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STAMMERING, or STUTTERING

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Originally appearing in Volume V25, Page 771 of the 1911 Encyclopedia Britannica.
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STAMMERING, or STUTTERING , a spasmodic See also:affection of the See also:organs of speech in which the See also:articulation of words is suddenly checked and a pause ensues, often followed by a repetition in rapid sequence of the particular See also:sound at which the stoppage occurred. Of this distressing affection there are many grades, from a slight inability to pronounce with ease certain letters or syllables, or a tendency to hesitate and to interject unmeaning sounds in a spoken See also:sentence, to the more severe See also:condition in which there is a See also:paroxysm of spasms of the muscles, not only of the See also:tongue and See also:throat and See also:face, but even of those of respiration and of the See also:body generally. To understand in some degree the explanation of stammering it is necessary to consider shortly the physiological mechanism of articulate speech. Speech is the result of various See also:muscular movements affecting the current of See also:air as it passes in expiration from the larynx through the mouth. If the vocal cords are called into See also:action, and the sounds thus produced are modified by the muscular movements of the tongue, cheek and lips, we have vocal speech; but if the glottis is widely open and the vocal cords relaxed the current of air may still be moulded by the muscular apparatus so as to produce speech without See also:voice, or whispering (see VOICE). In both cases, how-ever, the mechanism is very complicated, requiring a See also:series of See also:nervous and muscular actions, all of which must be executed with precision and in accordance. In vocal speech, for example, it is necessary that the See also:respiratory movements, more especially those of expiration, occur regularly and with See also:nice See also:adjustment to the See also:kind of articulate expression required; that the vocal cords be approximated and tightened by the muscles of the larynx acting with delicate precision, so as to produce the sound of the See also:pitch desired; that the rima glottidis (or See also:aperture of the larynx) be opened so as to produce prolonged sounds, or suddenly closed so as to cut off the current of air; that the movements of the muscles of the tongue, of the soft See also:palate, of the jaws, of the cheeks and of the lips occur precisely at the right See also:time and to the requisite extent; and finally that all of these muscular adjustments take See also:place with rapidity and smoothness, gliding into each other without effort and without loss of time. Exquisite co-ordination of muscular See also:movement is therefore necessary, involving also complicated nervous actions. Hence is it that speech is acquired by See also:long and laborious effort. A See also:child possesses voice from the beginning; it is See also:born with the capacity for speech; but articulate expression is the result of See also:education. In See also:infancy, not only is knowledge acquired of See also:external See also:objects, and signs attached in the See also:form of words to the ideas thus awakened, but the nervous and muscular mechanisms by which these signs or words receive vocal expression are trained by long practice to See also:work harmoniously. It is not surprising, therefore, that in certain cases, owing to some obscure congenital defect, the co-ordination is not effected with sufficient precision, and that stammering is the result.

Even in severe cases no appreciable See also:

lesion can be detected either in the nervous or muscular mechanisms, and the condition is similar to what may affect all varieties of finely co-ordinated movements. The mechanism does not work smoothly, but the pathologist is unable to show any organic defect. Thus the co-ordinated movements necessary in See also:writing are disturbed in scrivener's palsy, and the skilful performer on the piano or on any See also:instrument requiring See also:minute manipulation may find that he is losing the See also:power of delicate adjustment. Stammering is occasionally hereditary. It rarely shows itself before the See also:age of four or five years, and as a See also:rule it is See also:developed between this age and See also:puberty. Men stammer in a much larger proportion than See also:women. It may occur during the course of nervous affections, such as See also:hysteria, See also:epilepsy or locomotor ataxia; some-times it follows febrile disorders; often it develops in a child in a feeble See also:state of See also:health, without any See also:special disease. In some cases a child may, imitate a stammerer and thus acquire the See also:habit. Any See also:general enfeeblement of the health, and especially nervous excitement, aggravates the condition of a confirmed stammerer. Stammerers, as a rule, find the explosive consonants b, p, d, t, k and hard g the most difficult to articulate, but many also are unable easily to See also:deal with the more continuous consonants; such as v, f, th, s, z, sh, m, n, y, and in severe cases even the vowels may cause a certain amount of spasm. Usually the defect is not observed in whispering or singing; but there are exceptions to this statement. In pronouncing the explosive sounds the See also:part of the oral apparatus that ought suddenly to open or See also:close remains spasmodically closed, and the stammerer remains for a moment voiceless or strives pitifully to overcome the obstruction, uttering a few successive puffs or sounds like the beginning of the sound he wishes to utter.

The lips thus remain closed at the attempted utterance of b and p; the tip of the tongue is pressed against the hard palate or the back of the upper front See also:

teeth in d and t; and the back of the tongue presses against the posterior part of the palate in pronouncing g hard and k. In attempting the continuous consonants, in which naturally the passage is not completely obstructed, the stammerer does not close the passage spasmodically, but the parts become fixed in the See also:half-opened condition, or there are intermittent attempts to open or close them, causing either a drawling sound or coming to a full stop. In severe cases, where even vowels cannot be freely uttered, the spasm appears to be at the rima glottidis (opening of the larynx). Again, in some cases, the spasm may affect the respiratory muscles, giving rise to a curious See also:barking articulation, in consequence of spasm of the expiratory muscles, and in such cases the patient utters the first part of the sentence slowly, gradually accelerates the See also:speed, and makes a See also:rush towards the close. In the See also:great See also:majority of cases the spasm affects the muscles of articulation proper, that is, those of the pharynx, tongue, cheeks and lips. A condition named aphthongia is particularly distressing. It totally prevents speech, and may, at intervals, come on when the See also:person attempts to speak; but fortunately it is only of temporary duration, and is usually caused by exceptional nervous excitement. It is characterized by spasm of the muscles supplied by the hypoglossal See also:nerve, including the sternohyoid, sterno-See also:thyroid and thyro-hyoid muscles. In almost all cases of stuttering it is noticed that the defect is most apparent when the person is obliged to make a sudden transition from one class of sounds to another, and the patient soon discovers this for himself and chooses his words so as to avoid dangerous muscular combinations. When one considers the delicate nature of the adjustments necessary in articulate speech, this is what may be expected. It is well known that a quickly diffusible stimulant, such as See also:alcohol, temporarily removes the difficulty in speech. Stuttering may be successfully overcome in some cases by a careful See also:process of education under a competent See also:tutor.

Not a few able public speakers were at first stutterers, but a prolonged course of vocal gymnastics has remedied the defect. The patient should be encouraged to read and speak slowly and deliberately, carefully pronouncing each syllable, and when he feels the tendency to stammer, he should be advised to pause for a See also:

short time, and then by a strong voluntary effort to See also:attempt to pronounce the word. He should also be taught how to regulate respiration during speech, so that he may not fail from want of breath. In some cases aid may be obtained by raising the voice towards the close of the sentence. Sounds or combinations of sounds that See also:present special difficulties should be made the subject of careful study, and the defect may be largely overcome by a series of graduated exercises in See also:reading. The practice of intoning is useful in many cases; and many per-sons who habitually stutter in conversation show no sign of the defect when they come to sing. In See also:ordinary conversation it is often important to have some one present who may by a look put the stammerer on his guard when he is observed to be talking too quickly or indistinctly. Thus by See also:patience and determination many stammerers have so far overcome the defect that it can scarcely be noticed in conversation; but even in such cases See also:mental excitement or slovenly inattention to the rules of speech suitable for the condition may cause a relapse. In very severe cases, where the spasmodic seizures affect other muscles than those of articulation, special medical treatment is necessary, as such are on the borderland of serious nervous disturbance. All See also:measures tending to improve the general health, the removal of any affection of the mouth or gums that may aggravate habitual stammering, the avoidance of great emotional excitement, a steady determination to overcome the defect by voluntary See also:control, and a See also:system of education such as has been sketched will do much in the great majority of cases to remedy stammering.

End of Article: STAMMERING, or STUTTERING

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