Stammering in adults: treatment at home, psychotherapy

Stammering in adults is quite rare, but this is no less an unattractive phenomenon, which may have different roots. It is not for nothing that ancient healers and scientists, and the modern luminaries of medicine, pay so much attention to him in searching for possible causes and effective methods for solving the problem of this speech disorder in both children and adults.

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Epidemiology

Methods of modern non-infectious epidemiology make it possible to determine as precisely as possible the level of stuttering prevalence among different strata of the population. According to various authors, the percentage of stutterers among schoolchildren is between 1.5 and 2.2%. By adolescence, approximately 1% of children have this speech disorder.

Among the adult population, this figure varies between 1-3%. At the same time among men, stammering occurs 3.5-4 times more often than among women.

Stammering, which has arisen already in adulthood, if it is not associated with organic brain damage, manifests itself only in communication with others. Talk "about myself" no longer has those speech defects, mentally the person communicates freely. This suggests that such stuttering should be easy to treat.

[2], [3], [4], [5], [6], [7],

Causes of the stuttering in adults

Stuttering in childhood is a matter, one might say, ordinary. Such a speech disorder, according to various sources, can be observed in 2-9% of children aged 2-4 years. The reason for this can be both the physiological features of the development of the organism, and stressful conditions. Sometimes a child's stuttering can lead to incorrect actions of parents in the development of their children's speech. But if problems with speech activity in younger children do not entail special problems in the socialization of the child, then at a later age, stuttering can cause psychological disorders: the child becomes withdrawn, uncommunicative, feels like an outcast in the team.

Stammering in adults has slightly different consequences. This is not only psychological discomfort in communication. Smooth speech with the correct pronunciation of words is one of the components of the image of a successful person. Stammering in most cases is a serious obstacle in building a career, as well as in creating a family and achieving personal happiness.

And yet, stuttering even in adulthood is completely curable. This is not so rare phenomenon, and many well-known personalities, like ordinary people, have long said goodbye to the problem of stuttering, pursuing them since childhood or made itself felt in adulthood.

Stuttering is a speech disorder associated with numerous short-term spasms of the muscles of the speech apparatus. The human speech apparatus consists of:

• respiratory (lungs, bronchi, trachea),
• active organs of speech (tongue, lips, soft palate, vocal cords, tongue),
• passive organs (teeth, pharynx, larynx and other immobile parts of the organs involved in the formation of sounds and words).

During the conversation with the interlocutor, the muscles of the vocal apparatus convulsively contract, and the speech turns out to be intermittent. The situation is aggravated if a person tries to speak quickly or worries, as well as with emotional overexcitation.

The main causes of stuttering in adults may be as follows:

1. Organic damage to the brain. Some head and CNS diseases (stroke of the brain tumor, meningitis, etc.), as well as head injuries, can cause stuttering due to inadequate nerve impulses. With this form of stuttering, the manifestations of the convulsive syndrome of facial muscles and respiratory muscles are particularly pronounced. Patients during a conversation can perform active actions in various parts of the body: fingering their hands, swinging or nodding their heads, etc.
2. Neurotic causes. Stammering in adults can occur under the influence of a stressful situation or severe emotional experiences. A person can be frightened of something, become a witness of a crime, be worried about relatives or survive their death, get into a situation that caused a shock. Sometimes there is a speech disorder on the background of a strong excitement before the performance or competition. The neurotic form of stuttering, as a rule, has a short course.
3. Inadequate treatment of early stuttering in childhood. Sometimes parents, listening to the advice of experienced people, think that stuttering will pass by itself, but there is no improvement, and the disease turns into a chronic form with muscle spasms. The treatment of such conditions is longer, it is necessary to stockpile with the necessary patience to pass it to the victorious end.
4. Heredity. Here you can include both generic physiological features, as well as a hereditary predisposition to certain brain diseases that cause disturbances in the functioning of the speech apparatus, and even a tendency to stuttering on the nerves.

It is the cause of stuttering in adults that often affects the duration of its treatment. And, of course, the persistence and desire of the patient.

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Pathogenesis

The pathogenesis of stuttering in adults, however, as well as in children, has not been sufficiently studied. There are various theories: psychogenic, genetic, semantigenic, which try to explain the origin and the pattern of development of the pathological process. Recently, scientists are inclined to the fact that the development of stuttering usually involves more than one factor. This complicates the situation with the definition of the exact cause of stuttering.

Nevertheless, recent studies confirm the influence of the hereditary factor on the probability of stuttering. In 17.5% of patients with neurotic stuttering there is a genetic predisposition to its occurrence.

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Symptoms of the stuttering in adults

Do not pay attention to the beginning of stammering in an adult is simply impossible. After all, what for a young child is the norm for an adult can be a deviation from this very norm. The first signs of stammering: frequent hiccups before something to say, uncertainty and the desire to avoid a prolonged conversation, the intermittence of pronunciation of sounds and words. Often at this stage, people try, if possible, to get off with a nod of the head, avoid public appearances.

The main symptoms of neurotic stuttering in adults are manifested as:

• Multiple repetition of certain words, individual syllables or even sounds.
• Unusual lengthening of sounds in words.
• Not associated with the semantic and emotional load of increasing the volume of speech, especially at the beginning of the word.
• Noticeable tense expression on the face and too strained neck muscles during conversation.
• Feelings of lack of air during conversation, spasmodic respiration.
• A frequent desire to avoid communication.

Very often the stuttering person starts to noticeably get nervous before the conversation starts or gets frustrated if he needs to communicate in public.

Forms

Stammering in adults can be divided into several types according to the following features:

• Course of the disease.
• Clinical manifestations of the disease (etiology).
• Characteristics of spasms of the speech muscles.

According to the nature of the course of the disease, the following types of stuttering can be distinguished:

1. Constant.

Once emerged, a violation of speech is present in all situations associated with the need for communication through speech.

1. Wavy.

This kind of stuttering is characterized by the fact that problems with speech periodically disappear and appear again. Usually this is due to emotional situations, intense excitement.

1. Recurrent or recurrent.

Stammering can disappear for a long period, not manifesting itself in any way, and then return again.

According to the characteristic of seizures, there are 3 types of stuttering:

• Clonic stammering in adults, when multiple spasms of the verbal musculature, going one after another, cause an involuntary duplication of consonant sounds, individual syllables and even words.
• Tonic stammering associated with prolonged strong contraction of the muscles of the mouth and throat, which leads to speech delay, lengthened pauses between words, repetition of vowels and some consonants (in Russian they are called sonorous).
• Mixed type with manifestations of symptoms of the previous 2 species.

And, finally, according to clinical manifestations, stuttering can be divided into 2 types:

• Neurotic stammering in adults or logoneurosis, caused by stressful situations.
• Neuro-like (organic) stammering due to the development of organic brain damage (oxygen starvation, birth trauma, strokes, tumor and inflammatory processes in the brain, etc.). Symptoms of such stuttering are stable and do not depend on the emotional state. Usually, speech disorders in such patients are accompanied by convulsions and twitching of facial muscles, additional movements that do not have emotional confirmation by the movements of the head, fingers and whole body.

Logoneurosis may be both permanent and temporary, depending on the psychological state of the patient. If a person is nervous or agitated, the symptoms of stuttering may become worse. And, conversely, the state of rest reduces manifestations of speech pathology. Sometimes, in order for a person to stop stuttering, it is enough to give him a warm tea or a small amount of alcohol, to listen to relaxing music or simply to psychologically support and calm him.

Neurotic stuttering is easily amenable to correction and treatment, nevertheless, it requires timely professional help in order to avoid undesirable consequences and complications. If you do not start treatment on time, stuttering can take a chronic form, when a person has established established stereotypes of behavior and speech skills. The patient may develop over time a fear of communication, causing severe anxiety and the associated appearance of symptoms of stuttering. Moreover, nervous reactions of the face and body can join the verbal disturbances, there is a lack of self-confidence and quick fatigue from the conversation, the mood worsens.

Perhaps, it is for this reason that stammering in adults, having roots as early as childhood, is treated much more difficult and longer. Whatever the original cause, neurotic or organic, the disease with age does not pass by itself, but acquires a stable character, which significantly complicates the treatment. So, the treatment must begin at the first signs of stuttering even in childhood.

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Diagnostics of the stuttering in adults

You should not rush yourself or your relatives to diagnose "stuttering." Small pauses between words during a conversation, rare repetition of words and syllables are not at all an indicator of the presence of stuttering in adults. Such minor disturbances in speech can be evidence of intense excitement, haste or, on the contrary, reverie. Some moments of speech (chanting, elongated pauses between words) can be the distinguishing features of some race or geographic region. Temperament can also contribute to changing the characteristics of speech.

Preliminary it is possible to put or refute the diagnosis of stuttering, following a pair of tests:

1. Count the number of unnecessary pauses by pronouncing a text of 100 words. Up to 7 breaks - the norm. More than 10 pauses - a high probability of developing speech pathology.
2. Watch the expression on your face. If during a conversation the muscles of the face look very tight, there is a possibility of speech disturbance. This is indicated by the presence of pauses between words lasting from 1 to 30 seconds.

These tests are not exact methods of research, and only are the reason to begin a more thorough professional diagnosis. Moreover, it is not enough to diagnose "stuttering", it is still necessary to determine to what type (neurotic or neurotic) this disorder of speech belongs, since this will determine the correctness and effectiveness of the chosen methods of treatment.

To establish the correct diagnosis, a specialist can prescribe various tests (blood and urine), as well as instrumental diagnostics, which can reveal organic brain damage at various stages. Instrumental methods in this case include the MRI (tomography) of the brain and the electroencephalogram (EEG).

And yet it is not enough to distinguish between two types of stuttering among adults. It is important to identify the cause of the occurrence of a speech disorder in order to understand which treatment methods will be most effective. It is differential diagnosis with the participation of a speech therapist, psychologist, neurologist, psychiatrist on the basis of a full history and the results of instrumental and laboratory studies can recreate the full picture of the disease, establish or disprove the hereditary predisposition to stuttering and develop a plan for effective control of this pathology.

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Treatment of the stuttering in adults

The problem of stuttering has in its decision several aspects that are related to the physiology, socialization and mental state of a person. And only complex treatment, covering all these aspects, will be able to give good results. Home treatment alone herbs and conspiracies, which many parents of stuttering children are inclined to, leads to the fact that the problem is only aggravated by the transition to the adult age, when the treatment is already hampered by incorrect habits and communication skills that were developed over the years.

The choice of methods for treating stuttering in adults depends on whether this speech disorder is related to the neurotic or organic type. An organic type of stammering is generally a topic for a separate conversation. His treatment comes down to fighting the problem that spawned it. And since the cause of this stuttering are serious disruptions in the brain, often complicated by a genetic factor, then the treatment of stuttering and its root cause can drag on for months and years.

The neurotic stuttering in adults is treated much more easily and successfully. But for him the complex approach, including medical and alternative treatment, appointed by a neurologist, as well as systematic work with a speech therapist, a psychologist and a psychotherapist, that will help the patient restore a normal rhythm of speech, overcome fears, join the normal rhythm of life, adjust communication.

The method of treatment by means of medicinal products has as its goal the removal of convulsive syndrome and the stabilization of the work of the CNS, responsible for the onset of various nervous reactions. Tablets from stammering in adults can be divided into 3 groups: nootropic (improve brain function), sedative (reduce nervous tension) and antispasmodics (have an anticonvulsant effect).

To the first group of drugs can be attributed nootropic remedy "Fenibut", which has a soothing, psychostimulating effect. In addition, "Fenibut" prevents the formation of clots in the vessels of the brain, the destruction of cells of the body and promotes their regeneration (renewal).

This drug can be prescribed by doctors as a therapy for both organic and neurotic stuttering to relieve an anxiety-neurotic state, expressed in the form of fears, face ticks, fear of communication, etc.

Dosage and route of administration. You can take Fenibut tablets at any time of the day, preferably after eating, swallowing the tablet whole. But the doses of the drug (the usual single dose of 1-3 tablets), the number of doses per day (the frequency of admission) and the course of treatment, as well as the duration of treatment, can be prescribed only by the attending physician, based on the indications, the age of the patient and the tolerability of the components of the drug.

Contraindications to the use of the drug are pregnancy and lactation period, liver failure, hypersensitivity to the components of the drug. The drug has virtually no side effects. At the beginning of taking the tablets, drowsiness may occur. The same symptom, especially in conjunction with nausea with vomiting, may indicate an overdose of the drug.

Taking "Phenibut" for a long time you need to monitor the morphological parameters of blood and liver function. Can affect the reaction rate.

Sedatives include Glycine, Afobazol and Grandaxin. "Glycine" acts as a regulator of metabolic processes in the brain, and "Grandaxin" and "Afobazol" differ in a pronounced sedative effect (tranquilizers).

"Afobazol"   - a tranquilizer that does not cause drug addiction. Its action is aimed at eliminating anxiety, fear, fears, and associated nervous muscular and respiratory reactions. It is recommended to take the drug after eating in the amount of 1-2 tablets (10 mg) three times a day. Usually the course of treatment lasts 14-28 days, but if necessary, the doctor can increase the dosage (up to 60 mg per day) and the duration of the course (up to 3 months).

Contraindications to the use of "Afobazol" may include pregnancy and breastfeeding, individual intolerance of the drug or its individual components, and also the age of less than 18 years. Side effects include possible reactions of the immune system with increased sensitivity to the drug.

A positive effect on the nervous system is also provided by the use of plant sedatives, such as Dormiplant and Novopassit.

Novopassit is a preparation based on a rich plant collection (valerian, melissa, St. John's wort, hawthorn, etc.) with a good sedative (sedative) and anti-anxious (anxiolytic) action. Produced in the form of tablets or a solution (syrup).

Dosage and route of administration. Usual single dose - 1 tablet or teaspoon of syrup (5 ml), in pure form or diluted with water. Take the drug three times a day before meals. If the drug causes depression and depression, the morning and evening doses are reduced by half, and the daytime dose is kept the same. If there is such a need, the doctor can increase the standard dose of the drug in half. When nausea occurs, the drug should be taken with food.

Contraindications to the use of Novopassit: age younger than 12 years, myasthenia gravis (genetic neuromuscular disease), individual intolerance to the drug or its components. Side effects: discomfort in the work of the digestive tract (heartburn, sometimes nausea and vomiting, changes in stool density), less often dizziness and drowsiness, as well as allergic manifestations and weakness.

Precautionary measures. During treatment, the drug should not drink alcohol. Caution should be observed patients with liver, stomach and intestines. The drug negatively affects the concentration of attention.

If after a week there is no noticeable improvement or symptoms will increase, you should immediately consult a doctor for the appointment of another drug.

Of the antispasmodics with stuttering in adults, doctors usually appoint "Midokalm", "Magnerot" and "Finlepsin" in combination with vitamin B preparations.

An anticonvulsant drug "Magnnerot" replenishes the magnesium deficiency in the body, which causes seizures and increased excitability. The medication can be divided into 2 stages:

• Seven-day course: 2 tablets 3 times a day,
• Starting from the second week: 1 tablet 2-3 times a day.

The full course of treatment is from 2 to 4 weeks, sometimes more. The tablets are drunk with a little water before eating.

Contraindications: kidney and liver diseases, stones in the bladder, lactose intolerance and lack of lactase, age younger than 18 years, as well as individual intolerance of the drug. Side effects: among the frequently occurring can be identified: a change in the frequency and quality of the stool and the response of the immune system.

In addition to drug treatment, patients with logoneurosis are shown psychotherapeutic sessions using sedative techniques, hypnosis treatment, and acupuncture. In such sessions, patients are helped to cope with fear of speech, increase self-esteem, correctly accept their problem and take responsibility for its overcoming.

Then therapies are connected to the therapy with a speech therapist, which either adjusts the already available speech skills, or instills new, correct ones. Approximately half an hour after these exercises are prescribed massage procedures. Massage with stuttering in adults is presented in the form of reflexotherapy (acupressure) and osteopathy (soft massage effect on the muscles), which have a positive effect on the articulatory voice apparatus and the breathing system.

At the third stage of treatment for stuttering in adults, therapeutic exercises, a swimming pool and a sauna are connected to the above procedures.

There are many different methods of complex impact on the problem of stuttering with various speech training systems, starting with "tet-a-tete" communication and ending with public appearances within the team (groups of patients with the same problem).

Physiotherapeutic treatment of stuttering, in addition to reflexology and osteopathy, includes:

• Procedures that normalize the tone of the facial muscles (darsonvalization of the muscles of the face and neck - the effect on the muscles of the alternating current of high frequency and voltage, but of small force and a brief impact of sinusoidal currents on the larynx)
• Procedures for the restoration and optimization of CNS functions (electro-therapy, therapeutic bath and massage, franklinization, alpha-massage, various types of relaxation).

Treatment of stuttering in adults at home

Many patients, and most often their relatives, tend to treat stuttering at home. Such, let us say directly, irresponsible attitude to the problem of speech disturbance can lead to a worsening of the situation. After all, at home, there is no way to implement a comprehensive approach to the treatment of stuttering in adults. In addition, lack of control by a doctor can affect the patient's own attitude towards treatment, the systematic use of medication and procedures.

Nevertheless, if you are so insistent on home treatment, you must first learn some elements of self-help, such as self-training (self-hypnosis), self-massage of the face and neck (medical!), As well as breathing exercises, for example, according to the Strelnikova method, which is based on the use of elements of yoga.

Respiratory gymnastics is aimed at normalizing both nasal and oral breathing, because without the skills of optimizing breathing during a conversation, it is very difficult for the patient to cope with stuttering. Different breathing exercises from stuttering in adults, according to the Strelnikova system, should be based on proper breathing during the performance of movements: a sharp breath and a prolonged quiet silent exhalation, active participation of the diaphragm in the respiratory process. All active movements (squats, head turns, body tilts) are performed only on inspiration.

Speech gymnastics at home. This gymnastics promotes the development of proper breathing during a conversation.

1. Try to read the Russian alternative fairy tale "Turnip", making a breath on pauses between words.
2. Taking a short breath with an open mouth, pronounce one of the vowels on the exhale until there is enough air in the lungs.
3. Try to do the same with several vowels, pronouncing them one by one.
4. Try on the exhalation to count to 10, gradually increasing the score.
5. Read on one exhalation different sayings, proverbs and tongue twisters, which promotes breathing training and faster relief from stuttering in adults and children.

Examples of tongue twisters for training speech and breathing:

• In the yard there is grass, on the grass, firewood: once the firewood, two firewood - do not cut the firewood on the grass of the yard.
• The advertising of stitches - seams with coverage, and potholders and without coverage snapped up.
• Our head has overheaded your head, overdid it.

In addition to proverbs and tongue twisters, you can try to sing songs known from childhood. Cheerful and kind they will cheer up, help to relax as much as possible and teach them how to breathe properly when talking.

Alternative stammering in adults

What does alternative medicine offer us to help cure stuttering in adults? Aromatherapy, self-massage, recipes for mixtures, infusions and herbal and fruit broths, honey recipes, as well as conspiracies and prayers are the main methods of stuttering, known since ancient times.

It is worth noting that they alone are unlikely to be able to cope effectively with the problem of stuttering, but in combination with the methods of traditional medicine, undoubtedly, will have a positive effect. Maybe some alternative methods, such as conspiracies or prayers, and seem to many dubious, but they too have a right to exist. Since the logoneurosis has at its base a trauma, the important factor of treatment is faith. It is necessary that the patient believes that by these methods he can be healed. Conspiracies and prayers are a kind of suggestion of self-confidence and self-reliance. If a person does not believe in the effectiveness of these methods, then there is no point in using them.

Another thing is aromatherapy. Here, faith is not required, all work will make essential oils that have a sedative effect, able to relieve nervous tension, calm fears. Such actions are oils of bergamot and pine, roses and sandalwood, rosemary and basil, thyme and wormwood, sage and geranium, and, of course, lavender. For this, it is necessary to drip the oil on the shawl and inhale its fragrance for a while. This procedure should be done three times a day.

Aromatic oils in a mixture with kefir can be used for bathing. To do this, take 100 g of fermented milk product and add to it 5-6 drops of any of the above essential oils. The oily-kefir mixture is added directly to the bath with warm water.

Stammering in adults can be treated with decoctions of fruits. The compost from the rind of apples, boiled in pure water for 5 minutes has a pronounced soothing effect. In it you can add lemon balm or just drink with sugar or honey.

By the way, honey also has a remarkable sedative effect, known in the old days. For example, Avicenna recommended 3 times a day to lubricate the tongue with a mixture of honey and mummies (the proportion for a mixture of 5: 1).

A similar treatment option can be found in "grandmother's" recipes. It is necessary to prepare 2 mixtures of mummies and honey in different proportions (1: 8 and 1: 5). Mummy should be taken in the amount of 0.2 grams. The first mixture (concentrated) is taken in the morning, the second (weaker) - in the evening for 4 months.

A mixture of the juices of viburnum, lemon, white cabbage and hips, taken in equal proportions with the addition of double honey (1: 1: 1: 1: 1: 2) also has a positive effect when stuttering. Take the mixture must be twice a day: in the morning and in the evening for 1 tbsp. L., eating seeds or a nut of almonds.

Herbs in the form of decoctions and infusions are also effective against stuttering in adults. And many herbal recipes only confirm this. Here are some of them:

• Recipe 1. Ruta fragrant. 5 g of chopped herbs pour 2 cups of boiling water and give a boil for 5 minutes. Decoction filter and slightly cool. We keep a hot broth in the mouth until it cools down completely (2-3 hours). The procedure is repeated very often (at least 6 times a day).
• Recipe 2. White ashen. Leave the plant pour boiling water and insist for 20 minutes, then strain. Infusion to apply for a mouthwash (3-5 minutes) 5-6 times a day.
• Recipe 3. Soothing collection. We prepare the herbal collection of chamomile, mint, nettle and valerian, pour a teaspoon of herbal mixture with a glass of boiling water and stand in the heat for 15 minutes. To drink infusion should be half a glass twice a day.
• Recipe 4. Herbal collection to inhibit the reactions of the nervous system. Birch leaves, licorice, melissa, sweet clover and marigold flowers are taken in equal proportions. Shredded herbs pour boiling water and warmed in a water bath without boiling. Constant for 2 hours and strained through cheesecloth infusion take before meals 5-6 times a day.
• Recipe 5. "Hmelnoye" broth. To prepare a medicine that relieves spasms of the brain, you need to take a glass of any wine and bring to a boil, along with a pinch of goose fuzz grass. Infuse until completely cooled, then drain. Drink the broth in a warm form. Instead of wine in the broth, you can use milk, but in no case water, which reduces the therapeutic effect of the drug to zero.

This is only a small fraction of all the prescriptions of alternative medicine, which our ancestors used with varying degrees of efficiency. And the fact that they have reached our times, speaks for them.

There are many alternative methods and methods of traditional medicine that can cure stuttering in adults as part of complex therapy. Nevertheless, a visible positive result can be obtained only with a strong desire of the patient to get rid of the rhythmic speech defect. Significant psychological support and assistance in treating a patient with speech disorders can be provided by relatives and friends. Treatment of an adult can be long and you need to be ready for this, be patient and activate your willpower. And then victory over the disease is bound to come.

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