Causes and types of stuttering and how a stutter can be managed
Many of us have struggled with stuttering at one point in our lives, or we've known someone who has. For many children, stuttering, also known as stammering, is simply a natural part of learning language and putting sentences together, and they’ll eventually outgrow it. For others, it may persist throughout their life.
As a parent or caregiver, it can be frustrating and upsetting to watch your child struggle to communicate. You may be asking yourself questions such as, “Is my child's stuttering a phase?” “Should I be concerned enough to get professional help?” “How will this affect my child’s social and emotional development?”
While stuttering is often developmental, it can also be a chronic condition that lasts into adulthood. This type of stuttering often has an impact on self-esteem and interactions with other people.
Whether you’re a parent of a young child who stutters, or an adult seeking guidance and support, we’ve put together this informational guide to help answer your questions about stuttering, identify common signs and symptoms, and learn how stuttering can be treated and managed.
What is stuttering?
Stuttering, sometimes called stammering or disfluency, is a communication disorder that disrupts the natural flow of speech. Stuttering can begin gradually and develop over time, or it can appear suddenly. People who stutter often repeat certain syllables, words, or phrases ("li-li-like this"), prolong them ("lllllike this"), or experience abnormal stops of certain sounds and syllables.
According to Stanford’s Children’s Hospital, there are several types of stuttering:
Developmental stuttering: This is the most common type of stuttering in children. It usually happens between the ages of 2 and 5. Developmental stuttering most often occurs when children's speech and language abilities are unable to meet their verbal demands.
Neurogenic stuttering: Neurogenic stuttering may happen after a stroke or brain injury. It's caused by signal problems between the brain and the nerves and muscles involved in speech.
Psychogenic stuttering: Psychogenic stuttering is not common. It may happen after emotional trauma, or it can accompany problems with thinking or reasoning.
How common is stuttering?
According to the Stuttering Foundation, over 3 million people in the United States stutter.
About 5% of all children go through a period of stuttering that lasts six months or more. As many as 75% of those children will recover by late childhood. Those who continue to stutter into school-age years are likely to have a more serious problem and continue to stutter in some way throughout their lives.
In adults, approximately 2% of the population between the ages of 21 and 49 stutters, and less than 2% of adults ages 50 and over stutters.
Stuttering is much more common in males than females, with males being about four times more likely to have stuttering issues.
What does stuttering sound like?
Every person is different, and the symptoms of stuttering can vary considerably. However, here are some of the most common signs to look for:
Repeating sounds, syllables, words, or phrases
Routinely using interjections when speaking, such as “um” or “like,” that disrupt the flow of speech
Taking a lot of pauses when speaking
Stopped or blocked speech; you may see your child’s mouth open, but nothing is being said
Routinely being out of breath when talking
Fast eye blinking, trembling, or shaking lips when speaking
Increased stuttering when tired, excited, or under stress
Being afraid or nervous to talk
What are the long-term consequences of stuttering?
For many children and adults, stuttering itself isn’t the worst part of the condition--it’s the impact on their daily lives. When people stutter, they feel like they’ve lost control of one of their most basic functions. This can be humiliating, uncomfortable, and unnerving. Stuttering can lead people to feel anxious about speaking, be less active or involved in the classroom or at work, avoid social interactions, and worry that they’ll be teased or embarrassed.
For older children and adults, these effects can be worse. Many avoid social situations altogether, and they feel constant frustration and embarrassment associated with how they talk. Stuttering adults can be stereotyped as being shy, self-conscious, or lacking confidence.
Ironically enough, many of our natural coping mechanisms can actually worsen stuttering. For example, people often try to avoid stuttering by speaking quickly, or by not speaking at all. These behaviors can increase the likelihood of stuttering.
What causes stuttering?
Unfortunately, doctors and scientists do not know the exact cause of stuttering. However, many experts believe there are several risk factors that contribute to stuttering. If any of these situations apply to you, it’s especially important that you speak with a doctor or speech-language pathologist.
A family history of stuttering: While there is still uncertainty about whether stuttering is genetic and inherited by family members, nearly 60% of all stutterers have someone in their family who also stutters or stuttered.
Child development: Children who have other speech and language disorders have a higher chance of stuttering than children who don’t.
Neurophysiology: It has been observed that some children who stutter process language in different parts of their brain than children who don’t stutter. This may interfere with how the brain sends messages to the muscles involved in speech.
Family dynamics: Some children's stuttering has been linked to high family expectations and a fast-paced lifestyle.
Late or adult-onset stuttering: This often occurs when stuttering symptoms appear later in life and are not attributed to a speech-motor or neurological issue, such as when someone experiences a stroke, tumor, or trauma.
When should I seek professional help for stuttering?
As with most developmental issues, the best prevention is often early intervention.
Talk with your doctor if you are concerned about your child's stuttering. In many cases, your doctor may refer you to a speech-language pathologist, also known as a speech therapist. Speech therapists are the most qualified professionals to evaluate and determine whether your child is at risk for long-term problems.
Signs that suggest your child’s stuttering is more severe, and that you should seek a speech evaluation, include:
Your child’s stuttering is getting worse over time
They make body or facial movements when speaking
Their speech is especially strained
Your child is actively avoiding situations that require talking
Stuttering continues after your child has turned 5 years old
Older children and adults whose lives are impacted by stuttering should also speak with their doctor or a speech therapist. Often, achieving better communication and coping strategies to manage stuttering is a lifelong process.
What does stuttering treatment look like?
Despite breakthroughs in our knowledge and understanding of stuttering, unfortunately there is still no therapy, device, or drug that can “cure” stuttering. However, early treatment can prevent stuttering from continuing into adulthood. Treatment will depend on your child’s symptoms, age, and general health. It will also depend on the severity of the condition.
To diagnose and treat stuttering, your doctor may ask questions about your family history with stuttering and review your child's symptoms. In many cases, they will refer you to a speech therapist.
Your speech therapist will ask questions about your child’s speech and test your child’s ability to speak with different techniques and in different situations. It’s important to realize that every child is unique, and certain methods that benefit some individuals may not work for others. Therefore, your speech therapist will work with you and your child to develop an individualized treatment plan to help your child speak more fluently and without disruptions. Speech therapy will also help your child learn to cope with their stutter.
For older children and adults, treatment focuses on managing stuttering. A speech therapist will help them feel less tense and speak more freely in school, at work, and in social settings. These strategies can help people face speaking situations head-on that make them nervous or uncomfortable, such as speaking on the phone or ordering food at a restaurant.
Other potential therapies and treatments include:
Cognitive behavioral therapy (CBT): CBT helps adults cope with their communication disorder in order to lessen the impact and burden it has on their quality of life.
Electronic devices: Electronic devices often sit in a person’s ear and are intended to help improve the fluency of their stutter. One example is an Altered Auditory Feedback (AAF) device. Research has shown that some individuals who stutter benefit from extending the time between speech and auditory perception. These devices can help mimic this sensation by allowing the person to hear their own voice with a slight time delay, creating the illusion of another person speaking at the same time.
Support groups: You are not alone, and support groups are a great way to meet other people who are also dealing with stuttering. Support groups can help you build self-confidence, practice speaking in a safe and accepting environment, and explore new ways to cope with stuttering
Tips to help parents support their child who stutters
One of the best tools children have to manage their stuttering is you--their caregiver. Numerous studies show that caregivers play an essential role in helping their child reach their speech and language goals. Caregivers spend the most time with their child, and there are many simple techniques and exercises you can do every day to help them.
While we’ve provided a few tips below, be sure your speech therapist empowers you with tools and knowledge to take an active role in your child’s progress.
Find opportunities to speak with your child that are fun, relaxing, and enjoyable. Putting stress and pressure on children can increase their stuttering.
Try not to react negatively or insist on correct speech when your child stutters. Instead, praise them when they speak correctly.
Try not to fill in the blanks. In other words, even when your child is struggling to say a word or sentence, let them finish without saying it for them.
Although you may find yourself saying things like "take a deep breath" or "slow down" with the best intentions, this can actually make children more self-conscious.
Model a slow, relaxed way of speaking. This will help your child slow down their own speech.
Don't be afraid to talk with your child about stuttering. If your child asks questions or expresses concern, help them understand that speech disruptions are normal and many people experience them to some degree.
If your child is school-age, educate their teachers to help them provide an environment that is safe and accepting.
How does Expressable evaluate and treat stuttering?
Expressable matches families with a certified speech therapist trained to evaluate and treat stuttering and fluency disorders. All therapy is delivered online via face-to-face video conferencing. Your child’s age and development will influence how your speech therapist interacts with them through these video chat capabilities.
Ages 0-3: Caregivers work directly with their child's speech therapist to learn cues and at-home strategies. This way they can confidently practice with their child outside the session and improve their child's communication. Learn more about the importance of parental involvement in children’s speech therapy here.
Ages 3-6: Caregivers attend video sessions alongside their child so they both learn valuable skills from their speech therapist. Reinforcing these lessons outside the session will continue to promote at-home skill building.
Ages 7 and up: Most children attend video sessions independently, but parents are kept in the loop with updates and tips during each session.
Adults: Adults attend sessions by themselves but are welcome to bring loved ones or family members as well.