Does your child stutter when he or she speaks? Let's talk about stuttering!

Have you ever noticed, or has it happened to you, that when you speak, words suddenly get stuck, or you keep saying the same letter or word? Sometimes this can be present since childhood, and sometimes it can also occur after you grow up. So today we are going to talk about this stuttering, or in medical terms, `(Stuttering)`. Don't worry, this is something that happens to many people, and it can often be cured.

What exactly is stuttering?

Simply put, stuttering is a disruption in the rhythm of the words we speak, that is, the smoothness of speech. In this, words do not come out the way we intend them to. There may be unnecessary sounds, unnecessary pauses in the middle of words, or other problems with the smoothness of speech.

There are several main types of stuttering:

• Developmental stuttering / child-onset fluency disorder: This is the most common type. It is caused by a small change in the way the brain develops during childhood . That is, it is a neurodevelopmental disorder . It can usually start between the ages of two and seven.
• Persistent stuttering: This means that stuttering that began in childhood continues into adulthood.
• Acquired stuttering: This is when stuttering begins after brain damage, either due to an illness or a head injury.

Stuttering is a condition that affects the smoothness of speech (Fluency disorder). These usually fall into the larger category of speech impediments.

Who is most affected by this situation?

Stuttering can happen to anyone. However, research has found that boys are about four times more likely to develop the condition than girls. The nature of the condition can change with age.

• Stuttering in childhood: This almost always begins in childhood. It can start as early as 2 years of age, but can sometimes be as late as 7 years of age. It usually begins around 3 years of age. About 95% of children show signs of stuttering before the age of 4.
• Stuttering that lasts into adulthood: Although this is a condition that affects adults, it usually begins in childhood.
• Later onset stuttering: This can occur at any age, especially after accidents or illnesses that cause brain damage.

How common is this condition?

Stuttering that begins in childhood affects between 1% and 2.4% of children. That means one or two out of every 100 children may have the condition. Stuttering that continues into adulthood is slightly less common, affecting between 0.3% and 1% of adults. There is still limited research information on how common stuttering that develops later in life is.

What are the symptoms of stuttering?

When we speak, many muscles in our face, mouth, throat, chest, and stomach are connected and have to work together. A person who stutters experiences uncontrolled movements or spasms in these muscles used for speaking.

For a doctor to diagnose stuttering, at least one of the seven main symptoms below must be present:

• Repeating sounds or syllables: This often happens at the beginning of a word. For example, when you say “mom,” you say “a-a-a-mom.” The sound or syllable is repeated until the entire word is said.
• Prolonging certain syllables or sounds: This involves getting stuck on a certain sound or syllable and prolonging it rather than thinking about it. For example, "Ss
• Pausing in the middle of a word: Pausing for a significant amount of time at an unnecessary point while speaking.
• Blocking: When speaking, there is a constant pause, either in silence or with a sound like “um…” or “ah…”. This is called ``Blocking'' because the words seem to be blocked by something.
• Word substitution: When you stutter when trying to say one word or phrase, you use another word or phrase to avoid it.
• Overstressing: Speaking with excessive emphasis or stress on part of a word or the entire word.
• Repetition of single-syllable words: Repetition of words made up of a single sound, such as “I”, “yes”, and “that”.

Other symptoms related to stuttering

People with this condition may also experience:

• Spasm overflow: Due to the muscle movements that cause stuttering, the spasms can "spread" to other parts of the face, neck, shoulders, and arms.
• Unusual movements or postures that increase with stuttering: One thing that can be seen among people who stutter is certain behaviors that appear when they stutter. For example, unusual eye blinking, looking away, frowning, and clenching their fists.
• How your mental state affects symptoms:Stuttering symptoms can be worse when you are tired, excited, anxious, or stressed. It can also happen when you are talking about new, complex topics. However, symptoms can also decrease when you are relaxed and at ease.
• No stuttering during other vocal activities: Surprisingly, stuttering usually doesn't occur during certain activities. For example, you may not stutter when talking to your pets, reading a book out loud, or singing.
• Contributing to other mental health problems: Stuttering can cause feelings of frustration, embarrassment , and shyness. People who stutter are more likely to have mental health conditions such as anxiety or depression .

What are the causes of stuttering?

Experts still don't fully understand why stuttering actually happens. However, there are a few things they think might contribute to it:

• Family history : If a first-degree relative, such as your mother, father, or siblings, stutters, you are about three times more likely to stutter.
• Genetics : It is thought that certain changes ( mutations ) in our genes ( DNA ) may contribute to stuttering. It also appears that genes may influence whether the condition improves over time or goes away completely.
• Changes in brain structure: It has been found that there are certain changes in certain areas of the brain of people who stutter. These are often the parts of the brain that control the muscles that help us speak, or that coordinate muscles.

How to recognize stuttering?

When diagnosing stuttering, a doctor will first ask about the symptoms associated with the condition. In addition, they will ask about your (or your child's) health history, when the symptoms started, and what times of day they usually occur.

If your child has stuttering, it is often diagnosed by your child's pediatrician. This happens either when you notice symptoms and tell the doctor about them, or when the doctor notices the symptoms when you take your child for a routine checkup.

Many people who stutter into adulthood have been diagnosed with the condition since childhood. However, in rare cases, there may be people who stutter into adulthood but were not formally diagnosed with it as children.

Special medical tests are usually not needed to diagnose stuttering in childhood or stuttering that persists into adulthood.

Acquired stuttering

If an adult suddenly starts stuttering, it is likely that they will be tested. Stuttering like this can sometimes be a symptom of a condition called aphasia . Possible causes of aphasia include traumatic brain injury (TBI), strokes , and brain tumors (including cancer ).

Tests that can be done at this time include:

• CT scans (CT scans – Computed tomography scans)
• MRI scans ( MRI scans – Magnetic resonance imaging scans)
• PET scans (Positron emission tomography scans)

Things like this may be included.

How is stuttering treated?

The main treatment for all types of stuttering is speech therapy . For young children, this involves practicing various activities that help the symptoms of stuttering gradually decrease and eventually disappear completely. The activities and techniques used in speech therapy are determined by the type of stuttering, the symptoms, and the severity of the stuttering. The number of treatment sessions and the length of each session can also affect this.

Medications are not commonly used to directly treat stuttering. However, medications can be used to treat mental health conditions, such as anxiety or depression, that can accompany stuttering and make stuttering worse. Antidepressants and anti- anxiety medications are examples of medications used in this way.

Complications/side effects of treatment

Complications and side effects of stuttering treatments depend on the treatment method and other factors. Speech therapy does not usually cause any risks, complications, or side effects. Side effects or complications from medications, although rare, can occur.

Your doctor can tell you more about these possible complications and side effects, as well as explain ways to avoid them or minimize their effects.

Can stuttering be prevented?

The only type of stuttering that can be prevented is acquired stuttering. The best way to prevent it is to reduce the risk of, or protect against, conditions such as stroke or traumatic brain injury (TBI).

What can we think about this situation? (Outlook)

Stuttering is not a dangerous condition, and many people recover from it. Treatment, especially speech therapy, can speed up recovery.

However, stuttering can have serious mental health implications. About 40% of children between the ages of 12 and 17 who stutter have conditions such as anxiety or depression.

Adults who stutter are twice as likely to have these conditions and three times more likely to have personality disorders. Identifying and treating mental health conditions can help limit how they affect stuttering.

How long does stuttering last?

About 90% of children with developmental stuttering recover on their own by the age of 18. Those who recover completely do not stutter again unless they develop acquired stuttering.

Persistent stuttering that persists into adulthood is rare, but it is usually a lifelong condition. However, it can also be treated, and many adults can learn to cope with and manage the condition.

Acquired stuttering can be permanent or temporary. This usually depends on the cause. If it is caused by severe, permanent brain damage, this type of stuttering is also more likely to be permanent. Your doctor can explain what is most likely to happen based on your situation.

How can I take care of myself? / How can I help the child?

If your child has signs of developmental stuttering, you should talk to their pediatrician. Early detection and treatment can help your child learn to speak and deal with feelings of embarrassment and shyness.

If you have persistent stuttering that continues into adulthood, speech therapy can also help you. Speech therapy teaches you how to deal with the effects of the condition.

Mental health care

It's always important to take care of your or your child's mental health. It's even more important when you have a condition like stuttering. Talking to a psychiatrist, therapist, or other mental health professional can help you with conditions like anxiety or depression.

Mental health care for children is especially important, as it can help reduce the severity of the mental health effects of stuttering. Children who stutter are more likely to be teased and bullied by others, which can worsen their anxiety or depression.

Remember, stuttering is not your fault or your child's fault. It's a medical condition. It's nothing to be ashamed of.

When should I see my doctor?

If you or your child has stuttering, you should see your doctor as recommended. Many children outgrow stuttering, so you may not need to see a doctor for this condition in time.

When should I go to the Emergency Department (ETU) ?

The only type of stuttering that requires emergency medical attention is acquired stuttering, which occurs suddenly, especially with other symptoms of stroke. If acquired stuttering develops gradually, it is important to see a doctor as soon as you notice the symptoms. Symptoms that develop and gradually worsen may be a sign of another brain-related condition.

Is stuttering a form of anxiety?

No, stuttering is a completely different condition from anxiety. However, there is a strong, reciprocal relationship between the two. That is, stuttering can either cause anxiety or increase existing anxiety. Also, stuttering often gets worse when you are feeling anxious.

Can stuttering be completely cured?

There is no “cure” for stuttering. That is, it cannot be completely eliminated with one medicine or one thing. However, you can recover from it. Speech therapy and other treatments can help speed up and facilitate this recovery. Many children recover almost completely.

If my child stutters, how can I help him?

If your child stutters, there are several things you can do to help him:

• Be a role model yourself: Speak slowly and calmly, and set an example for your child to speak in the same way.
• Don't punish stuttering: This has the opposite effect. It can worsen the child's anxiety and other psychological effects related to stuttering.
• Listen to what your child is saying: Your child needs to know that you are paying attention to what he or she is saying. Don't rush to speak as soon as he or she has finished speaking. It can also help to get down to your child's eye level and look them in the eye when you speak.
• Don't interrupt while speaking, don't focus on mistakes: Focus on what the child is saying, not how he or she is saying it. Don't try to finish his or her sentences, and don't interrupt while he or she is speaking.
• Build your child's self-esteem: Praise your child for the things they do well, beyond what they say. When they demonstrate their skills in nonverbal activities, clearly state your feelings about them.
• Spend time with your child: Spending time with your child, without distractions like TV or phone, helps build your child's confidence and mental health .
• Don't make your child feel like it's something to hide: If your child stutters, let them know that it's okay to talk about it. Talking about feelings like frustration and shame can help relieve negative feelings about the condition.
• Reassure your child that you support them: Tell your child that you support them no matter what. They need to hear that stuttering does not affect their personal worth.

What is the difference between stuttering and stammering?

Historically, the terms ``Stuttering`` and ``Stammering`` have described two related, but not exactly the same, speech impediments.

• Stuttering: Repeating the same sound while trying to speak. (Example: ma-ma-ma)
• Stammering: Repeated gaps or pauses when trying to speak. (Example: I went to school … today …)

Many people who stutter do both. Because the two often occur together, it's common to use the two words interchangeably. So whether you say `(Stuttering)` or `(Stammering)`, they often mean the same thing.

Finally, things to remember (Take-Home Message)

Stuttering can be frustrating and embarrassing, no matter your age. It's normal to feel anxious or embarrassed about the condition. However, stuttering is a medical condition, and it's not something to be ashamed of.

Many people recover from this condition and live very successful lives. There are many people who stuttered, such as world leaders, movie stars, and professional athletes, but who have become extremely successful. With speech therapy and other treatment options, you too can find the rhythm of your own words and express yourself confidently. So, if you think you or your child has something like this, don't hesitate to seek medical advice.