The hesitations in Anthony Stock's speech have been something he's had to "push through" all of his life, at times being a true struggle for the 27-year-old registered nurse.
"I can't tell you how many patients and doctors think I'm mentally slow," he said — something actually quite the opposite.
A charge nurse at Hendrick Health System, and about to become a nurse practitioner, Stock said he has to call doctors all the time, asking pointed questions and talking "pretty quickly during pretty stressful times."
"It's been a difficulty to overcome," he said of initial impressions created by his speech impediment, adding that he has had difficulties speaking since he was 3.
As with some who stutter, Stock's condition may be genetic. His grandfather and his father, he noted, have similar afflictions.
He's proud to say that he's done well, even with such an obstacle.
Autumn Heseman, a speech language pathologist with Hendrick Health System, said an easy definition of stuttering is a disruption in the production of one's speech.
Such disruptions can include repetition of words or syllables, prolongations of words, or outright blocks, in which the speaker gets stuck and can't even say the desired word.
The term "stuttering" itself is not as commonly used anymore, Heseman said, "disfluency" being a preferred term.
But although certain mechanisms are known, exact causes for the condition still aren't easy to pinpoint, she said.
"It's just something in the brain," she said.
In certain cases, medication or brain injury can be at the root, Heseman said.
And as in Stock's situation, there does seem to be a genetic component, she said.
"There can be a family history of it that affects whether they get it or not," she said.
But at least some of what used to be conventional wisdom about stuttering — such as a belief that it was caused by abuse as a child — is "not really (considered) the case anymore," Heseman said.
It's not uncommon, she said, for very young children to exhibit speech patterns with some disfluency present.
"It's actually a normal developmental milestone," she said. "It's as they get to be 4 or 5, into school age, that we start getting concerned about it if it hasn't gone away."
Standardized evaluations can help see how many disfluencies one has when speaking.
"And a lot of the time, we just use language samples in their conversation or in their speech to see how many disfluencies they have," she said.
Treatment differs based on what disfluencies are displayed, the patient's age and other factors.
"You can work with them on becoming, depending on how old they are, more aware of it," Heseman said, including working on self-monitoring, breath control and rate of speech.
In all cases, treatment is greatly individualized, she said, with many patients having to learn various "compensatory strategies" in a one-on-one environment.
Stock compared his personal disfluency to a disorganized file cabinet.
"The actual speech disfluency is the mind's way of trying to delay us so that we can find the word in our head," he said. "Even through we know what we're trying to say, the whole motor moments and the meaning and the emotional attachments to words, our brain has to find it."
Stock, who has tried everything from therapy to medication to technology called delayed auditory feedback, which he said tricks the brain into "thinking it's talking with someone else," said the treatments he's attempted have had varying levels of success.
But despite his difficulties, he said he remains positive about his future, both professionally and personally.
"I want people to understand that there's a lot more on face value to us than what they hear," he said of those who have disfluency. "They need to understand that what we say and what we think are two different things."
(Source: reporternews.com)
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