Stuttering

Medically Reviewed by Jabeen Begum, MD on October 10, 2023
7 min read

Stuttering is a disruption in the normal patterns of speech.  It’s sometimes called stammering or dysfluency. It can take many forms. For example, someone who stutters might repeat a sound or a syllable, especially at the beginning of the word, such as "li- li- like." Or they might use a prolonged sound such as "ssssssee." Sometimes they may completely stop talking or leave out sounds. Or they'll repeatedly interrupt speech with sounds such as "uh" or "um."

Anyone can stutter at any age. But it's most common among children who are learning to form words into sentences. Boys are more likely than girls to stutter. It often starts between the ages of 18 and 24 months and tends to come and go up to the age of 5.

About 1 out of every 5 children at some point have a problem with speech that seems serious enough to cause parents concern. And about 1 out of every 20 children will develop stuttering that lasts for more than 6 months. The fact that stuttering at times seems serious or continues for more than 6 months doesn’t necessarily mean that it will be a lifelong problem. Knowing what to look for and how to respond to your child's stuttering will go a long way toward preventing that.

Stuttering isn’t uncommon. For many children, it's simply part of learning to use language and putting words together to form sentences. It may come and go, and last for a few weeks or for a couple of years. Most children (50%-80%) outgrow it by puberty. But for some, stuttering becomes a lifelong condition that causes problems in school and in adult life, including self-esteem issues and communicating with other people. About 1% percent of the world's population stutters, according to the Stuttering Foundation.

Symptoms of stuttering include:

  • Having a hard time starting a word, phrase, or sentence
  • Repeating a sound, syllable, or word
  • Prolonging words or parts of words
  • Pausing within a word (broken word) or missing words or syllables
  • Stiffness in the face or upper body when saying a word
  • Adding an extra word like "um" before saying the next word or phrase
  • Anxiety about speaking
  • Trouble communicating effectively

Along with stuttering you may have:

  • Fast blinking of the eyes
  • Trembling lips or jaw
  • Jerking of the head
  • Clenching fists
  • Facial tics

Stuttering may get worse if you're excited, tired, or feeling stressed.

  • Developmental stuttering is the most common type. It affects children 3-8 years old and tends to come on gradually. It’s called “developmental” because it happens at the time the child is developing most of their speech and language skills. There may be issues with timing, patterning, and rhythms of speech. It tends to get worse when a child is speaking in front of a group or on the phone, but it gets better when they're singing, reading aloud, or speaking alone.
  • Neurogenic stuttering is much less common than developmental stuttering. It tends to happen after a traumatic brain injury (from a fall, motor vehicle accident, sports injury, etc.), a stroke, or the onset of Alzheimer’s disease.
  • Psychogenic stuttering is a rare form of stuttering. It happens in adults who've experienced trauma or have had a history of psychiatric illness. Patients with this type tend to rapidly repeat the first part of a word. 

It isn't always possible to tell when a child's stuttering will develop into a more serious problem that continues into the school years. But these signs could indicate that:

  • They grimace, or their facial muscles look tense when they speak.
  • Their voice gets higher when they repeat sounds or words.
  • You notice considerable effort and tension when they try to speak.

In more serious cases, your child may try to avoid stuttering by changing words or using extra sounds to start talking. Sometimes, they'll try to avoid situations where they need to talk.

Experts point to four things that contribute to stuttering:

  • A family history of stuttering. Experts disagree about whether stuttering is genetic because no specific genes have been identified. But close to 60% of all stutterers have someone in the family who also stutters or used to.
  • Child development. Children who have other language and speech problems are more likely to stutter.
  • Neurophysiology. In some children who stutter, language is processed in different parts of the brain than for those who don't stutter. This may also interfere with the interaction between the brain and the muscles that control speech.
  • Family dynamics. Some children's stuttering has been linked to high family expectations and a fast-paced lifestyle.

People once believed that stuttering was often the result of either physical or emotional trauma. Although there are some cases of stuttering following such traumas, they're rare and usually linked to physical trauma or illness later in life. There's little evidence to support the idea that children stutter as a result of emotional stress.

 

Some  risk factors for stuttering include:

  • Gender. Girls are more likely to outgrow stuttering than boys. Men are four times more likely to stutter than women.
  • Age when stuttering begins. Children who start stuttering before age 3 1/2 are more likely to outgrow it.
  • Other family members who stutter. A child is more likely to have longer-term stuttering if they have an older family member who stutters.
  • Problems in speech motor control. These can result from damage to the brain. They can also be caused by damage to nerves that are involved in controlling the muscles used for speech or in programming these muscles. This type of damage can lead to problems ranging from slurred speech to an inability to speak.
  • Stress. Although stress doesn’t cause stuttering, it can make it worse. This can happen if your child is feeling self-conscious, hurried, or pressured.

Talk with your doctor if you're concerned about your child's development, including stuttering. Your doctor may refer you to a specialist known as a speech-language pathologist (SLP) who can evaluate your child and tell whether there's a risk of a long-term problem. 

In most cases in children, treatment focuses on training and working with the parents to develop techniques to help the child. Sometimes the SLP will work directly with the child to develop techniques that can help them learn not to stutter.

There's no cure for stuttering. A number of medications have been tried, but so far none have been proven to help. 

For children who have a serious problem with stuttering, early testing and treatment is important. Signs to look for include:

  • Stuttering that becomes more frequent and gets worse with time
  • Stuttering along with body or facial movements
  • Speech that's especially difficult or strained
  • Your child avoids situations that require talking.
  • Their voice rises in pitch when they talk.
  • Stuttering that continues after a child turns 5 

 A speech-language pathologist or your doctor can diagnose stuttering. They may ask you a few questions, such as:

  • When your child began stuttering and when it usually happens 
  • How stuttering is affecting them at school and their interactions with other people

They may also:

  • Ask your child to read aloud to watch for speech issues
  • Determine which speech irregularities may be long-term problems
  • Rule out Tourette's syndrome and other disorders

Treatment for stuttering may involve a combination of methods tailored to your child’s needs. They may not cure it, but they can improve speech, communication, and participation in school activities. Types of treatment include:

  • Speech therapy. This can help your child to slow down their speech and notice when they stutter so that they speak more fluently over time.
  • Cognitive behavioral therapy. This helps your child deal with stress, anxiety, or self-esteem issues related to stuttering.
  • Parent-child interaction. Your doctor may give you techniques to practice at home with your child.
  • Electronic devices. These can help your child improve fluency through special speech exercises. 

 

 

There are many things you and other family members can do to help a child who stutters:

  • Create opportunities for talking that are relaxed, fun, and enjoyable.
  • Try to maintain a calm, quiet atmosphere at home.
  • Find times to have conversations with your child without distractions from a TV, smartphone, or other interruptions. For instance, you can make it a habit to involve them in family conversations at dinner each day.
  • Don't pressure your child to entertain or talk with other people when stuttering becomes a problem. Encourage activities that don't involve a lot of verbal interaction.
  • Listen attentively to what your child is saying, maintaining normal eye contact without showing signs of impatience or frustration.
  • Minimize questions and interruptions when your child is speaking.
  • Avoid reacting negatively when your child stutters, correcting their speech, or completing their sentences. It's important for your child to understand that people can communicate effectively even when they stutter.
  • Avoid phrases such as "Stop and take a deep breath" or "Slow down." Although they're meant to help your child, they can actually make them more self-conscious.
  • Model a slow, relaxed way of speaking to help your child slow down their speech.
  • Don't be afraid to talk with your child about stuttering. If they ask questions or express concern, listen and answer in ways that help them understand that disruptions in speech are normal and everyone has them to some degree.

To find out more about stuttering and how to help your child, try: