Stuttering: aetiology
The World Health Organisation (WHO) classifies stuttering as a specific developmental disorder, ‘a disorder of speech rhythm in which the patient knows exactly what he or she wants to say, but at the same time is unable to say it’ (1977)
Aetiology of stuttering
As a relationship disorder of psychogenic origin, stuttering begins by feeding on traumatic situations, together with difficult and precarious relationships felt by the child in the first years of life (uncertain structuring of the maternal relationship, anaffectivity, etc.).
Often the intervention of a reactive (triggering) situation breaks the psycho-emotional balance giving the stuttering-symptom the possibility of representing an internal, latent imbalance of the personality (stuttering-syndrome).
The child ‘chooses’ from among the innumerable communication systems a modality (blocked speech, hesitant language) that guarantees him a safe ‘sounding board’ to attract the parents’ attention, to communicate his internal state to ‘tell’ the adult of reference of his annoyance regarding particular events.
Statistical data show a very high incidence among typical dysfluencies; according to Italian and European studies, about 1/1.3 % of the adult Italian population is affected. In particular, around 85% present their first symptoms at pre-school age.
Stuttering, there are various trajectories and causes of disturbed communication after an initial, normal fluency of speech:
- remote causes of psycho-traumatic origin;
- idiopathic causes;
- organic-functional causes (not the subject of our research).
We also note among the causes in children
- imitation;
- language delays or multiple dysalalies: Ajuriaguerra and Marcelli consider up to 50% of cases;
- And again we find in some scholars a ‘presumption of heredity’.
More precisely, according to us, it is possible to refer to an environmental-hereditary predisposition confirmed by family histories of stuttering in about one third of cases.
According to our studies, it is a matter of inheritance not so much of stuttering as of an accentuated sensitivity of the child to certain psychological and relational factors (parental anxiety, family disharmonies, hypercorrection, anxious parents ready to correct natural physiological dysfluencies).
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The genetically based transmission of certain ‘structures’ from the stuttering parent should also be unquestionably noted
The numerous studies on stuttering reveal as statistically important the prevalence in the male sex, which in Italy, as Marcelli confirms, manifests itself with a ratio of 1:3, 1:4 to the female sex.
The language disorder before the age of 3-4 is very different from the disorder that occurs later (5-6 years) and still different from the disorder that emerges in adulthood.
Different external (social and relational) and internal (psychological and personal) structures are impaired over time and years.
Language begins to develop by progressing rapidly over a long phase of childhood life.
The richness of the things that surround the child, the desire for exploration and natural curiosity translate into a relentless desire to ‘ask’ and ‘communicate’ that is sometimes greater than the child’s actual communication skills and abilities.
It is therefore easy for the child’s language ‘in the running-in phase’ to have difficulties with the production of sounds, with vocabulary and with the structuring of first sentences.
Repetition of words, syllables, whole sentences, hesitations, prolongations, the sometimes frequent rephrasing of sentences, are frequent phenomena in the early stages of language.
These ‘verbal travails’ of the child are discontinuous signs that are also present in non-stuttering children, but must be closely monitored.
“It is a phase of repetition of syllables without spasmodic or tonic tension, which intervenes around 3 -4 years of age and which has no relation with true stuttering” (Marcelli).
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