Speech Management for People who Stammer (PWS)

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Greater fluency is one of the goals for PWS.  Being able to communicate effectively and comfortably is something we all want.  Whilst it may be difficult to be 100% fluent  all of the time(no one is), it helps if the speech is less of a struggle.

The first thing to understand in the journey of discovery, is what stammering actually is and what you do when you stammer.  It is also important to understand the thoughts, feelings and reactions to stammering, as this has a physical imprint on our speech and may prevent you from living a full and meaningful life.

Physical approaches to manage speech are varied, packaged up in various ways and ‘sold’ on different courses.  What is important to understand is that the brain of a PWS is wired in a different way, so no matter what ‘technique’ is used, it takes a lot of conscious control to change the speaking pattern all of the time.  Changing the way a PWS speaks also interferes with the way language and speech flow in conversation.  Whatever, approach you choose to take, it is important to try it for short periods of time, to build up using it in different situations and with different people. You will need to ‘toughen yourself up’ in the process, so that if it doesn’t always ‘work’ you are kind and compassionate to yourself.

Breathing should be free and easy. It should be well timed with phonation (voice).  This is what often gets interrupted for PWS; the timing of speech at the level of the vocal folds.  This results in tension anywhere in the vocal tract, which often result in tension elsewhere.  Letting go of tension is an important part of the process. Instead of trying to ‘push through’ you should try to ‘let go’. The Valsalva technique is useful to teach this, which I will talk about in a different post.

Block modification is a widely used ‘stammer more fluently’ speech management technique developed by the American, Van Riper.  The speech management section in his whole programme is about breaking habits of tension.  Cancellation, is stopping after the stammered word and saying it again in a smoother, more relaxed way.  In block modification aims to let go of the stammer whilst in the moment of stammering. Pre-block modification manages the approach to saying a word immediately before saying it. All three stages rely on a) noticing and understanding what is happening in that speech  moment b) letting go of tension c) moving forward and going for what you want to say.   The approach goes hand-in-hand with reducing avoidance of  social and communicative situations. It encourages the speaker to live a full and meaningful life and being who they really are.

Other approaches encourage PWS to change their entire speech pattern all of the time. These techniques are known in the trade as ‘speak more fluently’.  The McGuire programme is well-known for this and focuses heavily on breathing methods.

There is also a place for technology – apps and small devices work on altering the way the PWS hears themselves talking, which effects the way the brain plans movement for speech.

Whatever you chose to do on the journey of greater fluency, be patient and kind to yourself.  If something does not work for you, try something different.  If it works some of the time do more of it. Develop a ‘toolkit’ and stay authentically you…

Stammering Therapy – Acceptance

the-kings-speechPeople who stammer have many expectations from therapy.  Most people want to achieve greater fluency, whilst others want to feel better about themselves as communicators.  In my experience, the best outcomes have been achieved when people develop a greater ‘presence’ when communicating and acceptance of the stammer.  Many of us are frequently caught in the ‘mind reading’ trap of thinking that others may think less of us due to our vulnerabilities or perceived flaws.  Therapy for stammering needs to ‘toughen up’ the person to be less bothered by the stammer, worry less about what others may think of them and get on with communicating ideas, feelings and thoughts in an authentic, comfortable way.  The individual also needs to develop greater kindness and compassion towards themselves.  Therapy to achieve all this includes psychological approaches integrated into speech therapy approaches, such as Mindfulness, Acceptance and Commitment Therapy (ACT), Narrative Therapy and CBT.   The Voice and Communication Clinic uses these approaches effectively in the treatment for our clients. Contact us to find out more…