Stuttering

This, from the New York Times. Very important news for lifelong stutterers like myself.

"As a child who stuttered badly, Gerald Maguire learned the tricks of coping.

When called upon in class, he would sometimes answer in the voice of Elmer Fudd or Donald Duck because he didn’t stutter when imitating someone. He found easier-to-say synonyms for words that stymied him. And he almost never made phone calls because he stumbled over a phrase for which there was no substitute: his own name.

Now Dr. Maguire, a psychiatrist at the University of California, Irvine, wants to cure the ailment that afflicts him and an estimated three million Americans. He is searching for a drug to treat stuttering, organizing clinical trials and even testing treatments on himself.

He could be getting closer. In May, Indevus Pharmaceuticals announced what it called encouraging results from the largest clinical trial ever of a drug for stuttering. Even larger trials are still needed, which could take two or three years. But if they succeed, the drug, pagoclone, could become the first medical treatment approved for stuttering.

That is just part of a transformation of stuttering — in the medical view — from what was once widely considered a nervous or emotional condition to a neurological one that is at least partly genetic. Using brain scans, DNA studies and other modern techniques, scientists — many of whom stutter themselves — are slowly shedding light on a condition that has flustered its victims as far back as Moses, who some scholars believe was a stutterer because he told the Lord that he was “slow of speech and of a slow tongue” and had his brother Aaron speak for him.

“This is a total paradigm shift in the last 10 years,” said Dr. Maguire, who helped design the Indevus trial and was an investigator in it. “When I was in medical school, I learned nothing about stuttering.”

Still, much remains to be learned about the causes of stuttering and how to treat it. It is estimated that about 1 percent of the population worldwide stutters, though that figure may be high. Men who stutter outnumber women by a ratio of about 4 to 1, for reasons not known.

In most cases, stuttering begins between ages 2 and 6, when a child is just learning to speak. But three quarters of such children will stop stuttering within a few years without any intervention, said Ehud Yairi, emeritus professor of speech and hearing science at the University of Illinois, who stutters himself. Other children benefit from speech therapy.

Those who stutter say the condition — marked by repetitions of syllables, long silences and the contortion of the face as a person seems to try to force the words out — can exact a terrible emotional toll. Many talk of jobs or promotions not received, of relationships broken or not pursued. Some structure their entire lives to avoid having to speak unnecessarily or to avoid being teased.

“Stuttering is one of the last diseases it’s still O.K. to make fun of,” said Ernie Canadeo, an advertising executive from Oyster Bay, N.Y., who stutters.

Alan Rabinowitz, a noted wildlife conservationist, has told of how when called upon by a teacher in elementary school, he once avoided answering by stabbing his hand with a pencil so he would be taken to the hospital.

Still, many people overcome — if not totally cure — their stuttering, either through therapy or just the passage of time. Winston Churchill stuttered. So did Marilyn Monroe. Others who have coped with the problem include the author John Updike, Senator Joseph R. Biden Jr. of Delaware, the actor James Earl Jones, the newsman John Stossel, the singer Carly Simon and the sportscaster Bill Walton. Throughout history, various theories have been advanced for stuttering, including sexual fixations, emotional disorders, nervousness, and persistence into adult life of infantile nursing activities, according to the book “Knotted Tongues: Stuttering in History and the Quest for a Cure” by Benson Bobrick (Simon & Schuster, 1995).

One of the more popular theories from a few decades ago was that parents caused stuttering by reacting negatively to the repetitions that normally occur when children first learn to talk.

But a consensus is growing that stuttering is a neurological condition, though its exact nature is not clear. Emotional stress can make stuttering worse, however."