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Definition

Stuttering is a speech disorder in which sounds, syllables, or words are repeated or last longer than normal. These problems cause a break in the flow of speech called disfluency.

Causes

Stuttering usually affects children ages 2 to 5 years and is more common in boys. It may last for several weeks to several years.

For a small number of children, stuttering does not go away and may get worse. This is called developmental stuttering and it is the most common type of stuttering.

Stuttering tends to run in families. Genes that cause stuttering have been identified.

There is also evidence that stuttering may be a result of brain injuries, such as stroke or traumatic brain injuries.

In rare cases, stuttering is caused by emotional trauma (called psychogenic stuttering).

Stuttering persists into adulthood more in boys than in girls.

Symptoms

Stuttering may start with repeating consonants (k, g, t). If stuttering becomes worse, words and phrases are repeated.

Later, vocal spasms develop. There is a forced, almost explosive sound to speech. The person may appear to be struggling to speak.

Stressful social situations and anxiety can make symptoms worse.

Symptoms of stuttering may include:

• Feeling frustrated when trying to communicate
• Pausing or hesitating when starting or during sentences, phrases, or words, often with the lips together
• Putting in (interjecting) extra sounds or words ("We went to the...uh...store")
• Repeating sounds, words, parts of words, or phrases ("I want...I want my doll," "I...I see you," or "Ca-ca-ca-can")
• Tension in the voice
• Very long sounds within words ("I am Booooobbbby Jones" or "Llllllllike")

Other symptoms that might be seen with stuttering include:

• Eye blinking
• Jerking of the head or other body parts
• Jaw jerking
• Clenching fist

Children with mild stuttering are often unaware of their stuttering. In severe cases, children may be more aware. Facial movements, anxiety, and increased stuttering may occur when they are asked to speak.

Some people who stutter find that they do not stutter when they read aloud or sing.

Exams and Tests

Your health care provider will ask about your child's medical and developmental history, such as when your child started stuttering and its frequency. The provider will also check for:

• Fluency of speech
• Any emotional stress
• Any underlying condition
• Effect of stuttering on daily life

No testing is usually necessary. The diagnosis of stuttering may require consultation with a speech pathologist.

Treatment

There is no one best treatment for stuttering. Most early cases are short-term and resolve on their own.

Speech therapy may be helpful if:

• Stuttering has lasted more than 3 to 6 months, or the "blocked" speech lasts several seconds
• The child appears to be struggling when stuttering, or is embarrassed
• There is a family history of stuttering

Speech therapy can help make the speech more fluent or smooth.

Parents are encouraged to:

• Avoid expressing too much concern about the stuttering, which can actually make matters worse by making the child more self-conscious.
• Avoid stressful social situations whenever possible.
• Listen patiently to the child, make eye contact, don't interrupt, and show love and acceptance. Avoid finishing sentences for them.
• Set aside time for talking.
• Talk openly about stuttering when the child brings it up to you. Let them know you understand their frustration.
• Talk with the speech therapist about when to gently correct the stuttering.

Taking medicine has not been shown to be helpful for stuttering.

It is not clear whether electronic devices help with stuttering.

Self-help groups are often helpful for both the child and family.

Support Groups

More information and support for people with stuttering and their families can be found at:

• American Institute for Stuttering -- stutteringtreatment.org
• Friends: The National Association of Young People Who Stutter -- www.friendswhostutter.org
• The Stuttering Foundation -- www.stutteringhelp.org
• The National Stuttering Association(NSA) -- westutter.org

Outlook (Prognosis)

In most children who stutter, the phase passes and speech returns to normal within 3 or 4 years. Stuttering is more likely to last into adulthood if:

• It continues for more than 1 year
• The child stutters after age 6
• The child has speech or language problems

Possible Complications

Possible complications of stuttering include social problems caused by the fear of teasing, which may make a child avoid speaking entirely.

When to Contact a Medical Professional

Contact your provider if:

• Stuttering is interfering with your child's school work or emotional development.
• The child seems anxious or embarrassed about speaking.
• The symptoms last for more than 3 to 6 months.

Prevention

There is no known way to prevent stuttering. It can be reduced by speaking slowly and by managing stressful conditions.

References

Feldman HM, Messick C. Language and speech disorders. In: Feldman HM, Elias ER, Blum NJ, Jimenez ME, Stancin T, eds. Developmental-Behavioral Pediatrics. 5th ed. Philadelphia, PA: Elsevier; 2023:chap 44.

National Institute on Deafness and Other Communication Disorders website. Stuttering. www.nidcd.nih.gov/health/stuttering. Updated March 6, 2017. Accessed February 22, 2024.

Simms MD. Language development and communication disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 52.

Trauner DA, Nass RD. Developmental language disorders. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 53.

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