- What is stuttering?
- Who stutters?
- How is speech normally produced?
- What are the causes and types of stuttering?
- How is stuttering diagnosed?
- How is stuttering treated?
- What research is being conducted on stuttering?
What is stuttering?
Stuttering is a speech disorder
characterized by repetition of sounds, syllables, or words; prolongation of
sounds; and interruptions in speech known as blocks. An individual who stutters
exactly knows what he or she would like to say but has trouble producing a
normal flow of speech. These speech disruptions may be accompanied by struggle
behaviors, such as rapid eye blinks or tremors of the lips. Stuttering can make
it difficult to communicate with other people, which often affects a person’s
quality of life and interpersonal relationships. Stuttering can also negatively
influence job performance and opportunities, and treatment can come at a high
financial cost.
Symptoms of stuttering can vary
significantly throughout a person’s day. In general, speaking before a group or
talking on the telephone may make a person’s stuttering more severe, while
singing, reading, or speaking in unison may temporarily reduce stuttering.
Stuttering is sometimes referred to
as stammering and by a broader term, disfluent speech.
Who stutters?
Roughly 3 million Americans stutter.
Stuttering affects people of all ages. It occurs most often in children between
the ages of 2 and 6 as they are developing their language skills. Approximately
5 to 10 percent of all children will stutter for some period in their life,
lasting from a few weeks to several years. Boys are 2 to 3 times as likely to
stutter as girls and as they get older this gender difference increases; the
number of boys who continue to stutter is three to four times larger than the
number of girls. Most children outgrow stuttering. Approximately 75 percent of
children recover from stuttering. For the remaining 25 percent who continue to
stutter, stuttering can persist as a lifelong communication disorder.
How is speech normally produced?
We make speech sounds through a series
of precisely coordinated muscle movements involving breathing, phonation (voice
production), and articulation (movement of the throat, palate, tongue, and
lips). Muscle movements are controlled by the brain and monitored through our
senses of hearing and touch.
What are the causes and types of stuttering?
The precise mechanisms that cause
stuttering are not understood. Stuttering is commonly grouped into two types
termed developmental and neurogenic.
Developmental stuttering
Developmental stuttering occurs in
young children while they are still learning speech and language skills. It is
the most common form of stuttering. Some scientists and clinicians believe that
developmental stuttering occurs when children’s speech and language abilities
are unable to meet the child’s verbal demands. Most scientists and clinicians
believe that developmental stuttering stems from complex interactions of
multiple factors. Recent brain imaging studies have shown consistent
differences in those who stutter compared to nonstuttering peers. Developmental
stuttering may also run in families and research has shown that genetic factors
contribute to this type of stuttering. Starting in 2010, researchers at the
National Institute on Deafness and Other Communication Disorders (NIDCD) have
identified four different genes in which mutations are associated with
stuttering. More information on the genetics of stuttering can be found in
the research section of this fact sheet.
Neurogenic stuttering
Neurogenic stuttering may occur after a
stroke, head trauma, or other type of brain injury. With neurogenic stuttering,
the brain has difficulty coordinating the different brain regions involved in
speaking, resulting in problems in production of clear, fluent speech.
At one time, all stuttering was
believed to be psychogenic, caused by emotional trauma, but today we know that
psychogenic stuttering is rare.
How is stuttering diagnosed?
Stuttering is usually diagnosed by a
speech-language pathologist, a health professional who is trained to test and
treat individuals with voice, speech, and language disorders. The
speech-language pathologist will consider a variety of factors, including the
child’s case history (such as when the stuttering was first noticed and under
what circumstances), an analysis of the child’s stuttering behaviors, and an
evaluation of the child’s speech and language abilities and the impact of stuttering
on his or her life.
When evaluating a young child for
stuttering, a speech-language pathologist will try to determine if the child is
likely to continue his or her stuttering behavior or outgrow it. To determine
this difference, the speech-language pathologist will consider such factors as
the family’s history of stuttering, whether the child’s stuttering has lasted 6
months or longer, and whether the child exhibits other speech or language
problems.
How is stuttering treated?
Although there is currently no cure for
stuttering, there are a variety of treatments available. The nature of the
treatment will differ, based upon a person’s age, communication goals, and
other factors. If you or your child stutters, it is important to work with a
speech-language pathologist to determine the best treatment options.
Therapy for children
For very young children, early
treatment may prevent developmental stuttering from becoming a lifelong
problem. Certain strategies can help children learn to improve their speech fluency
while developing positive attitudes toward communication. Health professionals
generally recommend that a child be evaluated if he or she has stuttered for 3
to 6 months, exhibits struggle behaviors associated with stuttering, or has a
family history of stuttering or related communication disorders. Some
researchers recommend that a child be evaluated every 3 months to determine if
the stuttering is increasing or decreasing. Treatment often involves teaching
parents about ways to support their child’s production of fluent speech.
Parents may be encouraged to:
·
Provide a relaxed home environment that
allows many opportunities for the child to speak. This includes setting aside
time to talk to one another, especially when the child is excited and has a lot
to say.
·
Listen attentively when the child
speaks and focus on the content of the message, rather than responding to how
it is said or interruptng the child.
·
Speak in a slightly slowed and relaxed
manner. This can help reduce time pressures the child may be experiencing.
·
Listen attentively when the child
speaks and wait for him or her to say the intended word. Don't try to complete
the child’s sentences. Also, help the child learn that a person can communicate
successfully even when stuttering occurs.
·
Talk openly and honestly to the child
about stuttering if he or she brings up the subject. Let the child know that it
is okay for some disruptions to occur.
Stuttering therapy
Many of the current therapies for teens
and adults who stutter focus on helping them learn ways to minimize stuttering
when they speak, such as by speaking more slowly, regulating their breathing,
or gradually progressing from single-syllable responses to longer words and
more complex sentences. Most of these therapies also help address the anxiety a
person who stutters may feel in certain speaking situations.
Drug therapy
The U.S. Food and Drug Administration
has not approved any drug for the treatment of stuttering. However, some drugs
that are approved to treat other health problems—such as epilepsy, anxiety, or
depression—have been used to treat stuttering. These drugs often have side
effects that make them difficult to use over a long period of time.
Electronic devices
Some people who stutter use electronic
devices to help control fluency. For example, one type of device fits into the
ear canal, much like a hearing aid, and digitally replays a slightly altered
version of the wearer’s voice into the ear so that it sounds as if he or she is
speaking in unison with another person. In some people, electronic devices may
help improve fluency in a relatively short period of time. Additional research
is needed to determine how long such effects may last and whether people are
able to easily use and benefit from these devices in real-world situations. For
these reasons, researchers are continuing to study the long-term effectiveness
of these devices.
Self-help groups
Many people find that they achieve
their greatest success through a combination of self-study and therapy.
Self-help groups provide a way for people who stutter to find resources and
support as they face the challenges of stuttering.
What research is being conducted on stuttering?
Researchers around the world are
exploring ways to improve the early identification and treatment of stuttering
and to identify its causes. For example, scientists have been working to
identify the possible genes responsible for stuttering that tend to run in families.
NIDCD scientists have now identified variants in four such genes that account
for some cases of stuttering in many populations around the world, including
the United States and Europe. All of these genes encode proteins that direct
traffic within cells, ensuring that various cell components get to their proper
location within the cell. Such deficits in cellular trafficking are a newly
recognized cause of many neurological disorders. Researchers are now studying
how this defect in cellular trafficking leads to specific deficits in speech
fluency.
Researchers are also working to help
speech-language pathologists determine which children are most likely to
outgrow their stuttering and which children are at risk for continuing to
stutter into adulthood. In addition, researchers are examining ways to identify
groups of individuals who exhibit similar stuttering patterns and behaviors
that may be associated with a common cause.
Scientists are using brain imaging
tools such as PET (positron emission tomography) and functional MRI (magnetic
resonance imaging) scans to investigate brain activity in people who stutter.
NIDCD-funded researchers are also using brain imaging to examine brain
structure and functional changes that occur during childhood that differentiate
children who continue to stutter from those who recover from stuttering. Brain
imaging may be used in the future as a way to help treat people who stutter.
Researchers are studying whether volunteer patients who stutter can learn to
recognize, with the help of a computer program, specific speech patterns that
are linked to stuttering and to avoid using those patterns when speaking.
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