Thursday, October 22, is International Stuttering Awareness Day, a day for outreach to the 70 million people worldwide who live with the communication disorder that also affects 1 percent of the U.S. adult population (3 million people) and 5 percent of children. Established in 1998, International Stuttering Awareness Day also serves as a reminder to those speaking with a stutterer to show patience, empathy, and respect.
What Is Stuttering?
Stuttering is sometimes referred to as stammering or childhood-onset fluency disorder. It is a neurological disorder that involves frequent and significant problems with normal fluency and flow of speech, namely, the starting and timing of speech. People who stutter know what they want to say; they just have difficult saying it.
People who stutter sometimes:
- repeat a word or phrase
- prolong a word
- pause during speech to sound out a problematic word or sound (Words starting with the letters k, g, and t tend to be the most challenging.)
- prolong a syllable, consonant or vowel sound
- add extra words, such as “um,” when anticipating a difficult transition to a word
- have anxiety about talking
- have a limited ability to communicate
- express tension, tightness, or movement of the face or upper body to produce a word
- accompany stuttering with rapid eye blinks, tremors of the lips or jaw, facial tics, head jerks, or clenched fists
Stuttering is a common speech disorder in children as they learn to speak, but they tend to outgrow stuttering as language abilities develop. Sometimes stuttering is chronic, continuing into adulthood.
Speech therapy can be beneficial to stutterers, as can using electronic devices to improve speech fluency or cognitive behavioral therapy.
Causes of Stuttering
Research is ongoing as to the underlying causes of developmental stuttering, but possible causes include:
- abnormalities in speech motor control, including timing and sensory and motor coordination
- genetics, as stuttering tends to run in families
There are other causes to stuttering that are not developmental, including:
- traumatic brain injury
- other brain disorders that would make a stutterer’s speech slow or to have pauses or repeated sounds
Children who experience developmental delays or other speech problems may also stutter. Family stress, to include high parental expectations, can worsen existing stuttering.
Facts About Stuttering
Some facts about stuttering are:
- Stuttering typically begins between the ages of 2 and 5.
- Stuttering is marked by disruptions, or “disfluencies,” in a person’s speech.
- Stuttering either can begin gradually or develop over time.
- To a stutterer, stuttering feels like a loss of control of the speech mechanism, which can be uncomfortable and can lead to embarrassment, anxiety, or fear of stuttering again.
- Stuttering runs in families.
- Stuttering is associated with brain differences and not something learned by observing other stutterers.
- Stuttering is more common among males than females, with a 4:1 ratio in adults and a 2:1 ratio in children.
- 80 percent of young children who stutter stop stuttering, but those who continue to stutter into the 6- to 12-year age range tend to have the disorder their entire lives.
- The pattern of stuttering varies over time and is normal, with alternating periods of stuttering and periods of no stuttering.
- The presence of stuttering varies across situations and is normal, with periods of frequent stuttering and periods of little stuttering.
- The impact stuttering has on a person’s life is the most important part of the condition, even more important than the observable disfluencies.
Myths About Stuttering
The following are common myths about stuttering:
- People stutter when nervous. Although all people may stutter occasionally when nervous or in stressful situations, nervousness is not the cause in chronic stutterers.
- People stutter because they are shy or self-conscious. Although stutterers may be hesitant to speak up, people who stutter are not necessarily shy and can be assertive and outspoken people.
- Stuttering is a psychological disorder. Although stuttering may be accompanied by emotional factors, it is not a psychological condition. It is neurological.
- People who stutter are not intelligent or capable. People who stutter are like everyone else, including intelligent, capable people. Famous stutterers include presidential candidate Joe Biden; actors James Earl Jones, Marilyn Monroe, and Emily Blunt; athletes Darren Sproles and Kenyon Martin; and singer-songwriters Carly Simon and Ed Sheeran.
- Stuttering is caused by emotional trauma. Emotional trauma is not the root cause of stuttering, but it may be triggered by a traumatic event in children predisposed to the condition.
- Stuttering results from bad parenting. Stress in a family can increase stuttering in children, but it is not the cause.
- The habit to stutter can be broken. Because stuttering is a neurological condition and not formed by habit, it is difficult to completely eliminate stuttering even in people who receive speech assistance.
- Children who stutter are imitating a parent or relative who stutters. Shared genes, not just shared homes, is the cause of stuttering.
- Labeling a child as a stutterer will cause him or her to be a chronic stutterer. Although a premise of a 1939 study, this theory was discredited long ago.
- Forcing a left-handed child to write right-handed causes stuttering. This was a widely believed theory in the early 20th century that has since been discredited. Stuttering may have been observed in children forced to switch handedness because the situation caused stress that triggered the stuttering.
When to Seek Help for Stuttering
Stuttering is common in children ages 2 to 5 who are mastering language. It tends to improve on its own, but if stuttering persists into the school-age years, a doctor or speech-language pathologist should be consulted for an evaluation.
It is time to see a health-care professional if the condition:
- lasts beyond six months
- occurs with other speech or language problems
- increases in frequency or longevity
- affects the person’s ability to effectively communicate at school, at work, or in social situations
- causes anxiety or emotional distress
- begins in adulthood
How Do Face Masks Pose Problems for Stutterers?
Because they hide the wearer’s mouth, solid face masks used to prevent the spread of the novel coronavirus can be problematic for stutterers by contributing to misunderstandings. When speaking and pausing to sound out a word, a stuttering may go silent for a moment and the listener may not realize the stutterer is continuing to speak. As a result, the person stuttering may be talked over, misinterpreted, or passed over and looked on as nonresponsive or rude. This is most problematic when the stutterer is faced with an emergency situation.
The American Speech-Language-Hearing Association offers the following advice to stutterers to prevent miscommunication:
- Self-disclose that you are a stutterer by stating this verbally or carrying a printed card (one can be obtained from the Stuttering Foundation here).
- Wear a clear mask so others can see you are experiencing a block. (Clear masks can be found on many online stores, including Etsy and Amazon.)
- Rehearse at home to desensitize yourself to challenging scenarios.
- Consult a speech-language pathologist on ways to modify your speech therapy techniques.
- Turn to support networks for comfort. San Diego meetings of the National Stuttering Association for both adults and families are being held virtually during the pandemic. For the adult chapter, see the NSA Facebook page or contact chapter leaders by email at SDWeStutter@gmail.com. For the family chapter, visit the family Facebook page or Instagram page or contact chapter leaders by email at NSASanDiegoFamily@gmail.com or by calling 858-291-2858.
All people can help those who stutter by doing the following:
- Be patient and do not rush the person speaking.
- Be kind and understanding to those needing a little more time to speak.
- Ask for clarification if you do not understand what is being communicated.
- Be flexible in asking if someone needs more time to speak or would be more comfortable writing down their thoughts.
Herrick Library Resources
The following items can be requested and checked out from Herrick Library via curbside pickup:
- Advice to Those Who Stutter, by the Stuttering Foundation: This collection of helpful articles was written for stutterers by 28 therapists who are also stutterers.
- Back from the Dead, by Bill Walton: Local basketball great Bill Walton recounts the highs and lows of his life, including his stuttering problem, which lasted until age 28.
- If You Stutter: Advice for Adults, produced by Barry Guitar and Carroll Guitar: This DVD shares advice and therapy techniques on improving speech.
- If Your Child Stutters: A Guide for Parents, by Stanley Ainsworth: This book teaches parents who are concerned about their child’s speech to discern between normal disfluencies and stuttering and gives advice on seeking an evaluation and treatment.
- The King’s Speech (2011): In perhaps the best wide-release film featuring a stutterer, Oscar-winner Colin Firth portrays King George VI of Britain, who was rushed to the throne and forced to make radio broadcasts to his subjects during the height of World War II. He seeks the help of a speech therapist to overcome his stammer.
- One Flew Over the Cuckoo’s Nest (1975): One of the prominent characters in this film about a criminal who pleads insanity to be placed in a mental institution, causing a rebellion against the staff, is a stutterer.
- Self-Therapy for the Stutterer, by Malcolm Fraser: This book helps stutterers overcome their own speech difficulties.
- Shine (1996): Geoffrey Rush plays a promising pianist with a stutter who experiences a mental breakdown followed by a reemergence after a decade of total obscurity.
Sources: American Speech-Language-Hearing Association, Mask Use Poses Challenges for Children and Adults Who Stutter, https://www.asha.org/News/2020/Mask-Use-Poses-Challenges-for-Children-and-Adults-Who-Stutter/; Mayo Clinic, Stuttering, https://www.mayoclinic.org/diseases-conditions/stuttering/symptoms-causes/syc-20353572; National Stuttering Association (NSA), Facts About Stuttering, https://westutter.org/facts-about-stuttering/?cmpn=Non-Brand%7CUSA%7CDSA&device=c&kw=&adpos=&gclid=CjwKCAjwz6_8BRBkEiwA3p02Vevbv_se8TMsx58-CVeFeHb7nBDIG8hb6qXTmbU4RhkNuUk74hVHsRoCcbQQAvD_BwE; NSA, Myths About Stuttering, https://westutter.org/myths-about-stuttering/; NSA, National Stuttering Awareness Week (NSAW), https://westutter.org/what-is-stuttering/national-stuttering-awareness-week-nsaw/; Smithsonian Magazine, What Neuroscientists Are Discovering About Stuttering, https://www.smithsonianmag.com/science-nature/what-neuroscientists-are-discovering-about-stuttering-180975730/; The Stuttering Foundation, I Am a Person Who Stutters, https://www.stutteringhelp.org/sites/default/files/I_Stutter_Cards.pdf; The Stuttering Foundation, 18 Famous People Who Stutter, https://www.stutteringhelp.org/sites/default/files/FamousPeople.pdf
Graphics: National Stuttering Association, https://westutter.org/what-is-stuttering/international-stuttering-awareness-day/; Stamily, https://stamily.org/2020/05/27/stuttering-with-a-face-mask/