Is Stuttering caused by Anxiety ?

Anxiety is a feeling of unease, such as a worry or fear that can be mild or severe. Everyone can feel anxious in situations such as giving presentations, an oral exam or going for an interview. These anxious feelings are normal. Anxiety is not always ‘bad’. It can make us feel uncomfortable but it is also a really important function - we should feel anxious when we have an exam coming up as anxiety motivates us to study. Anxiety motivates us to prepare and take action. It is sometimes confused with excitement. Anxiety becomes difficult when it stops allowing you to do the things you enjoy in life and affects you everyday.

In the past, stuttering was thought to be due to psychological factors such as anxiety. We now know the cause of stuttering is not due to anxiety. Rather, it is regarded as having a neurological cause - differences have been found in areas of the brain involved in talking for those who stutter compared with those who do not stutter. In addition, stuttering has a genetic or hereditary component and tends to run in families. 

Do I stutter because I am an anxious? Am I anxious because I stutter?

Research has shown us that pre-school children who stutter show no difference in shyness or anxiety compared with pre-school children who do not stutter. People who stutter are no different to people who do not stutter in terms of their personalities. However, research has shown that as a group people who stutter present with higher levels of anxiety and are more likely to present with social anxiety disorder compared with people who do not stutter. The age at which anxiety symptoms begin to appear is not yet clear, however some studies have suggested that higher anxiety is shown in stuttering children from the age of 7 years and increases over time.  

Indeed, it is not surprising that stuttering is associated with increased levels of anxiety. The experience of stuttering is often difficult and people who stutter describe having a variety of negative emotional reactions to their talking including feelings of embarrassment and shame. They can also experience negative reactions to their stuttering from others.  We know that children who stutter are more likely to be bullied and to be viewed negatively by their peers and adults describe stigma and discrimination both socially and in their place of work. The anxiety demonstrated by people who stutter is regarded as being the result of living with stuttering and is not the cause of stuttering.  You don’t stutter because you are an anxious person.

How does anxiety or nervousness impact stuttering? 

Although people vary, we know that when someone is feeling anxious or nervous, they tend to stutter more. You might be feeling anxious about stuttering in front of others or concerned about how your listener will react, or what they will think if they hear you stutter. When we feel anxious or nervous, it is usually because we are expecting the worst to happen. You might be saying things to yourself like “I won’t be able to say my name” or “They’ll think there’s something wrong with me” This may lead you to tense your muscles, may distract you from focusing on what you want to say as you try hard either to be fluent or to hide your stuttering.  This can all lead to more stuttering. You may feel like you have suddenly started stammering.  It is important to remember that while you may stutter more when you are feeling anxious or nervous, these feelings are not the cause of stuttering.  

How can Speech and Language Therapy help with Stuttering? 

We know that learning more about your stuttering and what influences it can reduce your anxiety about it.  Speech and Language Therapy can be effective in reducing the impact that stuttering is having on your day to day life.  You can develop your confidence to communicate, learn how to respond differently to your thoughts and feelings about stuttering and to learn strategies to make talking easier and more comfortable. 

Stuttering does not have to hold you back. 

We are Clinical Specialists in Stuttering and are very happy provide you with more information regarding our reasonably priced fees via email.

What is a vocal fold paralysis?

What is a vocal cord paralysis?

A vocal fold palsy or vocal fold paralysis is when one or both of the vocal folds do not open or close properly. In most cases, only one vocal fold is affected. Paralysis of both vocal folds is a rare and serious condition.

The vocal folds are two elastic bands of muscle tissue located in the voice box directly above the windpipe. When you use your voice, air from the lungs causes your vocal folds to vibrate between open and closed positions. If you have a vocal fold paralysis, the paralysed fold may remain open. The voice then becomes weak and breathy.

What causes a vocal fold paralysis?  

The most common cause is a viral infection. It can be as a result of nerve damage due to surgery, injury or certain cancers. Neurological conditions such as Parkinson’s disease of multiple sclerosis can also lead to a vocal fold paralysis.

What are the symptoms of vocal fold paralysis?

Symptoms of a vocal fold paralysis are changes to a person’s voice. A breathy, hoarse or weak voice is common. Some people report difficulties swallowing and a swallowing assessment may be required by a Specialist Speech and Language Therapist in Dysphagia. Sometimes people become more breathless with exercise or find it hard to life heavy items.

Can vocal fold paralysis be cured?

Typically, damage is temporary and will improve over several weeks. However, the majority of people will require Voice Therapy by an experienced Speech and Language Therapist to improve their voice. Treatment is available via the NHS for free. We often treat people when there is no voice therapist available or they are waiting for NHS therapy. Online Speech Therapy for Voice is effective.

Our Private Voice Therapists are Clinical Specialists in Voice. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.

Is Online Speech Therapy Effective?

Online Speech Therapy (often called Tele-health in research studies) has been shown to be effective and often better in treating many conditions. Studies have looked at comparing online Speech Therapy vs seeing the clinician in person, often referred to face-to-face therapy.

Research shows us that Online Speech Therapy has shown be effective and has high levels of satisfaction for clients.

If you are interested in whether Online Speech Therapy is effective in your condition please see the relevant research below.

Is Online Speech Therapy effective for Language difficulties (Aphasia)?

The Efficacy of Telepractice on Expressive Language Outcomes for Adults with Aphasia: A Systematic Review Morgan Bailey B.S., Lauren Burningham, B.S., B.A., Erin Fifield, B.A (2018)

This study examined whether online Speech Therapy produces positive expressive language outcomes that are comparable to face-to-face therapy for adults with aphasia. They looked at all studies that have compared online Speech Therapy to face-to-face.

The results indicated that online therapy produces similar outcomes when compared to traditional face-to-face therapy.  Most studies showed positive patient satisfaction and quality of life.

Is Online Speech Therapy effective for Dysarthria (Slurred Speech)?

Telemed J E Health 2009 Nov;15(9):840-50.The Redesign and Re-Evaluation of an Internet-Based Telerehabilitation System for the Assessment of Dysarthria in AdultsAnne J Hill 1, Deborah G Theodoros, Trevor G Russell, Elizabeth C Ward

 This study showed high levels of satisfaction from patients being assessed Online. It also showed good strength of agreement between Online Speech Therapy in comparison to face – to –face assessment.

Is Online Speech Therapy effective for dysphagia (Swallowing difficulties)?

Morrell, K., Hyers, M., Stuchiner, T., Lucas, L., Schwartz, K., Mako, J., Spinelli, K. J. & Yanase, L. (2017). Telehealth Stroke Dysphagia Evaluation Is Safe and Effective. Cerebrovascular Diseases, 44 (3-4), 225-231. 10.1159/000478107.

 For swallowing difficulties (dysphagia) 100 patients were assessed comparing face to face with Tele-health (online speech therapy assessment) showing excellent agreement between therapists. This study indicated that online speech therapy was a safe and effective way to deliver dysphagia assessments online.

Evaluation of a Clinical Service Model for Dysphagia Assessment via Telerehabilitation. Elizabeth C. Ward,1,2 Clare L. Burns,3 Deborah G.Theodoros,l and Trevor G. Russell1

100 patients were assessed online and face to face. Results for swallowing difficulties were comparable to face to face assessment. There were high levels of patient satisfaction and patients felt comfortable with online assessment.

 Is Online Speech Therapy effective for Voice?

Voice Therapy Using Telecommunications Technology Pauline A. Mashima et al. American Journal of Speech Language Pathology. Vol 12. 2003.

This study showed that there was no difference in face-to-face outcomes vs online therapy. All patients had positive changes following rehabilitation for their voice through speech therapy.

 The effectiveness of Lee Silverman Voice Treatment therapy issued interactively through an iPad device: A non-inferiority study. Journal of Tele-medicine and Tele-care. 2017 Murray Griffin et al.

Lee Silverman treatment is the recommended Speech Therapy treatment for Parkinson’s Disease. It is intensive requiring four sessions a week for four weeks. For those people that struggle to travel, online therapy is ideal. This study even showed that online showed superior improvements than face-to-face therapy.

 Is Online Therapy effective for Stammering?

Research is in its infancy for stammering and online therapy. An NHS trust completed an improvement project in 2018 that looked at treating patients using online Therapy. The Therapy showed a reduction in the negative impact of stammering and many clients preferred therapy in their home environment rather than in a clinical setting.  

What can I do to look after my Voice?

• Stop smoking. If you can’t give up, cut down. Smoking irritates and damages the vocal folds. Talk to your GP about advice to support stopping smoking.

• Avoid eating spicy foods. Spicy foods can cause stomach acid to move into the throat or oesophagus, causing heartburn or reflux. If you do experience reflux, talk to your GP about possible medications.

• Avoid too much coffee, fizzy drinks and alcohol. These can dry out the vocal cords. Try drinking decaffeinated tea or coffee or follow an alcoholic drink with a soft drink.

• Avoid shouting and whispering

• If your voice feels tired or strained then rest it. This is your bodys way of telling you to rest your voice

• Try not to clear your throat unnecessarily. It can create excessive mucous and lead to a further need to clear your throat. Try drinking water instead or swallowing.

• Avoid dry and dusty atmospheres as they may dry out the vocal cords. Wear a mask in a dusty environment.

• Try to drink 2 litres (3 ½ pints) of liquid a day (not including coffee, alcohol or fizzy drinks). This will prevent dehydration of the vocal cords.

• Try steaming to keep the vocal folds hydrated

Our Private Voice Therapists are Clinical Specialists in Voice. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.

What is Aphasia?

 How is aphasia caused?

 Aphasia is caused by damage to the language areas of the brain. In most people, this is typically the left hand side of the brain. It is most commonly caused by a stroke or a brain injury. It can also be caused by progressive disorders such as brain tumors.

How does aphasia affects communication?

 It can affect a persons understanding, speaking, reading and writing. Symptoms can vary in severity from people not being able to express themselves by any means, to milder symptoms of a delay in accessing words. However, even mild symptoms can have an impact on peoples confidence requiring Speech Therapy.

Does aphasia go away?

 It depends on the cause and severity of the aphasia. If it is caused by a brain injury and stroke, it is likely to improve. If it is caused by a progressive disorder this is means that it will unfortunately not improve.

Can aphasia be cured?

Speech therapy aims to restore a persons language through exercises but also support them

Can Aphasia be treated?

The treatment for Aphasia is with Speech and Language Therapy. Evidence shows that Speech Therapy is effective for people with Aphasia following a stroke, compared to no therapy.

How can you help someone with Aphasia?

After an assessment, a Speech Therapist will be able to give you specific advice about the best ways in which to communicate.

Below is some general guidance:  

• Give the person plenty of time to respond. If a person with Aphasia feels rushed or pressured to speak they may become anxious, which can affect their ability to communicate.

• Use short, uncomplicated sentences.

• Do not change the topic of conversation too quickly.

• Avoid finishing a person's sentences or correcting their errors.

• Reduce distractions.

• If you don't understand something a person with Aphasia is trying to communicate, don't pretend you understand.

• Use visual references, such as pointing, gesturing and objects, to support their understanding.

• If they're having difficulty finding the right word, prompt them – ask them to describe the word, think of a similar word, try to visualise it, think of the sound the word starts with, try to write the word, use gestures, or point to an object.

Our Speech and Language Therapists are Specialists in Aphasia. Feel free to book a free consultation or email us for further information.