Rumbling (speech disorder)

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Classification according to ICD-10
F98.6 Rumble
ICD-10 online (WHO version 2019)

Rumbling is a disturbance of the flow of speech or a speech disorder . “Rumbling shows up in an increased occurrence of phonetic abnormalities such as omissions and amalgamation of sounds and syllable sequences, sound substitutions and sound changes, which often lead to incomprehensibility of utterances, with a high and / or irregular articulation rate. In addition, there are often no fluids in the form of repeated syllables, words, sounds and parts of sentences (Sick 1999). "

Battarism , tachyphemia and tumultus sermonis are also used as synonyms for “rumbling” . At times, rumbling in the German-speaking area was also referred to as a paraphrasia praeceps .

Symptoms

The speech is difficult to understand by irregularities and disturbed rhythm that attempts are jerky and fast, the sentence patterns can often be erroneous. In addition to rushed speaking, sound fusions ( elions ) are typical, e.g. B. "Hatur" instead of "Front door". So (unstressed) syllables are often swallowed. Speaking does not sound fluent, which means it is not clear what the person concerned is trying to say. Speaking shows an increased proportion of inconsistencies that normally occur, such as interjections (e.g. "um") and revisions (sentence changes). The person who rumbles shows little effort in speaking and little secondary movements (which are more common in stuttering ). Although there is usually an awareness of the disorder, at the moment when the problems arise, it is difficult for those affected to identify them.

In addition to these symptoms, the following can often be noticed (secondary symptoms): disorganized speaking and little awareness of the speed and flow of speech. Learning difficulties may already be known. Polterers can be easily distracted and hyperactive, and more likely to have short attention spans and auditory processing problems.

Although no pathophysiological definition of rumbling exists to date , especially since the phenomenology is still unclear because it has hardly been researched, the possible symptoms are divided into mandatory and optional.

Mandatory symptoms

  • Too fast and irregular speaking rate
  • Syllable or sound amalgamation (elisions), sound substitutions, sound changes and slip of the tongue
  • Losses and embolophrasias (i.e. empty phrases, stretches, broken sentences and repetitions)

Facultative symptoms

  • Speech disorders or speech production weaknesses
  • Semantic disorders and word finding disorders
  • Pragmatic disorders (i.e. impaired social executive functions)
  • Attention deficit

diagnosis

After the first contact with speech therapy, the focus is on the collection of spontaneous speech samples. Differential diagnosis is used to distinguish it from stuttering . In children up to 7 years of age, speech comprehension is checked, otherwise oral diadochokinesis is tested before investigations into the variation of the speech speed and the communicative - pragmatic skills are carried out. The testing of the auditory memory for numbers and syllable sequences, the examination of deliberately clear articulation using a reading text and the examination of linguistic structuring conclude the first contact with speech therapy. Further diagnostics will be carried out at a later follow-up appointment.

classification

Despite still unexplained etiology is rumbling in the 10 ICD- under group Mental and behavioral disorders in the subgroup Other behavioral and emotional disorders with onset in childhood and adolescence subsumed and differential diagnosis the stuttering and tics compared.

etiology

Since there is hardly any research on the topic of rumbling, the cause of this flow disorder has so far not been clarified, so that only hypotheses on the etiology exist. Previous assumptions, such as the hypothesis that rumbling is a behavioral disorder , are untenable. Today, disturbances in perception and processing, control disorders, planning disorders, timing disorders in the broadest sense are cited.

therapy

“In contrast to stuttering, there are no fixed therapy programs for people who are rumbling. Nonetheless, rumbling patients are also treated in fluency shaping programs. ”Usually the psychosocial problems caused by the rumbling are treated first. The flow of speech is dealt with at the same time because working on the pace of speech is very important. You have to practice at different speaking speeds, paying particular attention to the pauses . The pronunciation , syllable expression and speech problems - if the latter exist - are part of the therapy. If there are stuttering symptoms in addition to rumbling, work will be carried out on it.

Rumbling is treated by speech therapists .

Knowledge and research

Compared to stuttering, rumbling occurs relatively rarely. Furthermore, there is little specialist literature on this. After a book about this flow disorder had not been published for many years, a medical-logopedic monograph by speech therapist Ulrike Sick was published in 2004. Many therapists interested in cluttering (as well as researchers and those affected) united in May 2007 to form the International Cluttering Association (ICA) in order to do more research on the disorder in the future; at this time the first world congress on rumbling took place in Raslog , Bulgaria. The ICA wants to address this disorder at all levels and has formed various committees for researchers, therapists and those affected. It is represented in many countries, in Germany by Manon Abbink-Spruit and Ulrike Sick.

In 2014, under the direction of Katrin Neumann , a larger stag study was started.

literature

  • Horst Coblenzer, Franz Muhar: breath and voice. Instructions for speaking well. Verlag öbv / hpt.
  • Claudia Iven: Rumbling. In: M. Grohnfeldt (Ed.): Textbook of speech therapy and speech therapy. Tape. 2: Appearances and disorders. Kohlhammer, Stuttgart, pp. 173-182.
  • Michael Schneider: Rumbling. In: M. Grohnfeldt (Ed.): Textbook of speech therapy and speech therapy. Tape. 4: Counseling, therapy and rehabilitation. Kohlhammer, Stuttgart, pp. 235-241.
  • Susanne Schönmackers: Relaxation procedures in speech therapy with rumbling children. Verlag Ernst Reinhardt, 2002.
  • Katrin Schulte: Empirical investigation of disturbed communication: the flow disorder of rumbling and its characteristic features and side effects. Dissertation. TU Dortmund University, Dortmund 2009.
  • Ulrike Sick: Rumbling. Theoretical basics, diagnostics, therapy. 2nd, completely revised edition. Verlag Thieme, 2014, ISBN 978-3-13-131212-9 .
  • Anna Stenzel: Comparison of stuttering and rumbling, with a focus on psychosocial components. Grin, Munich 2010, ISBN 978-3-640-75362-8 .
  • Stuttering Foundation of America: Cluttering, Some Guidelines
  • Hartmut Zückner: Kinesthetically controlled speaking (KKS) for rumbling and stuttering. Natke-Verlag, Neuss 2011, ISBN 978-3-936640-15-1 .

See also

Web links

Individual evidence

  1. ↑ Ulrike Sick: Rumble. Theoretical basics, diagnostics, therapy. G. Thieme, Stuttgart / New York 2004, ISBN 3-13-131211-4 , p. 13 (with reference to Sick's diploma thesis on spontaneous speech in clumsiness).
  2. ↑ See also the article by Maria-Dorothea Heidler on the following: Is rumbling an executive problem? In: Research Language - E-Journal for Speech Therapy, Speech Therapy and Language Promotion. 1 (1/2013, May 2013), pp. 23–35, here: 23–24, 29–30. (As of March 6, 2014)
  3. ↑ See also the simplified presentation for patients by Ulrike Sick, which conceptually distinguishes between core and secondary symptoms. (As of March 6, 2014)
  4. ↑ See also Ulrike Sick: Poltern. Theoretical basics, diagnostics, therapy. G. Thieme, Stuttgart / New York 2004, ISBN 3-13-131211-4 , pp. 69-70.
  5. ↑ See also Ulrike Sick: Poltern. Theoretical basics, diagnostics, therapy. G. Thieme, Stuttgart / New York 2004, ISBN 3-13-131211-4 , pp. 52-55.
  6. ↑ Ulrike Sick: Rumble. Theoretical basics, diagnostics, therapy. G. Thieme, Stuttgart / New York 2004, ISBN 3-13-131211-4 , p. 112.
  7. ↑ See Anna Stenzel: Comparison of stuttering / rumbling, with a focus on psychosocial components. Grin, Munich 2010, approved BA thesis, FH Johanneum Graz (speech therapy), ISBN 978-3-640-75362-8 , p. 26.
  8. ↑ See the press release RUB-Mediziner sucht Testen from January 6, 2014.