Stuttering

What is Stuttering?

Stuttering, which is also known as stammering or disfluent speech, is a speech disorder in which a patient is unable to smoothly say words at a normal and ongoing pace without any kind of interruption. These various breaks and disruptions, which are otherwise known as disfluencies, are usually the repetition of sounds, syllables, or words; the prolongation of sounds; and blocks which is when a child or adult essentially has the word he or she would like to say on the tip of their tongue but has a hard time getting it out. 

How do I know if my child has a stutter?

It may be a bit confusing to identify whether someone has a stutter or if they are just using a lot of filler words, such as “like” or “um”. A large percentage of children experience a common phase of stuttering that will last about 6 months, but if a child’s stuttering phase goes over that period of time it may need some treatment and attention from a speech language pathologist. The best plan of action would be to pay close attention to the way the child or adult speaks consistently and to take him or her to a speech language pathologist for an evaluation to be certain. 

During a child’s development of language, he or she may display some disfluencies in their speech production. This is because the child is in the process of learning many new words and sounds all at once. He or she may need some more practice using these new words and sounds before producing them correctly all the time. Sentences similar to the ones below are considered disfluencies, but are not considered to be stuttering:

• Interjection, which means adding a word –“I um need to get that?”
• Repeating full words –“Can can I play?”
• Repeating full phrases –“This is – this is really good.”
• Revision, which means starting a sentence one way and then changing it –“It won’t – I can’t open the box.”
• Not finishing a full thought–“When is….nevermind”

Below are some sentences with disfluencies that are commonly associated with individuals who have a stutter:

• Part-word repetition – “I d-d-don’t know.”
• One-syllable word repetitions – “Can I have a ba-ba-banana.”
• Prolonged sounds – “I llllllove that team.”
• Blocks – “I am so (pause) excited!”

In addition to these verbal signs, some physical cues that may suggest a child or adult may have a stutter include head nodding or eye blinking as a way to keep themselves from stuttering. Also, in some cases, a patient may avoid using certain words that he or she knows will give them trouble. 

What is stuttering caused by?

Similar to many other speech disorders, there isn’t a direct link between a characteristic or behavior of a patient and whether they will have a stutter or not. However, research has shown that most children, if they develop a stutter, will do so between the ages of 2 and 6 years old. 

Some possible attributes of a child that may put them at higher risk of stuttering include, but are not limited to, if the child:

• has a family member who also has a stutter and has continued to have a stutter in their adult life
• Is about 3 ½ years old, most children develop a stutter at this age
• Is a male, male are more likely to develop and continue a stutter than females are
• has difference in the way he or she produces any language

In some cases, children or adults may develop a stutter after experiencing head trauma, such as a traumatic brain injury (TBI) or stroke which is known as neurogenic stuttering. Neurogenic stuttering occurs because the brain essentially has trouble organizing and arranging for every part of the brain that is needed for creating language to work together and produce smooth, fluent speech.

Is it possible for stuttering to be a selective process?

Yes, not every individual with a stutter will be in the exact same position in terms of their disfluency and their overall environment. A stutter is largely dependent on the patient’s personal life and feelings. 

Individuals who stutter know what they would like to say, it is just the production of the words that are affected. This inability to produce a normal flow of speech often creates frustration and negative feelings about speaking for someone who stutters. This frustration and negative mindset can lead to a gradual or even complete avoidance of speaking in certain situations where he or she knows that they are more likely to stutter.

Additionally, a patient may get extremely embarrassed by the presence of their disfluency. This could make him or her stutter more in certain situations where they are actively being teased or even the idea that they could be. Similar to an individual with a stutter getting frustrated with their stutter being more likely to avoid speaking, the same could occur with an individual who is embarrassed of their stutter due to fear and nervousness of how they will be perceived by others.

A patient could also just have trouble with a certain speech sound, sound combination, or a full word but be perfectly normally in all other aspects of their speech. For example, a patient could consistently have trouble with the “m” sound like in the word “mommy” and always produce the word as “m-m-mommy”. Similarly, a patient could consistently have trouble with the sound combination of “st” like in the word “store” and always produce the word as “sttttore”. Another example of a patient having a stutter with a full word could be consistently having trouble with “for”. So instead of smoothly saying “Can I have this for my birthday?”, an individual with a stutter may say “Can I have this for for for my birthday?” instead.

If you have concerns about your child’s fluency, schedule an evaluation with Back Bay Speech & Occupational Therapy. Speech therapy can support your child to decrease their disfluencies using evidence based strategies for stuttering.