Stuttering

Topic Overview

What is stuttering?

Stuttering is a communication problem in which spoken words or sounds are involuntarily repeated, drawn out, not completed, or skipped.

Stuttering is not unusual in young children between ages 2 and 7 years. Stuttering that begins during a child's intensive language-learning years and resolves on its own sometime before puberty is called normal disfluency. It is considered a normal phase of language development.

Developmental stuttering is a speech problem that persists, gets worse over time, and causes embarrassment or discomfort.

What causes stuttering?

Stuttering results when the brain is unable to transmit messages properly. The exact cause of this failure is unknown, although genetics most likely play a role in some people. About 60% of people who stutter have other family members with the disorder.¹ Environmental factors, such as a stressful environment, or biological influences, such as a developmental delay, may trigger stuttering, especially in people who have inherited the tendency to develop the disorder.

In rare cases, stuttering develops as a result of brain damage, such as following a traumatic head injury or stroke.

What are the symptoms?

Symptoms may include:

• Repeating sounds, parts of words, and sometimes entire words.
• Pausing between words or within a word.
• Substituting simple words for those that are hard to speak.
• Showing obvious tension or discomfort while talking.
• Using incomplete phrases.
• Making interjections (such as adding "uh" or "um" in the middle of a sentence).
• Making parenthetical remarks (adding explanatory or seemingly unrelated words or phrases).

Stuttering often becomes worse during stressful situations, such as public speaking. Interestingly, it often does not occur during other activities, such as singing, whispering, talking while alone or to pets, or during choral reading.

How is stuttering diagnosed?

A speech-language pathologist can usually diagnose stuttering by having the child read aloud, videotaping or recording the child while he or she is talking, or checking speech patterns in other ways.

Also, doctors usually conduct a physical examination to rule out health problems, such as hearing loss, that can interfere with speech development.

Stuttering that appears for the first time in an adult is usually related to an injury, health problem, or severe emotional trauma. Diagnosis includes a physical examination, questioning, and observation.

How is it treated?

When it begins in early childhood, stuttering usually resolves on its own. Even if stuttering is not expected to last long, treatment can be helpful. Treatment usually includes parent counselling and speech therapy.

The focus of parent counselling is to educate you (and other caregivers) about how speech develops and to help you learn how to positively interact with your child. It also provides guidelines on how to help your child with basic home treatment techniques, such as using appropriate eye contact and body language when your child is trying to talk.

Speech therapy for your child is also important, especially if stuttering persists, gets worse, or is severe. The exact methods vary, but generally a child practises techniques in different settings or directly with the therapist. The goal is for your child to master specific speech and language skills and gain confidence in his or her speaking abilities.

Counselling is sometimes used along with speech therapy, most commonly for adults. This treatment can help manage problems, such as anxiety or low self-esteem, that may coexist with stuttering or make it worse.

When stuttering results from brain damage, such as after a head injury, a combination of treatments is usually needed. This often includes speech therapy, physical rehabilitation, medications, and treatments targeted to the specific underlying condition.

Frequently Asked Questions

Learning about stuttering:	What is stuttering? What are the symptoms of stuttering? How common is stuttering?
Being diagnosed:	How is stuttering diagnosed?
Getting treatment:	How is stuttering treated?
Living with stuttering:	How can I manage stuttering at home?

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Author:	Amy Fackler, MA Debby Golonka, MPH Carrie Henley	Last Updated: November 10, 2006
Medical Review:	Adam Husney, MD - Family Medicine Michael J. Sexton, MD - Pediatrics Robert M. Kroll, BSc, MSc, PhD - Speech Pathology
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