Stuttering

What is stuttering?

Stuttering is a speech disorder that affects the rhythm and flow of how you talk. This disorder disrupts how you speak, causing unintended sounds, pauses or other problems with talking smoothly.

There are a few different subtypes of stuttering:

• Developmental stuttering (child-onset fluency disorder). This is a neurodevelopmental disorder, meaning it happens because your brain develops differently than expected. This form starts when you’re a child.
• Persistent stuttering. This is developmental stuttering that continues into adulthood.
• Acquired stuttering. This is stuttering you develop because of an illness or injury that affects your brain.

Stuttering is a specific type of fluency disorder. These fall under the overall category of speech impediments.

Who does stuttering affect?

Stuttering can happen to anyone, but men or people assigned male at birth (AMAB) are four times more likely to develop it. Age can affect the type of stuttering you have:

• Developmental stuttering is always a childhood condition. It can start as early as age 2 or as late as age 7. The average age for it to start is around 3 years old, and 95% of children start before age 4.
• Persistent stuttering is always an adult condition that begins during childhood.
• Acquired stuttering can affect people of any age. It’s more likely to happen with injuries or conditions that damage areas of your brain.

How common is this condition?

Childhood stuttering affects between 1% and 2.4% of children. Persistent stuttering affects about 0.3% to 1% of adults. There’s limited research on how commonly acquired stuttering happens.

What are the symptoms of stuttering?

Talking takes coordination between muscles in your face, mouth, throat, chest and belly. Stuttering causes uncontrolled movements or spasms in the muscles you use for speaking.

Seven key symptoms make up the official criteria for stuttering, and you have to have at least one of them for a healthcare provider to diagnose it:

• Repeating sounds or syllables. This usually happens on the first syllable of a word. You’ll repeat the sound or syllable until you can say the whole word and then resume speaking.
• Holding and drawing out certain syllables or sounds. This is when you get stuck on a sound or syllable and draw out the sound longer than intended.
• Mid-word pauses. This is when you pause for a noticeably long time at a point in a word where it’s unnecessary.
• Blocking. This is frequent pausing — either silently or with a sound (like “um” or “ah”) — while you’re talking. Its name refers to feeling like something’s blocking your flow of words.
• Word switching. This is when you stutter on a word or phrase and switch to a different word or phrase to get around it.
• Overstressing. This means you put too much stress or tension on part or all of a word.
• Repeating single-syllable words. This is repeating a word that consists of a single sound, such as “I” or “the.”

Other characteristics of stuttering

People who have this condition may also do or experience the following:

• Spasm overflow. 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 often worsen when you’re tired, excited, anxious or stressed. It can also happen when you talk about new or complicated topics. Symptoms often get better when you’re rested or relaxed.
• Other vocal activities don’t cause it. Stuttering usually doesn’t happen during certain activities, like talking to objects or pets, reading aloud and singing.
• Stuttering can contribute to other mental health conditions. Stuttering can cause feelings of frustration, embarrassment or shame. People who stutter are more likely to have mental health conditions like anxiety or depression.

What causes stuttering?

Experts don’t fully understand why stuttering happens. However, they suspect that several factors can contribute to it.

• Family history. You’re three times more likely to stutter if you have a first-degree relative (a parent or sibling) who stutters.
• Genetics. DNA mutations may contribute to stuttering. Genetics also seem to influence whether this condition improves or goes away over time.
• Brain structure differences. People who stutter are more likely to have differences in certain brain areas. These are usually areas that control speaking muscles or muscle coordination.

How is stuttering diagnosed?

A provider diagnosing stuttering will start with listening for any of the condition’s symptoms. They’ll also ask about your (or your child’s) health history, when the symptoms started, and when they usually happen.

Your child’s pediatrician will often diagnose your child’s stuttering. 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.

Acquired stuttering

Tests are likely if you begin stuttering unexpectedly as an adult. Stuttering like this can be a sign of aphasia. Conditions that can cause aphasia include traumatic brain injury (also known as TBI), strokes and brain tumors (including cancer).

These include imaging, diagnostic or lab tests. Examples include:

• Computed tomography (CT) scans.
• Magnetic resonance imaging (MRI) scans.
• Positron emission tomography (PET) scans.

How is stuttering treated?

Speech therapy is the main form of treatment for all forms of stuttering. In children, this involves learning and activities that help stuttering symptoms improve until they go away. Speech therapy activities and techniques depend on the stuttering type, symptoms and severity. Therapy frequency and session length can also play a role.

Medications aren’t common for treating stuttering directly. However, medications can treat mental health conditions like anxiety or depression, which often happen with and contribute to stuttering. Depression medicines (antidepressants) and anti-anxiety medications are examples of medications used this way.

Complications/side effects of treatments

The possible complications and side effects of stuttering treatments depend on the treatments themselves and other factors. Speech therapy typically has no risks of complications or side effects. Medication side effects or complications are rare but still possible.

Your healthcare provider can tell you more about possible complications and side effects. They can also explain ways to avoid or minimize the possible impacts.

Is stuttering preventable?

The only form of stuttering that’s preventable is acquired stuttering. The best way to prevent it is to prevent or reduce your risk of conditions like stroke or TBI.

What’s the outlook for this condition?

Stuttering isn’t a dangerous condition, and most people recover from it. Treatment — especially speech therapy — can speed up recovery.

However, stuttering can seriously affect mental health. Nearly 40% of children between 12 and 17 who stutter also have conditions like anxiety or depression.

Adults who stutter are twice as likely to develop similar conditions and three times more likely to develop personality disorders. Diagnosis and treatment for mental health conditions can help limit how they affect stuttering.

How long does stuttering last?

Up to 90% of children with developmental stuttering will recover on their own by the time they turn 18. For those who recover fully, stuttering doesn’t return unless it’s acquired stuttering.

Persistent stuttering, while rare, does happen. When it does, it’s usually a lifelong condition. However, it’s still treatable, and many adults can learn to compensate for and manage it.

Acquired stuttering can be either permanent or temporary. This usually depends on what caused it. When it happens due to severe or permanent brain damage, it’s likely that this type of stuttering will also be permanent. Your healthcare provider can explain what’s most likely to happen in your case.

How do I take care of myself?

If your child has symptoms of developmental stuttering, you should talk to their pediatrician. Early diagnosis and treatment can help your child with speaking, and help them process and deal with feelings like embarrassment or shame.

If you have a persistent stutter, speech therapy can also help you. Speech therapy can help teach you ways to work around the condition’s effects.

Mental health care

Caring for your or your child’s mental health is always important, and it’s even more important when you or your child has a condition like stuttering. Talking to a psychiatrist, therapist or another mental health professional can help with conditions like anxiety or depression.

Mental health care in children is especially important, as it can help reduce the severity of stuttering’s effects on mental health. Children with stuttering are often the targets of teasing or bullying, making anxiety or depression about their condition even worse.

When should I see my healthcare provider?

If you or your child has stuttering, you should see your healthcare provider as recommended. Most children recover from stuttering and eventually won’t need to see a provider for this condition.

When should I go to the ER?

The only form of stuttering that needs emergency medical care is acquired stuttering that appears suddenly, especially with any other stroke symptoms. When acquired stuttering develops gradually, it’s important to see a healthcare provider as soon as you notice symptoms. Symptoms that appear and gradually worsen can be signs of other brain conditions.

Is stuttering a form of anxiety?

No, stuttering is a condition that’s totally different from anxiety. However, there’s a strong, two-way link between the conditions. That means stuttering can make anxiety develop or get worse, and stuttering often gets worse when you feel anxious.

Can a stutter be cured?

There’s no cure for stuttering, but you can recover from it. Speech therapy and other treatments can help make recovery faster and easier.

If my child has stuttering, what can I do to help them?

If your child has stuttering, you can do several things to help them:

• Lead by example. Show your child how to speak at a slower, relaxed pace by doing so yourself.
• Don’t punish them for stuttering. This can have the opposite effect and make anxiety and other mental health effects of stuttering much worse.
• Listen to them. Make sure your child knows they have your attention. Don’t rush to talk when they finish. Talking to them at their eye level and with eye contact can also help.
• Don’t interrupt or focus on errors. Focus on what your child says, not how they say it. Avoid finishing their sentences or giving them advice while they’re speaking.
• Build their self-esteem. Praise what your child does well outside of how they talk. Tell them clearly when they do well in nonspeaking activities and how you feel about what they did.
• Spend time with them. Time together with your child — without distractions like TV or devices — can help your child’s confidence and mental health.
• Don’t make them feel they have to hide it. If your child stutters, let them know it’s okay to talk about it. Discussing feelings of frustration or embarrassment may ease their negative feelings about the condition.
• Make sure they know you support them. Be sure to tell your child that you support them no matter what. They need to hear that stuttering doesn’t affect their worth as a person.

What is the difference between stuttering vs. stammering?

Historically, stuttering and stammering described two related — but not quite the same — disruptions in how you talk.

• Stuttering. Repeatedly making the same sound while trying to speak.
• Stammering. Repeated gaps or pauses while trying to speak.

Most people who stutter do both of these. Because these two usually happen together, it’s common to use these terms interchangeably.

A note from Cleveland Clinic

Stuttering can be frustrating or embarrassing no matter your age when you develop it. It’s common to feel anxious or ashamed of the condition. However, stuttering is a medical condition, and it’s no reason to feel ashamed.

Many people recover from this condition and go on to become extremely successful. There’s no shortage of famous or successful people who had stuttering, including world leaders, movie stars, professional athletes and more. Speech therapy and other treatment options can help you find the rhythm in your own words and make yourself confidently understood.