Stuttering Research and Treatment Around the World: India Stuttering as a speech disorder has been documented and treated in India since Vedic times (5000 BC-200 BC). Texts of Ayurveda (the ancient system of Indian medicine) contain references to medicines and yogic practices that help persons who stutter. The first known speech treatment clinic for stuttering, started in India ... World Beat
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World Beat  |   October 01, 2005
Stuttering Research and Treatment Around the World: India
Author Notes
  • Uma Subramanian, is currently principal of Samvaad Institute of Speech and Hearing, Bangalore, and also a visiting professor to several speech and hearing colleges. She has 33 years of experience in the field. Her areas of interest are child language and its disorders. Contact her at uma_s1@yahoo.com.
    Uma Subramanian, is currently principal of Samvaad Institute of Speech and Hearing, Bangalore, and also a visiting professor to several speech and hearing colleges. She has 33 years of experience in the field. Her areas of interest are child language and its disorders. Contact her at uma_s1@yahoo.com.×
  • Bharathi Prabhu, is a consultant speech-language pathologist at Spandana Nursing Home, Bangalore. Her areas of interest include language and stuttering. She has a keen interest in writing and has written several articles for newspapers, many on speech and hearing topics. Contact her at bprabhu@vsnl.net.
    Bharathi Prabhu, is a consultant speech-language pathologist at Spandana Nursing Home, Bangalore. Her areas of interest include language and stuttering. She has a keen interest in writing and has written several articles for newspapers, many on speech and hearing topics. Contact her at bprabhu@vsnl.net.×
Article Information
Speech, Voice & Prosodic Disorders / Fluency Disorders / International & Global / World Beat
World Beat   |   October 01, 2005
Stuttering Research and Treatment Around the World: India
The ASHA Leader, October 2005, Vol. 10, 7-8. doi:10.1044/leader.WB4.10142005.7
The ASHA Leader, October 2005, Vol. 10, 7-8. doi:10.1044/leader.WB4.10142005.7
Stuttering as a speech disorder has been documented and treated in India since Vedic times (5000 BC-200 BC). Texts of Ayurveda (the ancient system of Indian medicine) contain references to medicines and yogic practices that help persons who stutter. The first known speech treatment clinic for stuttering, started in India in 1937 by Japan-trained M. S. Rami, still functions in Mumbai.
Speech treatment facilities are currently available at training institutions that offer programs in speech-language pathology and audiology, hospitals, and private speech and hearing clinics. Clinics are available where persons who stutter (who are not formally trained) themselves provide counseling and treatment for stuttering. Apart from speech-language pathologists, psychologists, and psychiatrists, practitioners of alternate systems of medicine also treat stuttering in India.
No studies are documented on the incidence and prevalence of stuttering in India. However, the All India Institute of Speech and Hearing (AIISH), a premier training institute, reports that 10% of those with communication disorders stutter. Systematic study, research, and treatment of stuttering in India began with the establishment of the AIISH in 1965. This institute and several other training institutes subsequently established by the government and private organizations contribute to the bulk of research in the field. Students are required to carry out research projects in their graduate programs and some of them choose stuttering as their area of research. Doctoral projects also have been done on stuttering.
Data Gathering
To gather information for this article, we sent out questionnaires-eight to teaching institutes and seven to private practitioners across the country. The 14 responses revealed that research in stuttering covers a wide spectrum of topics ranging from development of fluency in children to the effect of treatment on various aspects of stuttering.
The aspects under research in India also reflect prevalent research interests elsewhere in the world. For instance, in the 1980s, researchers in India focused on acoustical, laryngeal, and aerodynamic features while the current research focus is on motor programming in persons who stutter.
Other topics being researched include neural networking and its application in differential diagnosis of stuttering and normal non-fluency, sub-grouping of stuttering, variables that affect treatment outcome, and naturalness of speech after treatment. Respondents indicated that status of research in the country needs improvement.
The number of research projects are insufficient, both in the area of stuttering and in the entire field of speech and hearing. The reasons are lack of funds, brain drain, and the overwhelming demand for clinical services, which take up time and energy. Even in teaching institutions, the amount of research is less than required because of the multiple demands (teaching, clinical supervision, administration) placed on staff already small in number.
The research done also does not get published because few Indian journals exist and many Indian SLPs need to hone their writing skills for international publication.
The questionnaire also asked clinicians about the treatment procedures they follow. Responses revealed the generally used treatment procedures are prolongation, air-flow modification, slow-rate of speech, soft contacts, and DAF and different combinations of the above based on age, severity, and type of dysfluency. Clinicians also find group treatment effective with adult persons who stutter.
Among 2- to 5-year-olds, the chief method of management used to be counseling parents. Now clinicians use direct treatment depending on the severity and the need for management indicated by the parents.
Our Own Clinical Observations
We believe that demand for speech treatment in urban India is on the rise due to:
  • growing awareness about speech treatment services for stuttering. This awareness is due to the country’s media revolution. Articles and programs related to health appear frequently in the media and stuttering has received its share of attention. SLPs also have played a significant role in raising the awareness levels among the general public, doctors, and teachers through interactions, which range from lectures at schools and service organizations to conducting awareness seminars.

  • rapid increases in jobs in the BPO (Business Process Outsourcing) sector and call centers where young employees need excellent communication skills. Even those with mild stuttering now seek professional help.

  • a burgeoning educated middle-class that wants the very best for its children in all spheres of development, including communication.

In order to extend health and other rehabilitation services to rural and remote areas of the country, service organizations such as the Lions and Rotary Clubs conduct camps. In speech and hearing camps, large numbers of people are screened for various speech and hearing disabilities and some services (e.g., further referrals, counseling, audiometry) are provided.
An interesting observation based on our participation in these camps is that the rural population of India has a greater tolerance for stuttering than do urban people. The reasons could be that demands on communication in those social settings are less as most people are known to each other and livelihood is mostly through manual labor. In the light of many other pressing health and economic problems, stuttering is not considered a disability and there is a philosophical acceptance of any disabling condition.
Current and Future Needs
The majority of SLPs in India are engaged primarily in provision of clinical services, yet the country’s clinical needs are not being met. Clinical work is documented but the drive to research and publish is not strong. India, with its large multilingual and multicultural population, offers enormous opportunities for research in stuttering. Severity across languages and perception of stuttering across different socioeconomic groups are some of the issues for study.
Our ancient Yoga practices as they apply to stuttering should be investigated too. Yoga has been practiced in India for thousands of years for better control of mind and body. Yoga aims to improve people’s inner tranquility and free them from fears and anxieties. Since it is known that stuttering includes an element of anxiety and fear, Yoga can help reduce this. Pranayama, one of the Yoga techniques, focuses on regulating breathing. Whether fluency can be improved with slow and controlled breathing, as Pranayama teaches, should be scientifically tested.
Finally, because of the dearth of SLPs and the paucity of available funds, the amount of research produced in India is far less than desired. More training programs and foreign collaborations may address these issues.
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October 2005
Volume 10, Issue 14