International Journal of Applied Ayurved Research ISSN: 2347- 6362

STAMMERING- AN AYURVEDA VIEW

Ravishankar K1 Akhilesh PM2
1. PG Dept of Kaumarabhritya, SDM College of Ayurveda, Kuthpady, Udupi, Karnataka.
2. Principal & Professor, Father Muller College of Speech & Hearing, Mangalore, Karnataka.
Corresponding author: Asst.Professor, PG Dept of Kaumarabhritya, SDM College of
Ayurveda, Kuthpady, Udupi, Karnataka.
ABSTRACT:
Man acquires prestigious position in life because of his unlimited thoughts and ambitions. It
is discriminative capacity and power expressing thoughts in the form of speech makes him
to conquer all walks of life. Struggle between health and disease begins with the onset of life
i.e. since childhood and main aim is to gain healthy childhood. Child is multifaceted entity
of society.Stammering is a disorder of human communication prevails 1- 5% of children
population. It is defined as disruption of fluency of verbal expression and is by spasmodic
repetition and prolongation of vocal sounds by fear, anxiety and struggle to avoid speech
errors. In current system of medicine Speech Therapy takes the upper hand in the
management of Stuttering. There is no elaborate explanation regarding the speech disorder
in Ayurvedic literature.
Key Words : Stammering, repetition, prolongation, speech therapy.
INTRODUCTION:Speech is the unique Articulatory disorders- In some children
characteristic feature of the human being. only one or two sounds may be
Speech is the ability to convey thoughts, mispronounced whereas in others so
ideas, or other information by means of many sounds may be mispronounced that
articulating sound into meaningful words. the child's speech may be unintelligible.
Fluent speech is essential for Voice disorders- Voice problems include
psychological development of the child complete absence of voice (aphonia),
and for proper convey of thoughts. It hoarseness, harshness, breathiness,
enables one person to convey knowledge high/low pitched voice, etc. Children who
to a roomful of other people. Any fluent scream and talk excessively are prone to
problem in speech will create a voice problems.
disturbance in the emotional and social STAMMERING:Stammering is a
behavior of the children. One such complex disorder composed of many
fluency disorder of speech is stammering levels factors because there is no single
in children, which is the most trouble reason. In most cases the syndrome
shooting problem in childhood age group appears to arise from a combination of
and which can lead to the disability in the several factors that come together within
later ages. a requisite time interval. Stammering can
The speech disorders can be classified found in some early literature, where it is
1
under three main headings . These are used interchangeably with Stuttering.
fluency disorders, articulatory disorders Currently the term stuttering is used in the
and voice disorders. Fluency disorder United States; Stammering is often used
means a disorder in which fluency is to mean essentially the same thing in
affected. Eg: stammering, cluttering. Europe.
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A comprehensive definition of stuttering Identification: is the phase in which the

must also take into account the effect of stutterer explores, analyzes and classifies
the experience on the speaker. Van Riper the covert behaviors and covert
acknowledged that ‘stuttering occurs experiences that characterize his
when the forward flow of speech is particular kind of stuttering.
interrupted by motorically disrupted Desensitization: is the phase devoted to
sound, syllable, or word, or by the decreasing his speech anxieties and the
speaker’s reactions2. Characteristics of other negative emotions connected with
stammering are Repetition or syllables, his disorder.
words, Prolongations, Silent pauses, Hard Modification: is the phase involving first
contacts, Hesitations and Physical the varying and then the unlearning of
concomitants like Distracting sounds, habitual avoidances and struggle
Facial grimaces, Head movements, responses, and also the learning, through
Movement of the extremities. counter conditioning, of a new fluent, less
The assessment of Stammering is difficult abnormal way of stuttering.
in children when compare to that of Stabilization: is the phase in which
adults. At the most basic level frequency, helping the stutterer to consolidate his
duration and tension3 are the three gains, to create generalized sets that will
categories of behavior that may be used to make the new fluent form of stuttering
determine the severity of stuttering. automatic, and to develop proprioceptive
Following parameters are used to assess monitoring of his normal speech.
stammering in young children: Stuttering modification therapies focus on
1. Stuttering Severity instrument(SSI-3) changing individual moments of
2. Modified Erickson Scale of stuttering to make them smoother,
Communication Attitudes (S-24) shorter, less tense and hard, and less
3. Perceptions of Stuttering Inventory penalizing. Stuttering modification
(PSI) approaches do not strive to make a
4. Locus of Control of Behavior (LCB) stutterer fluent but rather, to stutter with
5. Communicative Attitudes test- control. Stuttering modification therapies
revised (CAT-R) tend to recognize the fear and avoidance
6. A-19 Scale for children that builds up surrounding the stuttering
7. Stuttering Prediction Instrument for and consequently spend a great deal of
Young Children time helping people who stutter to work
TREATMENT OF STAMMERING: through those emotions. The fluency
The goal of Treatment is to achieve shaping therapies focus on changing all
spontaneous fluency and modeling. The speech of the stutterer, not just the
speech therapy is the well-known moments of stuttering. These therapies
treatment modality done in stammering. have a more global approach because they
The steps4 in stammering treatment are teach the person to slow down and
1. Identification. smooth out all of their words.
2. Desensitization. General Guidelines in the treatment of
3. Modification. stammering:
4. Stabilization.  Help the child gain a sense of
mastery and control, not only over
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stuttering, but over the aspects of life as Swara like Swarabheda, Vak Graha.
well. These conditions are coming under
 With fluency shaping and stuttering fluency problems, articulatory problems
modification, help the child become and voice problems. Also there are
appropriately open about stuttering. This references regarding the lakshanas of
reduces the tendency to avoid or Swara in other systemic disorders.
withdraw from anticipated difficult Acharya kashyapa mentioned
speaking situations. about the mookatva in the context of
 Help the child to develop unique and Samvardhana ghrita along with other
natural responses. developmental problems of children7.
 Help the child to build the self-esteem Acharya Charaka has mentioned about
by developing areas in which he or she Prakruta and Vaikruta Swara in
can excel. Indriyasthana, where he states that
 If a child is susceptible to stress and Gadgada is one of the Vaikruta Swara.
excitement, help the child to develop While explaining the indications of
response to stress, such as slowing the certain formulations like Kalyanaka
rate of speech. ghrita, Saraswatha arishta, Kalyana leha
AYURVEDIC PERSPECTIVE: etc there is references of Speech
Kashyapa has explained the parts of Disorders.
Vakindriya5. It is divided into two, one The Nidana, Samprapti and
part works for Vachana and one part Lakshana of the disease Gadgada is not
works for Grahana of Shabdha. It clearly elaborately mentioned in Ayurveda
indicates that the speech function is not classics. Gadgada is mentioned in
mere sound production. It also includes Vatavyadhi Avarana Prakarana by
sound perception. He also explained a Acharya Charaka8 and Acharya
9
child born deaf cannot learn the speech Sushruta . Vruddha Vagbhata mentioned
production. He will be Mooka. Because Gadgada is due to intake of Vata
Shrotra acts as Vakmoola. aggravating Aharavihara by garbhini10.
Acharya Kashyapa has mentioned Word meaning:Word Gadgada refers to
the developmental mile stone for speech6. Aspashta Vak, Ashpashta Dhvani,
In Shareera Sthana while explaining the Avyakta Dhvani, Avyakta Sphuta Sabdha
characters of persons, he has mentioned and Vak Skhalana11.
that in Kaliyuga Vachana will be Nidana and Samprapti of Gadgada:
developed by the first year of life for Specific nidana for Gadgada is not
human beings. mentioned. As it is mentioned in Avarana
Even though there is no prakarana the Nidana for Vata Vriddhi
mentioning of separate category of speech can be considered. Acharya Vagbhata
disorders in Ayurveda, we get the stated that Vataja Ahara Vihara intake by
references in classics which tell about the Garbhini leads to vata vriddhi which in
fluency disorders, developmental speech due course leads to the problems in the
problems, voice problems etc. The speech child like Jada, Badhira, mooka,
problems mentioned in the classics are Minmina, Gadgada, Khanja, Kubja,
Mooka, Minmina, Gadgada, diseases of Vamana, Hena Anga, Adhika Anga and
other Vata vikaras. Acharyas have
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enumerated group of diseases under symptom of Gadgada which denotes the

Janmabala Pravritta Vyadhis in which neurological cause of the disease.
Pangu, Jatyandha, Badhira, Mooka, There is no direct reference of
Minmina are included. Hence there is a particular Ahara which can lead into
scope to include Gadgada in this category Gadgada. The causative factors which can
as Sushruta has mentioned the word aggravate Vata and Kapha can be taken as
‘Prabhritayah’. Nidana for Gadgada14. As there is
Acharya Charaka has explained dominance of Kapha in childhood period
excess Madhura rasa intake during these causative factors can influence to
pregnancy will lead to Mookatva in produce Gadgada. There is no reference
child12. This denotes the speech pathology of Manasika karanas leading to Gadgada,
caused by Garbhini Ahara. Here Gadgada but the Vata can aggravate by Kama,
can be included as Mooktava word is Shoka, Bhaya these factors may cause
used in broader meaning. Chakrapani manifestation of Gadgada.
while commenting on the Lakshana: features of the Gadgada are as
Garbhopaghatakara bhavas said that these follows
types of Ahara Vihara if taken by the 1. Lupta pada vyanjanadi9
woman before conception can lead to 2. Avyakta Vak9
Artva Dushti and in man Shukra Dushti. 3. Aspashta vachana15
Because of vitiation of Artava and 4. Gardhabavat Swara15
Shukra, the disease can manifest in the 5. Sphuta Vak16
child. These are called as Adibala 6. Svalpa Asambaddha Vak17
Pravritta vyadhi. 7. Gharghara Shabdha
In Prakruti formation of a person, The characteristic features will be absence
it is mentioned Matura Ahara Vihara of syllable, consonants, word, difficult to
prakruti13. This indicates food and understand the speech. Aspashta vachana
regimen of the pregnant woman has may be in the form of repetition, gap
influence on Garbha. So the disease also between words or in words, wrong
can be caused by improper Ahara Vihara pronunciation.
by mother which can bring the In Ayurvedic classics the
abnormality of Vata Dosha. Sushruta has treatment procedures for Gadgada and
given the explanation regarding the other speech problems are not elaborately
manifestation of Speech Disorders as explained. Speech problem is one of the
Vata gets Avarana by Kapha in indications in some of the combinations
Shabdhavaha Dhamani and produces mentioned by Acharyas in the treatment
Mooka, Minmina and Gadgada9. of Unmada, Apasmara etc disorders.
Charaka said in avarana pakarana Following line of treatment can be
that Gadgada is the symptom produced by followed for Gadgada:
the Avarana of Samana Vata by Prana Common Vata Vyadhi Treatments: Chatu
Vata8. Also mentioned Swara and Vak Sneha ie, Sarpi, Taila, Vasa and majja
Sanga occur because of Avarana of used as Pana, Abhyanga, Basti. Snigdha
Udana Vata by Kapha. Charaka Acharya Sweda can be adopted. Person should be
has stated the Abhigata to Shiro Marma, in Nivata Pradesha and adopt Pravarana
one among three marma, can cause the ie, covering with Blankets. Ksheera
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Bhojana can be indicated. Madhura, of Nasya is according to the vitiation of

Amla, Lavana are the Rasas to be taken in Dosha involved and severity22.
Vata vyadhi. Brihmana line of treatment Siravyadha: Sushruta has indicated
should be adopted in Vata Vyadhi. siravyadha in Jihvagata Vaydhis. The
Treatment for Udana Vata: Siravyadha has to be done in Adhi Jihva
Acharya Charaka has stated the common Pradesha23.
line of treatment of diseases which Gandusha: Acharya Chakrapanidatta in
involves the Udana Vata. He has indicated his book Chakradatta has mentioned Jihva
Urdhva Bhaga Chikitsa. Gangadhara said Dhamanigata Vata related disorders
avarana of udana vata should be treated should be treated by Gandusha specially
with Urdvabheshaja18. Chakrapani opined Sneha Gandusha24.
pakriti sthapana of vata has to be done by Treatment of Shiro Abhigata: Acharya
Vamanadi kriya in the context of Charaka has explained the treatment
uadanavata chikitsa19. modalities for Abhighata to the Shiro
Treatment of Avarana vata: Common Marma. He has mentioned Abhyanga,
treatment principle for Avarana is Sweda, Upanaha, Sneha pana, Nasya
mentioned by Acharya Charaka. He states Karma, Avapeeda nasya, Dhumapana etc,
that after analyzing the disease condition for the treatment of Abhigata to Shiras25.
treatment should be done by Prayatna: Prayatna is one among six
Anabhishyandi, Snigdha drugs and by Adhyatma Gunas which is the stimulating
Shodhana of Srotas20. quality for the person to get corrected.
The Kapha Pitta Avirodhi and Vata When person is doing mistake in speech,
Anulomana should be the main treatment there should be motivation in him, that he
principle in any Avarana of Vata. should be get corrected. This motivation
According to Bala Madhura Yapana is necessary to get initiation to adopt the
Basti, Madhura Anuvasana basti, Mrudu advices and adopt the measures.
or Sramsana type of Virechana can be Abhyasa: Abhyasa is one of the Paradi
adopted19.Rasayanas like Shilajitu, Gunas mentioned, where person can learn
Guggulu etc are indicated in Avarana the correct things by practicing again and
after Samyak Shodhana20.Treatment of again. Here also the wrong methods in
Kaphavrita Vata: Acharya Charaka has Speech can be corrected by proper
stated that Kaphaghna with Vata Avirodhi practice of correct method. Continuous
type of treatment should be adopted in practicing will result in correction of
Kaphavrita Vata20. defects of speech.
Treatment of Prannavrita Samana: Nidana Parivarjana: The Vatakara Ahara
Charaka has indicated Sneha should not be taken in excess by Stree and
Chatushprayoga and Yapana Basti in Purusha to avoid the Artava dushti and
Pranavrita Samana condition. Sneha Sukra dushti. Proper regimens of Rutu
chatushprayoga refers to Pana, Abhyanga, Kala, Rajasvala charya should be
Anuvasana and Nasya21. followed for good progeny.
Nasya: Acharya Charaka has indicated Garbhini stree should not indulge in
Nasya in speech pathologies like Ahara and Vihara which increases Vata.
Gadgada. Swarabheda, Vakgraha. Type Garbhini should avoid excess Madhura
rasa intake. Garbha Upaghatakara Bhavas
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should be avoided. Douhrida apachara nidana, Shukra and Artava dushti,

should be avoided. Garbhini Vataja Nidana, Madhura rasa
Pathya and Apathya: In Kaphavrita vata excess intake by Garbhini, Abhighata to
Yavanna, Jangala Mamsa, Sweda, Niruha, Shiras, Adrishta are contributing their role
Teekshna Vamana Virechana, Purana in manifestation of Gadgada. Even the
Sarpi and Taila are Pathya. Manasika karanas like Shoka, Bhaya,
Several Yogas indicated for speech Udvega can influence speech in person,
disorders are Kalyanakavaleha, because proper functioning of Manas is
Saraswatha choorna, Brihat Saraswatha essential for Indriya to work
choorna, Saraswatha ghrita, Saraswatha physiologically. Causative factor of
arishta, Kalyanaka ghrita, Brahmi ghrita, stuttering is mentioned as multifactorial
Amrita Prashavaleha, Kushmanda like Genetis influence, familial
Rasayana, Chyavanaprashavaleha, inheritance learned behavior,
Kumara Kalyana Rasa, Rasnadi kwatha, psychological causes, CNS injury,
Ashwagandha Taila, Vachadi yoga etc. developmental and unknown cause.
DISCUSSION:The Gadgada word itself Acharya Charaka has stated that only two
indicates the disease in which fluency of causes such as Dhatukshaya and Avarana
speech is not present. It denotes the are responsible for Vatavyadhi and the
Avyakta vak or shabdha. Stuttering is the Samsarga of other Doshas has to be seen.
dysfluency type of speech pathology This principle should be applied in case
where fluent speech is interrupted by of Gadgada for the betterment of
repetition of syllable or word, pause, treatment. Gadgada can be caused due to
prolongation, hard contacts and the Dhatukshaya as well as Avarana. The
hesitation. There are normal non fluent Dhatukshayaja vatavridhi is caused by
speech is observed in children during the Garbhini vataja ahara vihara,
speech developmental period and child is Garbhopaghatakara nidana. These lead
unaware of the problem. The child into garbha shoshana leading to
displays no special effort or tension Dhatukshayaja vatavriddhi. Avarana of
during speaking. The primary behaviors Vata occurs because of Nidana which can
are differentiated from secondary vitiate Vata as well as Kapha explained as
behaviors that gradually develop around Kaphavrita vata in classics. The
the core of the small breaks and pauses in Abhighata to Shiras as explained by
speech. The initial breaks in the timing of Charaka is Achaya poorvaka prakopa of
speech sometimes indicate the incipient Vata causing Gadgada.
stages of stuttering in young children. Modern literature explains Stuttering as it
These breaks take the form of repetitions can be continued as secondary from
and prolongations. As awareness primary disfluency during developmental
increases and struggle behavior develops, age of child generally by 6 or 7 years of
there may be blockages or disruptions in age. This type is called as Developmental
air flow, phonation, or even respiration. Stuttering. CNS injury causes
The disease Gadgada is caused because of Neurological Stuttering and
Avarana of Vata by Kapha in Psychological disturbances can lead into
shabdhavaha dhamani. The causative Psychogenic Stuttering. Stuttering can
factors like Kapha and Vata vitiating
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also be the learned behavior from other does the avarana for Vata in Shabdhava
stutterer. Dhamani.
Gadgada has to be treated by considering The Gadgada and Stammering can
causative factors and Dosha involved. be correlated by observing the causative
Yuktivyapashraya and Satvavajaya factors and symptomatology. Gadgada is
treatments play equal role in treating characterized by Lupta Pada or Vyanjana
Gadgada. According to Dosha etc. The word ‘adi’ i.e., etc has given
involvement the various Urdhvajatrugata wide range to understand which can be
treatment procedures like Nasya, fulfilled by the definition of Stuttering.
Gandusha etc can be adopted. Nasya of The etiopathogenisis of the condition was
teekshna dravyas and Sneha Madhura not explained in detail in classics but it is
dravyas are beneficial in Avaranajanya clear that Gadgada is of multi factorial in
and Dhatukshayajanya Gadgada origin by observing scattered references.
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Sangraha Dalhana commentary, edited Kaumarabhritya,SDM College of
by Yadavji Triakamji Acharya, Ayurveda, Kuthpady, Udupi, Karnataka.
shareera sthana, siravyadha vidhi
adhyaya, Varanasi: Chaukambha
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381. Source of support: Nil
24. Chakrapani. Chakradatta, Hindi Conflict of interest: None
commentary by Dr. Indradev Tripathy, Declared
edited by Prof Ramanath Dwivedy,

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