Study Shows Brain Changes After Speech Therapy
By Denise Mann
WebMD Health News
Reviewed by Louise Chang, MD
Aug. 8, 2012 -- A week-long, intense course of speech therapy may help reduce stuttering, a new study shows. What's more, improvements in speech corresponded with actual brain changes documented on MRI scans.
In the study of 28 people who stuttered and 13 who did not, stutterers who participated in speech therapy three times a day for one week improved compared with stutterers who did not get the speech therapy.
As part of the therapy, participants repeat two-syllable words and then read words they are shown. None of these exercises were timed. People who stuttered performed better on stuttering tests and stuttered syllables less frequently after the therapy.
Brain scans taken at the beginning and end of the week-long trial showed improvements in brain regions involved in stuttering. Specifically, strength of signals in an area called the cerebellum, which was increased before therapy among people who stuttered, were reduced to the same level as what was seen in the brains of people who did not have stutters, once the therapy ended.
The findings appear in Neurology.
About 20% of all children may stutter as part of their speech and language development, and about 5% will stutter for six months or more. Three-quarters will recover by late childhood, leaving about 1% of the population with a long-term problem, according to the National Stuttering Foundation.
"The findings are thrilling for people who stutter and parents of little children because it shows that you are doing things to help and some changes occur in the brain at same time," says Jane Fraser, president of the Stuttering Foundation, based in Memphis, Tenn.
But what happens when the therapy stops? "A relapse is likely," she says. "People go through with programs and everyone around them expects them to be cured, and they find themselves feeling all sorts of pressure that could trigger stuttering."
Cognitive behavioral therapy can make a big difference in stuttering and stuttering-related anxiety, she says. "It helps people realize that the world doesn't go unhinged if you stutter, and that people aren't going to be rolling on the floor laughing at you."
Other speech therapies are also helpful in teaching people how to pull themselves out when they begin to stutter, and fluency-shaping encourages slow speech with stretched-out vowel sounds to reduce stuttering.
Stuttering is a real problem marked by real brain changes as evidenced by the study, says American Academy of Neurology member Jeffrey Buchhalter, MD. He is a pediatric neurologist in Phoenix, Ariz. "There is also a way of measuring an intervention to see if it works. This is very exciting."
Parents of younger children who are concerned about their child's language developments should talk to the child's pediatrician or primary care provider. "Find out who is the expert on stuttering in your town," he says.
It may be a pediatric neurologist or a speech pathologist such as Melissa Wexler Gurfein. She is a speech language pathologist in private practice in New York City.
Stuttering is not always a chronic problem, she says. "Typically children between ages 2 and 6 will stutter. This is normal and is more prevalent among boys," she says. "If you are concerned, schedule an evaluation so a therapist can see how frequently it is occurring." Treatments exist, and vary based on age.
Christian A. Kell, MD, of Goethe University in Frankfurt, Germany, wrote an editorial accompanying the study, and he also stresses that help is out there.
He tells WebMD, by email, that "people who stutter should invest time in good therapy programs. There are lots of efficient speech therapy programs available that all focus on different aspects (breathing, way of speaking, rhythm, speech melody, speed) and change the way a person speaks."
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SOURCES: Jane Fraser president, The Stuttering Foundation, Memphis, Tenn. Jeffrey Buchhalter, MD, pediatric neurologist, Phoenix, Ariz., Melissa Wexler Gurfein, speech language pathologist in private practice in New York City. Lu, C. Neurology, 2012. Christian A. Kell, MD, Goethe University in Frankfurt, Germany. The Stuttering Foundation: "Stuttering Facts and Information."
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