Stuttering is a speech disorder that disrupts the natural flow of speech, marked by repeating, pausing, or prolonging certain sounds and syllables. Individuals who stutter know what they want to say; the challenge lies in producing the physical sound.
In the DSM-5, stuttering is called Child-Onset Fluency Disorder.
Stuttering, also called stammering, emerges in childhood. The condition typically begins between 2 and 6 years old, but three-quarters of children who stutter eventually outgrow the condition. Stuttering may influence relationships, academic goals, and professional pursuits, but there are effective strategies to address the condition or embrace it.
Around 70 million people worldwide stutter, representing 1 percent of the global population. In the United States, about 3 million people stutter, and boys are two to three times more likely to stutter than are girls. Stuttering is most common in young children, but 75 percent eventually outgrow the condition, according to the National Institute on Deafness and Other Communication Disorders.
Stuttering takes two forms. Developmental stuttering begins in childhood and may materialize when a child wants to express language, but their speech skills haven’t fully developed yet. The second type of stuttering, neurogenic stuttering, occurs as a result of brain injury such as stroke or head trauma, after which the brain regions involved in speech production aren’t able to coordinate effectively.
The causes of stuttering are not fully understood, but genetics play an important role. Researchers have identified several genetic mutations that occur in those who stutter, and the risk of stuttering is three times higher when a first-degree relative has the condition, according to the DSM-5. Differences in brain structure and function and family dynamics may play a role as well.
Stuttering is diagnosed by a speech-language pathologist. The clinician will listen to the patient’s speech to assess characteristics of stuttering, such as whether the person repeats syllables, prolongs sounds, pauses in the middle of words or between words, or avoids certain words. The speech language pathologist will also take into account a person’s age, length of time of stuttering, and family history of stuttering to make the determination.
Stuttering often emerges between 2 and 6 years old in children developing language, when their desire to speak exceeds their speech and language abilities. Around 5 to 10 percent of toddlers develop a stutter, yet three-quarters of those children will outgrow it, according to the National Institute on Deafness and Other Communication Disorders. If this occurs, experts advise to wait until the age of 3 to see if it passes, be patient and listen, avoid giving advice, smile encouragement, ask one question at a time, and acknowledge the stutter kindly and supportively.
The belief that anxiety causes stuttering is a myth. Although anxiety can at times exacerbate stuttering, it does not always indicate that a person is anxious. Folks who don’t stutter may have this misconception because they stumble over their words when they become nervous or anxious. But that’s not what’s at the root of stuttering for people with this speech disorder.
Stuttering and Tourette syndrome may be more closely connected than previously thought. Tourette syndrome—a neurological disorder characterized by involuntary verbal or nonverbal tics—is associated with elevated levels of dopamine. Dopamine is a chemical that helps the basal ganglia function, the network of brain structures that control movement. Medications that target high dopamine levels have reduced symptoms of Tourette syndrome. When patients with stutters were provided similar medications in a recent study, the effects were equally positive. This suggests that stuttering may function similarly to Tourette syndrome, as both involve dopamine levels in the brain.
People who stutter may struggle with embarrassment, frustration, or self-esteem at times. Yet speech therapy can help with speech fluency and talk therapy can address those difficult emotions. Many who stutter come to feel resilient and empowered, and some refrain from treating the condition altogether, choosing to embrace their stutter instead.
People often work with a speech therapist to alleviate stuttering. Adults who stutter can speak more slowly, use breathing exercises to relax, and address the accompanying anxiety. Techniques for parents of children who stutter include providing plenty of time to talk in a relaxed environment, not rushing or interrupting, and speaking more slowly themselves.
No medications are currently approved to treat stuttering, but drugs for epilepsy, anxiety, and depression may be helpful, although they are not without side effects. An electronic device, similar to a hearing aid, can also help people who stutter to speak more fluently.
Stuttering can vary widely by context. For example, stuttering is often exacerbated during public speaking but disappears while singing or reading. A difficult cycle underlying the condition is that stuttering can lead to anxiety while speaking, which in turn can lead to more stuttering—especially in pressured situations such as a school presentation or job interview.
Absolutely. Many people who stutter occupy corporate or political leadership positions, such as President-Elect Joe Biden, CEO Jack Welch, actress Emily Blunt, and news anchor Byron Pitts. People who stutter often report that the challenge of stuttering has instilled a sense of insight, grit, and resilience that allows them to achieve their personal and professional goals.
Some people in the stuttering community have created and now counsel a movement toward self-acceptance. They believe it’s better to learn to accept their stutter rather than strive to overcome it. For many who have explored various therapies and programs, it may be better to release the constant pressure of trying to achieve fluency and replace feelings of guilt and shame with acceptance and solidarity.
People who stutter may find support and acceptance through community, such as the National Stuttering Association or other organizations. They may strive to reframe harmful views of stuttering that they’ve encountered in society. They may focus on fostering resilience, as people who stutter have reported positive outcomes, such as the fact that stuttering “increased their empathy” or “instilled a fighting instinct.” In one unique example, a woman turned her experiences of stuttering into jokes, which helped her to release frustration and accomplish her goal of becoming a comedian.