Temperament, Emotions, and Stuttering
Which types of temperaments are likely to experience negative thoughts and emotions regarding their stutter?
Stuttering is dynamic and consists of multiple layers. It is widely known that stuttering is the result of differences in the brain and differences in genetic makeup. However, current research is peeling back another layer of the onion.
Emotions are variable and can influence stuttering before, during, and after speaking situations. Reactivity is dependent on the sympathetic nervous system; It's how much motor activity and attention is spent on the emotions. High amounts of reactivity are often the result of an active amygdala, or the "fight or flight" region of the brain. When the amygdala is activated, it leads to increased tension in the body. Tension in the body, specifically in the chest, shoulders, and larynx, makes it harder to produce fluent speech.
Addressing negative emotions in speech therapy is key to breaking the cycle.
Emotions and reactivity are inherited, but are also highly influenced by external factors.
In one study, researchers examined the temperaments of 123 children who stutter. They found that children who were: more extraverted, less shy, and less reactive, had a lower overall impact of stuttering according to the Overall Assessment of the Speaker's Experience of Stuttering (OASES). These children were more likely to express experience positive emotions rather than negative emotions related to their speech.
Children who were: more reactive, had higher levels of irritability and frustration, and were more introverted, had a higher overall impact of stuttering according to the OASES. Highly reactive children may be sensitive to new experiences, meeting new people, eating new foods, and being in new setting. They may respond to the new stimuli by increasing tension in the body. Children who stutter appear to demonstrate greater reactivity, both positive and negative, and less emotional and attentional regulation.
For young children who stutter (i.e. ages 2-5), it is important to build a positive environment around speaking. Children at this age are starting to understand that their body, emotions, and mind are their own. It is the age that children start to experience negative emotions (e.g. shame, guilt, embarrassment) related to experiences. Children begin to report negative emotions that are related to how badly they feel following failure. They can begin to judge weather a task was easy or hard, and decide if they are willing to attempt it again.
What Can You Do?
For School-Age Children and Adults:
Collaborate with a speech therapist and psychologist- A psychologist is certified to conduct cognitive behavioral therapy (i.e. CBT) and cognitive restructuring to reshape negative thoughts.
Include a mindfulness practice- Including a mindfulness practice every day can help someone who stutters bring attention and acceptance to the present moment.
Create a community- Creating a community with other people who share similar experiences can alleviate feelings of isolation and help you accept that its okay to stutter. Connect with associations like the National Stuttering Association (i.e. NSA), The National Association of Young People Who Stutter (i.e. FRIENDS), and the Stuttering Association for the Young (i.e. SAY).
Advocacy- A person who stutters can advocate for himself/herself by politely asking people to not interrupt them and/or finish their sentences. Advocacy can include writing a one to two sentence-long script for initial interactions to decrease the anxiety of introducing one's self.
For Parents of Young Children (i.e. 2-5) Who Stutter:
Create a positive environment around speaking to help them gain confidence for future speaking events.
Give praise to them for sharing their thoughts (regardless of fluent or disfluent speech).
Ask about your child's opinion (e.g. "I like the red dress better. What do you like better?")
Avoid complex "why?" questions and ask concrete questions.
Model slowed and relaxed speech.
Ask one question at a time.
Model pausing when speaking.
Model turn-taking during play and conversation.
Model advocating for yourself (e.g. "excuse me, I would like to finish my sentence")- Allowing a child to feel like they can advocate for themselves when speaking is allowing them to feel empowered.
Build routines- Building routines (e.g. eating, bedtime) increases predictability and decreases stressors.
Avoid asking them to repeat themselves or telling them to slow down.
References:
E;, Eggers K;Millard S;Kelman. “Temperament and the Impact of Stuttering in Children Aged 8-14 Years.” Journal of Speech, Language, and Hearing Research : JSLHR, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/33465312/.
Temperament can be defined as, a "child’s biological contribution to his own emotional, cognitive, and motor profile" (Scott, 2008)
Scott, L., 2008. Communication disorders and temperament. [online] Stuttering Foundation: A Nonprofit Organization Helping Those Who Stutter. Available at: <https://www.stutteringhelp.org/communication-disorders-and-temperament> [Accessed 18 May 2022].
