Have you, as a child, ever run to a drain, confident that you will jump across- and then suddenly stopped right at the edge? Discovered that you just could not- not even for your life, leap across? Do you recall the feelings of disappointment and frustration? Even confusion and shame? This is what happens to many children when they try to speak and can not get out one word.

People who stammer (PWS) know it intuitively. For others, it is involuntary repetition of part of a word (syllable) while speaking. It is caused by a rare neuro-physiological disorder of the speech nerves in the brain. It is important to understand its 'involuntary' and 'variable' nature. It may not be present while singing, whispering, reading with others, talking to pets, friends and under a variety of other conditions. On the other hand, it may strike under quite common situations like
saying our name, talking over the phone, speaking while being observed, etc. There is considerable variety in its symptoms and factors which lessen or make it worse.

It is one of the truly ubiquitous health disorders. PWS are found in every socio-economic group, culture and region. It is more common among men than women by 4 to 1. About half of PWS may have a close relative with the same disorder. But people do not know enough about it and therefore many misconceptions prevail about this disorder:

“Stammering is just a bad or funny habit.”
“Stammerers can't think clearly.”
“Stammerers think too fast for their tongues..”
“Stammerers are not intelligent.” Etc.

The fact is that PWS are normal people in all other respects. But as they grow older in a society which does not understand their particular disorder, they tend to mask their problems at considerable emotional cost and suffer in isolation. Society and PWS need to acknowledge the problem and take necessary steps. Let us go back a little and understand how we talk. Speech is a complex activity, wherein hundreds of muscles act in close coordination. One of these muscles is the diaphragm, the muscular partition between the chest and abdomen. It acts as the bellows and pushes streams of air up, passing through the vocal cords. This gets the vocal cords vibrating. The tongue and lips, other muscles, modulate this vibrating air stream by coming in contact with each other and other parts of the mouth.

All this fine coordination takes place because of minute electrical impulses originating in the brain and running down to these muscles through fine nerves. Within the brain itself, a group of nerves, designated as the 'speech area' are connected with other parts of the brain dealing with grammar, syntax, speech content, emotions, thinking, analysis, visualization, memory, etc. We all know that strong emotions can rob one of the powers of speech. It seems that among people who stammer, this vulnerability is greater than 'normal'. The most common symptom is repetition of a part of the word: My name is S-S-Sachin. But over the years, a child develops many more
symptoms of which he himself may be largely unaware:

• Breathing abnormalities during stuttering, especially upper chest tension.
• Laryngeal blocks, which cut off airflow during stuttering.
• Articulation problems, including tension in the lips, jaw and tongue, and prolonged or repeated sounds.
• Secondary or "escape" behaviors, such as head jerks, eye blinking, or facial grimaces.
• Neurological abnormalities visible via brain scans.

As the child moves to adulthood, some psychological symptoms are added :

• Avoidance of feared sounds , words , and speaking situations. For example, the PWS may
  avoid making telephone calls. Even the choice of a career may be dictated by these difficulties.
• Substitution of another easily said word.
• "Anti-expectancy" speech behaviors to prevent stuttering such as speaking in a monotone or affecting an accent.
• Deep anxiety about keeping it hidden.

Some PWS may be able to manage their dysfluencies so well that even their family may not know that they stammer. Even though their speech sounds fine, these "covert" PWS can be crippled by severe psychological fears and anxiety.