National Stuttering Association

What Is Stuttering?

Before discussing stuttering, it is important to understand the concepts of speech fluency and disfluency. Fluency is generally described as the forward flow of speech. For most speakers, fluent speech appears easy and effortless. Fluent speech is generally free of interruptions, blockages, or fragmentations. Disfluency is abreakdown in the forward flow of speech. For all speakers, some disfluency is normal. For example, people may insert short sounds or words, such as “um”, “like”, or “uh”, when speaking. Also, speakers might repeat phrases, revise words or phrases, or repeat whole words (e.g., for clarification). For young children, disfluency is a part of the normal development of speech and language, especially during the preschool years (between the ages of 2-5).

Still, these disfluencies are not the same as stuttering. Stuttered speech is typically characterized by an excessive amount of disfluency, or by the speaker’s attempts to avoid disfluencies. The disfluencies produced by people who stutter are often similar to those of individuals who do not stutter, but certain types of disfluent behavior are more likely to appear in the speech of people who stutter. These disfluencies include sound and syllable repetitions (ca-ca-ca-cat), sound prolongations (sssss-salad, ffffff-fish), and complete blockages of airflow. These behaviors are referred to as stuttering-type disfluencies.

Most people who stutter react negatively to their disfluencies. A person may develop a number of physical reactions including tension of the muscles involved in speech (e.g. tongue, jaw, lips, or chest) and tension in muscles not related to speech (e.g. shoulders, limbs, and forehead). In addition, people who stutter often develop negative emotional reactions to their stuttering, such as embarrassment, guilt, and frustration. Finally, many develop negative attitudes and beliefs about themselves and their speaking ability. These physiological, emotional, and attitudinal (cognitive) reactions are often very disruptive to the communication process–and to the person’s life in general.

What Causes Stuttering?

The overt symptoms of stuttering sometimes cause observers to make assumptions about stuttering that are incorrect. For example, the nervousness and rapid speaking rate often seen in children who stutter is not the cause of their stuttering. Rather, it is a symptom of trying to cope with stuttering. Consequently, advice to “just relax” or “slow down” may sometimes address the behavioral symptoms of speaking, but it does not affect the stuttering itself. In other words, the nervousness and rapid rate of speech result from the fear of stuttering and being embarrassed.

Research suggests that there are several factors that play a role in the development of stuttering for young children. In other words, there is no single cause for stuttering, so simple explanations such as “he’s talking too fast” or “he’s nervous” do not adequately explain this complicated disorder. Interestingly, studies examining adults who stutter have shown that they tend to use their brain in a different way when they stutter. Furthermore, stuttering tends to run in families, and there appears to be a genetic factor in determining which children will stutter.

Basic Facts About Stuttering

About 1% of the world’s population stutters. Stuttering is more common among boys than girls; about 4 times more males stutter than females. Stuttering usually begins in childhood, between the ages of 2 and 5 years. Stuttering behaviors will develop and vary throughout the lifespan. Sometimes, children will have periods in which the stuttering will appear to “go away”, only to return in a more severe pattern. As many as 80% of preschool children who begin to stutter appear to develop out of their stuttering. For those who continue to stutter into the school-age years and adolescence, however, there is a much greater likelihood that stuttering will become an issue that the individual will deal with throughout his life.

Many people who stutter report that the experience significant variability in their stuttering – sometimes they stutter a lot, and sometimes they may stutter just a little. For most, stuttering feels like their speech is out of their control. This is a very disconcerting feeling and commonly causes significant embarrassment, anxiety about speaking, and fear of stuttering again. These feelings may result in the child who stutters trying to speak quickly or trying to force his way through disfluent moments. These behaviors usually increase the likelihood that more stuttering will result. From one perspective it can be said that stuttering and feeling out of control lead to anxieties about speaking and a series nervous behaviors that increase the frequency and severity of stuttering — a cycle which perpetuates the stuttering.

Note: Original material provided by Gary Rentschler, PhD, CCC-SLP (Duquesne University, Pittsburgh, PA), and Rod Gabel, PhD, CCC-SLP (Bowling Green State University, Bowling Green, OH).