The King’s Speech – Disorder and Therapy

What do Moses, Demosthenes, Charles Darwin, Henry James, Lewis Carroll, Winston Churchill, W. Somerset Maugham, and Marilyn Monroe have in common?

All of them had a stammering – Americans call it a stuttering – problem. King George VI of England too suffered from this malady, and how he managed to overcome it has been a source of motivation for many with similar problem and makes a fascinating study for biographers and movie makers.

“The King’s Speech”, is a biopic set in pre-World War II England about soon-to-be King George VI who has to conquer a stammer  that has hindered him since childhood and makes public speaking an agony. The film chronicles the relationship between the to-be King and his speech therapist, helping the king to control his stutter enough to get through a wartime speech.

Directed by Tom Hooper, the film had stars like Colin Firth, Geoffrey Rush, Helena Bonham Carter and a talented British cast. It won several awards, including the Academy award for best picture , best director, best original screenplay and best actor for Colin Firth performance. King George never completely defeated his stutter, he only managed to overcome the characteristic repetition of sounds at the beginnings of word.

In fact, in old films you can still see him pausing, grimacing, gathering his courage and moving on as best he can. More than 50 years later, therapies for those who stutter aren’t that different from the King’s. Many, like King George’s, focus on learning ways to minimize the impact of the disorder. They involve learning to speak more slowly, regulating breathing, and gradually progressing from single-syllable responses to longer words and more complex sentences.

Here is a video- the Real King’s Speech of King George VI made on September 3, 1939

 

 

What is stuttering?

Stuttering, also referred to as disfluent speech or stammering is a speech fluency disorder. Normally, we make speech sounds through a series of precisely coordinated muscle movements involving breathing, phonation (voice production), and articulation (movement of the throat, palate, tongue, and lips). These muscle movements are controlled by the brain and monitored through our senses of hearing and touch. A person who stutters knows exactly what he or she would like to say but has trouble producing a normal flow of speech.

People who stutter repeat sounds, syllables, or words; prolong sounds; and/or experience unwanted interruptions—known as blocks—in their speech. It can severely hinder communication, interpersonal relationships and negatively affect their influence job performance, opportunities and a person’s quality of life.

What are the causes and types of stuttering?

The precise mechanisms that cause stuttering are not understood. Stuttering is commonly grouped into two types: Developmental stuttering – The most common form of stuttering is Developmental stuttering and it occurs in young children while they are still learning speech and language skills. Some scientists and clinicians believe that developmental stuttering occurs when children’s speech and language abilities are unable to meet the child’s verbal demands. Neurogenic stuttering – Neurogenic stuttering may occur after a stroke, head trauma, or other type of brain injury. With neurogenic stuttering, the brain has difficulty coordinating the different brain regions involved in speaking, resulting in problems in production of clear, fluent speech. Further research could provide new insights into what causes stuttering.

Who is at risk of stuttering?

People have recognized stuttering as a speech disorder for thousands of years. They’ve speculated about what causes it for just as long.  At one time, all stuttering was believed to be psychogenic, meaning caused due to experiencing a psychological disturbance or emotionally traumatic event. Today, some people still mistakenly think that stuttering is caused by psychological or social problems, or nervousness and anxiety.

In King George’s time, it was thought to stem from childhood emotional trauma or an unhealthy attachment to a parent, usually the mother. The disorder can affect people of all ages but begins most frequently in young children between the ages of 2 and 6, as they are developing their language skills.

Important Facts about Stuttering

  • About 1% of adults stutter worldwide i.e Stuttering affects more than 3 million people in America and another 60 million worldwide
  • Approximately 5 to 10 percent of all children stutter for some period, lasting from a few weeks to several years
  • 75% to 85% of those who stutter in childhood will outgrow it when they become adults, while the 15-25 percent may have it persist as a lifelong communication disorder
  • In young age, Boys are more than twice as likely as girls to stutter
  • In adulthood, Men are 3 to 4 times more likely to stutter than women

What are the symptoms of stuttering?

Symptoms of stuttering can vary significantly throughout a person’s day. In general, speaking before a group or talking on the telephone may make a person’s stuttering more severe, while singing, reading, or speaking in unison may temporarily reduce stuttering. Speech disruptions may be accompanied by struggle behaviors, such as rapid eye blinks or tremors of the lips. Many children stutter as toddlers and pre-schoolers but grow out of it. You should take your child for evaluation if:

  • stuttering has continued for 6 months or longer
  • your child has other problems with speech or language
  • your child has strong fears or concerns about stuttering
  • there is a family history of stuttering

A variety of treatments are available. Talk to a speech-language pathologist—a health professional trained to test and treat children with voice, speech and language problems—about the options.

How is stuttering diagnosed?

Stuttering is usually diagnosed by a speech-language pathologist, a health professional who is trained to test and treat individuals with voice, speech, and language disorders. The speech-language pathologist will consider a variety of factors, including the child’s case history (such as when the stuttering was first noticed and under what circumstances), an analysis of the child’s stuttering behaviors, and an evaluation of the child’s speech and language abilities and the impact of stuttering on his or her life.

When evaluating a young child for stuttering, a speech-language pathologist will try to determine if the child is likely to continue his or her stuttering behavior or outgrow it. To determine this difference, the speech-language pathologist will consider such factors as the family’s history of stuttering, whether the child’s stuttering has lasted 6 months or longer, and whether the child exhibits other speech or language problems.

How is stuttering treated?

Although there is currently no cure for stuttering, there are a variety of treatments available. The nature of the treatment will differ, based upon a person’s age, communication goals, and other factors. If you or your child stutters, it is important to work with a speech-language pathologist to determine the best treatment options.

Therapy for children

For very young children, early treatment may prevent developmental stuttering from becoming a lifelong problem. Certain strategies can help children learn to improve their speech fluency while developing positive attitudes toward communication. Health professionals generally recommend that a child be evaluated if he or she has stuttered for 3 to 6 months, exhibits struggle behaviors associated with stuttering, or has a family history of stuttering or related communication disorders. Some researchers recommend that a child be evaluated every 3 months to determine if the stuttering is increasing or decreasing. Treatment often involves teaching parents about ways to support their child’s production of fluent speech. Parents may be encouraged to:

  • Provide a relaxed home environment that allows many opportunities for the child to speak. This includes setting aside time to talk to one another, especially when the child is excited and has a lot to say.
  • Listen attentively when the child speaks and focus on the content of the message, rather than responding to how it is said or interrupting the child.
  • Speak in a slightly slowed and relaxed manner. This can help reduce time pressures the child may be experiencing.
  • Listen attentively when the child speaks and wait for him or her to say the intended word. Don’t try to complete the child’s sentences. Also, help the child learn that a person can communicate successfully even when stuttering occurs.
  • Talk openly and honestly to the child about stuttering if he or she brings up the subject. Let the child know that it is okay for some disruptions to occur.

Stuttering therapy

Many of the current therapies for teens and adults who stutter focus on helping them learn ways to minimize stuttering when they speak, such as by speaking more slowly, regulating their breathing, or gradually progressing from single-syllable responses to longer words and more complex sentences. Most of these therapies also help address the anxiety a person who stutters may feel in certain speaking situations.

Drug therapy

The U.S. Food and Drug Administration has not approved any drug for the treatment of stuttering. However, some drugs that are approved to treat other health problems—such as epilepsy, anxiety, or depression—have been used to treat stuttering. These drugs often have side effects that make them difficult to use over a long period of time.

Electronic devices

Some people who stutter use electronic devices to help control fluency. For example, one type of device fits into the ear canal, much like a hearing aid, and digitally replays a slightly altered version of the wearer’s voice into the ear so that it sounds as if he or she is speaking in unison with another person. In some people, electronic devices may help improve fluency in a relatively short period of time. Additional research is needed to determine how long such effects may last and whether people are able to easily use and benefit from these devices in real-world situations. For these reasons, researchers are continuing to study the long-term effectiveness of these devices.

Self-help groups

Many people find that they achieve their greatest success through a combination of self-study and therapy. Self-help groups provide a way for people who stutter to find resources and support as they face the challenges of stuttering.

What do recent studies and research indicate?

Most scientists and clinicians believe that developmental stuttering stems from complex interactions of multiple factors. Recent brain imaging studies have shown consistent differences in those who stutter compared to non-stuttering peers. The researchers propose that part of the brain dedicated to fluency of speech may be uniquely sensitive to problems caused by defects in these genes i.e it may also run in families as genetic factors contribute to this type of stuttering.

Researchers at the National Institute on Deafness and Other Communication Disorders (NIDCD) have identified four different genes in which mutations are associated with stuttering.They hope that one day stuttering can be treated as a biological disorder with a medical cure, not a character weakness.  Click here to know more.

Did you know that 22nd October is observed as the International Stuttering Awareness Day (ISAD).  Please visit their website to know more.

Image courtesy and source: https://www.imdb.com/title/tt1504320/mediaviewer/rm2203260928

Author: Blog Desk
Blog Desk comprises many freelance medical and science writers with over a decade of experience in journalism. They have masters qualifications in journalism, science and management and have contributed significantly to the building of this portal. The authors can be contacted at blogdesk (at) skillmd (dot) com.

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