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Camden doctor sheds light on stuttering

Posted: May 17, 2013 8:53 a.m.
Updated: May 17, 2013 8:53 a.m.

The handsome young contestant strides onto the "American Idol" stage. The music swells, and Lazaro Arbos sings -- fluently, confidently. Thunderous applause and cheers follow. Then a judge on the popular TV show asks him a question. Lazaro opens his mouth emitting halting, repetitive sounds at first. In a few seconds, the spoken words come, but it’s a struggle.

How can that be? How can a person who stutters when he speaks not stutter when he sings? Even sing well enough to make it to the top six finalists on "American Idol?"

"The study of stuttering is fascinating because there are so many components and questions. As you saw on ‘Idol,’ one can be a fluent singer and then stutter in conversation," fluency specialist Dr. Judy Martin of Camden said. "This works most of the time for most of the people who stutter (PWS). Activities that are most likely to create fluency in a PWS are singing, acting, talking over masking noise (like a buzz or a metronome), talking with delayed auditory feedback, speaking with an accent and speaking chorally with another person. These ‘tricks’ can be used effectively to give a person a feeling of relief and assurance that the speech mechanism can work properly. However, they should not be confused with a ‘cure’ for stuttering.

"We believe different areas of the brain are activated in these activities."

Dr. Martin was quick to say, however, that stuttering is a complex disorder and that the medical world does not have all the answers about its causes or treatments. She is well-qualified to discuss the subject, and because May is Better Hearing and Speech Month, and this week is National Stuttering Awareness Week, this is an ideal time to do it.

Lazaro Arbos may have achieved a measure of fame on "American Idol," but he’s not the only PWS who hasn’t let stuttering stop him.

A pamphlet published by the Stuttering Foundation of America to promote the week features a number of celebrities who have not let stuttering hold them back.

For instance, arguably one of the most recognizable and authoritative voices in the world belongs to a PWS, none other than that of actor James Earl Jones, who is well known for his voice as Darth Vader in "Star Wars."

King George VI of Great Britain during World War II inspired his country with his radio broadcasts despite a severe stutter. His story was the subject of "The King’s Speech," winner of four Academy Awards.

Other famous people who didn’t let stuttering stop them include Winston Churchill, who captured the attention of millions during WWII with his inspiring speeches; country music star Mel Tillis; author John Updike; legendary golfer Ken Venturi; singer Carly Simon; and movie star Marilyn Monroe.

Dr. Martin welcomed the opportunity to observe Better Hearing and Speech Month and National Stuttering Awareness Week by sharing information on speech pathology and especially on fluency disorders.

Her list of credentials is impressive: a Ph.D in speech-language pathology from the University of South Carolina (USC), and a certificate of clinical competence in speech-language pathology (CCC-SLP) making her one of only two fluency SLPs in South Carolina, who are board-recognized specialists in fluency disorders (BRS-FD). The certifications are awarded by the American Speech-Language and Hearing Association (ASHA).

Dr. Martin earned her master’s degree in communication disorders from Northwestern University in 1961 and did postgraduate work at Kansas State University and Northwestern but put earning her doctorate on hold while she raised her three daughters.

"My career has always been driven by family first," she said.

In the interim, Dr. Martin worked in her profession part time until her children were grown. Those academic positions included being an adjunct professor at USC from 1971 to 1976. It was not until 1987 that she earned her doctorate. Then, from 1989 till her retirement in 2001, she served as director of the USC Speech and Hearing Center.

Dr. Martin also began teaching USC Distance Education courses in 1995 and still teaches the online courses, now called USC Distributed Learning. Additionally, after her retirement, she joined the adjunct faculty at the Medical University of South Carolina for five years.

Focusing on fluency

Since retiring, Dr. Martin has been able to narrow her professional focus to her first love -- stuttering. She finds the fluency disorder fascinating, and said she is passionate about helping people manage the disorder and become more fluent speakers, whether they are adults or children.

"There is a natural recovery from stuttering during childhood, and therapy increases that chance of recovery," Dr. Martin said.

Although about 5 percent of the population has stuttered longer than six months in childhood, only about 1 percent stutters in adulthood, she said.

"It is typical for preschoolers to have a period of normal disfluency as they learn speech and language. Usually, we are talking about whole word repetition. However, the child who is stuttering is likely to have a lot of broken words (ba ba ba baby). There is a difference in the quantity and quality of disfluency in a child who stutters," Dr. Martin said.

The most important thing you can do for a disfluent preschooler is to help him enjoy talking and to know that speech doesn’t have to be perfect, she said, and advised that it’s important for families and pediatricians to take advantage of the resources available online or to be evaluated by a speech-language pathologist, especially if the stuttering lasts more than six months.

Therapy helps at all ages, Dr. Martin said, but goals and methods change the longer a person stutters.

"Some adults prefer to work with overall talking and their approach to speech. Others work on modifying their moments of stuttering by easing tension and easing out of blocks," she said, adding, "It’s not what happens to you, it’s what you do when you stutter that makes a difference. We want to make sure that people feel free to communicate without struggle or fear."

Dr. Martin said she encourages everyone who stutters to approach rather than avoid speaking situations. "Avoidance of speech is a person’s worst enemy."

She recommended that relatives and friends of a PWS can help by listening patiently, not finishing his or her sentences and by accentuating the positive, instead of focusing on correction.

Her passion for helping PWS and training others to help them transferred to a huge project created in conjunction with the only other board recognized fluency specialist in South Carolina, Alice Anne G. Farley, M.ED, CCC-SLP, BRS-FD. Held during the summers of 2003 and 2004 on the USC campus, it was called the Fluency Roundup, a Western-themed workshop designed for school-age children, their school clinicians, their parents and student clinicians.

Inspiring future accomplishment

Currently, Dr. Martin is enmeshed in teaching her online course, Stuttering: Evaluation and Therapy. The program was originally started to give working speech therapists in South Carolina schools a chance to get their master’s degrees in speech pathology and their ASHA-awarded CCCs.

"Now, I have students all over the United States and beyond," she said.

This year, her 28 students live in Virginia, Massachusetts, Indiana and California, plus the South Carolina contingency. For two years, all of her students were from the Virgin Islands.

Her students access her course lectures via DVD or streaming video recorded in a USC studio. When recording, she faces video cameras and a director instead of students.

"The field of speech-language pathology is very broad. The core areas are language, voice, articulation and fluency, but we have branched out to include so many other functions of the speech mechanism, including swallowing, even dealing with patients requiring tracheostomy and vents. We offer augmented communication when speech isn’t possible," Dr. Martin said. "We serve many different populations, including those on the autistic spectrum, or with neurogenic disorders, cleft palate, closed-head injuries. We also work with audiologists to cover hearing impairments and are responsible for auditory verbal therapy after cochlear implant.

"Sometimes, low incidence disorders like stuttering get lost in the training. My job has been to give my students a foundation and an interest in serving the stuttering population."

This energetic retiree is showing no signs of slowing down professionally. In addition to inspiring students, she said she feels another obligation. The National Institute of Health paid for most of her graduate work and research.

"Since I chose to only work part time while raising a family, I think I still owe the public part of my time, and now I can pick and choose. I can return to my first love, which is fluency disorders," Dr. Martin said.

To maintain her specialty recognition, she must have 45 hours of continuing education and 300 hours of contact with people who stutter and/or their clinicians every three years.

"My means is through teaching the online course and mentoring future fluency specialists. Right now, I am mentoring speech-language pathologist Jill Fannin of Canton, Ga.," she said.

But family still comes first. Her three daughters are now married and have two children each. Dr. Martin has acquired two grown stepdaughters and a stepson who recently married.

Her husband, Scotty, is kind enough to let her plan some family vacations around stuttering conferences, she says with a smile. For instance, during a recent trip to visit a daughter in Nashville, they had to divert to Canton, Ga., for a meeting with her mentee. Dr. Martin is only beginning this commitment.

"The Specialty Recognition Board on Fluency Disorders has just given approval for our three- to five-year plan," she said.

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