Transcript of Healthweek Segment on Stuttering

Ira Zimmerman transcribed and posted on Stutt-L, September 27, 1997, the portion of the transcript of the PBS Healthweek No. 122 program that was about stuttering, Taped Sept. 25, 1997

(TV Program's Host Sharyl Attkisson)

Host: Which of the following people stuttered as a child-Bruce Willis, Winston Churchill, or Marilyn Monroe? Actually all three stuttered. They are just a few of the people who have overcome stuttering along the road to success. Now thanks to recent advances in our understanding of stuttering, it is getting easier for others to achieve the same kind of success. Healthweek's Diane Vegas has more from Norfolk, Virginia.

Steven Lewis: My name is-is SSSSteven L-L-Lewis

Vegas: The first twenty three years of his life Steve Lewis just couldn't get the words out

[Steve is shown stuttering a little more. IZ]

Vegas: Steve is one of the three million adults who stutter-the majority of them men. For centuries stuttering was thought to be a psychological problem. But Steve says his experience suggests otherwise. It was a physical struggle for him to force out words.

Steve: I can't say those words. Have you ever swam underwater, OK. You are under there running out of air and there is a long way to get to the top. That is what it was like for me to talk.

Vegas: Not any longer. Steve says he is still a stutterer and he always will be. But he has learned how to control his speech. He did it through a therapy called fluency shaping. Fluency shaping is one of two main approaches in the treatment of stuttering. Here patients spend three weeks, eight hours a day relearning how to speak. They start by exaggerating sounds, gradually working up to a normal speaking pattern.

(Ross Barrett, Eastern Virginia Medical School)

Ross Barrett: What we are teaching people is how to breath using the diaphragm, how to phonate using vocal folds and how to articulate sounds using the muscles around the front of the mouth.

Vegas: The results can be dramatic.

Steve: I'll need a sirloin steak medium room service, chicken Parmesan and a New York steak medium.

Vegas: Steve who is a chef now makes a living training other chefs. Something that his stuttering prevented him from doing in the past.

Barrett: Probably about 90% of the patients we see are able to learn to control their speech after the three weeks of therapy.

Vegas: The other main approach to stuttering is behavior modification. As the name implies, this therapy tries to control behaviors that contribute to stuttering.

(Woodruff Starkweather, Ph.D)

Starkweather: There have been a number of studies that have shown that when people become more aware of the details of their behavior- of their thoughts and feelings-that is a sort of beginning-a step on the path to recovery.

Stutterer: There was g-g-group t-t-that's

Starkweather: Tell me what's going on there

Stutterer: I was tensing out in my stomach when my throat closed off on me.

Starkweather: People can become more comfortable with their stuttering. They can become more easy to talk. So there recovery from the problem is quite possible.

Vegas: Some therapists use a combination of behavior modification and fluency shaping. But there approaches while helpful to many don't always work. Jim Spurlock stuttered for thirty years. After trying everything else, he has now turned to an experimental drug treatment. It is a combination of medications normally used for other problems like depression. Jim says it is helping.

Jim: What the medication does it deals with the fear, the anxiety. It makes me feel more relaxed-feel less stressed.

Vegas: Experts disagree on the best treatment for stuttering because they still can't pinpoint the exact cause. After years of believing it was strictly a psychological problem, most experts now agree it has a physical basis awhile.

(Charles Diggs, Ph. D, American Speech Language Hearing Association)

Diggs: There seems to be a family history of people who stutter. And that the actual behaviors of the stuttering seems to reflect an incoordination in the many systems involved in the production of speech.

Vegas: A new study out of the National Institutes of Health seems to support that idea. These sophisticated brain scans show that when a fluent speaker is talking, the left side of the brain is most active- the side that normally controls speech. But in a person who stutters, there is activity in both the left and right halves of the brain. It may be that the right side is trying to compensate for problems on the left.

(Allen Braun, MD National Institutes of Health)

Braun: My thinking is that the underlying disorder is physiological. That is clear. It is exasperated by the psychological context.

Vegas: So the studies continue. One fact that has emerged. That the earlier stutterers begin treatment the better their chance for success. Steve says earlier could be nice. But finding the right therapy even in his twenties was for him is like finding a winning lottery ticket.

Host: Here to tells us more about the treatment of stuttering is Dr. Nan Ratner, Chairman of the department of hearing and speech sciences at the University of Maryland. So we heard that the earlier that you get treatment the better. So if how do you know that a child is really having a problem? We all know that 2 or 3 year olds seem to stutter, all of them practically.

(Nan Bernstein Ratner, Ph.D, University of Maryland)

Ratner: That is absolutely correct. Somebody once said that almost everyone between the ages of 2 and 4 looks like they are stuttering at some point. We are most concerned when children stutter on sounds whether than whole words. When they prolong some sounds like mmmmmmmmommmie. And when they seem to do something we call "blocking. " They open their mouth to talk and nothing comes out. That sort of stuff is not so typical. We would be very concerned particular if it lasted in an unchanged pattern, an unvaried pattern for six months or more. In addition, we are highly concerned if a child concerned if the child is concern. If the child looks like he is having trouble talking or says that he is having trouble talking, he should be taken to a specialist immediately.

Vegas: Children do that. They will tell a parent that they are frustrated or upset.

Ratner: Absolutely. They will say things like, "I can't talk, it's hard, I'm stuck."

Vegas: So how do you treat someone who comes to you for professional help.

Ratner: The very little children are difficult to treat using some of the techniques that you have demonstrated earlier. We tend to first start in trying to manipulate the environment to make the stuttering moments less common and to make them more comfortable with their speech. So we will advise parents to slow their speech rate when talking to children. That seems to reduce the stuttered moments in our research by as much as 50%. The other thing we will tell parents to do is to take more time between conversational turns with their child. We teach the parent and child not to interrupt because that tends to increase the frequency of stuttering. We also tell parents to acknowledge the child's problem when the child is upset with his speech. For example. say something like "that seems like that was tough. Sometime I have trouble talking too." That takes a lot of fear away from the child. It is the fear that creates the secondary symptoms.

Host: In our final seconds, how effective is that treatment if the child is brought to you in the early stages.

Ratner: It is most effective when children don't develop secondary fears and anxieties about their speech. Because if they do develop those fears, nothing we teach them later can be used so efficiently to be fluent. So we really need to make them comfortable with their speech to be able to use those techniques.

Host: Nan Ratner, thank you so much.

added with permission of Ira Zimmerman
September 27, 1997