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Frequently Asked Questions

 

Click on the following questions that may apply to you. These are basic answers to many questions received by the CSA. You can contact us for more information on any of these topics.

Please note that this FAQ page is a work in progress.

 


There are many factors that contribute to the condition of stuttering, and, despite ongoing research, the ultimate cause is not known. Genetics, neurology and environmental factors can all play a role.  From a neurological standpoint, a person who stutters has overactive, unfocused neurological activity while speaking compared to that of a person who does not stutter. For instance, normally the left hemisphere is predominantly utilized for speech, but stutterers have overactivity in the right hemisphere as well. The reasons are complicated, but the main cause is believe to be an excess of the drug dopamine, a neurotransmitter the brain produces to control movement during stressful situations. Family and social dynamics such as high expectations, frustration, listener reactions and anxiety to talk fluently can also contribute to stuttering.

Stuttering is known to run in families. Approximately 60% of those who stutter have a family member who shares the condition. In large scale studies of extended families from around the world in which stuttering was predominant, researchers found a mutation in one of three different human chromosomes present in those who stuttered. These mutations are believed to cause the elevated levels of dopamine which contribute to stuttering. However it is estimated only 9% of people who stutter have one of these mutations. The inherited factor in the majority of stutterers is still unknown.

There is no cure for stuttering. Many people who stutter have learned to control their speech to varying degrees after attending speech therapy. As for young children who stutter when they are first learning to talk, about half of them grow out of it.

The only treatment that has been clinically proven to be effective to control stuttering is speech therapy administered on a long-term or intensive basis by a speech-language pathologist. 2-4 week long intensive courses show the best results. For a list of such intensive courses in Canada, check our clinics web page.

The first step in obtaining speech therapy is to contact a speech-language pathologist (SLP) who has experience working with people who stutter.  The Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA) has a database of registered SLPs. The CSA site offers a listing of provincial associations of speech-language pathologists, that may also be able to direct you to clinic or health centers that provide therapy.

The CSA is also able to provide you with a list of clinics that offer intensive therapy programs in various locales across Canada.  Most of these programs are offered in large urban centers.

Most health insurance programs cover a small portion of speech therapy costs – usually about $500.00 per year.  This is minimal when private speech therapy costs are typically more than a $100 per hour.  Many employers are beginning to offer additional insurance programs such as health spending accounts which can be used for such costs as speech therapy.  Do not give up on obtaining therapy as there may be scholarships available through therapy programs for those in financial need.

Your speech therapist will show you techniques to help slow down and control your speech. These will include breathing, timing and articulation exercises and some training in positive self-talk. You will be expected to practice these techniques on your own when not in the clinic and apply them to real life speaking situations. This is known as "maintenance" and is the most difficult thing about controlling stuttering in the long term. Particularly after an intensive course, a person can see a big difference in their stuttering right away, but get a false sense of security. If he neglects to put the necessary work into maintaining the effects of the therapy, he will fall back into old patterns.

Many clinics offer "Refresher courses" at various times throughout the year that can help to remind you of the proper use of the techniques and renew your commitment to a maintenance program.

Currently there are no drugs on the market that are FDA approved for the purposes of controlling stuttering. Some drugs that are developed for other purposes serve as "dopamine antagonists" and counteract the production of dopamine in the brain, a naturally produced neurotransmitter that is believed to contribute to stuttering. However these drugs have some side effects and are not recommended for the treatment of stuttering. Attempts to develop a dopamine antagonist with minimal side effects specifically to target stuttering (such as Pagoclone) so far have not been successful.

It is recommended that children who exhibit stuttering receive speech therapy as soon as possible. More than half of young children who stutter grow out of it, but that is little consolation for the parents of those who don't. There is no way to tell if a child's stuttering is a temporary phase that will pass or if it will be permanent.

Any registered speech-language pathologist in your community who treats children would be of help. A treatment specifically to help children who stutter, the Lidcombe method (see below), has been shown to be very effective. The CSA site features a listing of  provincial associations of speech-language pathologists. You can contact them for more information about your best options for speech therapy and intensive courses for children that may be offered near you. Sometimes children can receive speech therapy through the public school system or your local general hospital, at no charge. There is usually a waiting list for these free services, if they are offered. Enquire in your community.

The British Columbia Association for People who Stutter sponsors an annual summer camp for children who stutter. Camp BCAPS is about creating a positive social environment for kids who stutter, and focuses less on speech therapy and more on developing confidence, self-esteem and social skills, although there is a speech therapist present at the camp. The cost of the camp is subsidized for those who live in the province of BC.

You can support your child by encouraging conversation and self expression in his/her life, giving him time to talk, and not criticizing or correcting his speech. You don't need to ask him questions all the time – share your own thoughts and opinions with him, and give him a chance to share his. Listen and respond to the content of what he says to you. Like any child, he needs verbal stimulation in order to flourish.

Lidcombe is a behavioural treatment method for children who stutter. It was originally developed for children under six, but has recently been used on school-aged children. The parent (s) administers the therapy in everyday environments after receiving directions from a Lidcombe trained speech language pathologist. The results of this therapy have been very positive.

LINKS:

CSA article on Lidcombe

Some children do not respond to speech therapy. In fact, some people who stutter never benefit from speech therapy in that it helps make them fluent. It doesn't mean they are failures. There may have made other gains, such as increased confidence. Even though you may be disappointed, try to focus on the positive things about your child, and remember that he can still benefit greatly from conversation and communication at home with his family. He may choose to return to therapy when he is older.

School is certainly a challenge for children who stutter, especially if the teacher is not understanding of the problem. You need to speak to the teacher(s) and explain that he is a child who stutters, and may need to be given options when it comes to speaking in class.

Sometimes students who stutter don't mind speaking in class if there is a good environment. If the environment is not accepting and there is bullying and teasing on the part of other students, and/or insensitivity on the part of the teacher, you and your child can request that he be given a different assignment in place of oral assignments, or be asked questions in private and not in front of the class. If the teacher is still insensitive to his plight, go up the chain to the principal and higher if you must. You may have to advocate for the child quite a bit depending on the situation.

CSA Article on bullying

The SpeechEasy is a delayed auditory feedback device (DAF) that has been shown to reduce stuttering in some people in some situations. The effect of DAF on stuttering was illustrated in the movie the King's Speech. The modern version is worn like a hearing aid, and feeds back a person's voice as he speaks with a micro-second delay. Speech pathologists recommend it be used in conjunction with speech therapy techniques. It is not a treatment per se, as the effects are not present when one is not wearing the device. The degree of effectiveness varies depending on the person and the situation.

Because it has to be personally fitted to you, the cost of the SpeechEasy is high, more than $4,000, and is not covered by provincial health care programs.

For more information:

CSA Article on SpeechEasy 1

CSA Article on SpeechEasy 2

As therapy is expensive and time consuming, it is important to get the right kind suitable to your specific condition. Your physician can advise you. Certain kinds of brain damage can cause speech disorders and will require therapy. In some cases, it is possible that a psychologist or trauma counselor might be more effective to address late onset stuttering.

You may be tempted to try an obscure or quick-fix treatment to help your stuttering. You may also want to go to the casino and play Black Jack. That is your prerogative. Remember that the only treatment for people who stutter that has been clinically proven to be effective in reducing stuttering is speech therapy administered by a speech-language pathologist. If money is an issue for you, as it is for most people, this is the type of treatment that is recommended. Other "cures" like hypnotism and things advertised on the internet have been shown to have no results or very short-lived minor improvements.

For as many people that have been encouraged by the improvements they saw from speech therapy, there are those who are disappointed by the lack of results. There could be many reasons for this. It is possible that the therapist was not a good match for you, or perhaps it was not the right time in your life.  Maybe there are other personal issues that are preventing you from succeeding. To see any long-term benefits from therapy, a person must be committed to work on their own to maintain the effects of the therapy through practice. Some people who stutter find speech therapy and its demands too much of a burden and would rather stutter. If fluency is important to you, try visiting a speech pathologist again at a time when you feel ready.

The CSA site has a listing of self-help groups across Canada. Groups can have different purposes. Some focus on loose discussion, some are more structured like the Toronto toastmasters group, and some are purely social, like the ones associated with the meetup.com website.

Unfortunately not a lot of cities have groups running. If you are interested in starting a group, you can advertise through the CSA website.

Yes, stuttering is officially a disability as defined by the Canadian Charter.

A person who stutters can apply for the disability tax credit by submitting the Canada Revenue Agency Form T2201.  The form is jointly completed by the applicant and a “Qualified Practitioner”. In the case of stuttering, a “Qualified Practitioner” can be a medical doctor or a Speech Language Pathologist.  Whether or not you qualify depends solely on the degree to which a disability restricts one of the basic activities of daily life.  The CRA defines these as Speaking, Hearing, Walking, Elimination (or bowels or bladder), Feeding, Dressing and Mental Function.

It is important to note that a recent change to this credit allows the CRA to take into consideration the cumulative effect of restriction in two or more of the basic  activities of daily life.  In effect, even if you do not meet the threshold level of restriction in any one daily life activity (like Speaking), a lesser degree of restriction in two or more categories may still qualify you for this credit.

Additional details about this credit can be found here.