Did you know that over 5 million people in the United States at any time live with a long-term disability resulting from traumatic brain injury? Among them, one often overlooked side effect is stuttering—a speech disorder that affects life quality by impairing smooth communication. It is also called neurogenic stuttering.
Though not as visible or tangible as many other head injury symptoms, stuttering carries much weight in the big picture. So, fret not; it does not matter if you are a caregiver, someone’s mother, or have experienced an injury yourself.
We will explore the topic of stuttering after a head injury: the types, exact causes, and varieties of treatments.
What is Neurogenic Stutter
Neurogenic stuttering seems to be caused by damage to the brain. Interestingly, it can also occur in adults who have never experienced stuttering. This form, however, is not what we usually call “developmental” stuttering—that which begins in childhood.
In another distinction from developmental stuttering, neurogenic stuttering does not relate to early language development or the associated linguistic and motor skills. Instead, it seems to just happen all of a sudden in adults due to certain neurological events or conditions.
The sudden onset of this stutter is a significant identifying feature, particularly in those who have not suffered any previous problems with speech. Other neurologic signs and symptoms, such as ataxia, weakness, or sensory deficits, strengthen the diagnosis of neurogenic stutter.
It is crucial for medical practitioners to understand these differences so that they can offer therapies and interventions tailored to the specific challenges that people face with this type of stuttering.
Speech is not easy for those living with neurogenic stuttering. An individual with neurogenic stuttering struggles to speak fluently and smoothly. At times, they will be stuck with sentence initiation. Repetition of words or prolonging of sounds often characterizes their speech.
Etiology and Risk Factors for Neurogenic Stuttering
There are two general categories to account for stuttering after a head injury:
- Stuttering that occurs in combination with aphasia
- Stuttering that is related to speech motor difficulties, also known as apraxia of speech
In this post, we will discuss aphasia and apraxia more and explain why these disorders are likely to cause stuttering.
Aphasia
Aphasia is a condition characterized by damage to both the language-associated centers in the brain: Wernicke’s and Broca’s areas. These categorical brain areas have a critical role in understanding and producing text. They are located in the language-dominant side of the brain, which in most cases is the left cerebral hemisphere.
For instance, an injury in Broca’s brain area will result in incoherence in speech output. Most of the time, individuals with Broca’s aphasia speak in short and fragmented sentences.
In addition, a person with Broca’s aphasia may even begin to stutter. This happens simply because the brain has difficulty selecting the right words, so it keeps on trying to fix whatever it says, which may lead to stuttering.
Apraxia of Speech
Apraxia is a disorder that usually occurs following damage to the cerebellum and makes controlled muscle movement difficult. It can strike all muscles, including those responsible for speech production, by moving the mouth or tongue.
Most people with apraxia demonstrate strange or exaggerated lip motions. They may even articulate certain sounds with an abnormal pronunciation. However, sometimes, apraxia may even contribute to stuttering after brain injury.
Understanding Stuttering Post-Head Injury
Post head injury, one might experience a unique kind of stuttering known as psychogenic stuttering. The emergence of this kind of stuttering is typically tied to emotional stress or distress.
Rather than being related to specific types of brain injury, psychogenic stuttering typically arises from a coping strategy.
Here are some distinguishing features of psychogenic stuttering:
- A sudden onset of stuttering behavior
- The regular repetition of the same stressed syllable in a word
- Absence of secondary symptoms
- The stutter persists when the person engages in casual conversation or reading aloud.
- As psychogenic stutters have no physical basis, they require a unique method of treatment.
Characteristics of Neurogenic Stuttering
Neurogenic stuttering differs from prolonged developmental stuttering, especially when it has an adult onset. In adult stuttering, a person might display the pattern of disfluencies at a considerably high rate and widely spread through their conversational exchanges. The disfluency types can be organized under three different streams:
- Reiterations: Repetitions of one or more words, syllables, or sounds.
- Lengthening: The duration of a sound can be extended beyond that which occurs under normal conditions.
- Pauses: A person stops for a moment between a sentence or a word, unable to pronounce the next sound.
- Fillers: Use irrelevant words or sounds in your speech, such as “um” or “uh.”
- Alterations: This includes modifying words or phrases while speaking a sentence.
Remember, these are the typical characteristics of adult-onset, or neurogenic, stuttering. They represent a different pattern from persistent developmental stuttering, suggesting a distinction between the two.
Neurogenic Stuttering Diagnosis
The differential diagnosis should be made with speech and language assessment while understanding neurogenic stuttering; it can fasten the diagnosis and ensure timely detection of the condition.
This is doubtlessly a paramount reason why the neurologist’s role is so important when it comes to diagnosing and treating neurogenic stuttering: this disorder often signals that the suffering person could speak fluently before the accident, incident, or manifestation of disease took place.
Teamwork by health service providers, such as speech therapists, in cooperation with neurologists is important during the identification of the problem and the development of an optimal treatment plan according to the patient’s needs. Possible treatment methods might take effect through speech therapy techniques, medications, and counseling to help with the psychological effects caused by stuttering.
Neurogenic Stuttering Treatment
Methods for dealing with neurogenic stuttering aim to enhance clarity of speech and thus improve the quality of life. These techniques are directed by seasoned professionals and are personalized to tackle the physical and emotional aspects of the issue.
The collective efforts of a team of devoted healthcare professionals guarantee a thorough and practical treatment regimen.
- Speech Therapy: Working with a speech-language pathologist can help one master techniques that support fluency and develop strategies for managing stuttering moments.
- Neurological Interventions: Depending on the cause, medical treatment, including prescribed drugs and surgical procedures, may be recommended to control the neurological disorder.
- Supportive Environment: Promote a supportive and empathic environment, which can significantly save one from the emotional toll associated with neurogenic stuttering.
- Practice and Patience: Regular practice of speech techniques with patience and self-kindness are key elements in managing neurogenic stuttering.
- Collaborative Care: A speech therapist working in cooperation with neurologists can be a comprehensive and implementable approach to managing the problem.
Speech and Language Evaluation
When diagnosing neurogenic stuttering, an SLP conducts a comprehensive evaluation to determine the nature and severity of the stuttering and its neurological underpinnings. The assessment begins with an extensive interview to collect information on the individual’s medical history, including acquired neurological diseases, relevant medical history related to cerebrovascular accident, traumatic brain injury, or neoplastic condition, and medications they are currently taking.
The SLP will also be very interested in knowing when the stuttering started, how it proceeded, what the symptoms were that accompanied it, and which therapies or other solutions to stuttering have already been applied.
The information gathered from this cognitive assessment helps customize treatment strategies that capitalize on the individual’s cognitive strengths and tackle their challenges competently.
Techniques for Speech Therapy
Certainly, coping with neurogenic stuttering is a bit of a struggle. Still, ways and methods exist to alleviate this condition and make life entirely satisfactory. These coping methods will help the individual deal with their unique condition in a better way.
Some of these helpful strategies comprise:
- Taking the time to talk slowly and with purpose
- Mindfulness in speech with self-monitoring and awareness of trends
- Implementing strategies such as delayed auditory feedback or auditory masking
- Adding biofeedback for speech rhythm management
- Adapting speech to simpler forms and allocating additional time for dialogue
- Creating a coping approach that suits the individual’s aim for comprehension, self-acceptance, and support from society
- Participating in cognitive-behavioral therapy to deal with the consequences of communication impairment
Techniques of Fluency Modification
At their core, fluency modification techniques are essentially developed strategies to help people with neurogenic stuttering increase their fluidity of speech. Most of these techniques are very useful because they include:
- Taking time to slow down speech
- Using delayed auditory feedback or auditory masking techniques
- Applying biofeedback in speech trends
Deep inhalation and Exhalation
Reduced speech speed, light touch during articulation, and soft and gentle speech initiations are techniques of fluency modification that, with regular practice, may enable people with neurogenic stuttering to handle their speech pattern better, uplift their overall communicative ability, build confidence in speaking, and result in a better quality of life.
Bottomline
Neurogenic stuttering can be a pretty complicated speech defect. It may exert a significant influence on a person’s ordinarily fluent speech and badly disrupt one’s life. Therefore, understanding the root causes, the symptoms, and how to differentiate between neurogenic stuttering and psychogenic stuttering is critical to making an accurate diagnosis and giving proper treatment.