As a child, Louise Kennedy stuttered so badly that eventually she just stopped talking.
Now a 37-year-old administrator at Harvard’s John F. Kennedy School of Government, Kennedy recalls that the other kids in Dundee, Scotland, where she grew up, were merciless. One rode by on his bike yelling, “Stutterer, stutterer.” Others “tied me up and put me in a rubbish bin.”
Her father was even worse. “He refused to believe there was something wrong,” even as she dropped more and more words from her vocabulary, including, not surprisingly, “Daddy.”
“I’d say D-d-d-d,” she remembers. “He’d say, ‘Spit it out, girl.’ “
She just plain couldn’t.
Stuttering is a defect in which the flow of speech is broken up abnormally. Sometimes there’s no sound at all. Sometimes the stutterer repeats the beginning of a word, like st-st-stuttering. Sometimes there’s a prolongation of sounds, like ssssssstuttering. Sometimes the stutterer tries so hard to get words out he clenches his fist or starts developing facial tics.
For the 3 million Americans who stutter – and sometimes for those who listen – stuttering can be torture, partly because of sheer frustration but also because many people assume that someone who stutters must be dumb or emotionally disturbed.
Wrong. Scientists still don’t know exactly what causes stuttering, but they’re convinced it’s not nervousness or emotional problems, though stuttering can lead to both. But while the root causes remain elusive, researchers have developed increasingly refined therapies and uncovered important clues to the underlying biology of stuttering. For instance:
- Stuttering runs in families. If you have a parent, sibling or child who stutters, you are 5 to 20 times more likely to stutter than someone who has no such history – a clear sign that genes play a role, says geneticist Dennis Drayna of the National Institutes of Health.
- If one identical twin stutters, there’s a 25 to 80 percent chance the other will, too – another sign that genes are involved.
- If a child with biological parents who speak normally is adopted by a parent who stutters, there is no increased risk the child will stutter, according to a study of Colorado adoption records. This shows stuttering is not learned behavior, says the author, Susan Felsenfeld, a communication disorders specialist at Duquesne University.
- Brain imaging studies suggest the brains of people who stutter are different from those of people who don’t, says Dr. Anne Foundas, a behavioral neurologist at Tulane University School of Medicine.
In fact, Broca’s area – crucial for producing speech – is in the left hemisphere in most people. But stutterers often use the right hemisphere to produce speech, says speech-language pathologist Barry Guitar at the University of Vermont.
One reason stutterers may have trouble is that the right hemisphere processes nerve signals more slowly than the left. Since speech is being generated in the “wrong” place, the pathways that nerve signals must travel to produce it – from the brain to muscles in the mouth, tongue, lips and larynx – may be more convoluted than normal. Stuttering then could be the result of a timing or coordination glitch in these signals.
Even stutterers don’t always stutter. If they whisper or speak very slowly, for instance, some may speak fine. They may also be fluent if they wear earphones that delay the sound of their own speech, a device that can actually disrupt the speech of people who don’t stutter, says psychologist Ron Webster, director of the Hollins Communications Research Institute in Roanoke, Va. This suggests that feedback – hearing your own speech – is a key part of speech production.
Perhaps most intriguing, males stutter at four times the rate of females. Researchers don’t know why that is either, but stuttering usually starts in childhood, and some think female brains may be better able to rewire bad connections.
Recently, scientists have been trying a number of drug treatments for stuttering, including medications normally used for Parkinson’s disease or psychosis, on the theory that stutterers may have an abnormality in certain brain chemicals. Others have tried injecting botulism toxin into the vocal folds to stop muscle spasms that can disrupt speech.
So far, none of these approaches is a “magic cure,” says Charles Diggs, a speech-language pathologist at the American Speech-Language-Hearing Association in Rockville, Md.
What can work are techniques called fluency shaping and stuttering modification, which are sometimes taught together.
Fluency training, like that taught at Hollins, involves having the stutterer slow his speech down to the glacial speed of two seconds per syllable. Therapists then painstakingly teach the stutterer how to form each of the 35 sounds in English correctly, and how to coordinate breathing and speaking better.
After 19 intense days – and $3,200 – many people he has treated, including Louise Kennedy and Annie Glenn, the astronaut’s wife, emerge speaking far more fluently, says psychologist Webster.
The other approach involves teaching stutterers not to feel so anxious about stuttering and to “shape the stutter” so that they are in control of it, and not vice versa. This involves slowing down the part of the word that’s problematic and not struggling with the sound.
Jane Fraser, president of the Stuttering Foundation of America, says this worked for her father, who started the group in 1947. He taught himself to say his last name slowly, FFFFuuuhhhraser, to get the initial sound out.
What doesn’t work, say speech pathologists like Laura Barrett at the Franciscan Children’s Hospital and Rehabilitation Center in Brighton, is to substitute easy words for tough ones. The list of taboo words just grows.
It also helps to remember that many stutterers triumph over the disorder, including Winston Churchill, who become a great orator. But for many stutterers, just being able to speak normally is reward enough.
Not long ago, Louise Kennedy invited her boyfriend to have lunch with her father, who was visiting from Asia. Kennedy’s boyfriend raved about the progress she’d made, adding that he knew she’d had a bad problem when she was a child.
“Oh, it was just all in her mind,” Kennedy recalls her father saying, adding that she thinks now he was “afraid of not being able to fix it.” And that’s true, he couldn’t.
But she did. “I found my voice,” at Hollins. “The world is now my oyster.”
When you talk to a stutterer
- Be calm and patient. Maintain eye contact and pay attention to what the person is saying, not how he’s saying it.
- Don’t interrupt or finish the person’s sentence.
- Some speech fluency problems are normal in children, especially in chilren under 4. In older children or any child with severe or persistent problems, consult a speech-language pathologist.
- To help a child who stutters, provide opportunities for him to talk to you without distraction or competition from others.
- Don’t ask a child a lot of questions at once. Give your child time to answer one question before you ask another.
- Don’t tell the child – or any stutterer – to relax or slow down. This won’t help and calls attention to the stuttering.
- Be extra patient if you are talking to a stutterer on the telephone – this is a high stress situation.
- Remember that the stutterer is not doing this on purpose. Be kind – that’s what you’d want if you were the stutterer.
For more information, you may contact:
- The American Speech-Language-Hearing Association, 1-800-638-8255 or on line at www.asha.org. The group offers referrals to speech therapists anywhere in the country.
- The Stuttering Foundation of America can provide information and referrals, 1-800-992-9392 or on line at www.stuttersfa.org.
- The National Stuttering Project runs self-help groups nationwide, 1-800-364-1677 or on line at www.nspstutter.org.