Reasons for stuttering:
There are many reasons for stuttering, such as imitating others when I was a child, accepting bad hints, being frightened by some kind, being affected by illness, being afraid of the language itself and so on. There are four factors that are most likely to lead to the occurrence and development of stuttering:
1) genetic factors, about 60% stutterers have a family member who stutters. Recently, a new research report published in Nature magazine said: Now scientists have determined the importance of special genes in language expression disorders.
2) children's development, those children with other language problems or developmental retardation are more likely to stutter;
3) Neurophysiological factors. The latest scientific research shows that stutterers use different areas of the brain to process speech and language compared with people who don't stutter. Pool et al. found that the absolute blood flow in the cerebral cortex of stutterers decreased by single photon emission computerized scanning imaging (SPECT), and the blood flow was asymmetrical in several areas, including those involving speech. Fox and other studies show that stuttering speech is related to the extensive over-activation of the right brain: stuttering reading lacks the normal activation of the left hemisphere, but on the contrary, it shows the selective inactivation of the frontotemporal system; When fluent speech is produced after fluency induction, the low activation state of temporal lobe auditory system and the inhibition state of frontal lobe speech production system are partially reversed. The stutterer may be the result of the lack of coordinated activities between the two hemispheres corresponding to speech movement.
4) Family motivation, high expectations and tense lifestyle will also promote the occurrence and development of stuttering.
Generally speaking, however, stutterers do not stutter in all cases. For example, when they sing in front of relatives, talk to subordinates and read aloud, their stuttering symptoms are not so serious, and they may even be quite fluent. In certain occasions, such as speaking in a meeting, meeting with an emergency, facing strangers, or meeting the opposite sex, you will appear tongue-tied, even blushing but unable to speak. It can be seen that no matter what factors play a role in stuttering, they are complex and change with the changes of patients' cognitive and emotional state.
Correction of stuttering:
Stuttering is a very complicated language barrier. Stutterers not only have abnormal speech behavior, but also are often accompanied by emotional distress and changes in attitudes and lifestyles. Different stutterers have different specific manifestations. Because of the complicated characteristics of stuttering, the treatment of stuttering is also very complicated and diverse. At present, the treatment of stuttering is mainly non-drug treatment, including speech training, psychotherapy, bioelectric feedback metronome, voice change method, delayed sound feedback method, sound masking method and so on. Treatment should be based on the differences of stuttering characteristics, personality, mood and behavior of individuals, and choose the treatment method suitable for individuals.
Children's mild and moderate stuttering is self-healing, and severe stuttering needs to be corrected. It is generally believed that about 80% of children's stuttering can heal itself with age, but early intervention by parents or orthodontists is very important. First of all, we should eliminate parents' disappointment and discriminatory attitude, remind children to speak slowly, don't criticize or punish them, ease their nervousness, enhance their confidence, reduce their fear of stuttering, and let them not pay too much attention to their own speech process. Parents should talk to their children slowly and relaxed, pause more, allow their children to speak at their own pace, and give them enough patience and affirmation. Here are some ways to correct stuttering:
First, speech feedback therapy.
When stutterers follow others, they stutter less and speak naturally and fluently. Therefore, foreign countries began to study this principle in the 1950s, and in the 1960s, the delayed auditory feedback DAF instrument was introduced to simulate this effect. When a person's voice changes, it sounds like someone else is saying the same thing to himself, which helps the stutterer to follow others when talking alone, thus improving stuttering immediately. It is believed that stutterers can speak fluently temporarily in two ways: one is the change of endogenous (spontaneous) speech production mechanism, and the other is the acceptance of certain external speech feedback during speech production. Endogenous methods to reduce stuttering, such as speaking with strange accent, lengthening pronunciation, softening pronunciation, and other correction methods based on speech dynamics. Because the endogenous methods to induce fluency are usually related to the mechanism of speech production, the fluent speech style of some corrected stutterers is considered unnatural, which may require a lot of cognitive efforts to maintain this kind of speech, and it is difficult to continue to use it in real life speech situations. The most effective way to improve fluency is to change voice feedback, which uses "second voice signal", that is, the first voice signal generated by the speaker presents discrete voice signals at the same time, and contains voice actions similar to the first voice signal of the speaker. Different from the endogenous methods that lead to fluency, the external methods that change verbal feedback (ASF) have been proved to make stutterers have stable and natural fluency immediately, and basically do not need cognitive efforts, although sometimes the effect is not lasting.
Chorus speech; Masking auditory feedback; Auditory feedback delay; Auditory feedback of frequency change; Changing the forms of oral feedback, such as visual chorus voice and delayed visual feedback, has been proved to immediately reduce stuttering behavior of some stutterers by 70- 100%. It is also found that the changed speech feedback can improve fluency regardless of the speech speed, and it can continue to improve fluency even if it is used in one ear instead of both ears.
In the past, this instrument for changing speech feedback was very bulky and could only be used in the laboratory, which had no practical effect on correcting stuttering. Until 2 1 century, with the development of science and technology, a small stuttering device appeared, similar to "hearing aid", such as speecheasy. Because it is directly put into the ear and microcomputer language processing technology is applied, the sensitivity and clarity of sound feedback are higher and the effect of correcting stuttering is better. In the United States, Canada, the European Union and other countries and regions, speecheasy has achieved remarkable correction effect, and related news has been reported by ABC TV, NBC TV, BBC Radio, USA-Today, People Weekly, Forbes and China CCTV.
Second, speech fluency training
Speech fluency training aims at adjusting the way of speaking to prevent stuttering, or controlling stuttering when it occurs, so that speech communication can continue. For example, pronunciation includes skills such as slowing down, inducing pronunciation, pronouncing softly, using airflow, and forming the rhythm and rhyme of speech. After mastering these pronunciation skills, stutterers can speak at a very slow speed, step by step, and finally transition to a nearly normal speech speed. In addition, breaking long sentences, changing the way of speaking and follow-up training are also important contents of speech fluency training. Although speech fluency training can't eliminate the physiological factors leading to stuttering and completely solve the psychological problems, it is indeed a feasible and palliative adjuvant therapy.
Third, psychotherapy.
Scholars at home and abroad have found that stutterers have a fear of stuttering and have no clear understanding of this language barrier, which is manifested in avoiding verbal communication with the outside world, and in severe cases, being isolated from the outside world. The aggravation of psychological disorder aggravates stuttering symptoms, which in turn deepens psychological disorder. As a result of the vicious circle, stuttering is deeply rooted. Zhang Jinghui believes that the key to eradicate stuttering should be to eliminate psychological barriers. The root of stuttering lies in the subjective desire of "not stuttering a word". If this wrong strong desire is not completely destroyed, all efforts will be in vain. To eliminate psychological barriers, stuttering must be allowed unconditionally. The basic spirit of Morita psychotherapy in Japan is not to exclude the established facts of stuttering, to work like a normal stutterer, to show a "natural" attitude, to allow stuttering and to do whatever you want. Huang Yi believes that stutterers are afraid of stuttering, but they are not afraid of stuttering itself, but of the possible adverse consequences of stuttering-the loss of quality material life and social status. The essence and core of stuttering psychotherapy should be to reduce or eliminate the fear of adverse consequences caused by stuttering.
In psychotherapy, behavioral, cognitive and emotional therapy are emphasized. Including:
1. Psychological counseling and psychological support therapy make patients gradually realize their wrong and paranoid cognitive concepts and consciously replace them with correct thinking concepts. At the same time, listen to the stutterers patiently and fully understand them.
2. Relaxation training, teaching patients to experience the effect of their own muscle contraction and relaxation. Through self-repeated training, the whole body muscles are relaxed, that is, the mind and body are relaxed. This can eliminate the patient's nervousness and gradually restore and maintain a good and stable mentality.
3. Systematic desensitization training therapy. In the treatment practice, self-systematic reading training, caring and heart-to-heart dialogue therapy are adopted; Systematic social training, etc. Let patients contact different environments and different people, relieve tension, fear, anxiety and depression in conversation and reading, and gradually cultivate patients' stable and calm mentality.
4. Exposure therapy: for young patients, especially students, the curative effect is better after the above-mentioned related treatments. Encourage patients to take bold breakthrough exposure therapy, encourage them to participate in various competitions organized by the school, such as speeches and recitations, so that they can exercise themselves on various occasions and establish their determination to be self-reliant, confident and self-reliant.
Fourth, other treatments.
Respiratory training: The respiratory organs and pronunciation organs of stutterers are generally normal, but stutterers often have respiratory disorders, improper breathing methods, or disharmony between breathing and pronunciation. Breathing therapy that conforms to the rules of pronunciation, such as practicing breathing exercises, coordinating breathing and pronunciation training, combined with other treatment methods, can further improve stuttering.
Biofeedback therapy: relaxation training through biofeedback, such as breathing and EMG feedback; It can reduce stuttering and improve fluency.
Drug therapy: Haloperidol is considered to be an effective drug for stuttering, but it has great side effects. Clomipramine (a tricyclic antidepressant with strong 5- hydroxytryptamine recovery blocking effect) can significantly reduce the severity of stuttering. Some scholars have suggested that calcium channel blockers and cholinergic blockers can be tried to treat stuttering.