Cognitive Dimension of Stuttering/Speech Disfluency

People with stuttering/disfluency often face a variety of cognitive challenges when communicating. These difficulties may relate to both the act of speaking and the psychological aspects of communication. It is thought that understanding these cognitive difficulties caused by stuttering/speech disfluency will help both clinicians and people experiencing stuttering/speech disfluency in their efforts.

So what is “cognition”? Cognition; It is defined as the process of acquiring knowledge and understanding through thought, experience and the senses. The mental processes involved in receiving and storing sensory stimuli through the senses, and the transformation and storage of these stimuli into data, which are then used to direct your behavior and make decisions, occur thanks to cognitive processes. In essence, it is the ability to perceive and act, process and understand, store and retrieve information, make decisions and exhibit appropriate behavior. People who stutter/ have speech disfluency may have difficulties in the cognitive processes described above, and these difficulties can further exacerbate the stuttering/speech disfluency.

1. Increased Cognitive Load: The effort required to manage speech fluency can increase cognitive load and make it difficult to focus on what they are saying and how they are saying it. This can lead to mental fatigue. Of course, a certain cognitive effort is required to manage speech fluency. However, people with stuttering/speech disfluency do not know how to manage this and often fail to conduct themselves for this purpose, making the process even more difficult. For this reason, people who stutter/have speech disfluency need to learn what they need to do to manage the increased cognitive load, practice and master these skills under the guidance of speech and language therapists who specialize in stuttering/speech disfluency.

2. Anticipating Stuttering: Many people who stutter/have speech dysfluency predict moments of stuttering/speech disfluencies before they happen; This can increase anxiety and tension. This expectation can further increase stuttering, like a self-fulfilling prophecy. However, predicting stutters before they happen can be a great help in controlling speech fluency rather than being a factor of anxiety, if the right actions are taken.

3. Word Substitution and Avoidance: To prevent stuttering/speech disfluency, individuals may frequently substitute words or sentences; This can interrupt the natural flow of conversation and require significant mental effort.

4. Self-Monitoring and Correction: Constantly self-monitoring speech to prevent stuttering/speech disfluency can be mentally exhausting. Constantly thinking about how to express words can negatively affect speech fluency, content, and cause mental fatigue. At this point, people who stutter/speech disfluency need to learn, practice and master necessary skills.

5. Negative Self-Perception: Stuttering/speech disfluency can lead to negative self-image, which can affect communication both cognitively and psychologically. Individuals may be overly critical of their own speech and worry about how others perceive them. A person may develop negative thoughts and beliefs about himself. They can further complicate these negative thoughts and beliefs by seeing themselves through the eyes of others. Therefore, all of these make it difficult for the person to communicate, may lead to increased speech disfluency, avoidance of communication, and even find oneself in a depressive state.

6. Social Anxiety: Fear of negative evaluation or judgment of others can lead to social anxiety. This anxiety may lead to avoidance of conversational situations and reduced opportunities for social interaction and communication practices. While the person tries to communicate and speak, he also tries to cope with the anxiety caused by stuttering/speech disfluency. This situation can be likened to a juggler. There are so many factors that a person must manage. If a person does not know what to do to cope with these, he may have a difficult time like an amateur juggler, and stuttering/speech disfluencies will cause anxiety, and anxiety will cause further stuttering/speech disfluency continuing in a vicious circle.

7. Memory and Focus: Cognitive effort to manage stuttering/speech disfluency can affect memory and focus during speech. This can make it difficult to follow what is being said and respond appropriately. The person wastes the mental energy, which he/she needs to communicate appropriately, in the expectation of getting stuck and getting rid of speech disfluencies instead of following the communication, and therefore communication is interrupted and the person experiences further disfluencies. He/she has difficulty remembering what is said during or after communication.

8. Emotional Regulation: A person may have difficulty managing emotional states such as frustration, shame, or embarrassment as a result of stuttering/speech disfluency. These negative emotional states can negatively affect a person's ability to think, organize himself mentally and emotionally in communication, and maintain communication.

9. Reducing the Naturalness of Communication: Not knowing what needs to be done to carefully plan and monitor the conversation/communication can reduce the naturalness of conversations. This can make interactions less natural and the person feel more stressed. People with stuttering/speech disfluency notice this condition, as a result they may become demoralized, which leads to an increase in the frequency and severity of stuttering/speech disfluency.

10. Attention to Nonverbal Cues: Intense focus on speech production can sometimes lead to decreased attention to nonverbal cues from the person being communicated with, affecting the overall quality of communication.

Although it is very difficult to truly understand the difficulties experienced by people with stuttering/speech dysfluency, with a little effort and thought, it can be seen that people with stuttering/speech dysfluency have to cope with multiple difficulties in more than one area. Since the person has this problem since the early years of life, he does not know what to do, often does wrong things to ensure fluency of speech, and as a result, he gets stuck in a vicious circle. At this point, what the person needs to do is to obtain the necessary cognitive tools to deal with stuttering/speech disfluency by accessing the right sources of information, experience, expertise and guidance with the acquisition of mastery on how to use it.