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That elusive word!
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People with stammering go through untold trauma in a society that is not fully sensitive to their problems. GEETA PADMANABHAN talks to doctors and therapists on how best to tackle the speech disorder
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When Tom Hooper's “The King's Speech” goes to the Oscars with 12 nominations, the film will do more than fetch fame for its makers. Its story of a British monarch battling a stutter throws the spotlight on an isolating speech problem and brings it to the public arena. In Colin Firth's extraordinary performance as Bertie (King George VI) we see an adult gulp and struggle over words he can't get out, yet retain his dignity. Staying close to recorded history, “The King's Speech” sensitively portrays the monarch's quest to find his voice.
The movie makes some crucial points. Lionel Logue, the king's therapist, traces the disability to overbearing parents and his being forced to write with his right hand.
Logue's unorthodox treatment relies on practice, physical exercises and provocation. There is no trace of stammer when Bertie swears, sings or records Hamlet's speech without hearing his own voice. The breakthrough happens, and the king makes his famous war speech.
Was Logue right in his diagnosis of how the problem occurred? “No one knows why people stutter,” says Uma Srinivasan, speech therapist at Apollo Hospital. “Regarded as a disorder of fluency and rhythm, stammering could be the result of genetic factors, neurophysiologic factors, environmental contingencies, or multiple factors.”
Great effort
Stutterers repeat and break words, pause and finally stop. Often, the effort shows — in the flaring nose, quivering lips, clenched teeth, tension in facial muscles and jerky hand movement.
Over the centuries, horrifying attempts have been made to “cure” the condition. The tongue of a person with stammering has been snipped, burnt with Hippocrates' acid or hot wine to thaw the “frozen” words. Stutterers have been sent to psychiatrists and some had lobotomies performed on them. Later, treatment got refined to speech therapy and “fluency intensives”. They now wear hearing-aids, pop anti-anxiety pills, use iPhone apps.
“Some procedures are questionable,” agrees Uma. “But, most Speech-Language-Pathologists (SLPs) combine effective components of a treatment to create a personal programme for the client.” Early intervention, systematic treatment, follow-up and periodic booster treatment will improve fluency, she says.
King or commoner, agony is a given. “I hated speech therapy,” says engineer Manimaran, 52. High-school embarrassment turned into trauma when he “couldn't ask questions during lectures” at his pre-university course at MCC, had to “ask friends to buy tickets and order food” at NIT, Trichy.
In 2001, following an intensive course, he learnt to change his speech behaviour. The dramatic improvement persuaded him to start a self-help group in Chennai. In 2008, he began to post at a yahoo group and discovered TISA (The Indian Stammering Association). With help from his self-help group, he launched its Chennai chapter. After a year of conducting self-help sessions, he has overcome 95 per cent of his problem.
A turning point was when Sachin, co-founder of TISA, asked him: “Do you accept your stuttering?” “I replied I was ashamed of it,” he recalls. “He said, ‘Why not accept it and see the results?' I felt as if a spark lit up my mind.”
Practise acceptance
What “therapy” failed to do happened easily and spontaneously, “as I went about trying to help people”. His occasional stutter doesn't bother him. Manimaran suggests that people talk and blog about stammering to practise acceptance. “Go for therapy if it helps you. If not, why not run a self-help group? It is free and fun.”
Infosys employee and software engineer Jai Prakash Sunda, 25, began stammering as an eight-year-old. Was it because of high expectations from his family? A new school? He can't say, but recalls that “ignorance about stammering in the adults around made life a living hell”. Change happened when he took six months off to revive an inactive self- help group to help People With Stammering (PWS) in Pune. “I've now started the first self-help group for PWS in Infosys, a first-of-its-kind initiative in corporate India,” he says. “Once I posted the advertisement inviting PWS, I didn't have to hide my problem. It took my confidence to a new level.”
Invisibility is the disorder's main problem, says Dr. Sachin. Stammering puts off people. Quite a few mistake it for “low intelligence”. Others believe it's “all in the mind”.
Childhood trauma is not the only reason, but teasing and bullying can aggravate the speech “block”. So, teasing and bullying must stop in schools, playgrounds, and workplace, he says.
And, sadly, because the triggers are different for different people, society fails to recognise stammering as a source of significant suffering.
But, it is, for 20 million to 30 million Indians.
In search of clarity
* Stammering cannot be cured, but it can be managed
* The success rate in speech therapy is low because the techniques are difficult to follow
* TISA disseminates up-to-date, rational information and connects PWS
* The key to overcoming it is to accept it and work on communication skills
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