Therapy / treatment

Is there a cure for stammering?

What do we mean by a cure?

BSA is frequently asked whether there is a cure for stammering. It's a natural enough question, given that there are courses advertised which claim to offer a complete and final cure for stammering. In addition, it is a question that is quite likely to be in the minds of people who have had some experience of speech therapy, perhaps when they were a lot younger, but find themselves still struggling with their speech.

Unfortunately, there is no evidence of a universal cure for stammering - in other words, there is no approach that works like a magic pill for everyone. This situation is perhaps not so surprising when it is considered that there is still no complete answer to the question, 'What causes stammering?' Most experts agree that it is due to a combination of factors - physiological, neurological, psychological and environmental - but the precise ways that these factors operate together is not known, and clearly the combination will be different from one individual to another.

What is clear, then, is that stammering is a complex condition with many characteristics affecting each individual in a unique way. Whilst two people who stammer may sound similar to an outsider, the factors that trigger stammering, and reactions to stammering (both physical and emotional) can be very different. These aspects are highly personal and make it important to consider individual needs in any course of therapy.

Furthermore, while there are techniques which can be extremely helpful, these require ongoing practice to become effective. This is not the same as a 'cure' - which implies something administered by an expert which will work for everyone in all situations. People who claim to have found a cure for stammering often passionately believe they have something to offer. We do not suggest that their motives are anything other than genuine, but we believe these claims are misleading. BSA advises caution in respect of such courses and we do not publicise them in our literature or on our website.

Considerations for different age groups

Adults and older teenagers

As mentioned above, the search for a cure for stammering may be a particular issue for you if you had some NHS speech therapy when you were younger but did not manage to achieve or maintain the level of fluency you were hoping for. In this case, our recommendation is to try again, because therapy may well have changed - new developments are made regularly - and you may well have changed, too, and respond differently to what is offered. A speech and language therapist working in the NHS will not offer you a cure, but she or he will be able to offer you a range of approaches and techniques, and from these you can focus on the ones that you find most helpful. The therapist will support whatever choice you make. Whilst there are no guarantees, many people who work conscientiously and in a sustained way with these sorts of approaches and techniques make real progress, in terms of speaking more freely and feeling more at ease with themselves as communicators.

Looking at what's on offer beyond NHS speech therapy, you may feel there is something to be gained from trying anything and everything - and this is obviously your personal decision. But please make your choice an informed one. If you decide to try a course or therapy which claims to cure stammering, you may well learn techniques which may help you speak fluently, in the short term. However, for ongoing fluency these techniques will need to be practised every day while you are at home and at work. Unless you are prepared for this, your time and money may be wasted. The 'cure', which may be promised while you are on the course, is unlikely to last of itself. Many of the techniques that are taught on such courses are familiar to speech and language therapists and we recommend that you first seek advice from these professionals.

School aged children

It is obviously distressing to see your child stammering and, as a result, perhaps struggling with issues of self-consciousness, lack of confidence, teasing and bullying. You may consider 'anything' to help your child, 'no matter what the cost'. However, expectations of a 'cure' can lead to even greater difficulties and a sense of failure for both parents and children if it doesn't work out. The experience may well put you both off trying other approaches in the future.

Most of the courses and therapies which claim a cure are aimed at teenagers and adults, but there may be some practitioners who accept younger children. We strongly recommend parents caution and that you instead seek advice from a qualified speech and language therapist who has experience of stammering. The most important issue at this stage is to help children who stammer develop self acceptance, and self confidence.

Pre-school aged children

Speech and language therapy has a high success rate in children under five years of age. Therapists carry out an assessment, taking into account many factors including the physiological and parent-child interactions. They may then choose to work in a variety of ways, indirectly or directly. The majority of children can be helped through these approaches and often have no recurring problems. However, it is not appropriate to think of this as a 'cure' because many children under 5 years go through a very normal phase of dysfluency anyway, and may just have grown through this phase. It is more accurate to say that these children have been supported at an early stage in a way that has prevented their early dysfluency from developing into a lasting stammer.

General recommendations

We recommend that you consider the following questions before deciding to pay for a private course or private therapy.

1) Is the person leading the course accountable to any registered professional body which is bound by a code of ethics? This is particularly important regarding therapies for children.

2) Does the person hold professional qualifications accredited by a professional body or institution? The Health Professions Council can verify this for you in the case of speech and language therapists - see their website at www.hpc-uk.org. It may well be that a person without professional qualifications can be of help to some people. However, it is important to note that, if you feel that you have been harmed by the treatment offered, either physically or psychologically, there is unlikely to be a professional body to which you can complain.

3) Is the person leading the course basically offering their own personal experience of a method which helped them? Don't forget that, because of the individual nature of stammering, there is no guarantee that what helps one person will necessarily help another.

4) What is the cost and is it reasonable compared to other courses? What do the costs cover? Are there any financial guarantees? Is there a refund policy?

5) Is follow-up support offered to increase the chance for long term fluency? You are likely to need direct help and ongoing support from your therapist while you practise and phone calls are unlikely to be sufficient. A characteristic of stammering is that it is prone to relapse, so care and ongoing attention needs to be given to this.

6) What emotional support is available for you if you 'fail' the course? This can be an issue, especially if the course leader is one who tells you that you must be a failure for 'failing to be fluent'.

Finally, with any form of therapy, it's no doubt best, having made the decision to try it, to give it your best shot, rather than do it half-heartedly. If, in the end, it doesn't work for you, you can at least be assured that it wasn't for want of trying. All it means is that, at this point of time in your life, it is not the right approach for you. Don't let anyone tell you otherwise!

British Stammering Association, April 2006

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