When thinking about stuttering, we typically think of word and sound repetitions. However, stuttering can also include:
– fixed postures of the mouth, jaw and lips causing ‘prolongations’ (eg. “Wwwwwwwhy?”) or ‘blocks’ (eg. “…………Can I go?”)
– signs of struggle and tension
– unnecessary extra words (eg. “Oh well- um, oh well-well-um”) or body movements (eg. blinking, grimacing, head movements)
Stuttering may therefore be quite visible. It can also interfere with the speaker’s occupational, psychological and social functioning.
We don’t know what causes stuttering but it’s thought to be related to difficulty processing information in the brain and possibly abnormal neuroanatomy. A behavioural approach called prolonged speech is effective for eliminating or reducing stuttering in many adults and adolescents. It involves considerable speech restructuring, starting with a slow, drawling pattern to eliminate stuttering then shaping speech to sound more natural. However, speech may still end up sounding unnatural and individuals need to monitor speech production continuously.
Australian researchers have investigated the behavioural treatment of ‘self-imposed time-out’, in which the individual pauses after stuttering. Advantages include:
– speakers can implement time-out independently in any setting
– time-out seems to be flexible because it’s not dependent on pause length or how consistently time-out is used
– speakers only use time-out after stuttering (prolonged speech must be used constantly), which is likely to be less noticeable than a new speech pattern
– it takes far less time to than prolonged speech and can reduce stuttering significantly
The researchers found that participants:
– ranged in responsiveness from very well to limited.
– sounded more unnatural after treatment than peers who did not stutter, but more natural than individuals using prolonged speech.
– overall, were generally satisfied with the treatment and their speech following treatment.
Over half the participants decreased their stuttering frequency by more than 50% and almost all would recommend time-out.
Although speech restructuring has more predictable outcomes than time-out and overall greater reductions in stuttering rate, the researchers note these advantages of time-out:
– Despite most participants reporting that time-out was hard to use, the procedure is easy to learn and controlling stuttering can be achieved in around 8 hours, much less than needed for most prolonged speech programs.
– Individuals don’t need to pay constant attention to speech, and use time-out less as stuttering reduces.
– It appeared that those who had received previous prolonged-speech treatment found time-out more effective and easier to use.
Further research is needed to explore the promising results of this study. Currently, time-out appears most effective for people with more severe stuttering and who have had previous treatment. Also, self-imposed time-out is probably most effective when combined with other treatments.
Our highly experienced team at Box Hill Speech Pathology Clinic have helped countless families with children who stutter. Vince Borg, principal speech pathologist, has a special interest in this area and offers in-clinic and Skype therapy. Call (03) 9899 5494 to arrange an appointment.
“A Phase II clinical trial of self-imposed time-out treatment for stuttering in adults and adolescents” by Hewat, S., Onslow, M., Packman, A., & O’Brian, Sue in Disability and Rehabilitation, Vol. 28, Iss. 1, 2006.
What is Stuttering?
By Nicola Anglin (Speech Pathologist)