“Don’t worry about it; you'll grow out of it"
"Just relax"
"Slow down, take a deep breath"
"Be more confident"

Sound Familiar?
It is easy for others to hand out advice, particularly when they don't know what it is like to stammer. Their advice is well meant - but doesn't help you very much.
You just want the stammer to go away so you can get on with your life.
While it isn't that easy, you can definitely learn to have more control of your stammering and how you feel about it
The more you know about stammering and the way it affects you, the better able you will be to control it and not let it hold you back. That's what this leaflet is for.

What is stammering?
"It is an involuntary repetition, prolongation or block which interrupts the normal flow of speech."
This describes what is happening but does not tell us anything about how you might feel: the shame and embarrassment, the fear and tension, the loss of self-confidence and the sense of frustration. After all, you know exactly what you want to say and may often feel you have something important to add to the conversation, but despite your best efforts, the words will not come out smoothly, normally.

When does stammering develop?
It usually starts between 3 and 5 years, it appears less often between 5 and 9 years and is very rare for it to start after 12 or 13 years old.

Who is affected - why me?
Stammering is more common than you might think.
One in 20 children less than five years old goes through a phase of stammering. About three in four of those will grow out of it. That still leaves half a million people in the UK who stammer. Stammering is found in all parts of the world and affects the rich, the poor, those that are highly intelligent and those who have learning difficulties.
There are many famous people who stammered, for example King George VI (the Queen's father), Marilyn Monroe, Bruce Willis and Gareth Gates.

What causes it?
We don't know exactly what causes stammering, or what triggers it in some situations. Current research suggests it results from the way some people's brains process speech. Stammering is not caused by anxiety or nervousness. There could be a genetic factor because stammering tends to run in families. You might have a parent, grandparent or other relative who stammers, but often this is not the case.
Many people spend a great deal of time trying to find out why they started to stammer. Perhaps they believe that if they could get an answer to this question, they would be 'cured'. Unfortunately such beliefs are not true, and only lead people to focus on the past rather than on what is happening now. By the time you are a young adult, the cause is unimportant - the real issue is what you can do about it.

Don't let your stammer hold you back
The teenage years are all about exploring, experimenting and communicating - talking, emailing and texting. You've got a real opportunity to find out what works for you, what doesn't work and how to talk to other people, teachers and adults. The first step is to realise that developing a positive approach will start to make other things happen.
You want to be independent and you're learning to adjust to the physical and mental changes that go along with sexual development. Making friends becomes more challenging as your own expectations of relationships change.
You're learning about your strengths and weaknesses. New experiences with parents, friends, and people at school or teachers occur every day to challenge your self-esteem and confidence.
And if you also stammer- It can be a dilemma - "Did I choose to avoid that situation because of my speech or because I wasn't confident?" It can be easy to blame the stammer - but perhaps that is not the whole truth.

Let's talk about it
Throughout your childhood many problems have been discussed in the open - except perhaps stammering. Often people pretend it is not happening. You might struggle to hide or avoid stammering - or talking, which can make it worse for you, even if you have tried to stop other people being embarrassed.
For example: You do not talk to them because you believe they do not want to talk about it, and they do not talk to you because they believe you do not want to talk about it!
However, being able to discuss a problem with someone makes it easier to deal with.

What can I do about it?
The main aim must be to take the mystery out of stammering. The British Stammering Association can help you to learn more about the problem. It can put you in touch with a speech and language therapist in your area, who specialises in stammering and has access to all the latest information and types of therapy available.

Therapy

• There is no guaranteed 'cure' for stammering. However, therapy will:
• Help you develop ways to speak more fluently and to take responsibility for your progress
• Help you to deal with your stammer, learn more about yourself and achieve your potential
• Enable you and your parents to cope better with your speech difficulties and with your own development.
• Address issues to do with school, teachers and friends. It will help you understand the problems they may have with your stammering and to develop strategies which will improve your confidence in dealing with them.
• Put speech techniques in perspective, to see whether certain speech skills can be taught and used successfully in everyday life.

Stammering can affect every part of your life. This is why speech therapy must address every angle: help you to help yourself in developing confidence, social skills, self-awareness, speech fluency and problem-solving strategies.

Do you want to know more about stammering?
The British Stammering Association has a lending library for its members and sells self help books and other items. CD-ROMs are available to help you to prepare for GCSEs English oral work and for oral work in S1 to S4 in Scotland.
The British Stammering Association (BSA) is a registered charity founded in 1978. BSA offers a free information service. We can provide details of specialist speech and language therapy, intensive courses and self-help groups. We also provide a professional telephone helpline and email service offering confidential information and support to all whose lives are affected by stammering. Through these activities we aim to provide up-to-date information about therapy for stammering.
We also help people who stammer to help themselves. BSA works to raise awareness of stammering together with those difficulties experienced by people who stammer. We aim to initiate and support research into stammering and wherever possible we aim to promote enhanced life experiences through shared understanding.

Becoming a member of the BSA

To join the BSA you must be 16 or over, but if you are under 16 your parents can join on your behalf. The benefits of membership are: quarterly issues of Speaking Out - the world's leading magazine on stammering; invitations to open days, access to the BSA lending library as well as advance information on special events, national and international conferences.

A list of Do's and Don'ts compiled by a group of young adults who stammer:
Try to:

speak slowly and clearly learn to breathe appropriately keep a good posture contact a speech therapist

tell people about stammering relax look at people when you speak

Try not to:

speak too quickly be frightened to speak be afraid to keep the volume up avoid situations

lose eye contact panic avoid words

A few tips when talking to people

"If I'm worried that someone will react if I stammer, I just say 'hello'. It's much better than saying nothing"
"If people know, it's much easier." "I try to find people who are okay with it. In a group, if the first person reacts well, it's okay."
"Act normal and not get nervous. I allow myself to stammer and do not think of other people's reactions."

If people take the Mick:
"I ask them how they would like it if they stammered."
"Act confident and don't react, don't look scared." "Stand up for yourself. Just look at them and wait until they stop."
If someone laughs at you, ask: 'If I was you and you were me, how would you feel?'
"Remember that the bully has problems. What is their future going to be? If they put you down, it's an incentive to do well and prove them wrong."

About 9% (almost 1 in 10) of the UK population stammers. It is about three times more common in males than females. It usually starts in childhood

For a printable version - click here .

The size zero debate is once again dominating Milan fashion week. But this time the emaciated frame causing the furore is not on the catwalks, but on a billboard.

A disturbing photograph of a naked anorexic woman, blown up to traffic-stopping scale, has been drawing shocked gasps from passing Milanese.

The photograph of 27-year-old Frenchwoman Isabelle Caro, who weighs 31kg (4st 12lb), bears the legend "No Anorexia" and the slogan of the Italian womenswear brand Nolita, for which it is an advertisement.

The Nolita campaign has been given the blessing of the Italian ministry of health, with health minister Livia Turco saying the image promotes responsibility towards the problem of anorexia.

The man behind the image is fashion photographer Oliviero Toscani, who was responsible for the controversial Benetton advertising campaigns of the 1980s and 1990s, including his 1992 portrait of dying Aids patient David Kirby.

Flash & Partners, owners of Nolita, have said that the image aims to raise awareness of an illness "caused in most cases by the stereotypes imposed by the world of fashion".

The billboards, launched during Milan fashion week, have met with a distinct froideur from many in the fashion industry, who dispute the theory that blame for anorexia can be laid wholly at their door. Caro, they point out, is not a model, but says that she has suffered from anorexia since she was 13 because of a "difficult childhood".

Designer Giorgio Armani queried the link between fashion and anorexia, commenting that "even people who take no notice of fashion get anorexic", while designers Domenico Dolce and Stefano Gabbana described anorexia as a psychiatric problem with "nothing to do with fashion".

Isabelle Caro, author of a blog about her battle with anorexia, said she had appeared in the campaign "to show young people how dangerous this illness is".

What is anorexia?
Anorexia nervosa is a psychiatric diagnosis that describes an eating disorder characterized by low body weight and body image distortion with an obsessive fear of gaining weight. Individuals with anorexia are known to commonly control body weight through the means of voluntary starvation, purging, vomiting, excessive exercise, or other weight control measures, such as diet pills or diuretic drugs. It primarily affects adolescent females, however approximately 10% of people with the diagnosis are male. Anorexia nervosa is a complex condition, involving psychological, neurobiological, and sociological components.

What are the effects?
Lack of food deprives the body of essential protein and prevents the normal metabolism of fat, resulting in:

• An irregular heartbeat that can lead to heart failure and death
• Dehydration
• Kidney stone formation and kidney failure
• Weakness because of muscle wasting
• Constipation
• Growth of fine downy hair on the face and arms
• Lack of calcium, which may cause osteoporosis
• Interrupted or no periods

Can it be prevented?
It's difficult to prevent anorexia from developing because it's unclear precisely why the condition occurs. But it may be possible to avoid or address some risk factors, such as social and cultural pressures to be thin, bullying, low self-esteem and family dysfunction. The most important step is recognition by the individual that they've got a problem.

What's the treatment?
After assessment by a psychiatrist at a specialist eating disorders unit, counselling, antidepressants and advice on healthy eating may be offered.
Admission to hospital is often needed to treat any physical problems that have resulted from under-eating.