Stuttering

Article

October 28, 2021

Stuttering (a name sometimes associated with the qualifiers persistent, developmental or chronic) is a speech disorder affecting the fluidity of speech. It is characterized by frequent disfluencies (involuntary interruptions in speech) typical of stuttering, including: repetitions of sounds, syllables or words, sound extensions, blockages (silent pauses during which the person is unable to produce the desired sound) These disfluidities can be accompanied by physical tension and secondary behaviors (blinking of the eyes, movement of the face or body, etc.). The person who stutters can also develop avoidance behaviors and negative reactions related to communication. The exact definition of developmental stuttering by the various relevant institutions and medical disciplines is the subject of debate. The ICD-11 of the World Health Organization (WHO) and the DSM-5 of the American Psychiatric Association classify this fluency disorder among "neurodevelopmental disorders". Stuttering can have significant psychological and social repercussions. When severe, it is recognized in a large number of countries, including France, as being a handicap. Some people who stutter nonetheless fear this “label” and claim “not to feel disabled”.

Description

General

There is no univocal definition recognized by all stakeholders on the boundaries of stuttering, its manifestations, its consequences and its causes. Stuttering has long been seen (and still is by some) as purely psychological. Its intermittence on words and sentences, depending on the conditions, can lead to think so, in the absence of more data and knowledge. In addition, a stutterer usually stutters much less when alone - or thinks they are alone -, when singing, when playing a role, when imitating someone, when taking an accent, when 'she speaks to the beat of a metronome. Since the end of the 20th century, discoveries in brain imaging and genetics have shown that psychology is not enough to explain stuttering or to summarize observed or experienced stuttering. Some cerebral weakness related to motor speech production seems highly likely, although stuttering appears to require other factors to develop. The notion of biological predispositions to stuttering is finding more and more arguments through research. These predispositions would be a necessary condition, or at least important, for the onset of stuttering. This now leads to the acceptance of stuttering as a medical problem, before being relational and social.

Classification according to Western phoniatry

Phoniatrists and speech-language pathologists describe some audible manifestations of stuttering as follows: Clonic stuttering: repetitions of syllables or "phonemes" such as an article, a preposition or a monosyllabic adverb preceding a word felt as "charged with obligation" and anticipated blocking on its first syllable, or the first syllable of such a word if the anticipation relates to a following syllable. ex. : "One coffee please" or "One coffee please". Tonic stuttering: realization of the blockage on a word, often one that breaks the silence or gives meaning to the intervention, and unblocking by the emission of the start of the planned blocking syllable in a glottic explosion after a period of resistance. ex. : "A ..... cccccafé please". Tonic-clonic stuttering: a combination of the two previous types of stuttering Some specialists add the

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