What is Stuttering? Stuttering is a communication disorder that effects speech fluency. It is characterized by breaks in the flow of speech referred to as disfluencies and typically begins in childhood. Everyone experiences disfluencies in their speech. Some disfluencies are totally normal but having too many can actually significantly affect one’s ability to communicate. In stuttering, we most often see the following types of primary behaviors:
- Repetitions: The repetition of sounds (B-b-b-b-b-b-baseball), syllables (Bay-bay-bay-bay-baseball) , or parts of words (alar-alar-alar-alarm).
- Prolongations: The prolongation of a sound in a word (Mmmmmmommy)
- Interjections: Sound (I, um, want to, um, go to the store), word (I like want to go to the store) or phrases (I want to, you know, go to the store) inserted into a sentence
- Blocks: When a person’s mouth is positioned for a sound (like the /b/ in baseball) yet no sound comes out. It is as though they physically cannot move the articulators to finish the word.
We may also see these secondary behaviors, typically in more severe cases of stuttering:
- Tension in the neck, shoulders, face, jaw, chest
- Eye blinks, nose flaring, other odd facial movements
- Clenched fists, stomping of feet
- Jerking or other unusual motor movements in arms, hands, legs, feet
What causes Stuttering? The simple answer is we don’t know for sure. However according to the The Stuttering Foundation of America:
“There are four factors most likely to contribute to the development of stuttering: genetics (approximately 60% of those who stutter have a family member who does also); child development (children with other speech and language problems or developmental delays are more likely to stutter); neurophysiology (recent neurological research has shown that people who stutter process speech and language slightly differently than those who do not stutter); and family dynamics (high expectations and fast-paced lifestyles can contribute to stuttering). Stuttering may occur when a combination of factors comes together and may have different causes in different people. It is probable that what causes stuttering differs from what makes it continue or get worse.”
Who Stutters? According to the The Stuttering Foundation of America approx 68 million people word wide stutter (about 1% of the population) and it effect 4 times as many men as women. Some preschool children (age 2-6) will experience “normal disfluencies” also that will go away on their own without intervention (more information below).
How is stuttering diagnosed? A full evaluation by a speech language pathologist is needed for a stuttering diagnosis. In this evaluation the SLP will take a full developmental and medical history and interview the parents (and child, when appropriate) regarding the symptoms and how they are affecting the child’s ability to communicate the and how it is affecting the child academically, socially, etc. The SLP assess the child’s speech using formal and informal methods and will take note of the types of disfluencies and their frequency of occurrence.
Many young children, ages 2-6, go through a period of time where they produce many disfluencies and 75% of them will stop spontaneouoly without treatment. This happens in the years that they are experiencing a “language explosion” and some theorize that this happens because their language skills are developing at a faster rate than their motor skills. Usually these disfluencies will pass as their speech and language skills mature, however it is not always possible to predict if the stuttering will go away on its own or will require speech therapy. Though there is no agreed upon set of criteria to predict this, there are some factors to consider:
- Family History: There is evidence that stuttering can run in families so if a family member has a history of stuttering that required therapy, this increases the chance that the behavior is real stuttering and nor just normal disfluencies.
- Age of Onset: According to The Stuttering Foundation of America children who begin stuttering before age three are more likely to be experiencing normal disfluecncies that they will outgrow within about 6 months.
- Length of Stuttering Behavior: Children who exhibit stuttering behavior longer than six months are less likely to grow out of it
- Gender: Boys are more likely that girls to have long term stuttering behavior
- Presence of additional speech/language concerns: The presence of additional speech or language problems can indicate that it may be less likely that the child will grow out of it.
In older children and adults, the length of time the stuttering behavior has been occurring is not nearly as important as the symptoms themselves. If the behavior is involuntary and is causing problems in the person’s communication it most likely will require some intervention.
How is Stuttering treated? Most treatment for stuttering is behavioral. The treatments involve teaching the person how to recognize their own periods of disfluncies and learning how to predict when they might happen or what may trigger episodes of disfluencies. Once they can do this, they are taught strategies to help control their disfluencies.
Where can I find more information? There are several different websites that provide excellent information on Stuttering:
- The Stuttering Foundation of America
- The American Speech Language Hearing Association
- The National Stuttering Foundation
- The Canadian Stuttering Association
Feel free to shoot me at email if you have any questions! Katie (at) playingwithwords (dot) com