Understanding Stuttering and How It Affects Speech

Stuttering also known as childhood-onset fluency disorder or stammering is a speech disorder that affects the rhythm and flow of speech. People who stutter may repeat sounds or words, stretch out syllables, or experience pauses where they're unable to speak at all. While most children grow out of it, stuttering can sometimes continue into adulthood.

Types of Stuttering

There are two main types of stuttering:

• Developmental stuttering: The most common form, usually begins between ages 2 and 6 as children develop language skills.

• Adult-onset stuttering: Rare, and often caused by trauma, neurological conditions, or certain medications.

Common Symptoms

Stuttering can show up in different ways, including:

• Repeating sounds, syllables, or words (e.g., “d-d-d-dog”)

• Stretching out sounds (“mmmmmilk”)

• Silent pauses or blocks where no sound comes out

• Breaking words up (e.g., “be—cause”)

• Substituting words to avoid stuttering (circumlocution)

Some people also show physical tension while speaking, like blinking rapidly, jerking their head, or clenching fists.

Causes

The exact cause of stuttering isn’t fully understood, but it’s likely a mix of:

• Genetics: It tends to run in families

• Brain differences: Imaging studies show less efficient communication between brain regions involved in speech

• Developmental factors: Stuttering often arises during periods of rapid language development

Contrary to popular belief, anxiety or nervousness doesn’t cause stuttering though stressful situations may make it worse.

Diagnosis

Stuttering is diagnosed through:

• Speech evaluations over time by a speech-language pathologist

• Observation of how often disfluencies occur, and how they affect communication

• Consideration of age, language development, and how much distress it causes

Treatment Options

There is no cure, but many people benefit from therapy:

• Speech therapy: Helps improve fluency, manage symptoms, and reduce tension during speech

• Cognitive behavioral therapy (CBT): Can address anxiety or self-esteem issues related to stuttering

• Acceptance-based approaches: Encouraging open stuttering to reduce fear and shame

Prognosis

• 75% to 80% of children who stutter will stop naturally or with therapy

• 20% to 25% may continue stuttering into adulthood

• The earlier treatment begins, the better the outcome

Coping and Support

Stuttering doesn’t define a person’s intelligence, abilities, or confidence. Many people who stutter thrive in careers that involve communication including President Joe Biden.

Helpful resources include:

• The National Stuttering Association

• FRIENDS: The National Association of Young People Who Stutter

• The Stuttering Foundation

Bottom Line

Stuttering is a common and manageable speech disorder. Most children outgrow it, and for those who don’t, effective therapies and supportive communities can make a big difference. Reducing stigma and understanding what stuttering is and isn’t helps create a more inclusive world for everyone.

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