What Is Stuttering?

Stuttering or stammering is a medical condition in which the normal flow of speech is interrupted by pauses, drawn-out sounds, or repeated sounds and syllables. It is a type of disfluency or chronic problem with continuity of speech. Persons who stutter think in normal sentences but are unable to articulate them clearly.

Stuttering mostly occurs in children, who often outgrow the condition with age. This is called developmental stuttering. In some cases, stuttering persists into adulthood and becomes a permanent condition (persistent stuttering). Adult-onset or acquired stuttering is rare, and usually occurs as the result of traumatic injury.

Stuttering is in no way life-threatening but is still regarded as a medical concern. Much of the harm it causes is psychological. Children who stutter have difficulty communicating with peers and sometimes become isolated, withdrawn, or depressed. Problems like these are exacerbated in adults, who are more likely to develop personality disorders and require mental health treatment.

Boys are more likely to stutter than girls. There is no cure for stuttering, but treatment can reduce occurrences and enhance speech. If you have a child that stutters, seek care. For more information, see your Baptist Health pediatrician or a member of our speech-language pathology (SLP) team.

Signs & Symptoms

The physical aspect of human speech involves the complex interplay of muscles in your face, mouth, throat, and chest. Stuttering is marked by involuntary spasms that disrupt the smooth coordination of these muscles, making speech more difficult.

Symptoms include:

• Repetition of sounds or syllables: Someone who stutters will often repeat a sound or syllable one or more times before finishing a word. This happens with single-syllable words (monosyllables) as well.
• Prolongation of sounds or syllables: Certain sounds or syllables are drawn out rather than spoken in a normal fashion.
• Pauses: The speaker hesitates in the middle of a word. A more extensive form of pausing is called blocking, in which word flow momentarily stops.
• Word changes: Individuals who stutter will sometimes switch words in mid-sentence, because of the difficulty in saying what was originally intended.
• Misplaced stresses: This means placing vocal stress on the wrong part of a word or overemphasizing a word altogether.

Stuttering’s vocal characteristics are frequently accompanied by gestural symptoms:

• Facial tics (unusual muscle movements in the face)
• Fist tightening
• Head nodding
• Rapid blinking of the eyes
• Trembling or fidgeting.

Stuttering is sometimes brought on by the speaker feeling excited, tired, hurried, or anxious. Speaking in front of groups or on a phone can be particularly stressful for someone who stammers.

Causes & Risk Factors

There is no consensus as to the exact cause or causes of stuttering, but medical science has identified several factors that appear to play a role:

• Family medical history: Persons with a close relative who stutters are more likely to experience some form of disfluency than those without.
• Genetics: The possibility that stuttering is at least partly heritable implies that genetics may be a contributor. Some type of DNA mutation is possibly involved.
• Speech motor control issues: Small variations in brain structure, particularly in those areas associated with speech motor control, may be causative.
• Emotional or psychological stress: Emotional stress is known to impact stuttering. Extreme cases involving trauma have been documented to bring on stuttering or related speech issues in individuals who were previously without them (psychogenic stuttering).
• Traumatic brain injury: Serious brain injury is the primary cause of adult-onset stuttering (neurogenic stuttering).

Children that undergo developmental delays or have conditions such as autism or attention-deficit/hyperactivity disorder are also more likely to experience stuttering or other forms of disfluency.

Impact of Stuttering

Be aware of the difficulties faced by persons who stutter. Vocal disfluency can impact individuals in numerous ways, including:

• Communication and daily interaction: Interacting with others is more challenging when a speech issue hampers communication.
• Emotional and psychological effects: No one wants to stand out because of a vocal disfluency. Keep in mind the emotional and psychological toll borne by someone who stutters.
• Anxiety and self-esteem issues: Individuals who stutter can experience heightened levels of anxiety, often inversely related to low levels of self-esteem.
• Social withdrawal and isolation: Difficulties in day-to-day interactions can drive a tendency toward social isolation, a separating from others, even family and friends.
• Academic and occupational challenges: Stuttering can lead to struggles in learning environments, including academic, occupational, and professional settings.

Diagnoses

As they learn to speak, many children between the ages of two and five experience phases of stuttering or similar vocal difficulties. These are rarely a concern and typically last only a short while. If, however, the condition persists over a longer period, contact your child’s pediatrician or obtain a referral to a speech-language pathologist.

Early indicators of stuttering include:

• Difficulties with speech lasting more than six months
• The onset of symptoms at age six or older
• Stuttering is accompanied by other forms of disfluency
• Your child has trouble communicating at home or school
• Speech issues occur with physical characteristics, such as looks of frustration or a tightening of the jaw muscles
• Speech difficulties become linked with emotional or psychological issues.

A pediatrician is typically able to make the diagnosis without formal testing. He or she will discuss with you the symptoms you have observed, their frequency and duration, your family medical history, and other relevant issues. He or she will also speak with your child. Communicating with the child one on one is often a sufficient basis for determining the nature of the concern. If warranted, you will receive a referral to a speech-language pathologist.

Any adult who experiences sudden-onset speech difficulties should contact his or her physician. He or she will document your symptoms and family medical history. In cases of acquired stuttering, you may undergo diagnostic or imaging exams, the latter to determine the possibility of brain injury from a stroke or tumor.

Treatment & Management

Your speech-language pathologist will develop a treatment plan for your child. A variety of methods may be employed, depending on the nature and severity of the condition. In general, the goals of any treatment plan are to enhance speech fluency, improve overall language skills, and increase the child’s ability to participate in social activities at home, school, and other settings.

Treatment options include:

• Speech therapy: Speech therapy helps the patient better manage his or her condition. He or she learns techniques for slowing speech, speaking in rhythm, and circumventing possible difficulties in enunciation.
• Cognitive behavioral therapy: Therapy assists the patient with identifying psychological factors that worsen stuttering. He or she learns to recognize problem areas, such as the impact stress has on speech.
• Parental reinforcement: The parents of a stuttering child are trained in the same techniques that he or she has learned, to be reinforced through mutual practice at home.
• Electronics: Electronic devices are available to assist the patient in improving fluency. These devices provide feedback to the speaker through the use of playback technology.
• Medicines: There aren’t at this time any approved medications for the treatment of stuttering. However, drugs are sometimes used with persons suffering from speech-related mental health conditions (for example, antidepressants for individuals with depression).

The treatment of stuttering and other speech impediments rarely gives rise to complications. A possible exception to this is the medications used in treating any related psychological conditions.

Prevention

Stuttering is not preventable, with the possible exception of the adult-onset version caused by traumatic brain injury. By guarding against strokes, falls, automobile and other accidents, you reduce the risk of injury, one consequence of which is some form of speech impediment.

The prognosis for developmental stuttering is generally positive, with many children outgrowing the condition by early adulthood. Early diagnosis and treatment through speech therapy can accelerate this process. The prognosis for persistent and acquired stuttering is complicated by their psychological impacts. Recognizing and addressing potential mental health issues is critical in these situations.

Learn More About Living With a Stutter

Stuttering is a serious medical condition with possibly life-altering consequences. The more understanding demonstrated toward stuttering, the easier it becomes for individuals with this condition to manage it.

Learn the symptoms and seek medical care when necessary. For more information on Baptist Health speech-language pathology services, contact a Pediatrician or Primary Care Provider.