In my last post, I pointed out that when we talk amongst ourselves about stuttering problems, it is too easy to say, “I stutter”, or, “I stammer”,or, “he is a person who stutters or stammers”, and we expect that the other person knows exactly what you are talking about regarding stuttering severity, but I asked the question, do we know what is being talked about, or, do we just make assumptions based on our own experience of what stuttering or stammering is, from what we have seen or experienced ourselves. I argued that it is the later, and that unless we use some other universally understood descriptive terminology when we describe and comment about the stutter, then we have no idea what is being described.

What I am trying to say here is that, the term “stuttering” is so broad, that it cannot, in isolation, be used to describe the many different forms of speech dysfluency. For example, I can say that John is a stutterer, and Sam is a stutterer, and Bill and Tom are also stutterers, but are they all experiencing the same phenomenon? The answer is likely to be, no! Stuttering has both a physical component and psychological component, and there is great variation in the degree of both, from one person to the next.

On the physical side, John may have some repetitions in his speech, but no blocking. On the psychological side, he may not give any thought to the fact that he has a level of speech dysfluency, and does not avoid any speaking situations because of it. On the other hand, Sam may have severe and regular speech blocks. He may avoid some words, and substitute others. His stuttering may completely control all aspects of how he lives his life, both professionally and socially. We then come to Bill, and he may have what some see as a pronounced speech dysfluency, with a combination of repetitions, prolongations and some blocking, however, on the psychological side, Sam may not be concerned about it to the same degree as Bill, in that it does not effect the way he lives his life in any way. Finally, we have Tom, and he may have what appears, to the outside world, to have no problem with speech fluency at all, yet he has a great fear of the possibility of blocking and stuttering, and as a result, he is highly anxious about that possibility, so lives in fear of it happening at some time and what that would mean to him. All these personalities would say that they have a stutter, or are a person who stutters, and seek treatment for stuttering, but if they were all to hear that the other was a stutterer, they could only assume, in absence of any other descriptive terminology, that the others all experienced stuttering in the same way as themself. This becomes a problem when we are talking about stuttering in regard to how it has affected us in various areas of our life and, how successful treatments have been for us and so on.

So what is the answer? Well the speech pathology profession has recognised that the degree of stuttering needs to be understood when offering to treat a person who stutters, and as a result certain questionnaires have been developed to determine the severity of the stuttering, from both a physical and psychological perspective, and two of the most widely used questionnaires are the OASES test and the WASSP test, however, these are only useful for a full academic analysis of the problem rather than for a quick and self evident assessment method to be used in casual conversation, where understanding of degree is necessary.

So what is a quick and self evident method? Well there are basically two main aspects to stuttering severity. The first is the severity of the physical degree of speech dysfluency, and the second is the severity of the psychological affectation on the individual, as a result of the speech dysfluency. Now in the stuttering support group that I coordinate, and the circles that I move in, we have for many years, used what others now call, the “Stuttering Jack Scale”. We give the physical symptoms a quick rating of 1 to 5, where 1 is mild repetitive stuttering and/or mild speech blocking, while 5 is severe and frequent blocking. 2, 3 & 4 are degrees in between. Now in the same way, we also give the psychological symptoms a quick rating of 1 to 5, where 1 is where the person sees the speech dysfluency as more of an irritation, or inconvenience, than a major issue, while the 5, is associated with social phobia, panic attacks and extreme anxiety surrounding the physical symptoms.

So how do we use this? Well, when talking about a person who stutters, we would say, John is a “1,1 Stutterer”, or Sam is a “5,5 Stutterer”. The first number refers to the degree of physical symptom, while the second number refers to the degree of psychological affectation. We might describe Bill as a “5,1 Stutterer”, while Tom would be a “1,5 Stutterer”. We might choose to tone our simple self assessments up or down a little, depending on how many other people we have seen or met who stutter, in saying, I am a “4,2 Stutterer”, and so on. The people that I associate with, and talk to, all clearly understand that when I say, “yes, but he is a 1,1 Stutterer”, we all instantly know that the person has a mild stutter, but does not let stuttering worry him, and sees it as a an inconvenience or irritation. We say, if that is the case then he may do better with a CBT or a Neurosemantic type of treatment, as opposed to an intensive fluency shaping approach. If someone says, “no, he is a “5,5 Stutterer”, then we know  that this stutterer has a real problem, and that would instantly and simply explain a lot of his behaviour. We would instantly start thinking about other treatments that would be different to what the, “1,1 Stutterer”, might be better directed to, and so on. All this is better than saying, “I am a stutterer, but I just get on with my life, why don’t you”, or, “I am a stutterer and I can’t find any treatment to help me, and my life is just a mess, why isn’t yours”. Using the “Stuttering Jack Scale”, one might be better described as, a “3,1 Stutterer”, and the other better described as, a “5,4 Stutterer”.

Now my little method does not replace the full clinical assessment methods mentioned above, that should be undertaken before any treatment is administered to a person who stutters, and it is not trying to usurp the use of more technical and professional terms. It is just a, “rough and ready”, way of clarifying to another person what is being referred to, when talking about an individual, who has a speech dysfluency problem. It can be used by professional and consumer alike as a simple universal terminology to put the other person, “in the ball park”, with reference to what is being described as, stuttering, in different individuals.

Do I need a clearer description of what is referenced by 1, 2, 3, and 5 in both groupings? Well maybe yes, but that would only serve to confuse and be a source of debate. One should be clear what a 1 is compared to a 5, in each classification, and as for what is a 2, 3 or a 4, really doesn’t matter, as the required message has been passed along to a sufficient degree, for the purposes of casual conversation, needing reference to degree of stuttering.

So do you know any “5,5,stutterers”? How about a “1,5 stutterer”, (who falls into the category of a “covert”). Are you a “1,1 stutterer”? Then maybe all you need to do is reshape the world that you see before you, do a bit of disclosure, and some voluntary stuttering, and get on with your life. If you are a “5,5 stutterer”, then you need to subscribe to my RSS feed because we have a lot more to share with each other on this blog. For I am a “0,0 stutterer, and, a 5,5 stutterer”, all rolled into one, but that is the subject for another blog post here. If you plan to read all my blogs, or follow me on Twitter, Facebook etc, please become familiar with this simple system so that our conversations are more meaningful. In the mean time, I invite you to comment on this post as to the soundness of the “Stuttering Jack Scale”, and where you believe you sit on the scale.

On any website about stuttering, stammering, studdering and stuttering severity, you will be sure to see a very nice academic definition of stuttering where terms like “repetitions”, “prolongations”, “cessations of sound” etc are used, but to truly have an understanding of what a person who stutters is really talking about when they say, “he stutters”, or, “he is a stutterer”, or “he is a stammerer” really requires something more than a single word terminology, because one person’s understanding or experience of stuttering severity, can be completely different to another, and that goes for people who stutter/stammer and professionals who treat them.

How often have you heard someone say, “I stutter”, or, “I am a stutterer”, or, “he stutters”, or, “Winston Churchill was a stutterer”? Have you ever stopped to think what the person means when they say that? What do they mean? What is it telling you? Well if you are really interested in knowing a little more about how that person speaks or thinks about speaking, then it really doesn’t tell you anything other than someone thinks he or she has some form of speech dysfluency, that has been defined as stuttering. But are you aware that there are some people who define themselves as having a stutter, that you will rarely, or never see stutter. So what is stuttering? Well if we are going to talk about stuttering, then we had better know what we are talking about, and understand “how deep this rabbit hole goes”.

There are so many different ways that speech dysfleuncy can manifest, and each person is different. Stuttering can be word related, (stutters on certain sounds or words), or situational related, (stutters in certain situations), or people related, (stutters with certain people or personalities), or time related, (stutters when tired etc), and the list goes on. Not only can the perceived triggers change, but the degree of stuttering can also change, from mild to severe, seldom to regular to constant, stumbling to complete blockages. All this we call stuttering, or if you like, stammering.

Now if that is not enough, there is a further dimension to stuttering, and that is the unseen aspect of the physical manifestation of stuttering, and that relates to the ability of the afflicted individual to be able to hide the speech dysfluency, when it is about to occur. This is generally done by what is called avoidance behaviour, in its many forms, ranging from avoiding words by substituting a similar word that is perceived as easier to say, to totally avoiding speaking at all, and all that is in between.

Getting confusing? Starting to see that, “I am a stutterer”, or, “he stutters”, tells you very little about the depth of the person’s problem, if it is even a problem. Well it doesn’t end there.

Speech is such an integral part of communication, and human nature. It is how we express to others our thoughts, feelings, wants and needs. We express our emotions of love and hate and all that is in between through the marvellous human facility of speech. So what do you think it would be like if you were not able to speak or speak fluently enough to get your message out in a normal timeframe without a major effort? How would you feel? How would it affect your self esteem, your general thoughts, feelings and emotions? How would you see the world that you live in? The answer is that we are all affected by our experiences in different ways. In simple terms people who stutter, along with any other person who perceives they have “an issue” with speech fluency are affected either mildly, moderately or severely.

Some people have, what most of us would agree, is a stutter, and appear to not even know they have a speech dysfluency, in that it does not have any effect on the way they live any aspect of their life, whereas another person, with the same level of stuttering, or much less, can be so effected by their problem, that it impacts on every part of their life, to the extent that some individuals, are totally debilitated by it, in every way and it influences almost every decision they make.

So no matter if we are a person who stutters, a professional seeking to treat those who stutter, or just a person trying to understand what stuttering is, if we are to talk about stuttering and stutterers and seek effective treatment for the different forms of stuttering, then we need a way of expanding our vocabulary when we speak amongst ourselves about it, so as to allow us to know instantly, the degree to which we are talking about, when we say that a person stutters. When one person seems to be coping well with stuttering, while another does not, we need to have some way of indicating why this could be the case. Finally, we need to have a way of separating one person who stutters from another, so that treatment for stuttering can be tailored correctly for that person’s complete problem, surrounding the dysfluent speech. How are we going to do this in a simple and easily understood way? Well, that is the subject of my next article, and in that regard I invite you to avail yourself of my RSS feed here, so that you will be the first to read and understand this simple yet revolutionary way of communicating the degree of speech dysfluency, and associated anxiety disorder, we are talking about.

In the mean time, I also invite you to comment below on the problem as you see it.