THIS week our guest GP Dr Zak Uddin, offers his advice to those with a stammer.

MOST of us are blessed with the ability to talk fluidly, communicating our thoughts and emotions in an easily understandable manner. Yet for those with a stammer, this is often not the case.

“The King’s Speech”, perhaps the most recent high-profile film to explore the issue of stammering, documented in heart-breaking detail the difficulties of living with a speech impediment, the massive anxieties it generates, as well as the lack of public awareness and often negativity toward a condition which will affect 1 in 20 preschool children at some point.

Stammering is also referred to as stuttering in American English, or dysfluency in medical terminology. It is a disorder of speech production. Common patterns include long pauses before a word (……mummy), unnecessary repetition of syllables (da, da, daddy) as well as prolongation of the first sound (ssssstory). Sometimes no sound is heard at all.

I use the above examples because the majority of stammering first presents in early childhood, first noticed when toddlers being to speak, with a large burst in vocabulary typical between 18-24 months of age.

The development of speech involves pathways between different areas of the brain, and between the brain and the muscles involved in speaking and breathing. If these routes develop incorrectly, then a stammer may occur.

This is known as developmental stammering, and can be made worse if the child is under pressure, is excited, or has a lot to say. However, in time, these pathways can correct themselves, and the child grows out of the stammer.

Stammering may also present in later life, typically after a stroke, head injury or as part of a neurological condition. It may also be a response to extreme psychological stress.

These are examples of acquired stammering. 

We still aren’t exactly sure what causes stammering. There is a genetic component to it, with two thirds of those with a stammer having a family member also affected.

Boys suffer the condition more than girls.

Sadly, there are a lot of myths associated with stammering, which I hope to clear up. It is not a psychiatric illness, rather a neurodevelopmental disorder. That being said, stress may make a stammer worse. It is certainly not a marker of reduced intellect. In fact, some studies show quite the opposite.

Most people with a stammer are not shy and retiring, but the stress of dealing with public speaking and engagements, and the negative comments and looks of some, may mean that they shy away from these events. Some individuals’ stammering means that they will not use certain words on which they know they will become unstuck, and hence others may not realise they have a stammer at all. This is called covert stammering.

Perhaps the saddest fact is that stammering may mean that persons with the condition avoid conversation altogether, apart from with those they are completely comfortable around. 

Although figures estimate that up to four fifths of children with a stammer will grow out of it, the evidence for better outcomes argues addressing the issue directly rather than adopting a position of watchful waiting, i.e. if your child is still stammering around the age of three.

You can access the local speech service by using the Talking Point website (www.talkingpoint.org.uk) and clicking the “Find Local Services” box.

You often won’t need to go through your GP, health visitor or nursery to access appropriate help.

As well as specialist input, there is a great deal you can do as a parent to help with your child’s speech development. Try to make your home environment as relaxing as possible. This will help your child’s global development, not just speech and language skills. 

Make chat fun! Remove distractions including the television, tablets and mobile phones.

Give your child your full attention, with plenty of eye contact and encouraging smiles. 
Speaking in a slow and gentle voice yourself, with gaps between your sentences, for you and your child to digest the information, is shown to aid. 

Try not to interrupt your child, over correct them, or complete their sentences. Give them the time to finish the sentence, no matter how long it takes. 

Certain comments should be avoided including “think before you speak”, “slow down” and “take your time”. Remember stuttering is an involuntary disorder, not one that can just be corrected by trying harder. 

It may be very upsetting for you as a parent, but please try not to show this. If you’re struggling yourself, make sure you access the appropriate support. 

Perhaps the most famous person of the here and now to suffer with a stutter is presidential candidate Joe Biden.

As Canadian speech and language therapist Carla Monteleone advises “A stutter does not define who you are, or your potential to succeed”.