Stuttering

(Stammering; Disfluent Speech)
  • Definition

    Stuttering is a speech disorder in which the flow of speech is interrupted by:
    • Repetition or prolongation of sounds, words, or syllables
    • An inability to begin a word
    In an attempt to speak, the person who is stuttering may:
    • Frequently blink the eyes
    • Have abnormal facial or upper body movements
  • Causes

    The cause of stuttering is not completely understood. Some experts have suggested that stuttering may occur when:
    • A child's ability to speak does not match his verbal demands
    • There are psychological factors in a child’s life such as mental illness, extreme stress
    • Problems occur in the connections between muscles, nerves, and areas of the brain that control speech
    • There are problems in the part of the brain that controls the timing of speech muscle activation
    Muscles and Nerves Involved in Speech
    Tongue Innervation
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  • Risk Factors

    Factors that may increase your chance of developing stuttering include:
    • Family history of stuttering
    • Sex: male
    • Age: between 2-6 years of age
  • Symptoms

    Symptoms may include:
    • Repetition of sounds, syllables, words, or phrases
    • Prolongation of sounds within words
    • Between-word pauses and lack of sound
    • Spurting speech
    • Accompanying behaviors, such as:
      • Blinking
      • Facial ticks
      • Lip tremors
      • Tense muscles of the mouth, jaw, or neck
    • Worsening symptoms when speaking in public
    • Improvement in symptoms when speaking in private
  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. Diagnosis may be based on:
    • Stuttering history
    • Circumstances under which stuttering occurs
    • Speech and language capabilities
    • Evaluation of hearing and motor skills, including a pediatric and neurological examination
    • Further testing and treatment by a speech language pathologist who specializes in communication disorders
  • Treatment

    Treatment can improve stuttering. The main goal is to get and maintain a feeling of control over speech fluency. The doctor or speech therapist can:
    • Evaluate the stuttering pattern
    • Assess what strategies may work best
    Treatment may include:
    • Behavioral therapy—This focuses on behavior modifications that can be made to improve fluency.
    • Speech therapy—A primary goal of this type of therapy is to slow the rate of speech.
    There is little evidence to support the use of drugs to improve speech fluency.
  • Prevention

    There are no guidelines to prevent stuttering. However, early recognition and treatment may minimize or prevent a life-long problem.
  • RESOURCES

    National Stuttering Association http://www.westutter.org

    Stuttering Foundation of America http://www.stutteringhelp.org

    CANADIAN RESOURCES

    Canadian Stuttering Association http://www.stutter.ca

    Institute for Stuttering Treatment and Research http://www.istar.ualberta.ca

    References

    Bothe AK, Davidow JH, et al. Stuttering treatment research 1970-2005:I. Systematic review incorporating trial quality assessment of behavioral, cognitive, and related approaches. Am J Speech Lang Pathol. 2006;15:321-352

    Gordon N. Stuttering: incidence and causes. Dev Med Child Neurol. 2002;44:278-281.

    Stuttering. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/public/speech/disorders/stuttering/. Accessed May 20, 2013.

    Stuttering. National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/health/voice/pages/stutter.aspx. Updated March 2010. Accessed May 20, 2013.

    Perkins WH. Anomalous anatomy of speech-language areas in adults with persistent developmental stuttering. Neurology. 2002;58:332-333

    Prasse JE, Kiakano GE. Stuttering: an overview. American Family Physician. 2008;7:1271-1276.

    Sommer M, Koch MA, et al. Disconnection of speech-relevant brain areas in persistent developmental stuttering. Lancet. 2002;360:380-383.

    What is stuttering? The National Stuttering Association website. Available at: http://www.westutter.org/what-is-stuttering/stuttering-info/. Accessed May 20, 2013.

    Yairi E, Ambrose NG. Early childhood stuttering: persistency and recovery rates. J Speech Lang Hear Res. 1999;42:1097-1112.

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