Stuttering: Symptoms, Causes, Types, Risk factors & Treatment

 

When your speaking muscles spasm or move uncontrollably while you speak, it's known as stuttering. This produces pauses, inadvertent sounds, and word sticking, all of which interfere with the flow of your speech. Although it can afflict people of any age, this condition typically affects children. Most patients eventually get well, and it is treatable.

What does stuttering mean?

The rhythm and flow of your speech are affected by stuttering, a speech disorder. Unintentional sounds, pauses, and other issues with speaking smoothly are caused by this disease.

A few distinct subtypes of stuttering exist:

• Developmental Stuttering: (child-onset fluency problem). This is a neurodevelopmental disorder that is caused by abnormal brain development. This kind begins in childhood.

• Persistent stuttering: This stuttering is developmental and persists into maturity.

• Acquired stuttering: This is stuttering that results from brain damage or sickness.

One particular type of fluency issue is stuttering. These are classified as speech impairments in general.

Also Read: Dementia: Symptoms, Causes, Types, Treatment & Prevention

Who is impacted by stuttering?

Although stuttering can affect anyone, men are four times more likely to experience it. The type of stuttering you have can change with age:

• Developmental stuttering is a condition that only affects children. It can begin as early as age 2 or as late as age 7. Approximately 95% of children start before the age of four, with the average age of onset being around three.

• A condition that starts in childhood and persists throughout adulthood is persistent stuttering.

•   Acquired stuttering can affect individuals of any age. It is more likely to occur when certain parts of your brain are damaged by conditions or injuries.

What symptoms of stuttering are present?

Coordination of your face, mouth, throat, chest, and abdomen muscles is necessary during speaking. The muscles you use to talk can spasm or move erratically when you stutter.

For a medical professional to diagnose stuttering, you must exhibit at least one of the following seven essential symptoms:

• Repeating syllables or sounds. This typically occurs on a word's initial syllable. Until you can articulate the entire word, you will repeat the sound or syllable before starting to speak again.

• Retaining and extracting specific sounds or syllables. This occurs when you become fixated on a sound or syllable and prolong it beyond what was meant.

• Pauses in between words. This occurs when you pause at an unneeded point in a word for an unusually extended period of time.

• Blocking. This involves pausing frequently when speaking, either quietly or with a sound (such as "um" or "ah"). Its name refers to the sensation that something blocks your ability to speak.

• Word swapping. This occurs when you stammer on a word or phrase and try to avoid it by switching to another word or phrase.

• Excessive stress. This indicates that you overstress or tense a word, either entirely or in part.

• Repeating words with just one syllable. This is repeating a single-sounding word, like "I" or "the."

Additional characteristics of stuttering

The following are additional behaviors or experiences that people with this condition may have:

• Overflowing spasm. Muscle movements that cause stuttering can cause “overflow.” That causes spasms to “spill over” to parts of your face, neck, shoulders, and arms.

• Gestures or actions that develop with and worsen when you stutter. People who stutter often develop movement habits that appear when they stutter. Examples include unusual blinking, looking away, grimacing your face and clenching your fists.

• How you feel can affect the symptoms. Stuttering symptoms sometimes worsen when you’re fatigued, eager, anxious or stressed. It might also happen when you discuss new or hard topics. Symptoms frequently become better when you’re rested or calm.

• It is not brought on by other vocal actions. Certain hobbies, such as reading aloud, singing, and conversing with objects or pets, typically do not cause stuttering.

• Other mental health conditions may be exacerbated by stuttering. Feelings of annoyance, shame, or embarrassment might result from stuttering. Mental health issues, including depression or anxiety are more common in stutterers.

What is the cause of stuttering?

The causes of stuttering are not entirely understood by experts. They do, however, believe that a number of factors may be involved.

• History. If you have a parent or sibling who stutters, you are three times more likely to stutter yourself.

• Genetics. Stuttering may be caused by mutations in the DNA. Whether this issue gets better or goes away over time appears to be influenced by genetics as well.

• Differences in brain structure. Stutterers are more likely to have abnormalities in specific brain regions. These are typically the regions that regulate muscle coordination or speaking muscles.

Risk factors:

Stuttering is far more common in men than in women. The following factors increase the likelihood of stuttering:

• Having a developmental condition in childhood. Stuttering may be more common in children with developmental disorders such as autism, attention-deficit/hyperactivity disorder, or developmental delays. This also applies to children who have other speech issues.

• Having stuttering relatives. Stuttering is often inherited.

• Tension. Existing stuttering can be exacerbated by familial stress and other forms of pressure.

Complications:

Stuttering may result in:

• Communication issues with other people.

• Either remaining silent or avoiding conversational settings.

• Not participating in opportunities for achievement and social, academic, or professional activities.

• Being bullied or harassed.

• Low self-worth.

How is the diagnosis of stuttering made?

In order to diagnose stuttering, a healthcare professional will first listen for any signs. They will also inquire about the onset of the symptoms, when they typically occur, and your (or your child's) medical history.

Stuttering is frequently diagnosed by your child's pediatrician. This usually happens after you notice and mention the symptoms, or after your child’s pediatrician notices symptoms during a checkup.

Most people with persistent stuttering received a developmental stuttering diagnosis as a child. However, it’s possible — though rare — for adults with a persistent stutter not to have had a formal diagnosis during childhood.

Medical tests aren’t usually necessary to diagnose developmental stuttering or persistent stuttering.

Stuttering that was acquired

If you start stuttering unexpectedly as an adult, tests are probably in order. This kind of stuttering may indicate aphasia. Aphasia can result from brain tumors, including cancer, strokes, and traumatic brain injury (TBI).

These tests could be lab, imaging, or diagnostic. Examples consist of:

• CT (computed tomography) scans.

• Scans using magnetic resonance imaging (MRI).

• Scans using positron emission tomography (PET).

Treatment:

How is stuttering treated?

• The primary treatment for all types of stuttering is speech therapy. This entails educational exercises that assist children's stuttering symptoms get better till they disappear. The type, symptoms, and severity of stuttering determine the activities and methods used in speech therapy. The frequency and duration of therapy sessions may also be important. Choose the best approach for your child by following the advice of the speech-language pathologist.

• Electronic devices. There are numerous electronic tools that can help with fluency. When using a single device, you will either have to slow down your speech or the machine will distort it due to delayed feedback. Your speech is copied by another device, giving the impression that you are speaking alongside someone else. Certain gadgets are compact enough to wear while going about regular tasks. Seek advice on selecting a device from a speech-language pathologist.

• Cognitive behavioral treatment. Psychotherapy, another name for this kind of mental health treatment, can assist you in recognizing and altering thought patterns that could exacerbate stuttering. Additionally, it can help you overcome or improve stuttering-related tension, anxiety, or self-esteem issues.

• Interaction between parents and children. A crucial component of helping your child deal with stuttering, particularly with certain therapy options, is practicing strategies at home. Choose the best approach for your child by following the advice of the speech-language pathologist.

• Direct treatment of stuttering with medication is uncommon. However, mental health issues like anxiety or depression, which frequently accompany and contribute to stuttering, can be treated with medication. Antidepressants and anxiety medications are two examples of medication used in this manner.

References:

• Stuttering Treatment and Research Trust | stuttering.co.nz. Stuttering in children and advice for parents (https://www.stuttering.co.nz/stuttering-for-parents/). Accessed 12/14/2022.

• The Stuttering Foundation | stutteringhelp.org. 7 tips for talking with your child (https://www.stutteringhelp.org/7-tips-talking-your-child-0). Accessed 12/14/2022.

• Disorders of Speech and Language. In: Ropper AH, Samuels MA, Klein JP, Prasad S. eds. Adams and Victor’s Principles of Neurology. 11th ed. McGraw Hill; 2019.

• Stuttering. National Institute on Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/stuttering. Accessed Feb. 2, 2024.

• Mulheren R, Tippett D, Azola A, et al. Speech, Language, and Swallowing Disorders. In: Mitra R. eds. Principles of Rehabilitation Medicine. McGraw Hill; 2019.

• Normal Development and Deviations in Development of the Nervous System. In: Ropper AH, Samuels MA, Klein JP, Prasad S. eds. Adams and Victor’s Principles of Neurology. 11th ed. McGraw Hill; 2019.

• Childhood-onset fluency disorder (stuttering). In: Diagnostic and Statistical Manual of Mental Disorders DSM-5-TR. 5th ed. American Psychiatric Association; 2022. https://dsm.psychiatryonline.org. Accessed Feb. 2, 2024.

• Perez HR, Stoeckle JH. Stuttering: Clinical and research update (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4907555/). Can Fam Physician. 2016;62(6):479-484. Accessed 12/14/2022.

• Neurodevelopmental disorders. Diagnostic and Statistical Manual of Mental Disorders, 5e text revision (DSM-5-TR™). March 2022.

• 6 tips for speaking with someone who stutters. The Stuttering Foundation. https://www.stutteringhelp.org/6-tips-speaking-someone-who-stutters-0. Accessed Feb. 2, 2024.

• Laiho A, et al. Stuttering interventions for children, adolescents and adults: A systematic review as part of the clinical guidelines. Journal of Communication Disorders. 2022; doi:10.1016/j.jcomdis.2022.106242.

• Medical review (expert opinion). Mayo Clinic. Feb. 11, 2024.