Here, the convulsive effort is not especially noticeable and the
marked results of long-continued stammering are not apparent. Most
cases pass quickly from the elementary stage unless checked in
their incipiency.

SPASMODIC STAMMERING: This marks the stage of the disorder where
the effort to speak brings about marked muscular contractions and
pronounced spasmodic efforts, resulting in all sorts of facial
contortions, grimaces and uncontrolled jerkings of the head, body
and limbs.

THOUGHT STAMMERING: This, like Thought-Stuttering, is a form of
Aphasia and manifests itself in the inability of the stammerer to
think of what he wishes to say. In other words, the thought-
stammerer, like the thought-stutterer, is unable to recall the
mental images necessary to the production of a certain word or
sound--and is, therefore, unable to produce sounds correctly. The
manifestations described under Thought Stuttering are present in
Thought Stammering also.

COMBINED STAMMERING AND STUTTERING: This is a compound
form of difficulty in which the sufferer finds himself at times not only
unable to utter a sound or begin a word or a sentence but also is
found to repeat a sound or syllable several times before the
following syllable can be uttered. Any case of stuttering or
stammering in the Simple or Elementary Stages may pass into
Combined Stammering and Stuttering without warning or without the
knowledge, even, of the stammerer or stutterer.