Stammering is a problem, a special educational need, a disability. It’s something to be overcome, conquered, corrected. Or at least that’s what we have been led to believe.

In schools, a stammer is usually seen this way - as something that needs intervention.

But some now argue that this general perception of stammering, and particularly the approach in schools, needs to change.

We caught up with Kathryn Bond, a highly specialist speech and language therapist in dysfluency at Bradford District Care NHS Foundation Trust, to find out more.

Stammering is more common than we might think, isn’t it?

Yes, about 8 per cent of children - that’s one in 12 - will experience stammering, particularly those between the ages of two and five. Most children who stammer stop, but not all: one per cent of the world’s adult population stammer, which, in the UK, equates to about 600,000 adults.

We identify stammering by what we see or hear a person do in response to their speech sound not being executed. What they do will depend on a multitude of factors: the situation, what they are thinking or feeling, and the reaction they get from others.

We may observe sounds being repeated or stretched, uneven breathing patterns, facial tension and other body movements in the attempt to speak. Some people hide their stammer by avoiding speaking or by changing what they say to avoid certain words.

Do we know why it occurs?

Speaking is a complicated motor activity in the body. Many parts of our brain work together quickly and at once to process speech. Research has found a random timing “blip” within the brain, which causes a delay in the messaging to the muscles in the mouth that need to move to release the sounds.

This is experienced as a hidden, involuntary, underlying feeling, which an eight-year-old once described to me as “petrifying”. So stammering has a neurological basis and genetics play a part for 60 per cent of people.

So, what are the usual ways of intervening with stammering?

Stammering therapy varies across the UK and is dependent on many factors, such as age or personal need. Most interventions are based on traditional, medical model approaches that attempt to stop, reduce or hide stammering.

Stammering is usually viewed as an abnormal, person-centred problem that needs fixing. For example, in the film The King’s Speech, we see George VI working tirelessly to “overcome” his stammer and appear “normal”. Similarly, in the TV programme Educating Yorkshire, people sobbed with relief when a boy called Musharaf, who had a stammer, finally spoke without struggle.

You see this deficit model way of thinking as not always correct, is that right?

Yes, stammering can be understood in light of neurodiversity - as a natural speaking variant - and in this vein, “therapy” is at an exciting time of transition and change.

In Bradford, we advocate a new approach, in which stammering is viewed as a social problem where, owing to stigma, people who stammer are not treated equitably. Through education and challenging people’s attitudes, beliefs, language and behaviours, we aim to reduce barriers and to promote the needs and rights of people who stammer.

Are you trying to normalise the stammer rather than correct it?

Positive therapy outcomes might be a parent using less negative language about stammering in front of their child, a teacher organising for a child to talk to the class about his stammer, or a teacher giving the lead part in a school play to a pupil who stammers because she is the best person for the part. It is about acceptance of the stammer.

I would also argue that the word “correct” is tainted with stigma and suggests that stammering is “wrong” and needs fixing. In light of neurodiversity, stammering is “different” not “abnormal”.

Scientists are currently carrying out a research project to try to “fix” stammering through the use of non-invasive brain stimulation technology, where a very weak electrical current is passed across surface electrodes placed on the scalp. People who are proud of their stammer and the gains it has given them might question this.

So, you are trying to get away from what you see as a stigma around stammering?

Yes. Dated, stigmatised attitudes affect the way people who stammer are treated. People think stammerers are nervous people, that they are not taking time to think carefully or that there is something wrong with their mouths. Children are unhelpfully told to calm down, slow down, think more carefully, speak properly or, often, the sentence is completed for them.

All this can have devastating effects on a child’s wellbeing and participation. Most children simply want their teachers to reassure them that when they talk, they will be given time, and that if they are teased or bullied, the teacher will support them.

Is this what led you to start a project to better support students who stammer and get this message of positive therapy and acceptance out?

Yes. I have just finished a two-year collaborative project to raise awareness of, and to reduce stigma about, stammering. I worked with students from the University of Bradford’s graphics department and young people on my caseload to create a visually, interactive, engaging 40-minute eLearning module, called About Stammering.

The course consists of two parts. Part one explores what stammering is (and isn’t) and provides evidence-based facts about stutters through quizzes, voice-overs by people who stammer and experiential exercises. It challenges stereotypes and myths about stammering through interactive exercises.

Part two explores responses and feelings about stammering: an adult speaks candidly about how he was bullied at school; language used about stammering is scrutinised, and scenarios are presented in which helpful and unhelpful responses to people who stammer are compared and commented upon.

Finally, positive role models are provided through a film clip by a teacher who stammers and the voices of some of the children on my caseload.

When did you roll this out?

It was launched just as Covid-19 hit the UK and the country went into lockdown. The eLearning become a valuable therapy and teaching tool to share with education staff, and speech and language therapists, in Bradford and nationally.

What was the feedback?

Initial feedback has been positive and plentiful. Colleagues have commented on engaging graphics and personal narratives, clear and accessible content and the non-stigmatised language used throughout. A doctor who stammers described it as, “a unique and valuable resource. I can’t think of anything else like it online.” I can’t wait to hear what teachers think.

What’s your next target?

I want to share this free resource as widely as possible. I have since developed a new education and therapy model, and resources, which I would like to offer as a training package. Ultimately, I want to create a more stammer-friendly world! You can access the resource at www.bdcftelearning.co.uk.

Kathryn Bond is a highly specialist speech and language therapist in dysfluency at Bradford District Care NHS Foundation Trust

This article originally appeared in the 2 October 2020 issue under the headline “How I...support pupils who stammer”