar effects on
fluency.

Early PET scans show that abnormal basal ganglia function may be responsible for
disfluent speech in individuals. Unfortunately, recent MRI scans and functional
MRI (fMRI) studies have failed to identify the dysfunctions in the basal ganglia
that may cause or characterize developmental stuttering.

Traditional MRI scans can determine the volume of gray matter, cortical
thickness, and the diffusion properties of white matter fiber tracts.
Conventional MRI or fMRI cannot provide enough imaging evidence to substantiate
or contradict this theory!

So, researchers used a multi-parameter mapping (MPM) protocol for creating
semi-quantitative whole-brain maps. These maps can reveal the differences in the
tissue microstructures that quantify the myelin and iron content in targeted
parts of the brain.

The aim of this study
[https://academic.oup.com/brain/article/144/10/2904/6446022] was to compare the
scans of the brains of individuals who stutter with individuals of similar age
and gender who are fluent. The imaging study produced semi-quantitative
whole-brain maps of the subjects for a thorough comparison.

Low concentrations of iron in the basal ganglia have been associated with poor
cognitive ability in adolescents. On the other hand, a higher concentration of
iron in the basal ganglia is the hallmark of neurodegenerative disorders like
Parkinson's disease.

The most recent MPM MRI study
[https://academic.oup.com/brain/article/144/10/2979/6423590] shows there are
considerable differences in the microstructures that may contribute to disfluent
speech. In simpler words, those who stutter have a higher concentration of iron
in the gray matter.

Since iron and dopamine have complex interactions in the brain, researchers say
that higher iron concentrations in the basal ganglia implicate a higher dopamine
presence that plays a significant role in the precipitation of stuttering.

Elevated Iron Concentration in the Basal Ganglia
The study included 73 participants. 41 of them were individuals who stutter, and
32 were individuals who are typically fluent. The whole-brain volume of those
who stuttered didn't differ from those who were fluent.

The researchers state, "The study provides proof of microstructural differences
in the cortico-basal ganglia-thalamocortical loops through the putamen among
those who have developmental stuttering. However, further investigation is
necessary to link the differences observed with the genetic profiles associated
with a childhood-onset fluency disorder."

The new finding that links the increased iron concentration in the basal ganglia
may shed more light on the increased dopamine release, lysosomal dysfunction, or
other neurobiological factors that contribute to developmental stuttering.

In 2019, a team of researchers led by Dr. Drayna used mouse models to 
demonstrate
[https://stamurai.com/blog/cellular-causes-of-stuttering-in-adults-and-children/] 
that mutations in the GNTAB genes cause a dip in the volume of astrocytes in the
corpus callosum of the brain. These astrocytes are star-shaped cells that
support the transmission of messages inside the brain, and the corpus callosum
is a bridge-like structure that connects the two hemispheres.

The findings from the latest research like these opens new avenues for more
studies on medication and therapy for developmental stuttering in all ages.

Very soon, it may also become possible to predict whether an infant will grow up
with a stutter from the analysis of the fetal genes or MRI of the newborns.

Stuttering and Gray Matter Volume
Despite studying a large sample size, researchers have found no inconsistencies
in the gray matter volume in the same age group.

No evidence links stuttering to cognitive functions. Those who stutter may be
just as capable and intelligent as those with fluent speech. The higher
concentration of iron in specific parts of one's brain may simply prevent them
from speaking as smoothly as 99% of the world's population!

New Research: Stuttering Linked To Elevated Iron Presence in Basal Ganglia

Transcranial direct current stimulation or tDCS is a non-invasive process that
uses electricity to stimulate areas of the brain. Now, we know transcranial
electrical stimulation has been a hot topic of controversy in the medical
research community.

One team claimed that tDCS can cure depression
[https://pubmed.ncbi.nlm.nih.gov/26842422/]. Another said that it can help
patients with manic episodes. The only problem is – tDCS works, but the
researchers aren’t completely sure how. In fact, research shows that
transcranial direct current stimulation can reduce stuttering in adolescents and
adults.

So, while we are aware of the controversies, let us simply state what new
studies on the effects of transcranial direct stimulation on stuttering have
found. Prof Kate Watkins, Principal Investigator and neuroscientist at the
University of Oxford states
[https://www.theguardian.com/science/2019/jan/25/electrical-stimulation-of-brain-trialled-as-aid-to-treating-stutter]
, "Stuttering can have a detrimental effect on people's lives…tDCS is the future
of stuttering treatment."

What's the Effect of tDCS on Stuttering in Adults?
Around 5% of all children and 1% of adults stutter. Early intervention
[https://stamurai.com/blog/stuttering-in-childhood-early-intervention/] can help
children who stutter. Without speech therapy, children can go on stuttering into
adulthood. Speech therapy for stuttering
[https://stamurai.com/blog/online-speech-therapy-for-stuttering/] does work for
adults. However, the results are not quick or long-lasting in adults
[https://academic.oup.com/brain/article/141/4/944/4954166] as they are in
children.

Although speech therapy has evolved since 1930, most popular therapy techniques
[https://stamurai.com/blog/stuttering-treatment-for-adults/] still use intensive
training, practice, and adopting "unnatural" sounding speech. Therefore, tDCS is
a new ray of hope for adults who have been stuttering for years.

tDCS involves strapping electrodes on the temple and passing an almost
undetectable direct current through the head. The study says that the current is
mild enough so the people involved cannot tell when the electrodes are switched
on or off.

Now, Watkins has been studying the effects of passing direct current via
electrodes through the head. Her team had already linked stuttering to subtle
differences in brain activity – more activity in the right hemisphere of the
brain than usual. Watkins observed that tDCS could shift patterns of brain
activity and reduce stuttering.

Study 1: tDCS and its long-term effects on stuttering in adults
Jennifer Chesters et al. conducted the first trial investigating whether tDCS
can offer long-lasting positive effects on stuttering among PWS (People Who
Stutter). The team predicted that applying (anodal) stimulation along with
temporary fluency inducers (like the use of a metronome during speech
production) could lead to longer-lasting fluency improvements in adults.

This particular study
[https://academic.oup.com/brain/article/141/4/1161/4831242?login=false] involved
30 male adults who stutter. The trial was double-blinded and completely
randomized. As a part of this study, 15-randomly chosen participants (Group 1)
received 1 mA of tDCS over their left frontal cortex for 20-minutes along with
metronome-guided speech and reading practice (choral speech) for 5 consecutive
days.

The other group (Group 2) of 15 adults who stutter received identical speech
fluency intervention alongside a sham stimulation.

Speech fluency during reading was assessed before and after stimulation each day
for 5-days. Next, the research team assessed speech fluency after 1-week and
6-weeks of the intervention.

The record shows that the anodal stimulation combined with traditional speech
fluency intervention significantly reduced the percentage of disfluent speech
measured after 1-week. At 6-weeks after the stimulation, Group 1 maintained the
improvement during reading. However, fluency was absent during conversations.

The outcome scores measured according to the Stuttering Severity Instrument
(Version 4) showed significant improvement at both 1-week and 6-weeks among
participants of Group 1, but not Group 2.

The team led by Jennifer Chesters concluded that tDCS can improve fluency in
adults when used in combination with direct behavioral interventions for
stuttering.

Shortcomings of using tDCS with Choral Speech Technique
Still, one question remains, why did the study group perform well during reading
tasks, but stutter during conversations? According to Jennifer Crinion
[https://academic.oup.com/brain/article/141/4/944/4954166], the study does not
clearly state how long Chesters' team paired the anodal tDCS with the metronome
conversation task. History shows that tDCS typically works well when paired with
known or familiar tasks.

However, tDCS may not facilitate fluency during novel tasks such as speaking in
front of an audience or holding a conversation. Crinion continues to state,
"This may explain why Chesters et al. found differences between two tasks after
6-weeks."

tDCS can modulate the firing of neurons in the stimulated brain area. The
process will only induce the firing of neurons that are already depolarized or
near the threshold. Neurons that are not meant to be engaged in a task will not
be influenced by tDCS.

Crinion has made this critical observation regarding the specificity of the tDCS
intervention and the resulting reading fluency achieved by Group 1.

Study 2: Cathodal tDCS of Right Broca’s Area to Reduce Stuttering
A similar study [https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.12796] was
conducted by Yasuto Yada MS et al. However, in this study, the team focused on
the activation of the right Broca’s area and Wernicke’s area using cathodal tDCS
among PWS.

The team chooses adults who stutter as participants. As the PWS read their
passages aloud, the team applied tDCS using electrodes. It included an anodal or
cathodal electrode placed over one of the language areas and its homologous
region in the right hemisphere and a second electrode placed on the
contralateral supraorbital region.

Each participant received anodal and cathodal tDCS sessions. Each of these
sessions included a sham simulation. The team then analysed the effects of
simulation polarity and electrode location.

The results of the analyses showed a significant interaction between polarity
and location, and the frequency of disfluencies. tDCS montage, including the
cathodal electrode over the right Broca's area, reduced the frequency of
stuttering among participants.

The tDCS induced a reduction of the over-activity of the right Broca's area and
reduced stuttering severity.

Can tDCS become The Future of Stuttering Treatment?
The two contemporary studies involving tDCS as a non-invasive tool that can test
the hypotheses researchers have gathered from functional imaging studies on
subjects who stutter. The effect of the tDCS will depend upon the polarity of
the electrodes.

We will need more longitudinal studies to understand or confirm whether tDCS can
become standard treatment or cure for stuttering. However, the present evidence
definitely gives us hope. For now, you can install Stamurai
[https://stamurai.com/]- the #1 speech therapy app for stuttering.