Stuttering
Stuttering is a speech disorder characterized by frequent repetition or prolongation of sounds, as well as interruptions of speech that break its rhythmic flow. Statistical studies confirm that children suffer from this disease much more often than adults. At the same time, boys are diagnosed with stuttering several times more often than girls. In most children, the defect goes away by itself as they grow up. In adults, this disease occurs with a frequency of about 1-3%.
The content of the article:
Classification of stuttering
Etiology and pathogenesis
Symptoms of stuttering
Diagnosis of stuttering
Complications of stuttering
Treatment of stuttering
Prognosis for stuttering
Prevention of stuttering
Stuttering
Classification of stuttering
The criteria for classifying seizures are the course of the disease, its forms and clinical manifestations. The following forms of stuttering are distinguished:
clonic — short-term convulsions follow one after another, which leads to involuntary repetition of sounds;
tonic — speech delay happens due to strong and prolonged muscle contraction;
mixed — occurs due to a combination of both types of speech disorders.
Along the flow, stuttering is constant (it bothers the patient constantly in all situations and forms of speech), undulating (it can appear and disappear), recurrent (after complete disappearance, it begins to bother the patient again). According to clinical forms, it is customary to distinguish neurotic and neurosis-like. The first arises because of neuroses and stress, and the second — because of diseases of the nervous system.
Etiology and pathogenesis
There is a whole complex of causes and risk factors that can provoke this disease. Therefore, it is possible to determine the exact etiology of the disease only in each case. The causes of the disease in adults and children differ significantly.
Stuttering in adults is extremely rarely diagnosed. One of the risk factors for the disease is hereditary predisposition. Patients are diagnosed with weakness of the central parts of speech, which, under the influence of adverse factors, can cause stuttering. It has also been proven that pathology is much more common in men than in women. This is due to the fact that in women, the left hemisphere of the brain, in which the Broca’s motor center is localized, is more developed.
A common cause of stuttering in adults is severe stress. Under its influence, the coordination of the muscles responsible for the formation of sounds is disrupted. Their contraction and relaxation becomes uncoordinated, which leads to seizures as a result. The causes of stuttering can also be diseases of the central nervous system: meningitis, encephalitis, neuroinfections, traumatic brain injuries. Brain tumors and strokes also play a great role in the appearance of stuttering.
In children, the main causes of pathology are mental trauma and pathology of the central nervous system. Children who have suffered any diseases that have affected the nervous system are especially prone to stuttering. Such diseases include traumatic brain injuries, intrauterine hypoxia, infectious diseases that were caused by viruses. Doctors also identify risk factors for the development of the disease. If there are such factors in a child’s life, any CNS disease or stress can lead to the development of pathology.
Risk factors for stuttering in children:
The child started talking early. Some children who have just turned one year old may have an extensive vocabulary. At the same time, most children normally speak only 3-5 words. Then the vocabulary begins to be replenished very quickly with new ones, the child at the age of 1.5 years already begins to speak in whole sentences. However, the lungs and speech apparatus of the baby are not yet able to cope with the increased load, which provokes stuttering.
Late start of speech. Usually such children pronounce their first words when they are two years old. Children begin to pronounce detailed phrases around the age of three. In this case, stuttering becomes the cause of motor disinhibition of the nervous system.
Emotionally labile nervous system. Such children are usually extremely tearful, they have a poor appetite and restless sleep. Any sudden change in the situation can provoke illness in children: moving to a new city, starting kindergarten, a long absence of mom.
Strict upbringing of the child. Some parents arrange a child’s life according to a clear schedule, and also often punish them for the slightest mistakes. As a result, the child grows clamped and timid, afraid to disappoint parents.
The physical health of the baby. If a child suffers from any chronic diseases or his parents constantly restrict him in something, he closes himself in, becomes timid and shy.
Hereditary predisposition.
Mastering several languages at once. If a child learns several languages at once, especially when parents speak different languages, then he may have a violation of the coordinated work of speech-motor centers.
Symptoms of stuttering
In neurology, two large groups of symptoms are conditionally distinguished, which are closely interrelated: physiological and psychological.
Physiological symptoms
The main external sign of the disease is the presence of seizures during the speech act. The duration of seizures can vary from 0.2 seconds to 90 in the most difficult cases. Seizures are divided by form into tonic, clonic and mixed, by frequency and localization into vocal, respiratory, articulatory and mixed.
With stuttering, patients are usually diagnosed with breathing problems. There are three forms of such violations:
exciratory (it is characterized by convulsive exhalation);
inspiratory (convulsive inhalation);
respiratory (convulsive inhalation and exhalation).
Noticeable symptoms of the disease are violations of speech and general motor skills (tics, speech seizures, myoclonus in the facial muscles). Patients who have difficulty with pronunciation begin to use various tricks to facilitate speech and hide its shortcomings.
Psychological symptoms
The main psychological manifestation of the disease is a feeling of inferiority. The more the patient concentrates on his defect, the more it worsens. There are three degrees of fixation of the patient’s attention on his disease, which differ in the severity of psychological symptoms.
For the zero degree of fixation, it is characteristic that children do not notice their defect or do not experience infringement because of it. At the same time, there are no attempts to eliminate the defect, the patient does not feel resentment or embarrassment due to stuttering.
A moderate degree of fixation is observed in older students who are embarrassed by the defect, and also try in every possible way to hide it.
With a pronounced degree of fixation, the child suffers from a sense of inferiority, concentrates on his problem and is afraid to communicate with other people.
Diagnosis of stuttering
To make a diagnosis, the doctor pays attention to the presence of the following main signs of the disease in the patient: stuttering and difficulties during pronunciation of words, a violation of the rhythm of speech, which is manifested by repetition of syllables, fragments of words, stretching sounds, as well as attempts to eliminate stuttering with the help of a tick or grimaces. Speech therapist and neurologist are engaged in the diagnosis of the disease. The doctor may also need to exclude organic diseases of the nervous system, which involves MRI and EEG of the brain, as well as rheoencephalography.
Complications of stuttering
Stuttering is accompanied by various complications. A child who stutters begins to avoid speech situations, as a result of which his circle of communication narrows. As a result, he becomes suspicious, wary, shy, acutely feels the difference between himself and his peers. In hypochondriacal children, the feeling of their own inferiority gradually worsens.
As the child grows up, he becomes timid and irritable, which depresses the psyche and thereby aggravates the disease more. Problems with social adaptation inevitably lead to a deterioration in school performance. Frequent complications of stuttering are fear of speech (logophobia) and fear of pronouncing certain sounds (sonophobia).
Treatment of stuttering
A speech therapist will help the patient to eliminate a speech defect. However, if convulsions have arisen due to damage to the central nervous system, a neurologist should be engaged in the treatment of pathology. A psychologist will help to get rid of stuttering caused by a traumatic situation. The treatment for stuttering is based on the restoration of the normal functioning of the speech circle, especially the inhibition of the Broca’s center.
Treatment for stuttering includes a whole range of techniques:
drug therapy;
acupuncture;
performing speech therapy exercises;
breathing exercises;
hypnosis and others.
All these techniques are aimed at solving different problems. In particular, hypnosis allows you to identify the underlying causes of pathology. However, this method is not used for the treatment of babies.
There are no special medications for the treatment of stuttering. Usually, drug therapy is prescribed only as an additional treatment. The patient may be prescribed the following groups of drugs: tranquilizers, nootropic medications, sedatives, anticonvulsants and homeopathic pills.
Acupressure has shown its effectiveness in getting rid of stuttering. It is used as a calming method of influence.
Respiratory gymnastics provides for the formation of normal speech breathing. The child learns to take a proper elongated breath, which allows him to stock up on enough air to pronounce a long phrase. Logorhythmic classes, which include singing, muscle relaxation, articulation exercises, and breathing exercises, will help to compensate for speech defects.
Of great importance in the treatment of the disease is the help of parents. Parents need to be patient and try to follow the following recommendations that will help the baby get rid of a speech defect:
Proper communication. You should try to talk to the child calmly, smoothly, slowly, pronounce all the words clearly. It is advisable to ask the child questions to which he can give a simple answer.
The mode of the day. A full sleep (at least 8 hours) will help the child cope with the disease, as well as the exclusion of computer and active games in the evening.
Proper nutrition. Parents should monitor the child’s diet. It should be dominated by dairy and vegetable food. It is necessary to limit sweets, salty, fried and spicy foods.
Observe the protective speech mode. In the early stages of treatment, parents should give the child only books that are familiar to him, not ask him to retell what he has read or teach poems. It is better to leave all these classes for a later date.
It is much more difficult for adult patients to get rid of the disease than for children. It will require painstaking work and strict compliance with all the doctor’s recommendations. The patient should regularly perform speech therapy exercises, keep a diary of his speeches, and also try to take initiative in communication more often in order to get rid of fear and feelings of inferiority due to his speech defect.
Prognosis for stuttering
It is quite difficult to predict the outcome of the disease, since a variety of factors can provoke it. Not all of them are easily and quickly eliminated. In many ways, the prognosis of stuttering depends on its form and the age of the patient. It has been proven that the younger the patient, the more chances he has for a full recovery. However, children who become ill due to congenital features of the speech apparatus still have low chances of recovery.
The type of course also affects the outcome of the disease. In particular, respiratory seizures are treated relatively easily, and clonic forms of the disease pass faster than tonic ones. The most favorable age for the treatment of pathology is 3-5 years. The hardest thing to get rid of stuttering is for children from 12 to 17 years old. Cases of relapses of the disease under the influence of adverse factors have also been recorded in speech therapy.
Prevention of stuttering
In speech therapy, it is customary to distinguish two groups of methods for preventing the disease: strengthening the child’s immunity and organizing his speech development. To maintain and strengthen the health of the baby, it is extremely important to observe the daily routine, proper nutrition, physical activity, proper hygiene. In order for the nervous system to function properly, it is necessary to protect it from unnecessary overloads and monitor the normal sleep and wakefulness.
The speech development of the baby should be aimed at expanding his horizons, ideas about the objects and phenomena surrounding him. It is also important that the child learns the correct pronunciation of sounds, the pace of speech and its rhythm. You can also avoid stuttering by preventing speech stutters, teaching the baby to speak smoothly and logically express his thoughts.
