The Academy Award-winning movie The King's Speech is a reminder that stuttering can be a devastating disability. But we know much more now about the causes of stuttering and how to treat it than we did back when King George VI struggled to overcome his stammer. Here, the latest findings…

Who stutters and why: Stuttering almost always begins in early childhood. About 80% of children who stutter outgrow it within six months to a year-of those who don't, only about 1% have problems as adults.

Contrary to popular opinion, stuttering is not caused by psychological problems, emotional trauma or stress. Stress can make it worse, but the underlying causes are thought to involve genetics, as well as factors such as neurophysiology. About 60% of those who stutter have a family member with the same problem.

Nearly everyone who stutters can benefit from the latest treatments, which typically are used in combination and include…

  • Fluency-shaping therapy. Patients work with a speech therapist to correct some of the "errors" that can lead to stuttering. Example: Speaking too quickly or trying to say too much. It's easier to speak fluently when you slow down and use shorter sentences.

King George VI broke down his speeches into groups of three or four words and allowed time for pauses-a technique known as pausing and phrasing

Stuttering modification therapy. This technique, combined with fluency shaping, isn't meant to eliminate stuttering. It helps patients overcome a stutter as it occurs. Example: When a stutter is imminent, the speaker stops speaking for a moment...releases tension from the lips... breathes normally...and then resumes speaking.

  • Cognitive behavior therapy. With cognitive behavior therapy, a person might predict the worst thing that could happen in a feared situation, such as being ridiculed for ordering a h-h-h-amburger. Then the slutleier and therapist work together to test the prediction in some way, such as going together to order a hamburger and really paying attention to others' reactions. Once people experience that the "worst" they imagine usually does not come true, it makes it easier to face other feared situations.
  • Electronic therapy. Anti-stuttering devices change how the stutterer hears his/her own voice. Units vary in size from small enough to be worn in the ear to the size of a deck of cards. There are different types. One type produces "white" noise that distracts stutterers so that they're less focused on their own voices when speaking

Drawbacks: The units are expensive. Some cost as much as $5,000. They're also awkward to use in real-life situations, in part because the listener can overhear the sounds from the headset. But they can be effective when people are reading or giving a presentation in a classroom or business setting

  • Medications. There are no medications for stuttering, although some patients report that they do better when they take antianxiety drugs, such as paroxetine (Paxil).

To find a speech therapist who specializes in stuttering in your area, go to www.stuttering and click on "Resources" and then "Therapy Referral Lists."

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