Reasons for stuttering:
There are many reasons for stuttering, such as imitating others' stuttering in childhood, accepting bad hints, being frightened by some kind, being affected by illness, and being afraid of language itself. There are four factors that are most likely to cause the occurrence and development of stuttering:
1) Genetic factors. About 6% of stutterers have a family member who also stutters. Recently, a new research report published in Nature magazine said: Now scientists have determined the importance of special genes in language expression disorders.
2) Childhood development, those children with other language problems or developmental retardation are more likely to stutter;
3) Neurophysiological factors. The latest scientific research shows that stutterers use different areas of the brain to process speech and language compared with those who don't stutter. Pool et al. found that the absolute blood flow in the cortex of stutterers decreased by single photon emission computerized scanning imaging (SPECT), and the blood flow was asymmetrical in several areas, including those involving speech. Fox and other studies show that stuttering speech is related to the extensive over-activation of the right brain: stuttering reading lacks the normal activation of the left hemisphere, on the contrary, it shows the selective deactivation of the frontotemporal system; When fluent speech is produced after fluency induction, the low activation state of temporal lobe auditory system and the inhibition state of frontal lobe speech production system are partially reversed. The stutterer may be the result of the lack of coordinated activities between the two hemispheres corresponding to speech movement.
4) Family motivation, high expectations and tense lifestyle will also promote the occurrence and development of stuttering.
However, generally speaking, stutterers don't stutter in all situations. For example, when they are in front of relatives, singing, speaking to subordinates and reading aloud, the stuttering symptoms are not so serious, and they may even be quite fluent. On certain occasions, such as speaking in a meeting, in an emergency, facing strangers, or meeting the opposite sex, you will appear tongue-tied, even blushing but unable to speak. It can be seen that no matter what factors play a role in stuttering, they are complex and change with the changes of patients' cognitive and emotional state.
correction of stuttering:
stuttering is a very complicated speech disorder. Stutterers not only have abnormal speech behavior, but also are often accompanied by emotional distress and changes in attitudes and ways of life. Different stutterers have various specific manifestations. Due to the complex characteristics of stuttering, the treatment of stuttering is also very complicated and diverse. At present, the treatment of stuttering mostly focuses on non-drug treatment, including speech training, psychotherapy, bioelectrical feedback metronome, changing voice method, delayed voice feedback method, voice masking method and so on. Treatment should be based on the differences of stuttering characteristics, personality, mood and behavior of individuals, and choose the treatment method suitable for individuals.
children's mild and moderate stuttering is self-healing, and severe stuttering needs to be corrected. It is generally believed that about 8% of children's stuttering can heal itself with age, but early intervention by parents or orthodontists is very important. First of all, we should eliminate parents' disappointment and discriminatory attitude, remind children to speak slowly, do not criticize or punish children, ease their nervousness, enhance children's confidence, reduce their fear of stuttering, and make them not pay too much attention to their own speech process. Parents should talk to their children slowly and relaxed, with more pauses, and allow them to speak at their own pace, giving them enough patience and affirmation. Here are several ways to correct stuttering:
1. Speech feedback treatment
When stutterers follow others, they stutter less and speak naturally and fluently. Therefore, foreign countries began to study this principle in 195s, and in 196s, they introduced the delayed auditory feedback DAF instrument to simulate this effect. When the voice of one's speech is changed, it sounds like someone else is saying the same thing to oneself, which helps the stutterer to follow others when he speaks alone, thus improving stuttering immediately. It is believed that stutterers can temporarily speak fluently in two ways: one is the change of endogenous (self-generated) speech production mechanism, and the other is to accept certain external speech feedback during speech production. Endogenous methods to reduce stuttering, such as speaking with a strange accent, lengthening the pronunciation, softening the pronunciation, and other corrective methods based on speech dynamics. Because the endogenous methods to induce fluency are usually related to the mechanism of speech production, some corrected stutterers' fluent speech style is considered unnatural, which may require a lot of cognitive efforts to maintain this kind of speech, and it is difficult to continue to use it in real-life speech situations. The most effective way to improve fluency is to change speech feedback, which uses the "second speech signal", that is, the first speech signal generated by the speaker presents discrete speech signals at the same time, and contains speech actions similar to the first speech signal of the speaker. Different from the endogenous method of causing fluency, the external method of changing speech feedback (ASF) has been proved to make stutterers produce stable and natural fluency immediately, basically without cognitive efforts, although sometimes the effect cannot last.
chorus speech; Masked auditory feedback; Delayed auditory feedback; Frequency altered auditory feedback; Visual choral speech and delayed visual feedback have been proved to reduce the stuttering behavior of some stutterers by 7-1% immediately. It is also found that the changed speech feedback can improve fluency regardless of the speaking speed, and even if it is used in one ear instead of both ears, it can continue to improve fluency.
In the past, this kind of instrument for changing speech feedback was very large and could only be used in the laboratory, which had no practical effect on correcting stuttering. It was not until the 21st century, with the development of science and technology, that a small stuttering appliance, like a "hearing aid", appeared, such as speecheasy. Because it is directly put into the ear and microcomputer language processing technology is applied, the sensitivity and clarity of sound feedback are higher and the effect of correcting stuttering is better. In the United States, Canada, European Union and other countries and regions, speecheasy has achieved remarkable correction effect, and related news has been reported by ABC TV, NBC TV, BBC Radio, USA-Today, People Weekly, Forbes and China CCTV.
second, speech fluency training
speech fluency training aims at adjusting the way of speaking to prevent stuttering, or to control stuttering when stuttering occurs so that verbal communication can continue. Pronunciation, for example, includes techniques such as slowing down, inducing pronunciation, pronouncing softly, using airflow and forming the rhythm and prosody of speech. After mastering these pronunciation techniques, stutterers can speak at a very slow speed, step by step and finally transition to a nearly normal speech speed. In addition, breaking long sentences, changing the way of speaking, and following-up training are also important contents of speech fluency training. Although speech fluency training can't eliminate the physical factors that lead to stuttering and can't completely solve the psychological problems, it is indeed a feasible and palliative adjuvant therapy.
Third, psychotherapy
Scholars at home and abroad have found that stutterers have a fear of stuttering, and they have no clear understanding of this speech disorder, which is manifested in escaping verbal communication with the outside world and being isolated from the outside world in severe cases. The aggravation of psychological disorder makes stuttering symptoms worse, which in turn deepens psychological disorder. As a result of vicious circle, stuttering is deeply rooted. Zhang Jinghui believes that the focus of radical treatment of stuttering should be on the elimination of psychological barriers. The root of stuttering lies in the subjective desire of "not stuttering a word", and all efforts will be in vain if this wrong strong desire is not completely destroyed. To eliminate psychological barriers, stuttering must be allowed unconditionally. The basic spirit of Morita psychotherapy in Japan is that it does not exclude the established fact of stuttering, works like a normal person with stuttering, shows an attitude of "conforming to nature", allows stuttering and does whatever it wants. Huang Yi believes that stutterers are afraid of stuttering, which is actually not the fear of stuttering itself, but the possible adverse consequences of stuttering-loss of quality material life and social status. The essence and core of psychotherapy for stuttering should be to reduce or eliminate the fear of adverse consequences caused by stuttering.
In psychotherapy, behavioral, cognitive and emotional treatments are emphasized. Including:
1. Psychological counseling and psychological support therapy, gradually let patients realize their wrong and paranoid cognitive concepts and consciously replace them with correct thinking concepts. At the same time, listen patiently to the stutterers and fully understand them.
2. Relaxation training, teaching patients to experience the effect of their own muscle contraction and relaxation. Through self-repeated training, the whole body muscles can be relaxed, that is, the body and mind can be relaxed. This can eliminate the patient's nervousness and gradually restore and maintain a good and stable mentality.
3. Systematic desensitization training therapy. In the practice of treatment, self-systematic reading training, caring and heart-to-heart dialogue therapy are adopted; Systematic social communication training, etc. Let patients contact with different environments and different people, relieve tension, fear, anxiety and depression in conversation and reading, and gradually cultivate patients' stable and calm mentality.
4. exposure therapy: for young patients, especially student patients, when they have better curative effect after the above-mentioned related treatments. Patients should be encouraged to take bold and breakthrough exposure therapy, and they should be encouraged to participate in various competitions such as speeches and recitations organized by the school, so that they can exercise themselves in various occasions and establish their determination to be self-reliant, confident and self-reliant.
Fourth, other treatment methods
Breathing training: The respiratory organs and pronunciation organs of stutterers are generally normal, but stutterers often have disordered breathing, improper breathing methods, or uncoordinated breathing and pronunciation. Breathing therapy that conforms to the rules of pronunciation, such as practicing breathing exercises, coordinating breathing and pronunciation training, combined with other treatment methods can further improve stuttering.
biofeedback therapy: relaxation training through biofeedback, such as breathing and EMG feedback; It can reduce stuttering and improve the fluency of speech.
drug therapy: haloperidol is considered to be an effective drug for stuttering, but it has great side effects. Clomipramine (tricyclic antidepressant with strong 5-hydroxytryptamine recovery blocking effect) can significantly reduce the severity of stuttering. Some scholars have suggested that calcium channel blockers and cholinergic blockers can be tried to treat stuttering.