An overview of stuttering

Stuttering is a disfluency of speech. It begins in early childhood, and sometimes, lasts throughout adulthood. The cause of stuttering is still a mystery. Scientists have yet to discover the causes, but have come up with many clues. There is evidence that there is a strong genetic factor; something is inherited that increase the likelihood a child will stutter. There are also environmental factors, such as abrupt change in lifestyle, or a traumatic event, such as a death in the family. The disorder is characterized by disfluencies, which are disruptions in the production of speech. Disfluencies are common in everyday life; for example, many people repeat words or precede them with "uh" or "um". Such disfluencies are not necessarily problematic in life, however, communication can be made difficult when a person produces too many.

For most people who stutter, it can have an impact on some daily activities. These vary across individuals. For some, it may affect a particular activity, such as talking on the phone, or public speaking. However, in the case of most people who stutter, communication difficulties occur across a number of daily activities in various settings, such as home, school, or work. Some people restrict themselves from participating in certain activities, as they fear the reaction of others. Others may try to hide their disfluencies by using a technique called "circumlocution", which is rearranging the words in a sentence. Other avoidance strategies include pretending to forget what they were going to say, or declining to speak. Other people may find that they are excluded from certain situations because of their stuttering. So we can see, the extent to which stuttering affects the daily life of an individual depends on how the person and others react to the disorder.


Signs and symptoms of stuttering

Stuttered speech often includes:

• Repetitions of words or parts of words

• Prolongations of speech sounds

• Breathlessness when talking

• Speech may become completely blocked (When the mouth is positioned to say a sound, however does not produce it. This can happen for several seconds) or stopped

• Interjections; using "uh", and "um" during speech, or to prolong words


Examples of stuttering

• "W-W-W-What are you doing?" (Part-word repetition: this speaker is having difficulty moving the "w" to the remaining sounds in the word)

• "SSSSS top the bus" (Sound prolongation: this speaker is having difficulty moving the "s" in stop to the remaining sounds in the word)

• "I'll see you- um um you know like- next weekend" (A series of interjections: This speaker is having difficulty joining the word "you" with "next")


How is stuttering diagnosed?

Listeners can often detect disfluencies, however, stuttering can affect more than just observable speech. Resultantly, the diagnosis of stuttering requires the skills of a certified speech-language pathologist (SLP).

During an evaluation, the SLP will:

• Note the number and types of disfluencies a person produces in various situations

• Assess the ways in which a person reacts to the disfluencies and their coping mechanisms

• Gather information about factors that may exacerbate the problem, such as teasing etc

• Conduct a variety of assessments such as speech rate, language skills etc, depending on the age and history of the person

This information is then analyzed to determine whether or not a fluency disorder exists.

For young children, it is very important to predict the likelihood that the stuttering will continue. An evaluation consists of observations, tests, and interviews designed to eradicate the risk that the child will continue to stutter. Many specialists hold importance on the following factors:

- A family history of stuttering

- Stuttering that has continued for over 6 months

- Presence of other speech or language disorders

- Fears/ concerns about stuttering from the child or family

** No single factor can determine whether a child will continue to stutter, however a combination of these factors will aid the SLP in determining whether or not treatment is needed **

Information from the evaluation is then used to develop specific treatment programs designed to:

• Help the individual speak more fluently

• Communicate more effectively

• Participate more fully in life activities


Treatments available for stuttering

Treatment programs are designed to train the person in specifics skills and behaviors that ultimately lead to improved communication. For example, controlling and monitoring speaking rate and breathing, using a less physically tense manner, practicing smooth, fluent speech at rates that are much slower than typical speech, and using short phrases and sentences. Over time, these skills will help to produce smooth speech at faster rates. As practice in more challenging situations arise, speech will eventually sound more fluent and natural. Follow-up and maintenance is necessary to prevent relapse.


How to better communicate with people who stutter


• Have patience

• Give them time

• Try not to finish sentences

• Don't fill in words

• Find supportive ways to let them know that you are interested in what they are saying, rather than how they are saying it



• Look away during moments of stuttering

• Interrupt the person

• Fill in the blanks/finish sentences

• Avoid people who stutter altogether

• Make suggestions like "relax", "slow-down", "take a deep breath". These can often make the person feel uncomfortable, as these comments suggest that the stuttering can be simply overcome.


Additional information