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Stuttering

Topic Overview

What is stuttering?

Stuttering is a speech problem in which you may repeat, draw out, not complete, or skip words or sounds without meaning to. The problem can range from mild to severe.

Stuttering that starts during a child's early language-learning years (ages 2 through 7 years) and goes away on its own before puberty is called normal disfluency. It's a normal part of language development. Most children aren't bothered by it and may not even notice that they're doing it. This type of stuttering may come and go for a while. Then it may slowly decrease until it doesn't happen anymore.

Stuttering that lasts or gets worse over time is called developmental stuttering. This type of stuttering can be embarrassing and hard to deal with. It probably won't get better without treatment.

What causes stuttering?

Stuttering happens when the brain isn't able to send and receive messages in the normal way. Doctors don't know why this happens.

Stuttering may run in the family. It may be triggered by things like stress or a developmental delay.

In rare cases, stuttering may be caused by brain damage, such as after a head injury or a stroke.

What are the symptoms?

People who stutter may:

  • Repeat sounds, parts of words, and sometimes entire words.
  • Draw out (prolong) a sound or syllable. For example, a child may say "I am fffive years old."
  • Try to say a word or form a sound, but no sound comes out. They may also pause between words or within a word.
  • Use a different word in place of a word that's hard to speak.
  • Show tension or discomfort while talking.
  • Use only parts of phrases.
  • Add words or phrases that aren't related.

You may notice that your child stutters more when he or she is excited, anxious, stressed, or tired. Having to ask or answer questions or explain something complex may trigger or increase stuttering.

The same is true for teens and adults who stutter. It tends to get worse at stressful times, such as during public speaking. It often doesn't occur during activities like singing, whispering, talking while alone or to pets, or reading aloud.

How is stuttering diagnosed?

A speech-language pathologist can usually diagnose stuttering by having the child read aloud. The pathologist may film or record the child talking or may check speech patterns in other ways. Your child may also need a physical exam and other tests to rule out health problems that affect speech development, such as hearing problems.

Talk with your child's doctor if you have any concerns about your child's speech, if stuttering lasts more than 6 to 12 months, or if stuttering runs in your family.

If you are an adult who has started to stutter, see your doctor. Stuttering that starts in an adult is most often linked to an injury, a health problem, or severe emotional trauma. To diagnose the problem, the doctor will do a physical exam, ask you some questions, and watch and listen to you speak.

How is it treated?

Treatment for stuttering often includes counseling for the parents and speech therapy for the child. The main goal of treatment is to help your child learn to speak as smoothly as possible.

Parent counseling can help you understand how speech develops and teach you how to relate to your child in a positive way. You'll also learn how to help your child at home by using proper eye contact and body language when your child is trying to talk to you.

Speech therapy is important in some cases, especially if your child's stuttering lasts, gets worse, or is severe. Working with a speech therapist can help your child master certain speech and language skills and feel better about his or her ability to speak.

Remember that when stuttering begins in early childhood, it tends to go away on its own. If you think your child's stuttering is not normal disfluency, talk with your child's doctor.

Adults or teens who stutter may find both speech therapy and counseling helpful. Counseling can help you manage anxiety, low self-esteem, and other problems that can make stuttering worse.

When stuttering is caused by brain damage, such as after a head injury, treatment may include speech therapy, physical rehabilitation, medicines, and treatments for the brain damage itself.

How can parents help a child who stutters?

By responding in a supportive and caring way, you can help your child avoid the social and emotional problems that sometimes result from stuttering.

  • Speak slowly and calmly, and pause often. Use short, simple sentences.
  • Spend some quiet, uninterrupted time with your child each day. Let your child guide what the two of you do and talk about during these times. Showing that you enjoy this time together can help build your child's confidence.
  • Be polite when your child speaks. Don't criticize, interrupt, or ask too many questions. Give your child the time and attention he or she needs to express thoughts and ideas.
  • Use positive facial expressions and body language when your child is talking. Show that you are focused on the message rather than how he or she talks.
  • Let your child know that you accept him or her no matter what.

Other Places To Get Help

Organizations

American Speech-Language-Hearing Association
Web Address: www.asha.org/public

National Institute on Deafness and Other Communication DisordersNational Institutes of Health
Web Address: www.nidcd.nih.gov

References

Other Works Consulted

  • American Psychiatric Association (2000). Stuttering. In Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev., pp. 67–69. Washington, DC: American Psychiatric Association.
  • Guitar B, Conture EG (2007). The Child Who Stutters: To the Pediatrician, revised 4th ed. (Publication No. 23). Memphis: Stuttering Foundation of America. Also available online: http://www.stutteringhelp.org/Portals/english/0023tped.pdf.
  • Paul R (2007). Disorders of communication. In A Martin, FR Volkmar, eds., Lewis's Child and Adolescent Psychiatry, 4th ed., pp. 418–430. Philadelphia: Lippincott Williams and Wilkins.
  • Prasse JE, Kikano GE (2008). Stuttering: An overview. American Family Physician, 77(9): 1271–1276.
  • Sadock BJ, Sadock VA (2007). Communication disorders. In Kaplan and Sadock's Synopsis of Psychiatry, Behavioral Sciences/Clinical Psychiatry, 10th ed., pp. 1175–1190. Philadelphia: Lippincott Williams and Wilkins.
  • Ursano AM, et al. (2008). Communication disorders section of Disorders usually first diagnosed in infancy, childhood, or adolescence. In RE Hales et al., eds., American Psychiatric Publishing Textbook of Psychiatry, 5th ed., pp. 874–877. Washington, DC: American Psychiatric Publishing.

Credits

By Healthwise Staff
Primary Medical Reviewer Susan C. Kim, MD - Pediatrics
Specialist Medical Reviewer Louis Pellegrino, MD - Developmental Pediatrics
Current as of December 6, 2013

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