Communication is an essential aspect of being human. It allows us to connect with our fellow man, share experiences and ideas.
Among the different mechanisms available to us for this purpose, oral language is one of the most widely used, and learning it is one of the aspects to which we devote most time during our development. Since it is a skill that has to be trained progressively, it is usual that while we are dominating it difficulties arise.
But in some cases these difficulties may be indicating the presence of a communication disorder of greater or lesser severity. One of these disorders is stuttering, or dysphemia .
Stuttering or Dysphemia: A Flow Disorder
Stuttering or dysphemia is a communication disorder based on alterations in language fluency . It is a disorder that generally originates in childhood, and in which there are no problems in the subject’s ability to speak or in his or her competence with it, but rather in its implementation. This problem is not due to illness, neurological problems or sensory or intellectual deficits.
The most visible symptom is the existence of repetitions of words or parts of words during speech, as well as blockages and prolongation of sounds. Speech becomes less fluid and interrupted. In some cases, circumlocutions are used in a way that alters sentence structure to prevent perception of the problem in fluency.
This is a problem linked to social speech, since stuttering only appears in the presence of an interlocutor , not existing in subvocal speech nor when the subject is alone. In this way, it can be observed that there is an affective component related to the dysphemia.
The child or even the adult lives all these difficulties with a high level of anxiety , due to the perception of the difficulties as something inappropriate and shameful. Feelings of abnormality or inferiority may arise. In fact, in some cases it can cause a high level of social withdrawal and even the refusal to speak.
This anxiety also tends to cause a higher level of repetition and interruption of speech, so that a vicious circle can be established between anxiety and communication problems. It is therefore a disorder that can cause a serious affectation in the subject and his communicational and social development .
Dysphemia is a communication disorder that becomes chronic in some cases, although in a large number of cases it can go into complete or partial remission if treated correctly and not made chronic.
Types of stuttering
Stuttering or dysphemia is a problem that can present itself in different forms, depending on the type of fluidity alteration that occurs. Specifically, three subtypes of stuttering are usually identified .
1. Tonic Dysphemia
This is a subtype of stuttering in which the problem is the existence of a blockage at the beginning of the speech , suffering a spasm at the beginning of the conversation which after an intense effort allows the expression.
2. Clonic Dysphemia
This subtype of stuttering is characterised by the presence of slight muscular contractions which cause the repetition of whole sounds or syllables during speech.
3. Mixed dysphemia
It is a combination of the two previous ones, appearing initial difficulties when starting the speech and repetitions derived from involuntary muscle contractions.
Origin of this disorder
The causes of stuttering or fluency disorder have often been explored and discussed, with the majority opinion today that the etiology of this communication disorder is found in both biological and environmental factors . It has been observed that there are psychological factors of great relevance for its appearance and maintenance, but the presence of alterations in brain functioning has also been speculated and analysed.
In terms of biological and constitutional aspects, stuttering has been linked to the outcome of competition for activity between the brain hemispheres during development. Many people with stuttering have a right-hemisphere dominance in language and have been found to have a slight time lag between the time they decide to speak and the motor response that allows it. There are also anomalies in the arched fascicle , a brain region linked to language.
On the other hand, on a more psychological and environmental level, the presence of conditioning can be observed in these children and adults, due to the repercussions in the form of mockery or recriminations in the face of their difficulties. This provokes the presence of a high level of anxiety and frustration if it is not able to correct it, which at the same time will generate less fluidity and an accentuation of the difficulties. Although it is not considered the cause of the problem, it can maintain and chronify the problem.
Aspects to consider when treating a case
Fluency of speech can be trained in such a way that the presence of stuttering is greatly reduced. Speech therapy can be very helpful, especially if applied with programs where the need to speed up speech is reduced (due to anticipation of problems many subjects tend to speed up their speech which often causes them to make mistakes) and the level of tension and anxiety.
It is important to take into account that the presence of mockery and criticism can be harmful , since they encourage an increase in the subject’s tension and a more than probable worsening of their communication. The same happens if they are forced to speak or complete sentences for them (a mistake that many members of the environment often make).
In fact, as mentioned above, self-esteem can drop and cause the subject to become withdrawn and inhibited, avoiding social participation and emotional attachment to other people. This contributes to the worsening and chronification of the disorder. Family and social support, and the subject’s perception of it, is very important.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
- Belloch, Sandín and Ramos (2008). Manual of Psychopathology. Madrid. McGraw-Hill. (vol. 1 and 2). Revised edition.
- Santos, J.L. (2012). Psychopathology. CEDE PIR Preparation Manual, 01. Madrid.