New research on stuttering:
Personality is important in deciding which treatment works best
People who stutter can benefit from going to a speech therapist. But their personality has as much to say as the treatment method itself in terms of results, one researcher says.
We all have different personalities. Some of us are introverts. Some are extroverted. Some are a bit of both.
“If a typical introverted person is told by a speech therapist to go out on the street and talk to people, that treatment may not work very well,” says Hilda Sønsterud.
Sønsterud has just completed her doctorate at the University of Oslo’s Department of Psychology, in which she documents clear, concrete knowledge regarding what works in treating stuttering.
“All kinds of treatments for stuttering can be good, but in the future we need to be better at adapting treatment to each individual patient,” she says.
Individual differences are important
Sønsterud believes it’s important not to get too hung up on any single treatment programme.
“Research shows that most treatments work. We just have to determine which treatment helps whom,” Sønsterud says.
She currently works as a speech therapist at Statped, a national service for special needs education.
Sønsterud conducted a treatment study of 20 people who stuttered, in which she used not just one single method, but several different methods on different people.
She documented how they spoke before and after treatment, and also used psychological survey tools that described emotions such as anxiety and moodiness.
“The value of considering the individual and their personalities cannot be underestimated in the treatment of people who stutter,” she says.
Neurological differences in the brain
There are still many myths surrounding stuttering.
People continue to think that individuals who stutter are more nervous or vulnerable than others. Another myth that has persisted is that stuttering is caused by a bad relationship with the person’s parents.
Today, more and more research indicates that there are neurological differences between people who stutter and those who don’t. These differences are linked to brain activation and brain structure and can be seen on an advanced X-ray image. Researchers now also know that stuttering can be hereditary.
Despite this knowledge, stuttering is undoubtedly a great psychological burden for many who stutter.
“Anger, frustration and helplessness are all common reactions,” says Sønsterud.
Scary to go on a date
Several of the people who participated in Sønsterud’s study had life challenges, either related to work and education or in social contexts.
“Finding a partner can be difficult enough for many people, but for people who stutter it can be extra scary to go on a date,” she says.
Some of the participants initially had a very high level of anxiety. It turns out that those with the most anxiety benefited the least from treatment, she says. In this case, they also needed psychological treatment.
But sometimes these patients may need help from a speech therapist before they can go into therapy.
“Having conversation therapy when you can't express your thoughts is very difficult,” she says.
Less likely to pull back
If you have problems saying what you think, it can influence your personality. You pull back.
Sønsterud didn’t just measure how stuttering was affected by treatment. She also looked at avoidance behaviours of participants in the project.
“I found a significant reduction in avoidance behaviours during the study. I think that’s good news, because this is about quality of life. The less avoidance, the better your life is,” she says.
Motivation has to be there
Speech therapists have long believed that the intensity of self-training and the person's motivation have much to say in determining the success of treatment.
Sønsterud's doctorate supports this presumption.
She documented motivation levels of participants in her treatment project.
“The people who were really motivated and who practiced the most — and most often — were also the people who got the best results,” she says.
Most people benefited greatly from focusing on their breathing, not necessarily to relax more, but to use their breathing to support their speech, and to unblock their stutters. As their confidence in their speech improved, they were less likely to avoid people. That, in turn, had a positive impact on their quality of life.
A better writer because of stuttering
The author Knut Faldbakken has talked openly about his stuttering in the media. Faldbakken is a novelist whose books have been translated into 18 languages and have sold two million copies worldwide.
In an interview with the Norwegian Association for Stuttering and Speech (NIFS), Faldbakken said that stuttering is a handicap that is easy not to talk about, no pun intended. Stuttering is easy to hide by not talking, being polite and withdrawing into oneself, he said.
“Your voice and language are your voice to the world. Stuttering is a serious handicap, even for the lucky people who have found the strength and a strategy to overcome the psychological and social problems it entails — because you never get rid of stuttering. It sits there as a constant hesitation, a stumbling block, between you and the outside world, and is really about more than speech itself,” says Faldbakken to NIFS.
The author said that he probably would not have had such a successful writing career had he not stuttered.
“Writing is my way of not stuttering. I use the term ‘stutter toughness’ — nothing is easy, and I never give up. It’s an advantage when you are an author and have to write long books — you have to be persistent.”
Also sees something positive in stuttering
Sønsterud says it’s encouraging when people who stutter find their own strengths, like Faldbakken describes.
There are other stutterers who also believe their ability to truly see and care for others has been strengthened by their stutter. They know what it means to have challenges in life.
In 2017, a journalist from forskning.no interviewed Berit Løkken, who suffers from so-called hidden stuttering. She has learned how to quickly swap out words in sentences where certain words would otherwise present problems.
The older she has become, the easier it has been to live with the stress, she says.
“The more calm and balanced I have become as a person, the easier it has become. But still, there are times when everything is suddenly difficult, and it takes a lot of energy for me to get through the day,” she said.
- Read the interview with Løkken here: She stutters, but hardly anyone knows it
She’s still able to see something positive in her stuttering.
“Everyone has something challenging in their lives. For me it's stuttering. It could have been something far worse,” she says.
Translated by: Nancy Bazilchuk
Read the Norwegian version of this article at forskning.no