Communication is an essential aspect of being human. It allows us to connect with our fellow human beings, to share experiences and ideas.
Among the various mechanisms available to us for this, oral language is one of the most used, and learning it is one of the aspects we spend the most time on in our development. Since this is a skill that needs to be trained gradually, it is common for difficulties to arise when we master it.
But in some cases, these difficulties may indicate the presence of a more or less serious communication disorder. One of these disorders is stuttering or dysphamia.
Stuttering or dysphamia: a fluency disorder
Stuttering or dysphamia is a communication disorder based on impaired language proficiency. It is a disorder which generally has its origin in childhood, and in which there are no problems in the ability to speak or in the subject’s competition with him but in its implementation. This problem is not due to disease, neurological problems, or sensory or intellectual deficits.
The most visible symptom is the existence of repetitions of words or parts of words during speech, as well as blockages and prolongation of sounds. The speech becomes not very fluid and with interruptions. In some cases, circumlocutions are used in order to modify the structure of the sentences to prevent the perception of the problem in the fluency.
It is a problem related to social discourse, because stuttering only appears in the presence of a speaker, Not existing in subvocal speech or when the subject is alone. Thus, we can observe that there is an affective component linked to dysphamia.
The child or even the adult he experiences all these difficulties with a high level of anxiety, Due to the catching of difficulties as something inappropriate and embarrassing. Feelings of abnormality or inferiority may arise. In fact, in some cases it can lead to strong social withdrawal and even refusal to speak.
In addition, this anxiety tends to cause them to have a higher level of repetition and interruption of speech, so that a vicious cycle can be established between anxiety and communication problems. It is therefore a disorder that can cause a severe affectation on the subject and its communicative and social development.
Dysphamia is a communication disorder that becomes chronic in some cases, although in a large number of cases it can go away completely or partially if treated properly and does not lead to its chronicity.
Types of stuttering
Stuttering or dysphamia is a problem that can present in different forms, depending on the type of fluency impairment that occurs. More precisely, three subtypes of stuttering are commonly identified.
1. Tonic dysphemia
It is a subtype of stuttering in which the problem is the existence of a blockage at the start of speech, Suffering from a spasm at the beginning of the conversation which after an intense effort allows the expression.
2. Clonal dysphemia
This subtype of stuttering is characterized by the presence of slight muscle twitching that cause the repetition of whole sounds or syllables during speech.
3. Mixed dysphemia
This is a combination of the above two, appearing initial difficulty starting speech and rehearsals derived from involuntary muscle contractions.
Origin of this disorder
The causes of stuttering or fluency disturbances have often been explored and discussed, and the majority opinion today is the etiology of this communication disorder. it is found in both biological and environmental factors. It has been observed that there are psychological factors of great importance for its appearance and maintenance, but the presence of alterations in the functioning of the brain has also been speculated and analyzed.
In terms of biological and constitutional aspects, stuttering has been linked to the result of competition for activity between cerebral hemispheres during development. Many people with stuttering have right hemisphere dominance in terms of speech, and they have been shown to have a slight gap between the time it takes to decide to speak and the motor response that allows it. here too curved fascicle abnormalities, A region of the brain related to language.
On the other hand, at a more psychological and environmental level, the presence of conditioning in these children and adults can be observed, due to repercussions in the form of mockery or recriminations in the face of their difficulties. this it causes the presence of a high level of anxiety and frustration if he does not manage to correct it, which will generate both less fluidity and an accentuation of the difficulties. Although the cause of the problem is not considered, it can maintain and chronicle the problem.
Aspects to consider when handling a case
Fluency of speech can be trained in a way that greatly reduces the presence of stuttering. Speech therapy can be very useful, especially if it is applied with programs in which the need to speed up speech is reduced (Due to the anticipation of problems, many subjects tend to speed up their speech, which usually causes them to make mistakes) and the level of stress and anxiety.
It is important to note that the presence of teasing and criticism can be detrimental, As they encourage an increase in the subject’s tension and a more than likely worsening of his communication. The same happens if they are meant to be in a hurry to speak or complete sentences for themselves (a mistake many members of the environment often make).
In fact, and as mentioned above, self-esteem can decrease and cause the subject to withdraw and inhibit themselves, avoiding social participation and emotional ties with other people. This helps to worsen the disorder and make it more chronic. Family and social support, and the subject’s perception of it, is very important.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
Belloch, Sandín and Ramos (2008). Manual of psychopathology. Madrid. McGraw-Hill. (Vol. 1 and 2) Revised edition.
Sants, JL (2012). Psychopathology. CEDE PIR preparation manual, 01. CEDE. Madrid.