FAQ – Answers to your most frequently asked questions
“How many people actually stutter?”
Around 5% of all children show stuttering symptoms in the first nine years of life, lasting at least 6 months. 50% of children start having speech disorders before the age of 4 and 90% by the age of 6. However, in only 1% of the population the stuttering solidifies and becomes chronic. In Germany, about 800,000 people are affected. In childhood twice as many boys as girls stutter, whereas in adulthood five times as many men as women stutter.
“What are the causes of stuttering?”
The causes of stuttering consist of genetic, neurological and reinforcing psychological factors. Due to the fact that stuttering often runs in families, it is presumed that stuttering is predisposed. This means that stuttering can be inherited, but does not have to necessarily. Many people have a predisposition to stuttering, but stuttering is not necessarily triggered in everyone. Basically, a distinction must be made between the cause and the trigger of stuttering. Traumatic experiences in childhood, for example the divorce of parents or an accident, are not the cause of stuttering according to all that is known today, but can be a trigger and thus promote its occurrence. In addition, changes in the brain’s anatomy and neurofunctional processes probably play a causal role.
“How should I react to my child’s initial speech imprecision?”
Basically, if the child notices the stuttering itself, then it should be addressed in a child-friendly manner. Making stuttering a taboo usually has a counterproductive effect and often leads to a cycle of avoidance strategies, increasing shame, stronger stuttering and chronicity in the worst case. The topic should be “carefully” addressed, in an open communication and the child should not be colored an outsider. It is important that the parents react patiently to the stuttering, let the child finish and allow him/her enough time to speak. The child should not be under pressure to perform when speaking, because this increases the likelihood of reinforcing the stuttering.
“At which age should a stuttering therapy be started?”
Despite intensive scientific research, it is still not possible to predict the course of stuttering for an affected person. Thus, it is difficult to predict whether children who stutter will become normal speakers due to remission or whether their stuttering will become chronic. The optimal starting point for a stuttering therapy can’t be generalized, as the onset and course of stuttering vary for each child.
A counselling session for the parents with an experienced therapist is a recommended step when the first inconsistencies occur. It can prevent a negative progression as well as years of unsuccessful therapy marathons later on.
“How should the topic of stuttering be dealt with at school?”
In daily school life, the topic of stuttering should not be taboo. Dealing openly with the topic reduces the inner pressure and speaking fears of the stuttering person. This makes it easier for classmates and teachers to deal with stuttering people, as they’re normally having little to no experience with stuttering.
In order to ensure that the stuttering person doesn’t suffer any disadvantages due to speech impairment, a so-called “disadvantage compensation” can be requested and agreed upon with the school. This includes individual compensatory services, which are based on the speaking abilities of the person who stutters.
“Can stuttering still be treated in adulthood?“
In general, the earlier the therapy starts, the better. If the stuttering persists into adulthood, there is very little chance of a complete recovery. However, adult stutterers can learn to deal with it confidently and use targeted speech techniques, thus achieving speech control and a much more fluent speech.
“Why can you speak more fluently in some situations than in others?”
Speech fluency can vary depending on the situation in general, how the affected is feeling and the personal state of mind. In addition, our voice is used in a very varied way every day. We all know situations that are sometimes more difficult or easier to handle than others, we’re all having a bad day once in a while – as do stuttering persons as well. And all of this affects the speech.
“Why can almost all people who stutter sing fluently?”
When you sing, your vocal chords remain in vibration permanently and different areas of your brain are active in contrast to situations where you’re speaking.
“How do I behave when talking to someone who stutters?”
Quite simple, the rule is to behave the same way as you would with any non-stuttering person. But many listeners (out of ignorance, impatience, helplessness, etc.) take the words out of the stutterer’s mouth, finish their sentences, give well-meaning advice like “take your time” or “speak slower”, which is not helpful at all. Even the assumption that looking away will make it easier for the person who stutters may be correct in some cases, but it usually means additional uncertainty for them. It is best to listen patiently and wait until everything has been said.
“Should stuttering be discussed with the person affected?”
Talking about stuttering and dealing with it openly can often make the situation much easier for everyone involved. If stuttering is made a taboo, this can lead to avoidance of certain situations, the development of speech fears and further (self imposed) restrictions throughout life. While many affected deal openly with stuttering in order to reduce the speaking pressure, it is difficult for others to talk about the stuttering, the accompanying feelings and the behaviors associated with it.
“Does stuttering have anything to do with improper breathing?”
To date, there is no evidence that incorrect breathing is the cause of stuttering. Often incorrect breathing results from tricks and strategies used to avoid stuttering or to dissolve a speech block more quickly. For example, some stutterers get into the habit of exhaling before speaking or speaking while inhaling. This may be a short-term relief for some, but it does not lead to more fluent speech in the long run.
“What distinguishes a reputable stuttering therapy?”
There is quite a range of different stuttering therapies and it is usually difficult to find a reputable therapy that is tailored to one’s individual needs. And to make things harder, there are unfortunately some unsound providers. Any stuttering therapy that promises the patient a cure in the shortest possible time should be viewed very critically. Achieving such short-term freedom from symptoms is not difficult, but it has nothing to do with “healing” and will nearly always just be a short term achievement.
The goal of any reputable stuttering therapy is the sustainable and long-term speech control that in ideal circumstances sticks for a lifetime. To achieve this, intensive training with a specific method accompanied by a well-structured long-term follow-up is essential. This is a crucial and important criterion for a serious and successful stuttering therapy, as is the continuous monitoring of success as well. You can also see the reliability and the seriousness of a given therapy in the fact that health insurance companies cover the costs of the therapy – they won’t do this for any mumbo-jumbo.
“Why is group therapy more effective than therapy in individual sessions?”
The right type of therapy depends on the individual stuttering person. While therapy in individual one-on-one sessions focuses on building a trustful atmosphere between the stutterer and the therapist, a group therapy convinces with motivating through like-minded people and the group dynamics. In these group sessions affected people share their experiences, thoughts and overcome negative speech experiences, all important steps for the success of the therapy. Support from fellow clients and the pursuit of a common goal also increases motivation and the determination. The thesis that group therapy tends to be more successful than therapy in individual sessions has been proven by scientific studies, but it certainly depends on the individual person. This is also stated in the medical S3 guidelines.
“Which form of therapy is recommended for a person who stutters?”
Generally we can make a distinction between out-patient and intensive therapy. But assigning a certain type of therapy in general, valid for any stuttering person, is difficult. Nonetheless a high degree of effectiveness and efficiency has been proven for intensive therapy. Also this form of therapy is recommended in the S3 medical guidelines. For a successful stuttering therapy it is essential that the learned techniques are consolidated and worked with, that mannerisms are changed in the long run and that affected people experience an accompanied transfer into everyday life. Unfortunately, out-patient therapy usually does not meet these criteria due to structural reasons and the lack of intensity.
The choice of method also depends on individual factors. However, whether someone prefers to work with soft speech, stuttering modification, Lidcombe or others: a specific, proven and effective therapy is essential.
Non-specific treatments often show unsatisfactory results and therefore cannot be recommended.
“Can stuttering be cured?”
“Cure” in the context of the disorder stuttering is still controversially discussed. A “cure” in the sense of a complete overcoming of stuttering is not to be expected, especially in adulthood. In preschool age, however, the chance of a spontaneous cure is about 60-80% and is significantly higher in girls than in boys. After the age of 6, the spontaneous cure rate decreases steadily and is rather the exception than the rule after puberty.
“Are the costs of intensive stuttering therapies covered by health insurance?”
All therapy costs of the Kassel Stuttering Therapy are covered by all major german health insurance companies through selective contracts. This means that the statutory and also the private health insurances pay the costs of the intensive course, as well as all follow-up modules and thus the Kassel Stuttering Therapy is one of the few intensive therapies that is covered by the health insurances. However, travel costs, accommodation and meals have to be covered by the patient.
So far no selective contracts exist with insurance companies not situated in Germany. We’re working to find partners in different countries, so please inquire for your country.
“Is there a medicine for stuttering?”
No! For several decades, researchers have been trying to develop a remedy for the complex disorder of stuttering, but so far without success. Drugs that are supposed to reduce or “cure” the speech impediments only help temporarily, if at all. But all these medicines that promise a cure should be treated with greatest caution, as strong side effects are usually the result.
“What can I expect of stutterer support groups?”
Stutterer support groups can not replace a stuttering therapy, but they can be a very helpful and important addition, supporting people with stuttering and their well-being and comfort.
Stuttering therapies primarily have the goal of showing the affected person possible courses of action that enable him or her to speak more fluently. But the intention of every stuttering support group, however, is the (experience) exchange and contact with other people who stutter. Of course these two things are interrelated. Regular attendance of a self-help group can promote the success of any form of therapy. A very good contact in this context is the BVSS: Bundesvereinigung Stottern und Selbsthilfe.