Definition

Stuttering is a speech disorder in which the flow of speech is interrupted by:

• Repetition or prolongation of sounds, words, or syllables
• An inability to begin a word

In an attempt to speak, the person who is stuttering may:

• Frequently blink the eyes
• Have abnormal facial or upper body movements

Causes

The cause of stuttering is not completely understood. Some experts have suggested that stuttering may occur when:

• A child's ability to speak does not match his verbal demands
• Psychological factors in a child’s life (eg, mental illness, extreme stress)
• Problems occur in the connections between muscles, nerves, and areas of the brain that control speech
• Problems in the part of the brain that controls the timing of speech muscle activation

Muscles and Nerves Involved in Speech

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Risk Factors

These factors increase your chance of developing stuttering. Tell your doctor if you have any of these risk factors:

• Family history of stuttering (There is increasing evidence to support a genetic link in stuttering.)
• Sex: male
• Age: between 2-6 years of age

Symptoms

Symptoms may include:

• Repetition of sounds, syllables, words, or phrases
• Prolongation of sounds within words
• Between-word pauses and lack of sound
• "Spurting" speech
• Accompanying behaviors, such as:
  • Blinking
  • Facial ticks
  • Lip tremors
  • Tense muscles of the mouth, jaw, or neck
• Worsening symptoms when speaking in public
• Improvement in symptoms when speaking in private

Diagnosis

The doctor will ask about your symptoms and medical history. She will also do a physical exam. Diagnosis may be based on:

• Stuttering history
• Circumstances under which stuttering occurs
• Speech and language capabilities
• Evaluation of hearing and motor skills, including a pediatric and neurological examination
• Further testing and treatment by a speech language pathologist (someone who specializes in communication disorders)

Treatment

Treatment can improve stuttering. The main goal is to get and maintain a feeling of control over speech fluency. Recovery rate is about 80%, more in girls than in boys. The doctor or speech therapist can:

• Evaluate the stuttering pattern
• Assess what strategies may work best

Treatment may include:

• Drug therapy—There is little evidence to support the use of drugs to improve speech fluency.
• Behavioral therapy—This focuses on behavior modifications that can be made to improve fluency.
• Speech therapy—A primary goal of this type of therapy is to slow the rate of speech.

Prevention

There are no guidelines for preventing stuttering. But, early recognition and treatment may minimize or prevent a life-long problem.