All of us have experienced "unsmooth" speech. We may have fumbled, repeated, and used filler sounds while talking. However, these instances are not referred to as stuttering. Stuttering occurs when an individual knows exactly what to say, but they experience disfluencies while speaking.
People who stutter have different types and intensities of disfluencies. They may repeat parts of words or entire words (repetition), stretch out a sound for a long time (prolongation), or have difficulty getting a sound out (block).
Stuttering is more than disfluent speech. It can affect how a person sees themselves. It affects communication, social interactions, personal relationships, and career choices.
If you stutter, or you know someone who stutters, talk to a speech-language pathologist (SLP) or speech therapist ASAP. Stuttering treatment options available today work for every age! All you need is some patience and persistence to smoothen out your speech.
You can learn all about stuttering, the signs and symptoms of stuttering, its causes, stuttering exercises, and stuttering treatment right here!
- What is Stuttering?
- What Are The Different Types Of Stuttering?
- Is Stuttering Common?
- What Are The Signs And Symptoms Of Stuttering?
- What Are The Long-Term Effects Of Stuttering?
- What Causes Stuttering?
- When Should You Talk To A Speech Therapist For Stuttering Treatment?
- What to Expect from Stuttering Treatment?
- What Is DAF? How Can It Help With Stuttering?
- What Is Fluency Shaping? How Can It Reduce Stuttering?
- What is Stuttering Modification?
- How Can Parents Help A Child Who Stutters?
- How Can Stamurai Help A Child With The Evaluation & Treatment Of Stuttering?
1. What is Stuttering?
Stuttering or stammering is a speech disorder. When it begins from early childhood, experts refer to it as a childhood-onset fluency disorder or developmental stuttering.
Repetition of sounds, syllables or whole words, prolongation of word sounds and blocks characterize stuttering. These are the core stuttering behaviors.
Stuttering interrupts the normal flow of speech. In many cases, these repetitions, prolongations, and blocks are accompanied by rapid eye blinks, twitching of the lips, and movements of the jaws and the head. These are the secondary behaviors of stuttering.
2. What Are The Different Types Of Stuttering?
Although almost all types of stuttering consist of repetitions, prolongations, and blocks, there are minute differences between the different types of stuttering.
Developmental Stuttering
Developmental stuttering is most common among children. Stuttering symptoms may begin when a child is between 2 and 5-years of age. One theory is that young children acquire verbal skills rapidly. However, their speech and language skills are not mature enough to meet their verbal demands. It causes stress that leads to stuttered speech. There is no cure for developmental stuttering. However, stuttering therapy techniques for a child who stutters can improve your child’s fluency.
Neurogenic Stuttering
Neurogenic stuttering is a form of acquired stuttering. Traumatic brain injuries (TBIs), strokes, brain tumors, and neurodegenerative diseases can lead to disfluent speech in individuals. Unlike developmental stuttering, neurogenic stuttering can begin suddenly in adults, who have no history of speech disorders.
Psychogenic Stuttering
Psychogenic stuttering is one of the least common forms of stuttering. It is typically observed in adults following psychological or emotional trauma. Several prominent psychologists and psychoanalysis consider psychogenic stuttering to be a conversion reaction.
Pharmacogenic Stuttering
Pharmacogenic or drug-induced stuttering begins after the individual has taken an incorrect dose of a medication or has started a new drug. It can be a side effect of medicines like broncho-dilators or anti-depressants. In most cases, adjusting the dose of the drug or replacing it reduces the speech disfluencies.
3. Is Stuttering Common?
Around 5% of the entire population stutters or has stuttered at one point. According to NIDCD, around 3 million Americans stutter. Data from Stutteringhelp.org shows more than 70 million of the world’s population stutters. That means 1% of the global population experiences stuttering!
It is a common fluency disorder that mainly affects kids. Almost 75% of children who experience stuttering will recover on their own. However, some children don’t outgrow it and continue to stutter into adulthood.
4. What Are The Signs And Symptoms Of Stuttering?
The Core Behaviors Of Stuttering
Repetitions, prolongations, and blocks are the core behaviors that characterize stuttering. Here's what each one might look like to any observer –
Repetition
A person who stutters might repeat partial or whole words or entire phrases. It may sound like “it’s suh-suh-sunny” or “goh-goh-go outside.”
Prolongation
The individual may stretch out a sound. They may say something like, “ssssend this” or “it’s ssssweet.”
Block
Blocks are sudden interruptions in speech. They may come across as sudden stops, such as “I like (pause) cars.”
The Secondary Stuttering Behaviors
When a child or adult has been stuttering for a long time, they develop secondary behaviors of stuttering. These are actions that accompany the repetitions, prolongations, and blocks. You can think of these as management tactics for bypassing repetitions, blocks and prolongations, feared words, and anticipated stuttering.
Avoidance
A person who has been stuttering for a while has an idea of where or how they might stutter. They have a set of feared words. To bypass any disfluency they entirely avoid these words and word sounds. Sometimes, they use a synonym. While at other times, they choose silence over expressing their needs or desires.
Escape
When avoidance doesn’t work, the person may use escape techniques to overcome stubborn disfluencies. The individual may use recurrent eye blinking, filler sounds like “ummm” or “uhhh", head nods, or shoulder jerks in an attempt to overcome the block(s). However, discerning an escape behavior is difficult for someone untrained in behavior sciences or speech therapy.
Someone who stutters may exhibit frequent repetitions, prolongations, blocks, avoidance, and escape behaviors when overjoyed, stressed, anxious, afraid, or angry. A surge of emotions can increase stuttering signs and symptoms. However, it is untrue that negative emotions like anxiety, anger, or fear cause stuttering.
5. What Are The Long-Term Effects Of Stuttering?
Although stuttering may seem like “just a speech disfluency” to many observers, it may have a deep emotional and psychological impact on the person who stutters (PWS). those who stutter know exactly what they want to say, but are unable to express themselves due to interrupted speech patterns.
Stuttering takes a heavy toll on a person's happiness, mental peace, self-esteem, and self-confidence. Many persons who experience speech disfluencies suffer from a depreciated self-image. Adolescents and young adults who stutter are prone to generalized anxiety disorders (GAD), depression and anger issues.
Older children and adults may avoid social interactions altogether. When stuttering and the emotional effects of stuttering go unaddressed for a long time, people experience frustration and embarrassment accompanied by depressive disorders. As a result, several adults who stutter are often labeled as shy, awkward, introverted, self-conscious, and lacking self-confidence.
Sadly, many of the coping mechanisms that people develop worsen the effects of stuttering. The anxiety, fear, or embarrassment a person feels due to stuttering may increase the frequency and intensity of their stutters. It is a vicious cycle, which is incredibly difficult to break alone.
Stuttering not only affects a person’s speech, but it can take a toll on their quality of life.
If you are someone who stutters or you know someone who stutters, know that you are not alone. It is possible to break the cycle of stuttering and self-depreciation. Talk to an SLP today or start using Stamurai speech therapy app for stuttering treatment!
6. What Causes Stuttering?
The causes of stuttering or stammering depend upon the type of stuttering. In most cases of acquired stuttering, the causes may be neurological, psychological, or drug-based. However, there is no well-established cause of developmental stuttering.
Several studies have pointed towards a combination of several factors that work together to increase a person's risk of stuttering.
Family History
Sometimes, children have family members who stutter. A family history of speech disfluency and other speech disorders may increase a child’s likelihood of developing stuttering in the future.
Speech-Language Disorders
Stuttering often co-occurs with other speech-language disorders. Someone who has social communication disorder (SCD), autism spectrum disorder (ASD), or attention-deficit hyperactivity disorder (ADHD) may be more prone to stuttering than others.
Differences In Brain Structure
Some studies show that people who stutter have lower activation in the areas of the brain involved in hearing. If someone's hearing and auditory processing are not optimal, it might explain their stuttered speech.
Another MRI study shows a higher level of activity in the right hemisphere of the brain for people who stutter.
Genetics
In 2010, a team of researchers discovered a set of hereditary mutations in the GNPTAB gene that are directly linked to stuttering.
Recent studies led by Dr. Drayna on mouse models with GNPTAB mutations show that mice with fewer astrocytes (star-shaped cells) in their corpus callosum of the brain produce stuttering-like vocalizations.
Over the last decade, scientists have linked the GNPTG and NAGPA gene mutations to stuttering. Around 9% of all humans who stutter have mutations in these 3 genes.
Environment
Charles Van Riper and Dr. Barry Guitar observed that the environment works together with family history (predisposition) to precipitate stuttering in a child. Stuttering is a heterogeneous condition and environment or environmental stress alone cannot create stuttering.
A child who has inherited the genetic mutations from either one or both of the parents may begin stuttering immediately after experiencing emotional trauma, sudden change, or serious loss.
7. When Should You Talk To A Speech Therapist For Stuttering Treatment?
Studies show that early interventions for stuttering have the best outcomes. When a child is young, they are less likely to experience intense negative emotions and exhibit the secondary behaviors associated with stuttering.
It is never too early to talk to a speech therapist or speech-language pathologist (SLP) about your or your child’s stuttering. If you see any of the signs or symptoms of stuttering we have mentioned above, feel free to contact Stamurai for evaluation and online speech therapy for stuttering.
However, here are a few signs that you or your child needs immediate professional attention for stuttering –
- The stuttering is becoming more frequent and intense over time.
- There is twitching, shrugging, head nodding, and jerking while speaking.
- There is an active avoidance of people and situations that warrant talking.
- The stuttering has persisted for longer than 6-months (in the case of a child).
Stuttering treatment for adults is effective as well. If you are someone who has been stuttering for a long time, you should speak to a licensed and experienced speech therapist. You will learn new strategies for effective communication and coping strategies to manage the secondary behaviors.
8. What to expect from Stuttering Treatment?
Treatment for stuttering primarily consists of speech therapy. The clinician will work with you or your child to minimize the repetitions, prolongations, and blocks. These may include stuttering modification and therapy via video-conferencing for fluency enhancement.
The stuttering therapy techniques for a child who stutters depend on the age of the person who stutters as well as the severity of their stutter. A speech-language pathologist or speech therapist is qualified to diagnose and treat stuttering.
Here’s what you can expect from a trained and experienced speech-language pathologist or speech therapist during speech therapy –
- Age and maturity-appropriate stuttering therapy exercises
- Tailored stuttering treatment plans to suit every client’s interest and needs
- Comprehensive understanding of one’s emotional condition and providing developmentally supportive services
- Family-centered and culturally responsive services
- Updated information about stuttering, the causes of stuttering, and the potential outcomes of fluency disorder treatment
The speech therapist will talk to the person who stutters and, if necessary, their family members. If your child is very young, your SLP will ask you questions about their speech habits, language skills, and developmental skills. They may also ask you about the prevalence of stuttering and other speech disorders in your family. For preschool-aged children, parents are directly involved in the stammering therapy process.
If you have a child older than 7-years, then the speech therapist may work directly with the child while keeping you in the loop. For older children (and adolescents) the therapy will focus on stuttering modification and fluency techniques for stuttering, as well as, the emotional impacts of stuttering. Your SLP may recommend cognitive behavioral therapy or psychotherapy if your child is showing signs of emotional distress due to stuttering.
The goals of stuttering therapy techniques for a child who stutters depend upon the age, severity, and aspirations of the individual who stutters. Your SLP will discuss the struggles of stuttering, social interactions, academics, and speech therapy exercises to improve fluency before setting short-term and long-term stuttering therapy goals.
Stuttering treatment may not end at speech therapy. There may be other potential therapies that may be beneficial for you or your child. These include –
Cognitive Behavioral Therapy (CBT) for Stuttering Treatment
Cognitive behavioral therapy can help a person replace an unwanted or disruptive behavior with the desired behavior. For example, if a person blinks repeatedly when they block, it can hinder effective communication.
Cognitive behavioral therapists may encourage you or your child to “experiment” with social situations. This practice often offers a new perspective to negative thoughts and assumptions.
CBT is not an overnight miracle. It takes a few sessions with an experienced and licensed clinician to recognize and act on the negative thoughts and emotions.
Psychological Counseling for Stuttering
Psychological counseling is necessary and recommended for all ages if they are experiencing distress due to stuttering. Psychological counseling can address anxiety, fear, stuttering anticipation, embarrassment, shame, and depression.
Depression is a common long-term effect of untreated stuttering. Psychotherapy and psychological counseling can help you or your loved one address repressed trauma, memories of bullying, and other negative feelings through talk therapy.
It provides the child or adult with a safe, judgment-free space to discuss their feelings about stuttering, self-image, and self-worth.
9. What Is DAF? How Can It Help With Stuttering?
DAF or delayed auditory feedback devices work by using the choral effect. DAF introduces a delay between the production and perception of speech. The delay can be between 50 and 70 milliseconds depending on your customization.
According to several studies, a delay of 50 to 70 milliseconds can reduce stuttering by about 70%. Although using DAF doesn't involve any previous training, it is always better to speak to an SLP about DAF use in stuttering treatment for finding the right ‘delay’ that works for you.
10. What Is Fluency Shaping? How Can It Reduce Stuttering?
Fluency shaping does not do a deep dive into the feelings and attitudes associated with stuttering. It simply aims to teach the person who stutters to use smart strategies and techniques to speak more fluently.
Fluency shaping is a set of techniques that include deep breathing, light articulatory contact (LAC), slowed speech rate, and gentle initiation.
You can learn and practice fluency shaping techniques with a little help from a certified speech therapist to reduce speech disfluency.
11. What is Stuttering Modification?
Unlike fluency shaping techniques that teach a PWS to speak with higher fluency, stuttering modification techniques work directly to reduce one’s stuttering. Stuttering modification techniques include catching the stutter, relaxing the stutter, pulling out of a block, and block cancellation.
For example, stuttering modification strategies involve exercises that make a person aware of how and when they are experiencing repetitions, prolongations, and blocks. This stuttering therapy technique aims to desensitize the person toward their own disfluencies and reduce their avoidance behaviors.
By applying stuttering modification techniques one can reduce their struggles with speech and stutter in a more relaxed way!
12. How Can Parents Help A Child Who Stutters?
Parents are the best resource and support system for a child who stutters. Parents play a critical role in helping a child reach their speech and language goals. Since you spend the most time with your child, you can implement different speech therapy exercises to improve fluency at home.
Here are a few tips from our SLPs to help you help your child –
- Learn more about stuttering and its impacts on a child’s life.
- Discuss stuttering openly and non-judgmentally with your child.
- Talk to a professional (speech therapist or SLP) about your child’s speech disfluencies.
- Give time to your child. Listen to their opinions, ideas, and views. Do not interrupt even when they are experiencing a particularly stubborn block.
- Do not finish your child’s sentences. Do not answer for them when they are talking to someone else.
- Reduce the number of questions you ask your child. Make positive and reinforcing statements.
- Give your child enough time to answer any question you ask. Prefer asking close-ended questions.
- Model speech for your child. Always talk slowly. That will show your child that they don't have to rush through their speech every time they have something to say.
- Stay in touch with their SLP, fluency disorder treatment, and progress. Empower them with encouraging words whenever possible.
- Teach them how to sing and recite poetry. Research shows that it is almost impossible to stutter while singing.
- Talk to other parents whose children also stutter. You can find support groups in your area. Or join Stamurai to stay in touch with others who have similar experiences.
13. How Can Stamurai Help A Child With The Evaluation & Treatment Of Stuttering?
The stuttering treatment will depend on the age and severity of the person who stutters. Therefore, the Stamurai team will work with you to find the best SLP who can help you and your child. Stamurai provides online speech therapy for stuttering via face-to-face video sessions as well as a mobile application.
The nature of the interactions between you, your child, and the therapist will depend on your child's age and development.
Stuttering Treatment For Ages 0 To 3-Years
Speech therapists typically prefer an indirect or integrated speech therapy strategy for treating stuttering in preschool-aged children.
In both cases, parents or caregivers play an integral role in the treatment process. The SLP will teach the family members different stuttering exercises and speech therapy activities. You will conduct them at home daily and give direct feedback to the therapist during the following session.
Stuttering Treatment For Ages 3.5 To 6-Years
School-aged children can attend stuttering therapy video sessions on their own. However, our therapists prefer that parents sit with the child during each session to observe and learn the different cues. Parents can help with at-home skill-building for each child attending speech therapy for stuttering.
Stuttering Treatment For Ages 7-Years And Above
Children older than 7-years are capable of attending video sessions for stuttering speech therapy alone. The speech therapist will keep the parents in the loop. You can receive feedback on your child’s performance and progress directly from the team.
Stuttering Treatment Adults
Stuttering therapy for adults consists of age-appropriate activities and stuttering exercises. You can attend the sessions on your own. However, you can always ask your loved ones to sit in with you during the stuttering therapy sessions.
