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Defining stuttering from the perspective of a person who stutters

I am Ana Karina Espinoza, a speech therapist from Chile. I have been specializing in stuttering for several years. In this blog, I would like to share you more about the definition of stuttering from the point of view of the speaker. This is something that we, as therapists, always have to look at.

Stuttering is a neurobiological condition that is complicated to describe. Understanding it from a social, rather than a biomedical approach, is the first step to update our form of intervention.

From the biological point of view, stuttering is described by its visible and observable aspects, which is, what we, the listeners, can hear and observe. From this viewpoint, definitions such as those of the DSM-5 and ICD-10 are derived, which describe stuttering behaviors such as repetitions, prolongations, blocking and physical concomitants (movements that accompany this form of speech, tension and effort).

The biomedical approach recognizes the impact that stuttering can have on the social, academic and occupational level in those who experience stuttering. This points out the importance of its intervention in therapy. When this medical approach is used, there is usually an attempt to "normalize" fluency or "eliminate" the visible aspects of it, suggesting that by achieving the desired fluency, the other aspects will be resolved or the negative impact of stuttering will gradually diminish. This approach has proven to be insufficient and ineffective in the long term to address in depth the complexity of the stuttering experience and mitigate the negative impact that the condition can bring throughout the person's life.

Thanks to current research, we have gained access to views on stuttering which are focused on the experience of those who stutter (Tichenor & Yaruss, 2019). People who stutter often experience the "feeling of loss of control" of speech, which is a product of underlying neurological differences. With this information we reaffirm that stuttering is not a "fault" or something that must be "repaired in the person", but is only a biological characteristic of the one who stutters. This feeling of loss of control shows us that its genesis is due to a complex, inevitable and unpredictable neurological interaction that accompanies some moments of speech.

Going deeper into the current definition of stuttering, we will add that, after perceiving the sensation of loss of control in speech, the person who stutters reacts in various ways in order to "regain control" or feel "able to continue speaking". These reactions are complex and include behavioral, cognitive and emotional aspects which, together, shape the most diverse forms of manifestation and experiences of stuttering. This transforms it into an individual and unique experience, which is something that as therapists we must consider as a fundamental part in the evaluation and intervention, because there is no single formula to accompany those who stutter in therapy. The way in which stuttering is lived, manifested and experienced, will help us to set goals focused on the person and their own characteristics.

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