Tuesday, June 05, 2007

Sandra Mello as guest blogger (III)

When I was a child I used to think stuttering could be learnt from imitation, but scientific knowledge presents evidence that, instead, stuttering may be caused by an hereditary factor or by a brain lesion (Alm, 2004; Drayna et al, 1999; Ludlow & Loucks, 2003).

When I was a child I also used to think stuttering should be the result of psychological problems, but scientific knowledge offers evidence that stuttering may be the result of basal ganglia (BG) disfunction (Alm, 2004, 2005; Ludlow & Loucks, 2003; Molt, 1999). In this case, BG would sometimes fail to generate commands to finish some sounds or syllables. This is exactly what I feel in my speech: I feel I start saying a sound/syllable and get stuck on it. This is also the way my patients usually describe their stuttering.

When I was a child I realized stuttering level had an oscillation and I thought I could control this. I did not know waxing and waning periods are intrinsic to the BG disorders and that this cannot be controled. I used to think that if I tried hard enough, I could always be with a good fluency level.

When I was a child I also used to think I did not have enought will-power, because I could not always hide my suttering. Scientific knowledge offers evidence that BG functioning is not under voluntary control. So, as a consequence, stuttering is not under our voluntary control.

If psychological problems do not cause suttering, what is the role of emotions in stuttering? I think Per Alm (2004) hits the nail on the head when he says the level of freezing response can explain emotional influences on suttering. The freezing responde occurs when the person antecipates an unpleasant situation with regard to stuttering that is going to happen and he/she does not know the best way to act and he/she does not decide fight or flight.

When I was a child I also used to think stuttering should be a so shameful thing since no one talked about it. In Brazilian society, stuttering is understood as a minor problem of minor people. I think because of this very few people and very few professionals are interested on stuttering.

Finally, when I was a child I also used to think I did not need treatment because I should be able to overcome stuttering all by myself. But this is really not the case: according to my experiences as a PWS and as a SLP, professional help is amost always necessary. Nowadays, we have at least three ways of professional help: speech therapy, pharmacological therapy and/or psychological therapy.

I used to blame myself for my stuttering, I used to blame my parents for not conducting me to a specialized treatment when I was a child, I used to blame my pediatrician for wrong professional advice, I used to blame my destiny… But, when I was 15 and I decided to be a SLP, I realized this was not a good way. I realized I could try to do something useful from my experiences: I could try to understand stuttering, I could try to improve my speech and I could try to help other people. At least try.


Henrique said...


Anonymous said...

Admirable personal report of someone who did not abdicate to autoknowledge. Congratulations, Sandra. You're an great example.

And thank you, Tom, by grant us the privilege to know the magnificent Sandra Merlo's life history.

There might not be better première for the column " guest blogger".