Overcoming the stigma of a stammer

Do you suffer from the speech disorder? The good news is that you can overcome it 100 per cent.

It's difficult to understand why people begin to stammer, but everyone who's been through it can relate to the frustration, stigma, and anxiety that it creates. Like King George IV in the Oscar-winning movie The King's Speech, overcoming this problem is a dream for many who suffer from the condition.

Hrithik Roshan is one of the few examples in modern times to manage just that. The actor recently spoke out on a television show about what he went through in childhood because of his stutter, and how difficult it was to overcome, despite the support and love he received from his parents.

So can stammering be completely overcome? Yes, it can says Dr Merzia Maskati, a speech therapist based in Mumbai. Although it is not necessarily a psychological problem, there are various theories floating around regarding its cause in the medical and academic fraternities. But Dr Maskati says that therapy can make a vast difference and solve the problem completely.

Stammering is medically associated with a cognitive and neurological failure, and is suspected to have genetic roots. But there are sufferers who pin their stammering to psychological factors.

"The reasons can be different for different people," says 53-year old Mani Maran who is part of the Chennai chapter of The International Stammering Association. "I believe it is 10 percent genetic and 90 percent psychological. It is often a product of social fears likes shame and embarrassment to speak in front of others," says 33 year old Nitin Tomer.

Both Mani Maran and Nitin Tomer are members of The International Stammering Association (TISA) and head the Chennai and Delhi chapters respectively. Like most other people who stammer, Maran says that the most relieving thing about the problem is to be able to acknowledge it. "Being a part of the association simply helped me come to terms with the fact that I stammer. Once I acknowledged that, a huge part of the psychological tension vanished with it," he explains. "All we really want is to simply complete a sentence: we need those few extra seconds of patience from the other person to let us finish saying what we have to."

But whether the roots are primarily emotional and psychological, as Tomer says, or neurological, cognitive and genetic like Dr Maskati says, the fact is that stammering is not an illness, but something that can be corrected. "It's basically the disfluent speech that must be replaced with fluent speech," says Dr Maskati, adding that it most often occurs when there is a cognitive overload on a toddler's mind, between the ages of two and a half and three and a half.

What speech therapy does is attempt to replace the disfluent speech with fluent speech, and treating it during childhood can be most effective. "Some of the methods we use are coordinated reading and writing, for instance," she explains.

"The most important part of therapy is to make sure it is not turned into a big deal that a person stammers. Often, there have been cases where stammering has worsened because the child has been made overly conscious about it in a new environment where he or she suddenly gets noticed."

Given the enormous number of people who have overcome their stammering, from Hrithik Roshan to those who have gained moral support at TISA, there's little doubt that the right therapy and awareness can do wonders.

"What we want is to spread awareness, and let people know that there's nothing wrong with stammering to start with," says Maran. "It's our endeavour to make sure more people know that they are not the only ones," he says.

Psychological effects of stammering

1. It can damage a person's sense of self-image, and this can lead to guilt, shame, and anxiety.

2. Fear of certain words, sounds and situations develops. There are people who tell Dr Maskati that they always stammer over a particular word, or a particular alphabet, or that they stammer when they have to speak on stage. There are certain psychological associations that the mind makes, based on past experiences, and these can trigger the stammering at later stages.

3. For some, it can be that psychological issues are the cause behind stammering. However, there is no necessary correlation between the two, as Dr Maskati says. Not everyone who has psychological problems or anxiety stammers, and not everyone who stammers has psychological problems or anxiety. Anxiety and depression are emotional, and stammering is related to speech, and while both may depend on each other, they may also be independent of each other.

How do parents know if their child needs help with a stammer?

Parents need to look for warning signs in children who are beginning to develop stammering and disfluent speech, says Dr Maskati. Some warning signs include the following:

1. Repetition of syllables and drawing out a particular syllable for very long. If this continues for more than six months, they should make sure that they see someone.

2. If there is a recurring disfluency. Often, children talk fluently for awhile and then revert to disfluent speech within a week or so. If the period of recurrence is as short as a week, it is a definite sign to see a therapist.

3. If someone in the family has had a stammering problem, seeking immediate help is advised.

4. If there's a lot of facial tension, and there is a sense of the child struggling with words and expression, it is also a cause for concern.

5. Never complete the child's sentences, wait till he finishes with it. Give the child lots of time to speak and be patient. Reduce the demands to speak. We tend to get into the habit of asking children to sing a song or repeat something. Never pressure the child into talking.

6. Acknowledge the problem.

7. For adults who suffer from stammering, what makes the most difference is moral support and acceptance. Being aware of the problem is the first step towards repairing damage done to a person's self-image, and being part of an association of sufferers who support each other is a good step forward.

What a family must keep in mind

The right age to visit a speech therapist is between the ages of three and a half and four years. This is the right age to nip the problem completely in the bud. It is later that complications in speech and psychology merge. A person's self-image gets affected later; earlier on you only need to work on the speech, whereas later, you need to work on both speech and self-image. Detecting it in a child is therefore very useful.

It's never too late, however. According to Dr Maskati, adults can also correct a stammer and she suggests they do it by using a form of therapy called 'block correction'.

"A block is disfluency or a stammer. An adult can ease out of this stammer by relaxing his/her muscles or repeating the stammer word in an easier relaxed way by breathing out and then saying it."

The other method is by co-coordinating reading and speaking. Instead of saying too many words at a stretch and running out of breath, you try and say only two to three words to correct stammering.