Researchers at UCSB are creating a revolutionary treatment program designed to help clinicians and patients identify and remedy stuttering problems, which affect over 3 million people in the United States.
Using a $920,000 grant they received in 1999, UCSB Speech and Hearing Sciences professors Janis and Roger Ingham have established a program that has been able to treat stuttering problems in 12 UCSB students. The grant also allowed the Inghams to do pioneering research using magnetic resonance imaging and positron emission tomography scan technology, studying the anatomy of a stutterer’s brain while he or she is talking.
The results of the brain scan research have produced new ideas about why stuttering occurs. Because the brain monitors speech in the temporal lobe, fluent speakers have the ability to articulate thoughts out loud, yet for stutterers, brain scans have revealed that this area in the temporal lobe is hyperactive. The stutterer will have formulated the words and thoughts correctly before trying to speak, but then he or she will have trouble vocalizing the articulated thoughts.
“A person who stutters is not stupid,” Janis Ingham said. “They have a high vocabulary. Their language is fine. They know what they want to say, but they get stuck on things.”
The Inghams’ program, called Modifying Phonation Intervals (MPI), is a three-phase program designed to teach the patients to maintain their own speech progress by using software and voice monitors, which enables patients to monitor their own speech with the same knowledge the clinician has.
The “establishment phase” assesses the stutterers’ speech patterns while allowing the patients to become aware of the treatment. In the “transfer phase,” the patients start to work on their speech patterns on their own. Finally, the “maintenance phase” requires several short sessions per week that the patients do without assistance.
“The most successful people are the highly motivated and those who take responsibility for their treatment and understand it is not magical,” Roger Ingham said.
Determining the success of the program can be problematic, Janis Ingham said, because of the small number of cases they have dealt with for the full term so far, and because it is hard to define when treatment is over. So far, the “vast majority” of people who have been monitored over the past three years have been successful, and very few have not.
A main benefit of this technology is that since the stutterers can use it by themselves, they can continue their treatment throughout their lives, if needed, Janis Ingham said.
“For many people fluent speech becomes automatic,” she said. “More typical is the person who gets fluent and needs to do the subtle thing of maintaining fluency.”
Stutterers tend to use several techniques of avoidance before ever seeking help, such as using synonyms for problem words, or whispering and singing because stuttering does not occur during these exercises. Stuttering is easy to treat in children but becomes very difficult to treat in adults.
Researchers have largely disproved theories that anxiety and psychological problems cause stuttering or ideas that stutterers have abnormalities in their throats and tongues. Roger Ingham said that stuttering is a result of genetics and physiological and environmental stresses, but there is no known cause or cure, just treatments. A person that is genetically predisposed to stutter may not express speech problems, but many stutterers have several family members that stutter as well.
Stuttering, which is much more common in men than in women, can cause a number of stigmas that can lead to serious problems in employment and social encounters, Roger Ingham said.
Junior Ly Nguyen, who picked computer science as his major because he wanted to avoid talking, is in the third phase of the MPI program and is now a peer counselor and enjoys public speaking.
“One time in high school I got up to do a presentation and couldn’t get out the first sentence,” Nguyen said. “My mentality is different now. I know stuttering is not a phase. I can never be free of stuttering. It is genetics, a neurological thing. I still stutter, but it is at a minimum.”
The treatment program, still in preliminary trials, is built on research previously done by Roger Ingham, which found that if stutterers slow their speech pattern, for example producing a drawl, the stuttering ceases. While altering speech patterns can alleviate problems, the result is an awkward style of talking that is even more uncomfortable than the stuttering.
The Inghams use a combination of slower patterns of speech with normal ones, so that the result sounds more natural than simply slowing down every sound. This method was first promoted and studied by Roger Ingham and is now the primary method of treatment used by clinicians around the country, Janis Ingham said.
“At this point it looks like a promising treatment,” Roger Ingham said. “I am cautiously optimistic.”
Senior speech and hearing science minor Heather Lehwald, who is working on the MPI program with the Inghams, said she would like to use the program as a clinician someday.
“It is phenomenal to see the improvement,” Lehwald said. “The patient becomes a different person. It is amazing. It makes me even more interested in the research. I am excited for the patients.”