fluency disorders

A) Stuttering

Confession is good for soul not for stuttering. Stuttering is all that one does in an attempt to hide it.

Stuttering and stammering are the two different names for the same problems. It is a disorder for fluency of speech. In a simple way the problem of stuttering can be defined as a break or block in the normal flow of speech. These can be stoppages (in which no sound comes out), repetitions of words or sounds, prolonging certain sounds and syllables or hesitations. There may also be unusual facial and body movements associated with the effort to speak .

What Social Behaviour Accompanies Stuttering?
Since stammering affects the normal communication with others, it adversely affects his school, family, job, or social relationships. Due to this a majority of stutterers are found to be more introverted, a social and antisocial behaviour, show higher neurotic tendencies, are less dominant in their interpersonal relationships, express lack of confidence, and tend to avoid social meetings where they would have to converse. What they suffer emotionally is what is depicted here. PFAGH are the different progressive stages of emotion that an adult stutter very often undergoes.

What Causes Stuttering?
Even after many many years of research. We still do not know for a fact what causes stuttering however, our best educated guess is that there are different causes for different people.
  • Home and school pressures at certain critical stages of development i.e. as developmental
  • Disorder
  • physical factors i.e. while immitating some one.
  • family history i.e.as genetic disorder
  • faulty learning i.e associated with Dyslexia as secondary disorder
  • As Psychological disorder
  • Organic causes ?
  • Phobias and fears as emotional disorder.
At What Age Is Stuttering Likely To Surface?
Stuttering normally begins at an early age (usually between 3 - 5 years), but will occasionally appear for the first time in a school age child, and, more rarely, in an adult if he is under stress, or has some physical problem. Some times we do get the history of stuttering as the follow up symptom of the high fever or illness.>

What Should I Do When I Hear A Non-Fluent Child Speaking?
Children may be unaware that they are speaking non-fluently. Do not call attention to the non-fluent speech pattern. Do not say "Stop and start over" "Think before you talk" "Talk slower" other such statements. Listen patiently and carefully to what the child is saying, and do not focus on how it is being said. Speak with your child in an unhurried way, pausing frequently. Reduce the number of questions you ask. Give a few minutes of undivided attention to the child. Listen with facial expressions, and body language to convey communication. Above all show the child that you accept him / her as he / she is to support and build up their confidence.

What Should I Do When An Adult Stammers?
Adult stutterers need the same patience, and attention to their ideas as speakers who do not stutter. Do not look away and don't hurry them or fill in words. This attempt to help can create anxiety and self-consciousness, which could make the problem worse.

My Child has Started Stuttering, Should I wait or Seek Help?
You should seek professional help as soon as the problem occurs. Most children outgrow their non-fluency, but others will not.(65 % of the children out grow their Non - Fluency, but do you or any one know whether your child belongs to this 65% or the other 35% ? hence one visit to a speech therapist proves to be very fruitful, and is a MUST. In early stages of non-fluency the problem of stuttering may be prevented from developing if treated early enough.

Who Can Help With This Problem?
A Speech & Language pathologist (therapist) who has had experience in dealing with the stuttering problems of children and adults.

Can Stuttering be Treated?
Yes, there are a variety of approaches for both children and adults for which successful outcomes are reported.

Can Stuttering be Cured?
While some individuals do achieve speech that is indistinguishable from normal, i.e. cannot be separated from normal; it is best to avoid thinking in terms of an absolute "cure" for stuttering when the causative factor is genetic or organic. Stuttering is not a disease. The goal should be to progress toward improved fluency and a feeling of success in communicating. Most importantly, the stutterer should have MOTIVATION and a POSITIVE ATTITUDE towards the treatment.

The condition of primary hesitancy where repetition or blocks or prolongations are not associated with bodily gestures or any other secondary symptoms, can be helped out with very easily. That has been our experience at 'nirmitee', where we use play therapy approach.

Our Director's contribution in the field of Stuttering
Our director, Mrs. Vora, has received standing ovation for her research paper on 'Stuttering as a secondary symptom of Learning Difficulty ( i.e. Dyslexia)' - Stuttering as a symptom also can be cured if primary problems of LD are looked after. Her paper titled 'Air Volume parameters in adult stutterers' is on the way for the publication in an international journal.

Age Range
Childhood to adulthood.

At Nirmitee m ost children outgrow their non fluency i. e. primary hesitancy but others will not.(65 % of the children out grow their Non fluency, but do you or any one know whether your child belongs to this 65% or the other 35%? Hence at least one visit to a speech therapist proves to be very fruitful, in early stages of non-fluency, for better understanding of the problem and how to tackle them.

The problem of stuttering may be prevented from developing if treated early enough. Our conscientious team of therapist are well trained to tackle stuttering as a cause ( for further social, emotional and behavioural problem) and stuttering as a symptom (when it is secondary to problem of Learning disability).

For adult stutterer we customize the therapy plan using various approaches such as Desensitization therapy, Psychotherapy, Fluent Speech Approach, Modification of Stuttering Approach, Operant and Classic conditioning, Increasing Fluency etc.

The sequence of therapy includes, beginning with - Motivation - Identification - Desensitization -Variation-Approximation-Stabilization.
At our clinic we have computer aided program with visual graphics to treat stuttering cases. The counselor offers counseling to the parents as well as the stutterer.

For Out station cases and for practice at home we offer Audio Cassette on Demand.

B) Cluttering

What is Cluttering?
It is a disorder of time and rhythm characterized by unorganized hasty spurts of speech often accompanied by slurred articulation and breaks in fluency - in short it manifests as a fast rate of speech where in which the speaker may misarticulate.

Speech of clutterer is: disorganised, jumbled, confused and chaotic. It is very often confused with stuttering as it too has many repetitions. Unlike shutterer, clutterers are unaware and indifferent towards their speech.

They are suspected to be Genetic, as a symptom of central language disturbance or learning disability, mixed laterality, brainwave irregularity, minimal brain dysfunction and deficits in auditory functioning.

Associated problems
  • Reading,
  • Writing,
  • Spelling problems.
  • Poor motor coordination,
  • Disorganised,
  • Impulsive,
  • Careless,
  • Untidy and suggestible,
  • Difficulty in sustaining Attention,
  • Normal in Intelligence,
  • Delayed Speech and language.
Age Group
Children to adulthood.

Since clutterers can not self-monitor, it is difficult to treat them. They can speak perfectly when they speak slowly. But they can carry it only for short periods.

'Nirmitee' offers comprehensive therapy for clutterers. Audio Cassette is suggested for those who wish to maintain and stabilize their rate of speech as self monitoring tool. This explains various techniques to slow down the rate of speech and gives allowance for practice.