Stuttering is a communication disorder in which the forward flow of speech is disrupted. People who stutter will:
- Repeat sounds, syllables, or words, have hesitations when talking, and will prolong speech sounds.
- These disruptions when talking are called disfluencies.
- Stuttering is often referred to as stammering.
- Most people will have normal disfluencies with speaking, however, stuttering is when interruptions in speech become too frequent and involuntary limiting a person's ability to communicate with others.
- The onset can either be sudden or gradual and typically begins in childhood, from the ages of two through five, when speech and language skills are rapidly expanding.
- Most children will outgrow their stutter as their language abilities mature, however, others will experience mild to severe stuttering throughout their lifetime.
These involuntary interruptions in communication vary among individuals and can occur in specific areas of daily activities, such as talking on the phone or in social situations which may lead to avoidance behaviors if not properly managed and treated. Social anxieties, fear of stuttering in public, teasing, and how a person copes with his or her speech disorder may affect the quality of life for people who stutter. Early intervention for children who stutter is advised to prevent this speech disorder from becoming a lifelong condition.
- Developmental Stuttering: The most common type, begins in preschool children, between the ages of two through five, when speech and language skills are rapidly expanding. During this stage, children may experience difficulty in coordinating their speech and language abilities and stuttered speech is produced.
- Genetic: It is found to be an inherited trait in families who stutter and several genes have been identified with non-fluent speech.
- Neurogenic Stuttering: Caused by a traumatic brain injury, stroke, or other brain injury resulting in disfluent speech.
- Emotional(Psychogenic) Stuttering: Once thought of as the main cause, it is now rarely considered to be a factor in the onset of stuttering.
- Stuttering affects 3,000,000 people in the United States or 1% of the population
- 5% of children, between the ages of 2 to 5, will have developmental stuttering
- Boys are affected more than girls
- After 5 years of onset, 80% of children will have recovered
- There is no known cure
- 70% of children who stutter have a family history of stuttering
- Affects all cultures and social and economic classes
- Stutterers have the same intelligence levels as non-stutterers
- In 1988, the second week of May was designated "National Stuttering Awareness Week" by Congress
Stuttering often includes repetitions of sounds, syllables, words, and phrases, prolongations, and blocks impeding the normal flow of speech. Examples of stuttered speech are as follows:
- "T-T-T-T-T-T-Take out the trash." (Repetition of parts of words.)
- "I left.....uh.....work early to....u-um-um....stop by the grocery store." (Interjecting extra sounds due to difficulty in joining words smoothly.)
- "I am fffffinished with my homework." (Prolonging sounds within words.)
- "Can I...Can I have a cookie?," "You...you are great!" (Repetition of phrases and words.)
Physical symptoms, known as secondary behaviors, often accompany stuttered speech and include:
- Muscle tension in the face and voice, jaw jerking, eye blinking, or appearance of being "out of breath" when speaking
- Blocked speech when their mouth is open with no words coming out for several seconds.
- Anxiety or fear when stuttering or anticipating talking (but not always if they have a healthy response to their own stuttering)
Symptoms may be mild to severe, vary from week to week, and may last several months or years.
Parents are often the first to notice signs of stuttering in their children. A differential diagnosis is made in preschool children between normal disfluencies associated with rapid language development at this age, in which they will outgrow, or the presence of a speech disorder.
- A diagnosis can be made by a speech-language pathologist (SLP), who is a trained health professional specializing in speech and language disorders.
- The SLP will evaluate for frequency and types of disfluencies when speaking and how an individual handles and copes with his or her stuttering in social situations to determine the presence and severity of the condition.
- They will assess for factors that may increase a child's risk for continued stuttering, such as family history, a condition lasting more than six months, other concomitant speech or language disorders, and emotional responses to stuttering by the child.
- No special tests are done.
There is no cure for stuttering, however, there exist several different treatment methods proven to be effective in decreasing the number of disfluencies when talking and producing more smooth speech.
A very important element of treatment is teaching individuals and family members to form healthy responses to his or her stuttering and to focus less on the utilization of clinical strategies, referred to as "speech tools." No one treatment is effective for all, and a comprehensive therapeutic approach is most beneficial. They include the following:
- Therapy sessions with a speech-language pathologist with follow-up visits
- Fluency shaping therapy to slow down speech, learn simple to more complex word and sentence responses, reduce facial and body tension when talking, and control breathing
- Instruction on developing a positive attitude toward stuttering, making eye-contact, and reducing anxiety associated with stressful situations (part of stuttering modification therapy by Van Riper)
- Lidcombe Program for preschool children that encourages parents to praise fluent speech and, less often, to gently correct stuttered speech, such as "that was bumpy"
- Assistive technology for audio feedback to regulate voice rate and for self-monitoring
- Self-help groups for sharing of ideas and social support
- Research into drug treatments show no specific drug to be effective.
Incidences of increased stuttering are often caused by being tired or anxious, having other communication or developmental disorders, teasing, stressful events, or having negative feelings associated with stuttering. "Maintenance" therapy is advised for teenagers and adults who stutter.
Effective Teaching Strategies
Teachers are advised to talk with their students who stutter and find out how they feel most comfortable handling their speech disorder in class. The goal is to help them feel at ease with other classmates and provide a relaxed environment for learning. For example, a teacher may want to ask their student in advance if they prefer to raise their hand to answer questions or to be called upon; if they want to read aloud or refrain from this activity; and if they want to discuss their speech disorder openly with the class or would rather not. For students diagnosed with disfluent speech and receiving therapy, the SLP may ask teachers to provide written reports describing the student's speech behaviors and attitudes observed in class to help with assessment.
- Electronic Devices-Well established speech tool similar in design to traditional hearing aids that delay or alter the sounds of one's voice to slow the rate of speech and reduce disfluencies using Delayed Auditory Feedback (DAF) and Frequency-Altered Feedback (FAF)
- Apps-Affordable and easily accessible apps available for download on smartphones. Fluency SIS, Smarty Ears, and MPiStutter are apps for stuttering.
- Software-Computer programs using DAF/FAF for speech therapy and home use to decrease disfluency. Speech monitor is a free software program.
- Electromylogram (EMG) Biofeedback-Trains the individual to reduce muscle tension in the lips, face,and jaw when speaking to minimize stuttering
Current Medical Research
The most current medical research is focused on finding the cause of stuttering by determining if there exists abnormal brain activity present at birth in the speech areas of babies with family members who stutter. Brain scans are performed as shown in the video clip above, and the research is so new that the results are not in. In other studies, medical research scientists at the National Institute of Deafness and other Communication Disorders (NIDCD) have identified mutations in three genes, GNPTAB, GNPTG, and NAGPA, that are found to be present in people with a family history of stuttering.
- Stuttering Foundation of America, P.O. Box 11749, Memphis, TN 38111-0749, Phone: (901)761-0343, Toll-free Hotline on Stuttering: (800) 992-9392, website: www.stutteringhelp.org
- National Stuttering Association(NSA), Maryland Chapter Meetings, 119 W. 40th Street 14th Floor, New York, NY 10018, Phone: (800)We-Stutter, website: www.nsastutter.org
- Anne Arundel County Public Schools, Speech and Language Services, Trish Dewitt, Coordinator of Special Services, Phone: (410)787-8812, website: www.aacps.org/specialed/speech.asp
- Maryland Speech Language Hearing Association (MSHA), P.O. Box 31, Manchester, MD 21102, Phone: (410)239-7770, website: www.mdslha.org
Famous People Who Stutter
A.D.A.M Medical Encyclopedia [Internet]. (2014). Stuttering. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002400/
American Speech-Language-Hearing Association. (2015) Stuttering. Retrieved from: http://www.asha.org/public/speech/disorders/stuttering.htm
Guitar, B. (2014). Stuttering: An Integrated Approach to Its Nature and Treatment. Philadephia, PA: Lippincott Williams & Wilkins.
Kehoe, T. (2013). What Stuttering Treatments Are Effective. Retrieved from: http://www.casafuturatech.com/what-stuttering-treatments-are-effective/
National Institute on Deafness and Other Communication Disorders. (2010). NIDCD Fact Sheet: Stuttering. Retrieved from: http://www.nidcd.nih.gov/staticresources/health/voice/StutteringFactSheet.pdf
Scott, L. (2010). Stuttering: Straight Talk for Teachers. Memphis, TN: The Stuttering Foundation.
Stuttering Foundation of America. (2014). 18 Famous People Who Stutter. Retrieved from: http://www.stutteringhelp.org/sites/default/files/...
The Stuttering Foundation. (2015). Electronic Devices, Software, and Apps. Retrieved from: http://www.stutteringhelp.org/electronic-devices-software-and-apps