Stuttering

What Is Stuttering?

 

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." It can also manifest as a prolongation of a sound such as "ssssssee." Sometimes stuttering involves the complete stoppage of speech or the omission of a sound. Or it can be the repeated interruption of 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. Normal language dysfluency 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 dysfluency that seems severe 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 severe or that it continues for more than 6 months doesn’t necessarily mean that stuttering is going to be a lifelong problem. Knowing what to look for and knowing how to respond to your child's stuttering will go a long way toward preventing that from happening.

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 it may last for a few weeks or for a couple of years. Most children (50%- 80%) outgrow it by puberty. But for some, stuttering can become a lifelong condition that causes problems in school and in functioning as an adult, including self-esteem issues and communicating with other people.

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Symptoms of Stuttering

Symptoms of stuttering include:

  • Challenges 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 word
  • Adding an extra word like "um" before saying the next word or phrase
  • Anxiety about speaking
  • Difficulty communicating effectively

Along with stuttering you may have:

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

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

Types of Stuttering

  • 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 telephone, but it gets better when they are 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 even Alzheimer’s disease.
  • Psychogenic stuttering is a rare form of stuttering. It happens in adults who have experienced emotional 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 there are signs to look for that show stuttering may be a problem:

  • You may notice tension and a struggle with facial muscles.
  • You may also notice the voice rising in pitch with repetitions.
  • In more severe cases of stuttering, your child may show considerable effort and tension in trying to speak.

More severe cases are often marked by attempts to avoid stuttering by changing words or using extra sounds to start talking. Sometimes, your child will try to avoid situations where they need to talk.

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Stuttering Causes and Risk Factors

Experts point to four things that contribute to stuttering:

A family history of stuttering. There is disagreement as to whether stuttering is genetic because specific genes have not been identified. But close to 60% of all stutterers have someone in the family who also stutters or stuttered.

Child development . Children who have other language and speech problems are more likely to stutter than children who don't.

Neurophysiology. In some children who stutter, language is processed in different parts of the brain than it is for children 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 attributed to high family expectations and a fast-paced lifestyle.

It was commonly believed that stuttering was often the result of either physical or emotional trauma. Although there are some instances of stuttering following such traumas, they are rare and usually connected with physical trauma or illness later in life. There is little evidence to support the idea that children stutter as a result of emotional upheaval.

Other risk factors 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.
  • Family recovery. A child is more likely to have longer-term stuttering if they have an older family member who stutters.
  • Abnormalities in speech motor control. These are caused from damage to the brain or nerves involved in controlling the muscles used for speech or programming these muscles for speech. They can cause 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.

When Should I Seek Professional Help for My Child's Stuttering?

Talk with your doctor if you are 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 or not there is a risk of a long-term problem. In most cases with children, treatment focuses on training and working with the parents to develop techniques to help the child.

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There is no cure for stuttering, and no drug has been approved to treat stuttering. Sometimes the SLP will work directly with the child to develop techniques that can help the child learn not to stutter.

For children who have a severe 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 is especially difficult or strained
  • Avoiding situations that require talking
  • Vocal tension that results in rising pitch while talking
  • Stuttering that continues after a child has turned 5 years old

Stuttering Diagnosis

The diagnosis for stuttering is made by a speech-language pathologist or your doctor. They may ask you a few questions, such as:

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

The health care professional 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

Stuttering Treatment

Treatment for stuttering may involve a combination of methods that are tailored to meet your child’s needs. They may not get rid of 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 by offering special speech exercises. 

A number of medications have been tried for stuttering, but so far none have been proven to help.

 Home remedies for stuttering

There are a lot of things you and other family members can do to help a child who stutters get beyond his or her problems with speaking:

  • Create opportunities for talking that are relaxed, fun, and enjoyable.
  • Find times to engage your child in conversations without distractions of TV or other interruptions. For instance, you can make it a habit to involve them in family conversations at dinner each day.
  • Don't be critical of your child's speech or insist on precise or correct speech.
  • Don't put pressure on your child to entertain or interact verbally 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 displaying signs of impatience or frustration.
  • 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 do stutter.
  • Although phrases such as "Stop and take a deep breath" or "Slow down" may be meant to help your child, they can actually make them more self-conscious and shouldn’t be used.
  • Model a slow, relaxed way of speaking to help your child slow down his or her speech.
  • Don't be afraid to talk with your child about stuttering. If he or she asks questions or expresses concern, listen and answer in ways that will help them understand that disruptions in speech are normal and that everyone experiences them to some degree.

To find out more about stuttering and how to help your child, call the Stuttering Foundation of America at 800-992-9392.

WebMD Medical Reference Reviewed by Hansa D. Bhargava, MD on July 02, 2020

Sources

SOURCES:

Stuttering Foundation of America: "F.A.Q."

Stuttering Foundation of America: "If You Think Your Child Is Stuttering."

KidsHealth.org: "Stuttering."

National Institute on Deafness and Other Communication Disorders: "Stuttering."

American Speech-Language-Hearing Association: "Stuttering."

Stuttering Foundation of America: "Did You Know ..."

The Journal of the American Osteopathic Association: “Developmental and Persistent Developmental Stuttering: An Overview for Primary Care Physicians.”

Mayo Clinic: “Stuttering,” “Traumatic Brain Injury, Causes.”

The Stuttering Foundation: “Recognize the Risk Factors for Stuttering,” “On the Gender Factor in Stuttering.”

Northern Arizona University: “Motor-Speech Disorders.”

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