Correcting stammering: Interview with Nakuyou Tassi Luc, Speech and Language Therapist at CNAO-Lomé

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Extract from the article: Stammering is a neuromuscular problem that causes difficulty in coordinating breathing, the vibration of the vocal cords and the movement of the articulators of speech (tongue, palate, lips). It is not a disease, but a neuromuscular dysfunction. What

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« Stammering is just a dysfunction. The degree of recovery varies from 0 to 100%. So you can get out of stammering »

Stammering is a neuromuscular problem that causes difficulty in coordinating breathing, the vibration of the vocal cords and the movement of the articulators of speech (tongue, palate, lips). It is not a disease, but a neuromuscular dysfunction. What causes stammering in children? What are its characteristics? What should be done about a child who stammers? Nakuyou Tassi Luc, speech therapist at the Centre National d'Appareillage Orthopédique (CNAO-Lomé) answers in this interview.

Santé & Education: What is stammering?

Luc Nakuyou Tassi: Stammering is a long-lasting and fluctuating language disorder. It manifests itself by blocking, prolonging, repeating and insisting on sounds, syllables or words. This disorder is often associated with behavioural, cognitive and affective elements. Language disorders are sometimes associated: slips of the tongue, use of inappropriate words, poor syntax, etc. Stammering should not be confused with stammering (indistinct speech) and stammering (slurred speech).

What causes stammering?

The exact cause of stammering is unknown, but research is tending towards the hypothesis of genetic transmission (predisposing factors).According to studies, 30 to 60% of people who stammer have someone else in their family who has had or still has a stammering problem.

Studies have also shown that stammering is neurophysiological in origin: the way the brain organises language and speech is different in people who stammer. Stammering can develop as a result of a psychological problem, excessive embarrassment or other factors.People who stammer are no less intelligent than others.

Stammering can be caused by a stressful event, such as starting daycare, the arrival of a new baby, moving house or parental divorce (precipitating or triggering factors).

Despite the presence of stammering, its onset will depend on the behaviour of those close to the child (family, school, service).In fact, our reactions (perpetuating factors) to the onset of stammering are fundamental to its success.

Is this a common occurrence in our country?

Yes, very common.According to international statistics, 5% of the population is affected. In Togo, 1% of adults suffer from stammering, while the rate among children is between 4% and 6%.Around 70,000 people in Togo suffer from stammering.At the CNAO-Lomé, 179 people (children, adolescents and adults) were monitored for stammering in 2022.How is it diagnosed?To diagnose stammering, a speech and language therapy assessment is needed.The speech therapist uses questionnaires and tests to determine the language disorder. There are related disorders.Is stammering contagious?

Stammering is never contagious.The onset may coincide with living with someone who stammers, but this does not make the circumstance contagious or a learning experience.Moreover, if the child has no genetic risk factors, he or she will never stammer, however long they have lived together.

What are the characteristics of stammering?

Stammering is characterised by repetition of sounds, syllables, words or groups of words, blocking and/or prolongation of sounds.There may also be muscle tension, the addition of sounds or movements of certain parts of the body (blinking, nodding, dilation of the nostrils).

When does it first appear?

Stammering generally appears between the ages of two and five.In around 75% of cases, the stammer will disappear on its own, usually between 6 and 35 months after its onset. However, there is no way of knowing whether the child will recover or not. Hence the importance of seeking help at the first sign of stammering.And there are 4 times more boys than girls who stammer.In adults, stammering can appear following an emotional situation, a stroke, a cranial trauma or a brain tumour.

When should you seek help?

In the vast majority of cases, stammering disappears spontaneously within a few months.Stammering is common in children aged 2 to 3. We start to worry when it persists beyond the age of 3 or 4 or over a long period of time (at least 1 year). Boys stammer more often than girls.When stammering persists beyond the age of 5, it is useful to consult a speech therapist to undertake rehabilitation.In all cases, you should consult a speech therapist as soon as you have any doubts about your child's language development or fluency difficulties.

How is stammering treated?

Stammering needs to be treated at an early stage (as soon as it is identified), starting with advice to the patient, his family and those around him.This is followed by targeted fluency exercises using breath, breathing, relaxation, pneumo-phonic coordination and verbal agility.No drug treatment.We show patients many fluency techniques.

When dealing with children, we try to avoid drawing their attention to their stammering or focusing on its disturbance. Instead, we give them all the time they need to finish their sentences, don't make them repeat themselves, play with them a lot (lots of nursery rhymes, board games and songs) and make fewer educational demands.

Can stammering be cured?Stammering cannot be cured because it is not an illness. It's just a dysfunction.The degree of recovery varies from 0 to 100%.So stammering can be overcome.

How should you deal with a child who stutters?

Parents play an essential role in the treatment of stammerers.They must be active partners.This means avoiding sarcasm, mockery and reactions of concern or annoyance, which serve no purpose other than to increase anxiety and stammering.

Take the time to listen to the child with a calming attitude, help the child when he blocks, by giving him confidence through a listening attitude (put yourself at his level, hold his hand or put your hand on his shoulder, etc.) by rephrasing his sentence without insisting that he repeat it or by offering him a choice of words. Don't make stammering a taboo. Don't hesitate to tell them that you understand their difficulty in expressing their needs easily. And above all, avoid pretending to understand or cutting him off by responding awkwardly or inappropriately to his request.

Interview by Abel OZIH