Stuttering

DEFINITION

Stuttering — also called stammering or childhood-onset fluency disorder — is a speech disorder that involves frequent and significant problems with the normal fluency and flow of speech. People who stutter know what they want to say, but have difficulty saying it. For example, they may repeat or prolong a word, syllable or phrase, or stop during speech and make no sound for certain syllables.

Stuttering is common among young children as a normal part of learning to speak. Young children may stutter when their speech and language abilities aren’t developed enough to keep up with what they want to say. Most children outgrow this developmental stuttering.

Sometimes, however, stuttering is a chronic condition that persists into adulthood. This type of stuttering can have an impact on self-esteem and interactions with other people.

If you’re an adult who stutters, seek help if stuttering causes you stress or anxiety or affects your self-esteem, career or relationships. See your doctor or a speech-language pathologist, or search for a program designed to treat adult stuttering.

Children and adults who stutter may benefit from treatments such as speech therapy, psychological counseling or using electronic devices to improve speech patterns. After a comprehensive evaluation by a speech-language pathologist, a decision about the best treatment approach can be made.

CAUSES

Researchers are still studying the underlying causes of persistent stuttering. A combination of factors may be involved. Possible causes of persistent stuttering include:

• Abnormalities in speech motor control. Some evidence indicates that abnormalities in speech motor control, such as timing, sensory and motor coordination, are implicated.
• Genetics. Stuttering tends to run in families. It appears that stuttering can result from inherited (genetic) abnormalities in the language centers of the brain.
• Medical conditions. Stuttering can sometimes result from a stroke, trauma or other brain injury.
• Mental health problems. In rare, isolated cases, emotional trauma can lead to stuttering.

SYMPTOMS

Stuttering signs and symptoms may include:

• Difficulty starting a word, sentence or phrase
• Prolonging a word or sounds within a word
• Repetition of a sound, syllable or word
• Brief silence for certain syllables or pauses within a word (broken word)
• Addition of extra words such as “um” if difficulty moving to the next word is anticipated
• Excess tension, tightness or movement of the face or upper body to produce a word
• Anxiety about talking
• Limited ability to effectively communicate
• The speech difficulties of stuttering may be accompanied by:
• Rapid eye blinks
• Tremors of the lips or jaw
• Facial tics
• Head jerks
• Clenching fists

Stuttering may be worse when you’re excited, tired or under stress, or when you feel self-conscious, hurried or pressured. Situations such as speaking in front of a group or talking on the phone can be particularly difficult for people who stutter.

However, most people who stutter can speak without stuttering when they talk to themselves and when they sing or speak in unison with someone else.

When to see a doctor or speech-language pathologist

It’s common for children between the ages of 2 and 5 to go through periods when they may stutter. For most children, this is part of learning to speak, and it gets better on its own. However, stuttering that persists may require treatment to get better.

Call your doctor for a referral or contact a speech-language pathologist directly for an appointment if stuttering:

• Lasts more than six months
• Occurs with other speech or language problems
• Becomes more frequent or continues as the child grows older
• Occurs with muscle tightening or visible struggling to speak
• Affects the ability to effectively communicate at school, work or in social interactions
• Causes anxiety or emotional problems, such as fear or avoidance of situations where speaking is required
• Begins as an adult