How Is Stuttering Recognized and Diagnosed?

You’re likely here because you, or someone you love, is impacted by a stutter. You may have some understanding of what stuttering is, but in this video, we’ll explore how stuttering is recognized and diagnosed. 

Stuttering can be defined as a disruption to the smoothness, or fluency, of a person’s speech. As we discuss in our video on what stuttering sounds like, there are many different characteristics of stuttering. It’s likely that the person who stutters has already noticed these in their own speech, or someone close to them has pointed them out. This is usually when a referral is made to a speech-language pathologist for an evaluation.

Speech-language pathologists, also known as speech therapists, are educated, trained, and licensed to assess a person’s speech and formally diagnose or rule out a stutter.

It’s important to note that none of us ever has 100% perfect speech. We’re all bound to repeat a word occasionally, or interject an “um” or two while speaking with someone. These are called non-stuttering-like disfluencies. Someone may occasionally interject filler words when they talk, such as “I, um, uh, well…” They may also repeat phrases excessively, such as “I went, I went, I went to the store.” Or they may even make revisions to their sentence, such as, “Yesterday, I mean yesterday morning, or, um, yesterday afternoon, I went to the store.”

Speech therapists know what to look for when listening to a person's speech to determine if they’re demonstrating stuttering-like disfluencies or non-stuttering-like disfluencies. If the non-stuttering-like disfluencies are excessive, there could be another type of fluency issue present, called cluttering. This is something we’ll cover in a future video.

In making a diagnosis, one of the most important things a speech therapist can do is take samples of the person’s speech in a variety of settings. A person may not stutter during their speech evaluation, although they do at other times. So it’s important for the speech therapist to observe the client’s speech several times in different settings. If it’s possible and the client or caregiver agrees, it’s extremely helpful to have audiovisual recordings of these different situations. These might include talking at home with family in a relaxed setting, or speaking with someone they don’t know well. The setting in which someone is speaking can often have a big impact on their speech fluency.

A speech therapist may also assess the person’s speech when they’re in conversation, retelling a familiar story, or in automatic speech exercises, like counting, reading, or singing. 

Listening to a variety of speech samples will help the speech therapist get the best sense of what’s going on with the person’s speech. The therapist will make note of the types of stuttering characteristics they see, whether they’re repetitions, prolongations, blocks, or other secondary behaviors.

The speech therapist will also measure the frequency of stutters. This is typically done by counting the frequency of stuttered words compared to total syllables spoken in that specific speech sample.

The speech therapist takes a few other things into account during the assessment. They make note of the person’s age, any other coexisting diagnoses, and any medical or family history that may relate to stuttering. They consider whether the  person responds negatively to their own speech, and if their speech negatively impacts their ability to participate in work and daily social life. They also assess how easily others can understand the person’s speech.

After formal testing is complete, the speech therapist will either confirm or rule out a stuttering diagnosis. If a stutter is found to be present, the speech therapist will then make a recommendation for speech therapy.

As we’ve mentioned, some people will stutter to some degree throughout their life. We can never say that speech therapy will “cure” a stutter. Speech therapy can, however, give a person techniques to use so that their speech becomes smoother, or more fluent. After a formal evaluation, the therapist will have a better idea of which techniques to try with the person in therapy sessions. 

So, to wrap up, let’s review what we’ve covered today: 

• First of all, speech-language pathologists are trained to diagnose or rule out a stutter. They do this through a detailed evaluation, which ideally includes observing a variety of speech samples.

• Speech therapists observe the characteristics of the person’s stuttering, assess the frequency of the stutter, and discuss medical and family history with the client. 

• A diagnosis will then be confirmed or ruled out, and treatment will be recommended if necessary.

If you or someone you love is in need of a speech evaluation, don’t wait. Find a speech-language pathologist to talk to today.