speech impediment

speech impediment

Overcoming Speech Impediments: Empowering Communication Skills

1. Introduction: Understanding Speech Impediments

Understanding the root and magnitude of speech impediments is paramount in sophisticating the efficacy of treatment. Impediments manifest themselves in a variety of ways; some affect fluency and smoothness of speech, others the clarity and articulation of sounds, and still others the rhythm and timing of speech. Such maladies can spawn from a myriad of causations such as physical and neurological trauma, genetic predisposition, or conditioned response to environmental stimuli. This paper will focus on maladies which affect articulatory capacity, such as those experienced by those suffering from cerebral palsy. People with speech impediments are sometimes inaccurately assumed to have cognitive disabilities, be antisocial, or unmotivated, but nothing could be further from the truth. Data on this section will be summarized from an interview between the author and Dr. Diane Paul, Director of Clinical Issues in Speech-Language Pathology at the American Speech-Language-Hearing Association. Although speech impediments can be quite a barrier to effective interpersonal communication, often people adapt mechanisms and strategies to offset their communication difficulties. Because articulation is impaired most often in those with cerebral palsy, they were focused upon in the interview to better understand how speech impediments can affect overall communicative effectiveness. An important and interesting highlight from Dr. Paul is that, because speech is very much tied to identity for most people, having a speech impediment can alter one’s self-concept and sense of self. This is why people with speech impediments will often avoid speaking situations that they do not feel are conducive to their levels of communicative effectiveness. This can be seen in anyone who avoids a situation likely to cause embarrassment.

2. The Impact of Speech Impediments on Daily Life

Despite the discrepancy between prevalence estimates for stuttering and other fluency disorders, a seemingly modest 3% or less of the preschool and school-aged children or of the general population, thirty people per thousand will visit a speech clinician at some time during their lives. The prevalence of speech impediments is striking and can vary greatly according to the type of disorder. Considering that people are more than likely to encounter someone else with a speech impediment if they do not have one themselves, its effects are felt much more wide-reaching than one would originally guess. A speech impediment does have its effect on social or lone activities, for example, when judging involvement in social clubs or organizations, a person of enough, but not excessive, mental capability will be overlooked solely based on speaking ability. Other areas in which speech plays a great part, for example performance arts, or as mentioned previously, teaching, are also fields of further discrimination to those who find speaking difficult. Essentially people with speech impediments are likely to do less with their lives than those without because they are often too afraid to take on tasks that involve speaking. This often leads to general low self-esteem as those who continually turn away opportunities to do things that they would actually like to do become disillusioned with themselves. At times the effects can even be far-reaching into people’s familial and romantic relationships and potential for employment. Ostensibly, to those who do not know the person well, people with severe speech impediments are often seen as less intelligent than they actually are. This misconception can sometimes affect children and teenagers so much that they indeed exhibit lower performance in school or are placed in lower level classes than is appropriate for their capability. A study done in New Zealand on the educational attainments of people who had sought treatment for stuttering as children found that those who had been teased about their stutter or who had a relative who stutters were more likely to leave school early and to have completed fewer total years of education compared to those who had neither of these experiences (O’Brien et al., 2003). People making comparisons with traditional ideas of disability have asked the question “are children who have communication difficulties the new underclass?” (Taylor, 1998). Although this may seem a strong statement, the obstacle of communication truly does create a division between those who can speak and those who cannot.

3. Techniques and Strategies for Improving Speech

Physiological techniques (body posture and relaxation) are primary indicators of how one speaks. If a person is tense and breathing shallow, speech will be less fluent and more effortful. Furthermore, it is impossible to be anxious and relaxed at the same time! By learning to first recognize when you are tense, learn what makes you tense, and then when relaxed, and through practice, you can learn to control and manage your own level of bodily tension and degree of relaxation. This will bring control of your speech out of the subconscious autonomic level and up to the conscious level. This can be accomplished through progressive relaxation exercises over all muscle groups. Alternatively, teachers of yoga or meditation can be very helpful for developing a deep sense of relaxed awareness. Note: Alcohol has an inhibitory effect and some people take a small measure to relax before speaking. However, it reduces the efficiency of the mechanisms of attention and does affect the control and quality of speech. It also has long-term adverse effects and is not a good area to start self-medicating. High levels of caffeine can increase arousal to a level where you feel jittery and often make anxiety-based symptoms worse. In this case, a degree of relaxation, and not just of activating speech, may be more beneficial. (This issue of inadequate differentiation of bodily activation; positive and negative, needs further research). Temporal organization of speech and fluency can be improved if the speaker has a sense of composure and freedom of time. This is likely to be achieved through feeling relaxed and in control while speaking. An analogy on the effects of bodily tension and control can be made with playing a musical instrument.

4. Building Confidence and Self-Esteem

As discussed in the chapter on self-esteem, individuals who are different in any way are often subject to a dual burden; not only must they learn to cope with having a disability, but they must also adopt the same coping mechanisms used by any people who are different in some way from the mainstream. Goffman (1963) referred to this process as managing a spoiled identity. When a child with a speech impediment is being evaluated for self-esteem issues, it is important to consider whether the child’s main problem lies with the impediment itself, or with the social reactions to the impairment. In a study by Blood and Blood (1976), a group of children receiving treatment for their stuttering were compared with a group of children receiving non-stuttering treatment, using semantic differential ratings of self-esteem. It was found that the children receiving treatment for stuttering had self-evaluations almost as high as the non-stuttering group, thus indicating that it is the social reactions to the impairment that pose the bigger threat to a child’s self-esteem, rather than the mere presence of a speech impediment. Speaker attitudes are also an important factor to consider when dealing with self-esteem issues. The more negative attitudes held by an individual who stutters are likely to become a self-fulfilling prophecy as they inhibit the speaker from participating in various communicative situations, thus limiting communication skills and overall life opportunities. This will increase the likelihood of a negative evaluation of the self, as suggested by the principle of the looking-glass self, and will further confirm the negative attitudes originally held. With attitudes and perceptions in mind, it is important to consider not only the present self-esteem levels of the client, but also what level of self-esteem is seen as desired by the client.

5. Embracing Support and Seeking Professional Help

Rising to the occasion, and in spite of failure, demonstration of strong self-efficacy, bolstered by an excellent social support system, is one of the most accurate predictors of success in overcoming any obstacle—speech impediments included. While those who stutter are often mischaracterized as lacking social skills or being shy, these characterizations are actually not accurate. Research has actually shown that instead, people who stutter are often marginalized or discriminated against, and therefore feel anxiety or reluctance to speak because of the negative attitudes or reactions they receive from others. When combating this discrimination or dealing with negative reactions, having a strong network of family and friends can be crucial. As an example, one person who overcame a stutter cites the unending patience and encouragement of his mother as a factor that motivated him to continue speaking in spite of a desire to just remain silent. Friends, who are known to torment each other endlessly, must have an understanding that humor at the expense of the individual’s speech will do nothing but hinder progress, and may greatly damage an individual’s self-confidence. Love and kindness from friends, and the occasional heartfelt encouragement, can do wonders for someone struggling with a speech impediment.