Stuttering is a disorder of speech that affects the fluent production of sounds, words, phrases, and sentences. Repetitions, hesitations, or prolongation of speech sounds at the beginning of words or within words are frequently heard, as are repetitions, single or multiple, of entire words or phrases.
Besides these common characteristics of stuttered speech, the individual who stutters may have problems producing speech at all. Speech may be blocked with the airflow halted. The individual struggles to release the air, and with it, the desired word. Other struggle behavior is also common in individuals who stutter. There may be excessive movement of the muscles of the face and neck, and eye contact with the listener is frequently broken. In addition, secondary behaviors may co-occur. These behaviors are particular to the individual and are used in order to help release the blocked sound or word. For some individuals, there may be a habitual turn of the head, for others, a snap of the fingers or protrusion of the tongue. Secondary behaviors develop as the individual tries to cope with his stuttering.
How prevalent is stuttering?
Approximately 3 million Americans stutter. Three times as many males as females stutter. Stuttering is recorded in countries worldwide. Well-known and successful people who stutter include Marilyn Monroe, James Earl Jones, Winston Churchill, and Annie Glenn.
What causes stuttering?
Because stuttering occurs in families, speech researchers are inclined to say that stuttering has genetic roots. Recent advances in the field of human genetics allow scientists to identify the genes that cause any disorder which shows inheritance in families. The identification of “stuttering genes” is the subject of The Stuttering Family Research Project at the National Institutes of Health, a project which has identified over 350 families who can donate cheek samples to be analyzed for DNA. There is a small but growing pool of data which show that the brain shows certain focal abnormalities in persons who stutter. These abnormalities appear only when the individual is speaking and appear within the pre-motor, motor, and auditory association areas of the cerebral cortex. Neuropharmacological attempts to control stuttering have been developed, but side effects of such medications have been numerous and unpleasant.
Is it normal for a preschooler to stutter?
Research has indeed shown that there is a period of normal dysfluency which may occur in preschoolers, simultaneous with the acquisition of language. It is believed that the dysfluency is a response to the child’s attempts to organize his thoughts and convert them into the words, syntax, and grammar which he is currently in the throes of learning. In many cases of dysfluency, particularly the repetitive type in which the child repeats a speech sound or word, the repetition acts as a placeholder which tells the listener to wait while the child formulates the language he needs in order to communicate his concept. This early dysfluency is not considered true stuttering, and properly handled, disappears as the child develops greater language competency. True stuttering occurs when a child becomes aware of his dysfluency and attempts to manage or hide it. Struggle behaviors and secondary symptoms may appear. The child may reveal his frustration at not being able to “get the words out.”
When should we seek help?
Although approximately 85% of the children who begin stuttering as preschoolers outgrow it before adolescence, it is not prudent to wait until adolescence before seeking services. It is important to have a speech evaluation at the onset of the dysfluency so that parents may be counseled in the ways to manage it. Mismanagement of a child who is dysfluent may cause speech anxiety which may make the problem worse. In cases of children who have a genetic predisposition to stuttering, or who exhibit symptoms of true stuttering, speech therapy is recommended.
How does speech therapy help?
For children who stutter, speech therapists use an eclectic approach, tailored to suit the needs of each individual. Therapy consists of training a new way of talking. Rate of speech is manipulated and monitored. New breathing patterns are established for optimal phrasing. Speech initiation is slow and easy, and troublesome sounds are targeted. Continuous phonation and airflow are practiced. Relaxation and breath control are introduced. Clients receive treatment in individual sessions, but group treatment is also recommended.
While a therapist provides treatment to the dysfluent child, the child’s parents are given hands-on training within the therapy sessions so that they too may learn to model easy, relaxed and slow speech for him. Additionally, parents receive counseling regarding environmental conditions that may increase or decrease their child’s dysfluent behaviors.
What other resources are available?
The Stuttering Foundation of America
The National Institutes of Deafness and Other Communication Disorders