Speaker: Oh, Jim, I wanted to talk to you. What's this trouble you've been having in school? Haven't you gotten over that stuttering yet?

Jim: Well -- well -- well --

Speaker: Now there you go. Just sit down, Jim, and get yourself organized and we'll try to talk about this in a minute.

[ Music ]

Narrator: The Exceptional Child, a child with differences. It is our hope that through these programs, we might better understand this child and help him.

[ Music ]

Narrator: Stuttering is not simply a bad habit, and it is a problem which can seriously affect a child's personality growth and his relationships in life, perhaps to such a degree that he is extremely inadequate in facing the challenges necessary to full growth in society.

I'm Ed Jones, your host on these programs, and today we're going to try to understand the special and important problems that confront the child who stutters with the hope that through our understanding and more positive attitudes, we may be able to help this child and his attempt to build a happy and constructive life.

Speech is not instinctive. A child inherits the ability to make vocal sounds but he must learn to speak. As a small baby, he babbles and cries and normally goes about making the noises of true speech. By constantly repeating the sounds, he builds a greater degree of control and discrimination. In time, he will use actual words and sentences, expanding his speech until it becomes his main avenue of communication.

Somewhere around the age of three, many children experience speech difficulties. These children may hesitate in their effort to find the desired words. Or they may become excited and try to say the words too fast, causing them to slur and repeat words. With most children, these difficulties disappear as they develop their ability to talk more fully, and especially if they're not constantly corrected and made to feel tense about speech requirements.

With some, however, these difficulties do not disappear and serious problems may result. Not only is the ability to speak clearly and understandably impaired, but speech difficulties have their visual effects, which in turn cause negative reactions in others, thus intensifying the communication problem for the child. It becomes increasingly difficult for this child to gain satisfactory relationships in life.

With us today to help us better understand the child who stutters we have Dr. Charles V. Mange, Assistant Professor of Audiology and Speech Pathology in the Division for the Education of Exceptional Children at Syracuse University.

Dr. Mange: The stutterer is not always a stutterer for there are many times when speech can be produced as easily and as fluently as is characteristic of most of our speech. When there are no other persons present, or when speaking in unison with other people, or when speaking highly automatic words such as in counting and naming the days of the week, fluency is the usual rule for the stutterer. Whenever there are persons present, however, who can hear and react to stuttering, the likelihood -- the probability of stuttering is greatly increased.

For stutterers, some persons are much more difficult to talk with than others, and, similarly, some situations cause much more difficulty than others. By finding substitute words for ones on which they expect to stutter, by inserting "ah," or "well," in words of the sentences, the stutterer oftentimes attempts to avoid the difficulty, and to minimize the reactions which you'll receive from others.

Unfortunately, these things do not always work well, and usually they're only of temporary help. And even more unfortunately, they add greater abnormality to the stuttering pattern.

Jim and Nancy, you both used a number of these stuttering symptoms, the kind of things that we've just been talking about. What -- what ones have you used especially, Jim?

Jim: Well, I've used eye -- eye blinks and -- and -- and retrials.

Dr. Mange: The eye blinks there, you had a good sample of your eye blink. Your eyes were closed rather tightly. What's the other one that you mentioned?

Jim: R-R-R-retrials.

Dr. Mange: And there you what? What happens in this -- not quite sure what a retrial is here.

Jim: Well -- well -- well, you say the word over again.

Dr. Mange: You mean if you -- you -- you mean if you -- you -- you mean if you -- you mean if you have trouble on a word that's coming up, you go back and say some other words?

Jim: Yes.

Dr. Mange: This is what you've done quite a little of, huh? Can you show us a good retrial of the kind that you usually do?

Jim: Yes. My -- my -- M-m-m-n-n-n-n-name -- name is James Steiner.

Dr. Mange: Good job, very good. What happened there is you came up with a word, you stuttered on it, you tried to say it over again and you stuttered on it over and over again. You have used some symptoms, too, huh, Nancy?

Nancy: Yes.

Dr. Mange: What kind of things have you used?

Nancy: Well, I've used pull-outs. That is when you say a word and you have a block on it and you pull yourself out, such as my name is -- iiisss -- Nancy Stout.

Dr. Mange: This is something that you use to try and get through a block, huh?

Nancy: Uh-huh, yes.

Dr. Mange: What kind of blocks do you have?

Nancy: Well, um, some are short and you can hardly notice them.

Dr. Mange: Are they kind of tight up here or --

Nancy: Well, no, I don't think so.

Dr. Mange: Do you kind of b-b-b-bounce along a little bit like this?

Nancy: Yes, on some I do.

Dr. Mange: Uh-huh. You usually come up to a word, you come up to this block, you have it, you work with it, you struggle and you try and get through it.

Jim, on the other hand, oftentimes goes back and tries to say words that he's already said in hopes that he can perhaps get a running start.

So you two have some difference in your symptoms here. You try and hit the block and go through it, you struggle with it, and Jim has retrials, tries to avoid blocks for the most part.

But why and how do people like Jim and Nancy and other stutterers develop their stuttering pattern? There are many things that we don't know about the causes of stuttering, but we do know that many children, usually between the ages of three and six years, experience considerable non-fluency and hesitancy in their speech as they begin to produce more and more complex sentences. And this is especially true whenever there is any competition to be heard or when a child is excited.

Parents and others frequently ask the child to slow down, to start again, to think before you speak, and a number of other things like that. If the child as a result of these cautions develops concern and begins to force on words as a result, the problem becomes more difficult. And it's extremely important that we do all that we can to prevent such problems from occurring.

By realizing that most children, normal children have non-fluency and hesitancy in their speech, becomes much easier to accept this. Some children, however, continue to increase their concern and their stuttering, and they begin to force as a result. The forcing helps to elicit negative reactions, and, again, increased concern. With increased concern, more stuttering, and so a vicious circle is established.

All this may make you think that the emotional maladjustment that is present in stuttering is basic, but research has failed to support this point of view. Probably, the stuttering causes whatever maladjustment may be present. But it is true that stutterers are usually sensitive about their speech and perhaps we can best understand this by thinking of our own sensitivities to small, physical imperfections and our other shortcomings. And as other people call these to our attention, we're even more sensitive about them.

There is little wonder, then, that the stutterer is concerned about his speech because so many speech situations are required each day. Each time the stutterer opens his mouth to speak, his problem shows.

Narrator: Some of the children in this class are new to Nancy and she's still unsure what their reactions to her stuttering will be. In this demonstration of the making of oxygen, the collecting bottle upsets momentarily. Nancy is also upset and begins to stutter. Her feelings of uneasiness about talking in this situation are reinforced and she anticipates a great deal more stuttering.

[ No audio ]

Narrator: The responses from the class vary from no reaction to smiles and looking away. One way to avoid further stuttering and embarrassment is to stop talking and return to her seat. Nancy's decided to give up. Further stuttering is avoided but the problem and Nancy's feelings are even more sharply apparent. The failure to communicate and to complete the assignment have resulted in frustration for Nancy and embarrassment for her classmates and herself.

And yet, there are many situations which offer little or no difficulty in speaking. With friends who accept her stuttering easily, and in situations when talking is a happy, spontaneous occurrence, Nancy is not worried about how she talks. Nancy and most other stutterers are fluent speakers when there is no emotional tension while speaking, while there's no expectation of criticism or reactions of ridicule, while there is an easy, relaxed speaking situation. But the most common situations are not always the easiest. Answering the telephone requires an immediate vocal response.

[ Phone ringing ]

[ No audio ]

Speaker: Hello, is this the Petersen residence? Hello, hello!

[ No audio ]

Speaker: Well, can't you answer? AH!

[ Person hangs up ]

Dr. Mange: The stutterer tries to avoid stuttering and, as a result, is highly disturbed when it occurs. One of the goals of therapy is to make it possible to stutter without the severe embarrassment usually present. But we must do more than just help the stutterer to become objective. We also need to help him control the blocks, to change them to a more normal form.

Speaker: Hi, Jim. Today I think we're going to start off working with eye contact. Do you remember what that means?

Jim: Yes.

Speaker: That's right. That means whenever you get into a block, we want you to look at us and not to look away. We want you to keep your stuttering easy so you don't have to work so hard at it. I want you to watch Nancy while you're talking today and she'll be your conscience, and she's going to say whoops whenever you look away from her, all right?

Jim: Yes.

Speaker: Okay. What would you like to tell us about today? Don't forget to look at Nancy.

Jim: My dog home.

Nancy: Whoops.

Speaker: Good, Nancy.

Jim: And -- and her name is P-P-Princess and she has brown---- brown spots, and -- and the veterinarian says shhh -- she couldn't grow bigger because that's as big --

Nancy: Oops.

Jim: Because that's as big as she could grow. So -- so she -- she had got her shots and --

Nancy: Whoops.

Jim: And -- and we had -- had --

Nancy: Whoops.

Speaker: That's good. That was a good conscience, Nancy. Did you realize you were looking away then?

Jim: Yes.

Speaker: Okay. Now, Jim, I'd like to you use the mirror and whenever you get into a block, I want you to tell me what you did, what happened while you were in that block, all right?

Jim: Yes.

Speaker: What would you like to tell us about now? What grade are you in school?

Jim: Ah-ah-ah-- I'm in -- I'm in 4th grade.

Speaker: Good. What happened to you there?

Jim: There was plenty of work to do but --

Speaker: No, what happened to you in that block, Jim?

Jim: Oh. Well, I had eye blinks and very slight h-h-h-head jerks.

Speaker: Uh-huh. There's another one just like it, wasn't it?

Jim: Yes.

Speaker: All right. Are you looking at yourself in the mirror now?

Jim: Yes.

Speaker: And what do you do in the fourth grade?

Jim: Well, I do -- do -- do plenty of work on every school day except for Fr -- except for Friday.

Speaker: Uh-huh. And that's the same type of thing that happened again, Jim, right?

Jim: Yes. The --

Speaker: The what happened?

Jim: H-h-had a retrial, too.

Speaker: That's right, that's good.

Now, Nancy, we'd like to talk to you for a while, and I want you to – when you're stuttering, to try to control it right within the block, like th,th,th,th, this. Slow it down while you're in that block and don't let it get away from you. And if you don't have any blocks, try to fake a couple, all right?

Nancy: Okay.

Speaker: All right. You took a nice trip a while back, didn't you?

Nancy: Yes.

Speaker: What was that like?

Nancy: Well, last Easter, we went to, um, Washington, D.C.

Speaker: Uh-huh.

Nancy: A-a-and -- annnnd, we saw many interesting places. We went to Mount Vernon.

Speaker: Uh-huh.

Nancy: And, um, we saw the White House but -- but -- buuuuuttt --

Speaker: Good.

Nancy: We didn't go inside.

Speaker: That's nice. What else did you see?

Nancy: Well, the Lincoln Mon -- monument and also the Tomb of the U-u-u-unnnnknown Soldier.

Speaker: Fine, very good. Uh-huh. And what did you see in Mount Vernon? Did you go through the whole house?

Nancy: Yes, we went through the whole house and the grounds.

Speaker: Uh-huh. Did you like that?

Nancy: Yes, it was very interesting.

Speaker: Uh-huh. I see. Well, that was pretty good today. I think we found some things that we can work on. Jim has to work some more on his eye contact and eliminating retrials, and Nancy, you're doing a good job on what we're doing now.

Dr. Mange: There are many ways to improve adjustment towards stuttering. Through actual practice in stuttering and in gaining control of it, on the street and in stores and classroom situations, the stutterer begins to see what he is doing and why he reacts as he does. But without the embarrassment which has previously been an integral part of all of these speech situations. By talking about these practice situations and many other real ones which have occurred in the past, becomes easier to learn how to handle them.

You've had some of these situations yourself, haven't you, Bob?

Bob: Yes, I have. Last summer a friend of mine and I, he was a stutterer also, had to go into a restaurant and order. I was supposed to order for both of us. He wanted a cup of coffee and I wanted a Coca Cola. I told the waitress I wanted a cup of coffee and a Coke. She didn't know what I meant and she stood there for a while and I sort of blacked out, I didn't know what was going on.

By the time I realized that she was standing there waiting for me to give the other boy's order, I had quite a bit of trouble trying to explain it, and quite a bit of blocks at the time, and that made it quite difficult for me to order things in the stores or restaurants again. I had to do quite a bit of work on that, going to -- ask about things, ask for prices and that sort of thing, and it's helped to break down my fear quite a bit.

Dr. Mange: You deliberately have done this kind of thing since.

Bob: Yes.

Dr. Mange: How is it coming?

Bob: Well.

Dr. Mange: Good. You've had some of these, though, too, haven't you, Betsy?

Betsy: Yes. One time I got to read in front of the class, and the class became quite unruly. The teacher asked whether it was their fault or whether it was mine, she couldn't understand me. After that, it became more difficult for me to read in front of the class. I began to stutter more and became more tense. But I've been working in therapy now. I had an assignment to go out in front of the class and give a speech and I had to tell them how I stuttered, how other people stuttered, and what were some of the causes, maybe, and that sort of thing. And my classmates liked this and they were quite interested in it and they asked quite a few questions.

Dr. Mange: You mean, you've actually gone back, then, and talked about stuttering in the same situation that you used to have a lot of difficulty?

Betsy: Yes, I have.

Dr. Mange: Very good. Stuttering blocks are kind of strange to a person the first time they've seen them, and I imagine you've had some strange reactions to yourself, haven't you?

Bob: Yes, I have. Sometimes people look away or they become embarrassed and they try to tell me what to do, like to smile, for instance, or to take a deep breath before I speak or something like that.

I've had situations where, talking on the street, I've asked for directions and the people become so embarrassed that they try to tell me where to go. I mean, not tell me where to go but take me there if it isn't too far away, because it usually isn't, and so in order to combat that, I have to tell them that I'm a stutterer and I'm on an assignment to improve my speech and to break down my fear of talking to people, and to tell them that -- that, thanks a lot, I don't really want to go there but you've helped me with my fear quite a bit.

Betsy: Yes, sometimes classmates will try to make fun of you. I know one girlfriend of mine, sometimes she'll say B-B-B-B-B-Betsy, and to counteract that, I say,wh-wh-wh-wh-what.

[ Laughter ]

Dr. Mange: You give her back the same thing that she gave you.

Betsy: Yes.

Dr. Mange: Okay.

Bob: I had a paper route and sometimes my customers tried to tell me to do things. Once I had a customer who said that she had a nephew and he stuttered and she always told him to smile, so she told me to smile when I spoke. That didn't help me very much, I was quite embarrassed about that.

Dr. Mange: There is no doubt that the negative reactions of one's listeners are a very important factor in causing the development of stuttering symptoms. However, when people are able to talk about their problems as Betsy and Bob have just done, a significant amount of improvement has already occurred.

But for the young child who's not yet learned how to deal with such reactions, the responses of others play a very great role in their adjustment towards speech. And the reactions of parents are probably most important since they are the greatest influence in the early life of a child. Favorable, relaxed, and pleasant responses to the child's attempt at speech can make the difference between stuttering and a more normal pattern of talking.

Speaker: Well, Jim, I wanted to talk to you. What about this trouble you've been having in school? Haven't you gotten over this stuttering yet?

Jim: W-w-w-i --

Speaker: There you go. Why don't you just sit down, young man, and get yourself organized so we can talk about this!

Jim, I'm sorry. Why don't you start at the beginning and tell me about this trouble you've been having in school.

Jim: Well -- well -- I -- I --

Speaker: Take your time, Jim. Take your time. Be very slow about it and tell me all about it.

Jim: Well, I -- I -- I did --

Speaker: Jim, Jim, why don't you go out and play with your friends and we can talk about it maybe a little later, huh?

Dr. Mange: A feeling of rejection is quickly and strongly felt by many children. Some parents will respond in a way which seems to be much more sympathetic but sympathy is usually the confirmation of a problem, and it may result in increased concern about speech. Speech is used so extensively in classroom work, in social contacts, and in nearly every situation where two or more people find themselves, that the stutterer finds himself subject to a large number of adverse reactions each day.

Narrator: Nancy finds it especially difficult to stop someone on the street to ask directions. A word or sentence has to be produced immediately to make them stop and listen. If that word is stuttered, a very frequent response is to laugh, or with some children, to mimic the stuttering. This is another situation where the tendency to avoid further speaking is very strong.

Going to the store poses similar problems. As a result of previous unhappy experiences when asking for articles, Jim rehearses what he's going to ask for and tries to avoid any difficult words. Despite the preparation, he stutters. To indicate the candy bar he wants, he points. The clerk doesn't understand the kind of candy Jim wants. The first candy available is offered. Jim accepts it rather than try to explain that he wants a different kind. And yet, he would much rather have what he came for. But the humorous mimicry and discussion of his speech are too much to face. Jim's understandable decision to avoid further trouble leaves him with a purchase he doesn't want and a very low opinion of himself.

Dr. Mange: We have seen some reactions which are unhealthy ones for the stutterer and which usually serve to intensify and prolong the stuttering. There are other reactions, more subtle but nevertheless damaging.

A question of how we react is an important one. But to answer it, we must clearly understand the two major stages in the development of stuttering symptoms. The young child who has non-fluencies, hesitations or repetitions in a relatively easy and effortless manner, has no conscious awareness of speech difficulty. If this awareness can be prevented, stuttering can be prevented. Speech work should be avoided. Rather, all concerned should make every effort to listen attentively and to avoid any unusual responses when hearing non-fluent speech.

Professional assistance can also be very useful and helpful for -- for the parents and teachers who work with the child. For the stutterer who is concerned about his speech, and who forces, uses avoidance and postponement and other such devices, speech therapy is needed.

Many schools, as a part of their regular services, and universities, have diagnostic and therapeutic facilities. If these are utilized as soon as a stuttering problem appears, it becomes much easier to reduce the difficulty.

Stuttering attracts attention, attention which yields emotional stress. Stress which causes more stuttering. Although many of these reactions are of a negative nature and serve to increase concern and reinforce feelings of rejection and inadequacy, there are also positive reactions, those which stem from an interest in the stutterer as a person and as a friend, and which makes speaking a pleasurable experience.

Therapy is directed toward reduction and control of the stuttering blocks, and toward an objective view of the reactions elicited by those blocks.

Narrator: Clear, understandable speech is something that must be learned. Since no two children are exactly alike, they learn to speak with varying degrees of speed and accuracy. Their parents can help them but they can't do it for them, and should not try to push the children too fast. If parents forget that each child is a separate individual, he is apt to be unfair in his expectations, causing the child great difficulty in his attempt to adjust.

If the child has a speech disorder, such as stuttering, his relationships may be unusually complicated and difficult. But the child who stutters is usually healthy and normal in other respects, and his personality differences in most cases are similar to those which contribute to the individuality of all children. If his personality becomes negative and unpleasant, it probably is because of the treatment he's received from others. If the treatment continues, these negative characteristics will grow to extremely unhappy proportions. Therefore, it is up to all of us to do whatever we can to help this child to gain satisfactory and maximum adjustment.

Next week, we shall try to understand the relationships of the child who is socially maladjusted. Remembering that a child with a handicap is yet a child, an exceptional child with a life that may be restricted, sometimes even distorted, but one which can grow and continue to grow toward fulfillment. As we know more about the growth and development of the child with a handicap, we will be able to help the exceptional child more in his quest for happier, more secure relationships with the hope that if he cannot completely eliminate his handicaps, he may effectively reduce the restrictions they cause.

A child is born, new life begun, a life that may be exceptional but need not be without beauty and achievement.

[ Music ]

Speaker: This is National Educational Television.