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Stuttering is a rhythmic disorder of speech characterized by intermittent repetitions, stops, or prolongations of sound and often accompanied by odd movements of the lips, jaw, or tongue. The interruptions in rhythm are inconsistent and unpredictable. Almost all stutterers have some periods of fluency during which their speech rhythms are undisturbed.
Stuttering occurs when muscular spasms impede the movement of breath from the lungs, immobilize the vocal folds, or Interfere with the action of the lips, jaw, or tongue. Clonic muscular spasms are marked by a rapid succession of repetitive movements, and tonic spasms are marked by continued muscular tension of a particular set of muscles.
The efforts of the stutterer to release the spasm make him appear to be going through a violent and painful struggle, which may be disturbing to an observer. Actually the spasms are unaccompanied by physical pain, although the stutterer may undergo emotional pain because of anxiety to speak without stuttering and to avoid being labeled a stutterer. One major school of speech therapists holds that only persons who have such awareness and anxiety should be considered stutterers.
Most stuttering begins between the ages of two and four, when a child is learning the complexities of language structure. During this period most children frequently repeat sounds and even whole words. It is important to distinguish between stuttering and a young child's normal repetitions and nonfluencies, but if true stuttering is present, therapy should start in the early years. Therapists use an indirect approach to keep the child unaware of the anxieties of others about his stuttering. Parent counseling is most important in therapy for the preschool stutterer. Parents should strive to provide an environment favorable to the development of emotional security, to eliminate stress and criticism in connection with speaking, and to build up tolerance to frustration.
There is no universal agreement as to the cause of stuttering or to its treatment beyond the early years.
No single physical or psychological trait has been found in all stutterers. Some speech therapists believe that stuttering is caused by deep emotional conflicts of which the individual is unaware, and they conclude that treatment should be in the hands of a psychiatrically trained specialist. Other speech therapists, although agreeing that most adolescent and adult stutterers show signs of emotional disturbances, feel that the symptoms of the disorder can be treated directly. They try to help the stutterer develop under standing and acceptance of his problem and to change its symptoms. Some therapists believe in providing opportunities for fluent speaking, such as acting out plays.