Causes of stuttering:
There are many reasons for stuttering, such as: imitating others' stuttering at a young age, receiving bad hints, being frightened in some way, the effects of illness, fear of speech itself, etc. There are four factors that are most likely to cause stuttering. There are four factors that are most likely to have contributed to the development of stuttering:
1) Genetic factors, about 60% of people who stutter have a family member who also stutters, and a recent study published in the journal Nature says that scientists have now identified the importance of specific genes in speech disorders.
2) childhood development, where children with other speech problems or developmental delays are more likely to stutter;
3) neurophysiological factors, where the latest scientific research shows that people who stutter use different areas of the brain to process speech and language than those who don't stutter. technique found that stutterers had decreased absolute cortical blood flow and asymmetrical blood flow in several regions, including those involved in speech.Fox et al. showed that stuttering speech was associated with widespread hyperactivation of the right side of the brain: stuttering read aloud lacked normal activation of the left hemisphere and instead showed a state of selective deactivation of the frontotemporal system; when fluent speech was produced after fluency was induced, it partially reversed the hypoactivated state of the temporal auditory system and the inhibited state of the frontal speech production system. Stutterers may be the result of a lack of coordinated activity between the two hemispheres corresponding to speech movements.
4) Family dynamics, high expectations, and an intensely paced lifestyle can likewise contribute to the development of stuttering.
However, stutterers in general do not stutter in all situations, e.g., when in the presence of loved ones, when singing, when speaking to subordinates, and when reading aloud, stuttering symptoms are less severe and may even be fairly fluent. On the other hand, on certain occasions, such as when speaking at meetings, in emergencies, in front of strangers, or when meeting with the opposite sex, the stuttering may be severe or even red in the face, but the words do not come out. Thus, whatever factors play a role in stuttering, they are complex and change with the cognitive and emotional state of the patient.
Correction of stuttering:
Stuttering is a very complex speech disorder. People who stutter not only have abnormal speech behaviors , often accompanied by emotional distress and changes in attitudes and ways of being in the world. Different stutterers have a variety of specific behaviors. Because of the complexity of stuttering, the treatment of stuttering is also very complex and varied. Currently, most stuttering treatments focus on non-pharmacological treatments, such as speech training, psychotherapy, bioelectrical feedback metronome, alteration of vocalizations, delayed speech feedback, voice masking, etc. The treatment should be tailored to the individual's stuttering needs. Treatment should be tailored to the individual's stuttering characteristics, personality, emotions and behavior, and choose the appropriate treatment method for the individual.
Mild and moderate stuttering in children is self-healing, while severe stuttering requires remediation. It is generally believed that about 80% of children's stuttering can be self-healed with age, but early intervention by parents or remediators is important. The first step is to eliminate parents' disappointment and discriminatory attitudes. They should remind the child to speak slowly, not to criticize or punish the child, to ease his/her tension, to enhance the child's confidence, to reduce the fear of stuttering, and to make him/her not overly conscious of his/her speech process. Parents should talk to their children slowly and relaxedly with more pauses and allow them to speak at their own pace, giving them plenty of patience and affirmation. Here are a few ways to correct stuttering:
I. Speech Feedback Therapy
Stutterers stutter less and speak naturally and fluently when they follow other people's speech. Therefore, foreign countries began to study the principle of this aspect in the 1950s, and introduced delayed auditory feedback (delayed auditory feedback DAF) instrument in the 1960s to simulate such an effect. When one's speech is altered, it sounds like someone else is saying the same thing to him/her, which helps stutterers achieve the effect of following other people's speech when they are speaking alone, thus instantly improving their stuttering. Research suggests that people who stutter can temporarily smooth out their speech in two ways: by endogenous (self-generated) changes in the mechanisms by which speech occurs, and by receiving specific certain extrinsic speech feedback while speech is occurring. Endogenous methods of reducing stuttering, such as speaking in odd accents, dragging out the voice, softening pronunciation, and other speech-dynamics-based remedies. Because endogenous methods of triggering fluency are usually associated with speech-genesis mechanisms, some corrected stutterers whose fluent speech is perceived as sounding unnatural may require substantial cognitive effort to maintain this speech and have difficulty applying it consistently in real-life speaking situations. The most effective altered speech feedback methods for improving fluency utilize "second speech signals," i.e., speech signals that are presented discretely alongside the first speech signal produced by the speaker and that contain speech actions that are similar to the speaker's first speech signal. In contrast to endogenous methods of triggering fluency, extrinsic methods that utilize altered speech feedback (ASF) have been shown to result in the immediate production of stable, natural fluent speech by stutterers, with essentially no cognitive effort required, although the effects are sometimes not sustained.
Choral Speech; masked auditory feedback; delayed auditory feedback; frequency altered feedback; visual choral speech. Visual choral speech, and delayed visual feedback have been shown to immediately reduce stuttering behavior by as much as 70-100% in some stutterers. Altered speech feedback has also been found to improve fluency regardless of speech rate, and to consistently improve fluency even when used monaurally rather than binaurally.
Previously, this instrument for altered speech feedback was so large that it could only be used in a laboratory and had no real effect on correcting stuttering. It was only in the 21st century that technological advances led to the emergence of small, "hearing aid"-like stuttering correctors such as the speecheasy. Because they are placed directly into the ear and apply microcomputer speech processing technology, the sensitivity and clarity of the sound feedback is higher and the effect of stuttering correction is better. In the United States, Canada, the European Union and other countries and regions, Speecheasy has achieved remarkable corrective effects, and related news has been reported by ABC TV, NBC TV, BBC Radio, USA Today, People Weekly, Forbes, and China Central Television.
Speech fluency training
Speech fluency training is designed to adjust the way you speak in order to prevent stuttering, or to control it when it occurs, so that verbal communication can continue. Pronunciation, for example, includes techniques such as slowing down the speed of speech, inducing articulation, soft articulation, using airflow, and forming rhythms and rhymes in speech. After mastering these articulation techniques, the stutterer can start speaking at a very slow speed and gradually transition to a near-normal speech rate. In addition, breaking up long sentences, changing the way of speaking, and reading along are also important elements of speech fluency training. Although speech fluency training can not eliminate the physical factors that lead to stuttering, and can not completely solve the problem of psychological barriers, but it is a feasible, treatment of the symptoms of auxiliary therapy.
Three, psychological treatment
Domestic and foreign scholars have found that stuttering patients have fear of stuttering, no clear understanding of this speech disorder, manifested in the avoidance of verbal exchanges with the outside world, and in severe cases, isolation from the outside world. The aggravation of the psychological disorder further worsens the stuttering symptoms, which in turn deepens the psychological disorder, and the result of the vicious circle makes the stuttering disease become deep-rooted. According to Zhang Jinghui, the focus of the cure for stuttering should be on breaking down psychological barriers. The root cause of stuttering lies in the subjective wish "not to stutter a single word". Without destroying this strong and wrong wish, all efforts are futile. In order to eliminate psychological barriers, stuttering must be allowed unconditionally. The basic spirit of Japanese Morita psychotherapy is not to reject the established fact of stuttering, to work like a normal person with stuttering, to show an attitude of "following nature", to allow stuttering, and to do what one should do. According to Huang Yi, the stutterer's fear of stuttering is not so much a fear of stuttering itself as it is a fear of the possible consequences of stuttering - the loss of a quality material life and social status. The essence and core of psychotherapy for stuttering should be to reduce or eliminate the fear of the negative consequences of stuttering.
In psychotherapy, behavioral, cognitive, and emotional treatments are emphasized. It includes:
1. Psychological guidance and psychological support therapy, gradually let the patient recognize their own wrong, paranoid cognitive concepts, and consciously replace them with correct thinking concepts. At the same time, the patient listens to the stutterer patiently and shows full understanding to them.
2. Relaxation training teaches patients to experience the effect of their own muscle contraction and relaxation, and through repeated self-training, to achieve the whole body muscle relaxation, that is, the role of the mind and body relaxation. This can eliminate the patient's tension, and gradually restore and maintain a good and stable state of mind.
3. Systematic desensitization training therapy. In the practice of treatment, the self-systematic reading training, caring intercourse heart dialogue therapy; systematic social interaction training. Let the patient contact a variety of different environments and different people, in the conversation and reading to relieve tension, fear, anxiety, depression, etc., and gradually cultivate the patient's stable, calm and composed state of mind.
4. Exposure therapy: for young patients, especially students, when they have been through the above and other related treatments, have a better effect. Patients should be motivated to take bold breakthrough exposure therapy, encourage them to participate in various competitions organized by the school speech, recitation, etc., so that they can exercise themselves in a variety of occasions, to establish self-reliance, self-confidence, self-improvement of the determination.
Fourth, other therapeutic methods
Breathing training: the respiratory organs and articulation organs of stutterers are generally normal, but stutterers often have breathing disorders when they speak, breathe inappropriately, or have uncoordinated breathing and articulation. The use of breathing therapy in accordance with the law of articulation, such as practicing breathing exercises, the coordination of breathing and articulation training, combined with other treatment methods can further improve stuttering.
Biofeedback therapy: through biofeedback, such as breathing, myoelectric feedback, and relaxation training; it can reduce stuttering and improve the fluency of speech.
Drug therapy: Haloperidol is considered an effective drug for stuttering, but with greater side effects. Chlorpromazine (tricyclic antidepressant, has a strong 5-hydroxytryptamine recycling blocking effect) orally, can make stuttering severity significantly reduced. There are also scholars have suggested that calcium channel blockers and cholinergic blockers can be tried to treat stuttering.