Stuttering

Stuttering, sometimes called stammering or disfluency, is a communication disorder that disrupts that natural flow of speech. Stuttering can begin gradually and develop over time, or it can appear suddenly. People who stutter often repeat certain syllables, words, or phrases (li-li-like this), prolong them (lllllike this), or experience abnormal stoppages of certain sounds and syllables.

According to Stanford’s Children’s Hospital, there are several types of stuttering:

• Developmental stuttering: This is the most common type of stuttering in children and it usually happens between the ages of 2 and 5. It most often occurs when children's speech and language abilities are unable to meet their verbal demands
• Neurogenic stuttering: Neurogenic stuttering may happen after a stroke or brain injury. It happens when there are signal problems between the brain and the nerves and muscles involved in speech.
• Psychogenic stuttering: Psychogenic stuttering is not common. It may happen after emotional trauma. Or it can happen along with problems thinking or reasoning.

According to the Stuttering Foundation, over 3 million people in the United States stutter.

Approximately 5% of all children go through a period of stuttering that lasts six months or more. As many as 75% of those children will recover by late childhood. Those who continue to stutter into school-age years are likely to have a more serious problem and continue to stutter in some way throughout their lives.

In older adults, approximately 2% of the population between the ages of 21 and 49 stutters, and less than 2% of adults ages 50 and over.

Stuttering is also much more common in males than females, with males being about 4x more likely to have stuttering issues.

Every person is different, and therefore the symptoms of stuttering can vary considerably. However, here are some of the most common signs to look for:

• Repeating sounds, syllables, words, or phrases.
• Prolonging sounds
• Routinely using interjections when speaking, such as “um” or “like” that disrupt the flow of speech
• Talking slowly
• Taking a lot of pauses when speaking
• Stopped or blocked speech. You may see your child’s mouth open, but nothing is being said
• Routinely being out of breath when talking
• Fast eye blinking, trembling, or shaking lips when speaking
• Increased stuttering when tired, excited, or under stress
• Being afraid or nervous to talk

For many children and adults, stuttering itself isn’t the worst part of the condition - it’s the impact on their daily lives. When people stutter, they feel like they’ve lost control of one of their most basic functions, and this can be humiliating, uncomfortable, and unnerving. This can lead them to experience anxiety about speaking, be less active or involved in the classroom or at work, avoid social interactions, and be fearful that they’ll be teased or embarrassed.

For older children and adults, these effects can often be exacerbated. Many avoid social situations all together, and experience constant frustration and embarrassment associated with their verbal communication. Stuttering adults can be stereotyped as being shy, self-conscious, or lacking confidence.

Ironically enough, many of our natural coping mechanisms can actually worsen stuttering. For example, people often try to avoid stuttering by speaking quickly, or by not speaking at all. These behaviors can increase the likelihood of stuttering.

Unfortunately, doctors and scientists do not know the exact cause of stuttering. However, many experts believe there are several risk factors that contribute to stuttering. If any of these situations apply to you, it’s especially important that you speak with a doctor or speech-language pathologist (SLP).

• A Family History of Stuttering: While there is still uncertainty about whether stuttering is genetic and inherited by family members, nearly 60% of all stutterers have someone in their family who also stutters or stuttered
• Child Development: Children who have other speech and language disorders have a higher chance of stuttering than children who don’t
• Neurophysiology: It has been observed that some children that stutter process language in different parts of their brain than children who don’t stutter. This may potentially interfere with how the brain sends messages to the muscles involved in speech
• Family Dynamics: Some children's stuttering has been attributed to high family expectations and a fast-paced lifestyle
• Late or Adult-Onset Stuttering: This often occurs when stuttering symptoms appear later in life and are not attributed to a speech-motor or neurological issue, such as when someone experiences a stroke, tumor, or trauma

As with most developmental issues, the best prevention is often early intervention.

Talk with your doctor if you are concerned about your child's stuttering. In many cases, your doctor may refer you to a specialist known as a speech-language pathologist (SLP), which are the most qualified professionals to help evaluate and determine whether your child is at risk for long-term problems.

Signs to look for that suggest your child’s stuttering is more severe and you should have them evaluated include:

• Your child’s stuttering is getting worse overtime
• They make body or facial movements when speaking
• Their speech is especially strained
• Your child is actively avoiding situations that require talking
• Stuttering continues after your child has turned 5 years old

Older children and adults whose lives are impacted by stuttering should also speak with their doctor or an SLP. Oftentimes, achieving better communication and coping strategies to manage stuttering is a lifelong process.

Despite breakthroughs in our knowledge and understanding of stuttering, unfortunately there is still no therapy, device, or drug that can “cure” stuttering. However, early treatment can prevent stuttering from continuing into adulthood. Treatment will depend on your child’s symptoms, age, and general health. It will also depend on the severity of the condition.

To diagnose and treat stuttering, your doctor may ask questions about your family history with stuttering and review stuttering symptoms. In many cases, they will refer you to a speech therapist.

Your speech therapist will ask questions about your child’s speech, and test your child’s ability to speak with different techniques and in different situations. It’s important to realize that every child is unique, and certain methods that benefit some individuals may not work for others. Therefore, your speech therapist will work with you and your child to develop an individualized treatment plan to help your child speak more fluently and without disruptions, and also to cope with their symptoms.

For older children and adults, treatment focuses on managing stuttering. A speech therapist will help them feel less tense and speak more freely in school, at work, and in different social settings. These strategies can help individuals face speaking situations head on that make them nervous or uncomfortable, such as speaking on the phone or ordering food at a restaurant.

Other potential therapies and treatments include:

• Cognitive Behavioral Therapy: This therapy helps adults cope with their communication disorder in order to minimize the impact and burden it has on their quality of life.
• Electronic Devices: Electronic devices often sit in a person’s ear and are intended to help improve the fluency of those who stutter. One example is an Altered Auditory Feedback (AAF) device. Research has shown that some individuals who stutter benefit extending the time between speech and auditory perception. These devices can help emulate this sensation by allowing the individual to hear their own voice with a slight time delay, creating the illusion of another individual speaking at the same time.
• Support Groups: You are not alone, and support groups are a great way to meet like-minded individuals who are also dealing with stuttering. Support groups can help build self-confidence, help you practice speaking in a safe and accepting environment, and allow you to collectively explore new ways to cope with stuttering

One of the most effective tools children have to manage their stuttering is you - their parents. Numerous studies show parents play an essential role in helping their child reach their speech and language goals. Parents spend the most time with their child, and there’s many simple techniques and exercises you can do everyday to help your child.

While we’ve provided a few tips below, be sure your speech therapist empowers you with the tools and knowledge to take an active role in your child’s progress.

• Find opportunities to speak with your child that are fun, relaxing, and enjoyable. Putting stress and pressure on children can increase their stuttering
• Try not to react negatively or insist on correct speech when your child stutters. Instead, praise them when they speak correctly
• Try not to fill in the blanks. In other words, even when your child is struggling to say a word or sentence, let them finish without saying it for them
• Although you may find yourself saying phrases such as "take a deep breath" or "slow down" with the best intentions, these can actually make children more self-conscious
• Model a slow, relaxed way of speaking. This will help them slow down their own speech
• Don't be afraid to talk with your child about stuttering. If your child asks questions or expresses concern, help them understand that speech disruptions are normal and many people experience them to some degree
• If your child is school-age, educate their teachers to help them provide an environment that is safe and accepting

Expressable matches families with a certified speech therapist trained to effectively evaluate and treat stuttering and fluency disorders. All therapy is delivered online via face-to-face video conferencing.

Your child’s age and development will influence how your speech therapist interacts with them through these video chat capabilities.

Ages 0-3: Parents work directly with their speech therapist to learn cues and at-home strategies so they can confidently practice with their child outside the session and improve their communication. For more information on the importance of parental involvement in their child’s speech therapy, click here.

Ages 3-6: Parents attend video sessions alongside their child so they both learn valuable skills from their speech therapist. Reinforcing these lessons outside the session will continue to promote at-home skill building.

Ages 7 and Up: Most children attend video sessions independently but parents are kept in the loop with updates and tips during each session.

Adults: Adults attend sessions by themselves, but are welcome to bring loved ones or family members as well.