Stuttering is a communication disorder characterized by involuntary interruptions of speech, which are accompanied by muscle tension. This disorder results in a lack of verbal fluency. Therefore, the psychological effects of stuttering can be very important. The incidence of this disorder is three to four times more common in men than in women.
For its correct treatment, speech therapy specialists always advise a thorough examination and evaluation.
Types of stuttering
There are several forms in which stuttering can appear in the patient:
- Tonic form: it appears with muscular tension and movements of body parts, in addition to spasms, blocking and/or repetitions of phonemes, syllables or words.
- Clonic form: It is characterized by the repetition of phonemes, syllables and/or whole words, but it is presented without spasms.
These expressions, visible from the interaction of certain factors, depend to a great extent on the age and the environment surrounding the patient. There are also patients who present stuttering after a vascular accident or after brain surgery.
Characteristics of stuttering
Child or adult patients with dysarthria, dysphasia or specific language disorders may have altered motor or paradigmatic verbal fluency, producing alterations in the rhythm of speech.
Likewise, some motor degenerative diseases can produce dysrhythmias and/or dysfluencies.
In the same way, for speech therapists, age is very important, since this factor indicates the stage of language development.
Diagnosis of stuttering
Through a video camera, which is in the background, the patient’s verbal and motor productions are recorded in order to carry out an in-depth examination.
First of all, the patient is asked to use spontaneous expressive language.
- Tell something
- Talking to his father and/or mother about a pleasant topic.
- Singing a short song or reciting a poem
- Numbering the days of the week or months of the year
- Naming numbers, reversing them or mentally calculating them
- Repeating a problem
Second, you must produce targeted expressive language. This is done through the expression of images or sequences: naming, expressing a temporal sequence of 3 or 4 elements.
Third, repeated language must be assessed, which is assessed by:
- Reading syllables, words, sentences or texts.
- Reading comprehension
- Phonetics
- Phonology
Stuttering: study of breathing.
Regarding the study of respiration, both inspiration and expiration of the patient should be evaluated. There are two types of inspiration: tonic and clonic.
- Tonic breathing can be: intercostal, which presents chest elevation, and diaphragmatic, with diaphragmatic elevation.
- Clonic breathing is observed in intercostal inspiration, where there is no thoracic mobility, and diaphragmatic clonic, where there is no abdominal mobility due to relaxation.
On the other hand, expiration is divided into intercostal tonic, which is difficult to control, and diaphragmatic tonic, which controls glottic pressure well.
There are other factors that must also be assessed:
- Velocity. This means the number of phonemes the patient produces per minute.
- Rhythm, referring to the melody and cadence in the utterance.
- Control, observing if he/she presents alterations in speech diction (oral, read, recited, sung, written).
Treatment of stuttering
Language problems can be of evocation or production. When it comes to linguistic evocation (linguistic structuring) may present, in terms of memory, alterations in perception, discrimination and fixation of elements and their use. As well as alterations in attention, discrimination, behavioral programming.
It may also affect in Specific Language Disorders: ability to foresee, predict, grammatical reasoning, working memory, intentional and association functions.
Similarly, it may present deficiencies in Behavioral Programming: Desire functions.
When it comes to production may present:
- Articulatory dysphasia of sounds, words nemonimias, and paradigmatic sentences.
- Verbal apraxia. Verbal inability or difficulty.
- Isolated phoneme production and sequencing difficulties.
- Deficits in phonological programming.
- Difficulties in structuring, phonological and syntactic comprehension.
- Difficulties in written language.
In all of them, the treatment of respiratory control is fundamental. It is necessary to achieve air fluency without sudden changes in pressure, accompanied by an articulation as efficient and relaxed as possible, with a clear sentence paradigm, since it is the basis of a fluent diction.