Stuttering

stuttering, also called stammering or dysphemia, speech defect characterized by involuntary repetition of sounds or syllables and the intermittent blocking or prolongation of sounds, syllables, and words. These disruptions alter the rhythm and fluency of speech and sometimes impede communication, with consequences on the affected individual’s confidence when speaking. About 1 percent of adults and 5 percent of children between ages two and five stutter. In Western countries stuttering is three to four times more common in boys than in girls.

Stutterers consistently have difficulty with certain types of words: those beginning with consonants, initial words in sentences, content words (nouns, verbs, adjectives; as opposed to function words, such as pronouns and prepositions), and words of several syllables. Since these are also the types of words that produce hesitation in normal speakers, there seems to be some link between stuttering and normal disfluency (pauses, repetition).

The causes of stuttering are unclear, although various factors have been implicated. For example, stuttering tends to run in families, indicating that genetics may contribute in part to its development. Researchers suspect that persons who are genetically predisposed to stuttering may be more susceptible to environmental factors, such as stress or excitement, that trigger stuttering than persons who do not have a family history of the disorder.

Three primary forms of stuttering have been described: developmental, neurogenic, and psychogenic. Developmental stuttering occurs in young children and typically manifests when a child is first learning to speak but lacks the speech and language skills necessary to express himself or herself through speech. In this instance stuttering may be precipitated by excitement, stress, or anxiety. For most children developmental stuttering is temporary, with recovery occurring within four years of symptom onset.

Neurogenic stuttering is defined by abnormalities in signaling between the brain and the nerve fibres and muscles controlling speech. This form of stuttering is associated with structural damage in the motor speech area of the brain. Damage to this area may occur as a result of stroke or other forms of brain trauma or in rare cases as a result of congenital defects of the brain.

Psychogenic stuttering is a rare condition that appears to occur almost exclusively in individuals who have experienced severe emotional trauma or who have a history of psychiatric illness. This form of stuttering is characterized primarily by the rapid repetition of initial word sounds.

Between 75 and 80 percent of children who stutter recover spontaneously. Recovery is probably the result of increased self-esteem, acceptance of the problem, and consequent relaxation. When stuttering persists, the condition may require diagnosis and treatment by a speech-language pathologist, who is trained to discern even minor disfluencies in speech that may underlie stuttering. Treatment frequently entails speech therapy, such as controlled fluency with self-monitoring of stuttering. Parental involvement, particularly with regard to ensuring a relaxed speaking environment and slow speech, plays an important supportive role in stuttering therapy.

Most adult stutterers can predict many of the words they will stutter in reading aloud a given passage. Supposedly taking their cue from past difficulties, they anticipate difficulty with certain words and avoid their use, instead relying on word substitutions and other forms of speech and sentence revision.

Throughout history a number of prominent individuals, including writers, orators, and actors, have been affected by stuttering in either childhood or adulthood. Included among these individuals are English novelist Lewis Carroll, King George VI of the United Kingdom, humanitarian and founder of the American Red Cross Clara Barton, and American actor Bruce Willis.