Public Awareness, Therapy and Research could be more accurately and succinctly discussed with the common use of agreed definitions.
Definitions in brief
- Stuttered Speech Syndrome: stuttering with feelings of panic associated with loss of speech control and concern over its social implications; symptoms arising from the compounding of the speech event of stuttering with the psychosocial pathology of Social Anxiety Disorder (SAD).
- Covert Stuttering: a type of stuttering speech event referring to word omitance, substitution and circumlocution in an effort to avoid overt stuttering.
- Stuttering: a speech event that can be either overt as characterised by repetitions, prolongations and blocks, or covert as the speaker gives the pretence of fluency by omitting, substituting and circumlocuting to avoid overt stuttering.
- Psellismophobia: fear of overt stuttering
Why does Stuttering (also known as Stammering) remain such a misunderstood condition?
- Reason 1. Lack of words and agreed definitions to describe differences in the “stuttering” experience. Not everyone who suffers the speech disruption of stuttering also suffers clinically significant psychosocial pathology. For example Isaac Newton, Charles Darwin, Marilyn Monroe and King George VI all stuttered but did they also suffer the associated disability of Social Anxiety Disorder that seems to affect at least 50% of people who stutter?
- Reason 2. Not everyone who stutters uses word substitution as a speaking strategy (covert stuttering) to hide the extent of their dysfluency. Therefore the frequency of stuttering is not able to be accurately appreciated by the listener.
- Reason 3. Stuttering is situationally specific. People who may stutter in one social setting will not stutter in another situation.
How could this lack of understanding be corrected?
Besides containing advice for people who stutter, this website aims to show how better understanding, recognition, treatment and research of stuttering could be achieved by using terminology to distinguish between:
- the speech events of stuttering both overt and covert (ie. repetitions, prolongations, blocks, word substitution and circumlocution); and
- the associated clinically distressful non-speech events (eg. “I avoid”, “I am hopeless”, “I feel anxious”). This is more generally described as sound and word fears, situational fears and avoidances, anxiety, tension, self-pity, stress, shame, and panic caused by a feeling of loss of control of speech. However where these thoughts, feelings and actions exist to a clinically significant level then they could be briefly and accurately described by the term Social Anxiety Disorder.)
Historical Situation. Both speech and non-speech events have previously been regarded as part of the “stuttering” disorder even though clinically distressful non-speech psychosocial pathology is not always experienced by people who stutter. This is confusing as people who stutter may be having entirely different experiences even though their dysfluency may seem similar to the listener. Until now there has been no distinguishing label as the only term available has been “stutterers” aka “people who stutter”. Imagine the confusion and restriction to therapy that would result if the only term used to define those who coughed was “coughers” rather than share common understanding through words like asthma, tuberculosis and emphysema etc.
What specific words and terms are appropriate?
Specifically this site seeks to develop the understanding of stuttering by:
- Promoting the new term ‘Stuttered Speech Syndrome’ (linking the speech event of stuttering with the psychological condition of Social Anxiety Disorder (SAD)).
- Clarifying the old term ‘covert stuttering’ as a type of stuttering speech event referring to word omittance, substitution and circumlocution in an effort to avoid overt stuttering. The total extent of speech disruption can only be measured if both overt and covert stuttering are considered.
How are the terms Stuttered Speech Syndrome and Covert Stuttering useful?
The use of the term Stuttered Speech Syndrome will…..
- Draw attention to the impact of psychosocial pathology (specifically Social Anxiety Disorder) on the person who stutters life.
- Allow convenient description of differences in stuttering impact as measured by severity of associated Social Anxiety Disorder.
- Indicate that therapy for both stuttering and SAD is appropriate. It is important for people who stutter and therapists to know that Cognitive Behavioural Therapy has been shown to be an extremely effective treatment for SAD. Also a person suffering from SAD is unable to think logically in what they perceive to be stressful situations. In this case rational advice on speech production and technique are unable to be followed. Hence the presence of SAD restricts the ability of the person who stutters to progress with fluency shaping therapy. Therapy for SAD is paramount in this case.
The new definition of covert stuttering will…
- Prevent confusion in discussions of associated psychosocial pathology.
- Allow true measurement of total speech disruption.