Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, October 24, 1995 TAG: 9510240028
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: PAUL ARNOLD THE WASHINGTON POST
DATELINE: LENGTH: Long
The phone ``always rings unexpectedly, and so I would get nervous right before I answered it,'' Derrick explained. ``I would stutter when I did answer it, because I didn't know who was calling. I felt uncomfortable and didn't like it.''
For the approximately 2.5 million Americans who stutter, everyday activities such as ordering a pizza, chatting at the office water cooler or asking directions can be formidable. For them, such simple communication requires overcoming both obvious symptoms and subtle pains.
``I would stutter when I had to read stuff in class and talk to adults,'' said Derrick, of Washington, D.C. ``I started to get down on myself, because I wished I didn't stutter. That's when my mother and I decided to find some help with my problem...I don't want to be stuttering all my life.''
Stuttering, once thought to be a physical problem with the mouth or tongue, is now believed by experts to be rooted in neurological problems. The exact cause is still not understood, but therapists have made strides in treating stuttering with new techniques. And the therapies have been enhanced - especially for children - with computer technology.
Speech pathologists today place just as much emphasis on changing how stutterers feel about speaking as they do on changing the mechanics of their speech. Two methods of treatment - stuttering modification and fluency shaping - dominate the field.
Stuttering modification is counseling designed to lessen the fear and anxiety stutterers have. Stutterers learn to reduce the tension that causes them to become completely blocked in speech.
When people gain confidence in their communication skills and don't fight to stop their stuttering, the frequency of stuttering often drops dramatically, according to officials at the American Speech Language Hearing Association.
``We take the kind of stuttering they are doing and make them do it better,'' said Walt Manning, a speech pathologist and researcher at the University of Memphis and a former stutterer. ``We adjust their feelings about speaking and help them to realize they can get through a stutter successfully.''
Because normal speakers do stutter occasionally, recipients of this ``stutter-easy'' therapy can learn to speak without noticeable hesitations.
``I consider myself a reformed stutterer although I still stutter,'' said Peter Kupferman of Reston, Va., who underwent the therapy. The 49-year-old astronomer said that by age 25 he had tried ``all sorts of therapy'' that didn't work before a therapist encouraged him to speak in public - intentionally displaying his stuttering - and stop hiding his problem.
Gradually he was able to get over what he calls ``every stutterer's greatest fear'': being exposed as a stutterer.
``I no longer fear sounding like Porky Pig,'' he said. ``I speak out when I want to and interrupt other people. I never used to do that. I changed my whole image of myself.''
Fluency shaping, which is used more with children than adults, is essentially physical therapy for the speech-production system. Stutterers are taught devices they can use - speaking more slowly and softly, linking words, using light articulation and enunciating all syllables - that may eventually prevent the problem. Ideally, children are able to use these devices until they become second nature.
Computer systems have been used with fluency shaping. They provide therapists with on-screen biofeedback regarding patients' respiratory curves and speech patterns.
Such programs are very popular with children, because they are made into video games that they can win by reaching desirable speech targets. Mastery of the video game requires patients to monitor the biofeedback while they manipulate breathing and speech to the point of fluency. Eventually, they become accustomed to what they must do to speak fluently, and the computer crutch is no longer needed.
Researchers at the National Institutes of Health say these therapy methods have not been subjected to the kind of well controlled studies that would determine whether the treatments are truly effective.
Clinical trials require a control group that does not receive such help, and there is an unwillingness on the part of researchers and parents to prevent any children from receiving therapy. Studies have been conducted without using control groups, but their results cannot determine whether therapy improved stutterers' speech or the problem simply resolved itself with time, the NIH officials said.
Stuttering is a disorder in which the rhythmic flow of speech is disrupted by rapid-fire repetitions of sounds, prolonged vowels and complete stops called verbal blocks.
A stutterer's speech is often uncontrollable - sometimes faster, but usually slower than the average speaking rate. Sometimes, too, the voice changes in pitch, loudness and inflection. Some people may stutter only over certain words or in particular situations.
Some well-known stutterers who overcame their problems are actor James Earl Jones, entertainer Jack Paar, singer Carly Simon, country music star Mel Tillis, novelist John Updike and statesman Winston Churchill, one of the finer orators of this century.
While the symptoms of stuttering are easily recognizable, the cause remains a mystery.
Many children between the ages of 2 and 4 go through a stage when they seem to stutter. This can be disturbing to parents, who don't know if it is the first sign of a long-term problem. Such speech problems are more common in these pre-school years, particularly when a child is learning to express new, abstract concepts.
However, if a child seems aware of his speech problem, or if it is accompanied by signs of tension or frustration, speech pathologists suggest a professional evaluation.
The key to successfully treating the problem, speech pathologists say, is catching it early - before years of embarrassment and the development of compensatory tricks forge a more severe and persistent speech problem. For this reason, children successfully complete therapy faster and more easily than adults.
In most cases, treatment may not end stuttering completely, but it can reduce the problem and make the person speak more comfortably and with greater assurance.
``Stuttering is not curable in the sense of what is medically curable. Try to think of it as a chronic disease like asthma that can be managed successfully,'' said Nan Ratner, who chairs the University of Maryland's Hearing and Speech Sciences department.
``The irony in therapy is that most stutterers have an all-or-nothing approach to it,'' Kupferman said. ``They think they must talk perfectly, or their therapy is unsuccessful. I have come to realize that you don't have to be a perfect speaker in order to communicate. You just have to keep working at it.''
Four months ago, Derrick Lane started speech therapy and a regimen of fluency shaping. He proudly says the weekly therapy sessions at Children's Hospital's Hearing and Speech Clinic in Washington have improved his speech - and his confidence - tremendously.
While reading the newspaper during his last therapy session, Derrick reached a personal target. He was able to complete successfully several paragraphs of an article without stumbling.
``I used the techniques,'' he said with a big smile to his therapist. ``I've been thinking about it, and I've been doing good.''
by CNB