Stuttering — also called stammering or childhood-onset fluency disorder — is a speech disorder that involves frequent and significant problems with the normal fluency and flow of speech. People who stutter know what they want to say, but have difficulty saying it. For example, they may repeat or prolong a word, syllable or phrase, or stop during speech and make no sound for certain syllables.

Stuttering is common among young children as a normal part of learning to speak. Young children may stutter when their speech and language abilities aren’t developed enough to keep up with what they want to say. Most children outgrow this developmental stuttering.

Sometimes, however, stuttering is a chronic condition that persists into adulthood. This type of stuttering can have an impact on self-esteem and interactions with other people.

If you’re an adult who stutters, seek help if stuttering causes you stress or anxiety or affects your self-esteem, career or relationships. See your doctor or a speech-language pathologist, or search for a program designed to treat adult stuttering.

Children and adults who stutter may benefit from treatments such as speech therapy, psychological counselling or using electronic devices to improve speech patterns. After a comprehensive evaluation by a speech-language pathologist, a decision about the best treatment approach can be made.

Stuttering signs and symptoms may include:

• Difficulty starting a word, sentence or phrase
• Prolonging a word or sounds within a word
• Repetition of a sound, syllable or word
• Brief silence for certain syllables or pauses within a word (broken word)
• Addition of extra words such as “um” if difficulty moving to the next word is anticipated
• Excess tension, tightness or movement of the face or upper body to produce a word
• Anxiety about talking
• Limited ability to effectively communicate

The speech difficulties of stuttering may be accompanied by:

• Rapid eye blinks
• Tremors of the lips or jaw
• Facial tics
• Head jerks
• Clenching fists

Stuttering may be worse when you’re excited, tired or under stress, or when you feel self-conscious, hurried or pressured. Situations such as speaking in front of a group or talking on the phone can be particularly difficult for people who stutter.

However, most people who stutter can speak without stuttering when they talk to themselves and when they sing or speak in unison with someone else.

When to see a doctor or speech-language pathologist

It’s common for children between the age of 2 and 5 to go through periods when they may stutter. For most children, this is part of learning to speak, and it gets better on its own. However, stuttering that persists may require treatment to get better.

Call your doctor for a referral or contact a speech-language pathologist directly for an appointment in case stuttering:

• Lasts more than six months
• Occurs with other speech or language problems
• Becomes more frequent or continues as the child grows older
• Occurs with muscle tightening or visible struggling to speak
• Affects the ability to effectively communicate at school, work or in social interactions
• Causes anxiety or emotional problems, such as fear or avoidance of situations where speaking is required
• Begins as an adult

Causes of Stuttering

Researchers are still studying the underlying causes of persistent stuttering. A combination of factors may be involved. Possible causes include:

• Stuttering tends to run in families. It appears that stuttering can result from inherited (genetic) abnormalities in the language centers of the brain.
• Medical conditions.Stuttering can sometimes result from a stroke, trauma or other brain injury.
• Mental health problems.In rare, isolated cases, emotional trauma can lead to stuttering.

Complications

Stuttering can lead to:

• Low self-esteem
• Problems communicating with others
• Not speaking or avoiding situations that require speaking
• Loss of social, school or work participation and success
• Being bullied or teased
• Being anxious in social situations or being diagnosed with social anxiety disorder

Tests and Diagnosis

Diagnosis is made by observations of the adult or child while speaking in a number of different types of situations.

What treatments are available for stuttering?

A qualified SLP will work to improve fluency aspect of the client. In a fluency therapy, SLP will focus on:

• helping to improve fluency
• helping the person understand more about stammering
• sharing experiences with others who stammer
• working on feelings associated with stammering, such as fear and anxiety
• improving communication skills
• developing self-confidence and positive attitudes

Working together with a speech pathologist who is knowledgeable about stuttering will help you overcome the problem.

Speaking to someone with a stammer.

When talking to someone who stammers, it can be helpful to:

• Avoid finishing their sentences if they are struggling to get their words out
• Give them enough time to finish what they are saying without interrupting
• Avoid asking them to speak faster or more slowly
• Show interest in what they are saying, not how they are saying it, and maintain eye contact

When talking to young children, it can also help to speak slowly and calmly yourself, giving them time to process what you have said, and use short sentences and simple language that they are likely to understand more easily.