Stuttering

What is stuttering?

Stuttering is a speech disorder. It involves interruptions in the flow of speech. These interruptions are called disfluencies. They may involve:

• Repeating sounds, syllables, or words
• Stretching out a sound
• Suddenly stopping in the middle of a syllable or word

Sometimes, along with the stuttering, there may be nodding, rapid blinking, or trembling lips. The stuttering may be worse when you are stressed, excited, or tired.

Stuttering can be frustrating, because you know exactly what you want to say, but you have trouble saying it. It can make it difficult to communicate with people. This can cause problems with school, work, and relationships.

What causes stuttering?

There are two main types of stuttering, and they have different causes:

• Developmental stuttering is the more common type. It starts in young children while they are still learning speech and language skills. Many children stutter when they first start talking. Most of them will outgrow it. But some continue to stutter, and the exact cause is unknown. There are differences in the brains of people who continue to stutter. Genetics may also play a role, since this type of stuttering can run in families.
• Neurogenic stuttering can happen after someone has a stroke, head trauma, or other type of brain injury. Because of the injury, the brain has trouble coordinating the different parts of the brain involved in speech.

Who is at risk for stuttering?

Stuttering can affect anyone, but it is much more common in boys than girls. Younger children are most likely to stutter. About 75% of children who stutter will get better. For the rest, stuttering can continue their whole lives.

How is stuttering diagnosed?

Stuttering is usually diagnosed by a speech-language pathologist. This is a health professional who is trained to test and treat people with voice, speech, and language disorders. If you or your child stutters, your regular health care provider may give you a referral to a speech-language pathologist. Or in some cases, a child's teacher may make a referral.

To make a diagnosis, the speech-language pathologist will:

• Look at the case history, such as when the stuttering was first noticed, how often it happens, and in what situations it happens
• Listen to you or your child speak and analyze the stuttering
• Evaluate you or your child's speech and language abilities, including the ability to understand and use language
• Ask about the impact of stuttering on you or your child's life
• Ask whether stuttering runs in the family
• For a child, consider how likely it is that he or she will outgrow it

What are the treatments for stuttering?

There are different treatments that can help with stuttering. Some of these may help one person but not another. You need to work with the speech-language pathologist to figure out the best plan for you or your child.

The plan should take into account how long the stuttering has been going on and whether there are any other speech or language problems. For a child, the plan should also take into account your child's age and whether he or she is likely to outgrow the stuttering.

Younger children may not need therapy right away. Their parents and teachers can learn strategies to help the child practice speaking. That can help some children. As a parent, it's important to be calm and relaxed when your child is speaking. If your child feels pressured, it can make it harder for them to talk. The speech-language pathologist will probably want to evaluate your child regularly, to see whether treatment is needed.

Speech therapy can help children and adults minimize stuttering. Some techniques include:

• Speaking more slowly
• Controlling breathing
• Gradually working up from single-syllable responses to longer words and more complex sentences

For adults, self-help groups can help you find resources and support as you face the challenges of stuttering.

There are electronic devices to help with fluency, but more research is needed to see whether they really help over the long term. Some people have tried medicines that usually treat other health problems such as epilepsy, anxiety, or depression. But these medicines are not approved for stuttering, and they often have side effects.

NIH: National Institute on Deafness and Other Communication Disorders

Questions for your care team

General prompts to help prepare for your appointment.

• How does this information apply to my situation?
• Which symptoms or results need evaluation?
• Which tests are useful, and what can they tell us?
• What care options, benefits, and risks should we discuss?
• When should I seek urgent help, and whom should I call?
• When is follow-up, and how will we know whether the plan is working?