Health Library
Stuttering (Disfluency)

What Is Stuttering (Disfluency)?

Stuttering is a disorder that appears as an interruption in the smooth flow or “fluency” of speech. Breaks or disruptions that occur in the flow of speech are labelled "disfluencies". All speakers may experience disfluent events, especially under certain conditions, such as nervousness, stress, fatigue or complexity of language. Stuttering, on the other hand, is a different type of disfluency. People who stutter generally tend to have more disfluencies than other speakers overall. They may develop negative perceptions and thoughts about their speech and themselves as a result of their speaking difficulties.

Stuttering usually begins in early childhood when speech and language skills are expanding and other developmental learning is taking place. This typically occurs between the ages of 2 and 5, and in most cases, stuttering will vary widely across days and months. In most cases, the stuttering resolves on its own. Current data suggest that 75 percent to 80 percent of children who stutter at some time in their development will recover.

For those who continue to stutter with consistency, early, effective treatment may leave them with little or no stuttering.

Currently, more than 3 million Americans, or 1 percent of the population, stutter. Males are three to four times more likely to continue to stutter into adulthood than females.

Many famous, successful people have dealt with stuttering in their lives. These include: James Earl Jones, Ed Sheeran, Joe Biden, Emily Blunt, Kenyon Martin, Shaquille O'Neal, John Stossel, Darren Sproles, Bill Walton, Nicholas Brendon, Alan Rabinowitz, Carly Simon, Bob Love, and Marilyn Monroe.

Causes of Stuttering

The exact cause of stuttering is unknown. However, most experts agree that stuttering has a neurological basis, affecting areas of the brain that control how speech and language are processed. Stuttering can run in families due to a genetic cause. The likelihood of recovery within a family that has a history of recovered stuttering is as significant as the likelihood of persistence in those families where recovery has not occurred.

Certain environmental stressors may increase the frequency and extent of stuttering although this is different for each child, such as anxiety or stress, urge to speak quickly, changes in routine (such as the birth of a baby), and demands to speak in front of others.

Children who stutter are just as intelligent and well-adjusted as other children of the same age who do not experience stuttering.

Characteristics of Stuttering

Stuttering takes many forms and can be differentiated from the typical kinds of speech breaks that all speakers exhibit. In general most children tend to have more disfluencies as they are developing longer and more complex language structure. Below are some examples of typical disfluencies and those considered more stutter-like in nature.

Typical Disfluencies

Whole phrase repetitions (“Where is … where is the ball?”)
Single whole word repetitions (“Where … where is the ball?”)
Interjections (“Where…um is the ball?”)
Revisions (“What ... where is the ball?”)
Hesitations (A long pause when thinking)

Less Typical (Stutter-Like) Disfluencies

Repetition of sounds (“sh-sh-shoe”)
Repetitions of syllables (“ba-ba-ball”)
Prolongation: stretching of sounds (“Wh-------re is the ball?”)
Blocks: a tense stop in the flow of speech; child may open his or her mouth to speak but no sound comes out and/or there is a noticeable stoppage of airflow at some point in the upper airway (mouth area).

Stuttering can become more difficult to deal with as children grow older. They may become more self-conscious and lack confidence in speaking situations. If left untreated, stuttering has the potential to affect future decisions including job choices and social relationships.

Treatment for Stuttering

The child should see a speech-language pathologist if:

The stuttering persists longer than six months and occurs frequently during the day
The child shows tension, a facial grimace, or struggle behavior during speech
The child avoids talking situations or expresses concerns about speech
The child avoids saying certain words or sounds
The family has a concern about their child’s speech
The child has shown signs of frustration or embarrassment during or after a stutter event

Stuttering is treated through speech therapy. There are different kinds of therapy depending on the individual child and his family. Therapy also focuses on building confidence and enhancing communication skills. Families and patients are counseled and given support throughout the therapy process.

Helping Your Child

The treatment of stuttering depends on the unique needs of the child. However, the following are some general suggestions for helping a child who stutters:

Reduce Things That Tend To Exacerbate Stuttering

Temporarily avoid creating situations that are likely to increase the child’s disfluencies. These situations may include talking on demand to an adult (e.g., “tell grandma about your day at school”) or talking in front of the class.
Refrain from telling your child to slow down, relax, take a deep breath, or think before trying to say something. Such suggestions may only bring more of a negative awareness about talking.

Listen Attentively

Actively listen to your child when they are talking. Direct your attention to what your child is saying.
Maintain eye contact when the child is talking. Don’t look away or show a negative reaction when the child is stuttering.
Reinforce the child’s attempts at talking by responding positively.
Make sure family members take turns when talking and don’t talk all at once.

Model Slower Talking with More Pauses

Use a relaxed rate of speech when talking to the child. An unhurried, Mr. Rogers approach to talking is suggested.
Talk about your own activities through the day. This will encourage the child to talk about their activities in a relaxed environment.