- What Causes Stuttering?
- What Are the Signs of Stuttering?
- When to Get Help
- How Can Parents Help?
- Who stutters?
- How is speech normally produced?
- What are the causes and types of stuttering?
- Developmental stuttering
- Neurogenic stuttering
- How is stuttering diagnosed?
- How is stuttering treated?
- Therapy for children
- Stuttering therapy
- Drug therapy
- Electronic devices
- Self-help groups
- What research is being conducted on stuttering?
- Stuttering | Stammer
- What causes stuttering?
- Who is at risk for stuttering?
- What are the treatments for stuttering?
- About Stuttering
- Signs and Symptoms of Stuttering
- Causes of Stuttering
- Seeing A Professional
- Testing For Stuttering
- Treatment For Stuttering
- Treatment For Preschool Children Who Stutter
- Treatment For Older Children and Adults Who Stutter
- Other Resources
Many young kids go through a stage between the ages of 2 and 5 when they stutter. This might make them:
- repeat certain syllables, words, or phrases
- prolong them
- stop, making no sound for certain sounds and syllables
Stuttering is a form of dysfluency (dis-FLOO-en-see), an interruption in the flow of speech.
In many cases, stuttering goes away on its own by age 5. In some kids, it goes on for longer. Effective treatments are available to help a child overcome it.
What Causes Stuttering?
Doctors and scientists aren't completely sure why some kids stutter. But most believe that a few things contribute to it, such as a problem with the way the brain's messages interact with the muscles and body parts needed for speaking.
Many believe that stuttering may be genetic. Kids who stutter are three times more ly to have a close family member who also stutters, or did.
What Are the Signs of Stuttering?
The first signs of stuttering tend to appear when a child is about 18–24 months old. At this age, there's a burst in vocabulary and kids are starting to put words together to form sentences. To parents, the stuttering may be upsetting and frustrating, but it is natural for kids to do some stuttering at this stage. Be as patient with your child as possible.
A child may stutter for a few weeks or several months, and the stuttering may come and go. Most kids who begin stuttering before the age of 5 stop without any need for help such as speech or language therapy.
But if your child's stuttering happens a lot, gets worse, or happens along with body or facial movements, seeing a speech-language therapist around age 3 is a good idea.
Usually, stuttering lets up when kids enter elementary school and start sharpening their communication skills. A school-age child who continues to stutter is ly aware of the problem and may be embarrassed by it. Classmates and friends may draw attention to it or even tease the child.
If this happens with your child, talk to the teacher, who can address this in the classroom with the kids. The teacher also might decrease the number of stressful speaking situations for your child until speech therapy begins.
When to Get Help
If your child is 5 years old and still stuttering, talk to your doctor or a speech-language therapist. Check with a speech therapist if your child:
- tries to avoid situations that require talking
- changes a word for fear of stuttering
- has facial or body movements along with the stuttering
- repeats whole words and phrases often and consistently
- repeats sounds and syllables more often
- has speech that sounds very strained
Also talk to the therapist if:
- you notice increased facial tension or tightness in your child's speech muscles
- you notice vocal tension that causes rising pitch or loudness
- you have other concerns about your child's speech
Most schools will offer testing and appropriate therapy if stuttering lasts for 6 months or more.
How Can Parents Help?
Try these steps to help your child:
- Don't require your child to speak precisely or correctly at all times. Allow talking to be fun and enjoyable.
- Use family meals as a conversation time. Avoid distractions such as radio or TV.
- Avoid corrections or criticisms such as «slow down,» «take your time,» or «take a deep breath.» These comments, however well-intentioned, will only make your child feel more self-conscious.
- Avoid having your child speak or read aloud when uncomfortable or when the stuttering increases. Instead, during these times encourage activities that do not require a lot of talking.
- Don't interrupt your child or tell him or her to start over.
- Don't tell your child to think before speaking.
- Provide a calm atmosphere in the home. Try to slow down the pace of family life.
- Speak slowly and clearly when talking to your child or others in his or her presence.
- Maintain eye contact with your child. Try not to look away or show signs of being upset.
- Let your child speak for himself or herself and to finish thoughts and sentences. Pause before responding to your child's questions or comments.
- Talk slowly to your child. This takes practice! Modeling a slow rate of speech will help with your child's fluency.
Roughly 3 million Americans stutter. Stuttering affects people of all ages. It occurs most often in children between the ages of 2 and 6 as they are developing their language skills. Approximately 5 to 10 percent of all children will stutter for some period in their life, lasting from a few weeks to several years.
Boys are 2 to 3 times as ly to stutter as girls and as they get older this gender difference increases; the number of boys who continue to stutter is three to four times larger than the number of girls. Most children outgrow stuttering. Approximately 75 percent of children recover from stuttering.
For the remaining 25 percent who continue to stutter, stuttering can persist as a lifelong communication disorder.
How is speech normally produced?
We make speech sounds through a series of precisely coordinated muscle movements involving breathing, phonation (voice production), and articulation (movement of the throat, palate, tongue, and lips). Muscle movements are controlled by the brain and monitored through our senses of hearing and touch.
What are the causes and types of stuttering?
The precise mechanisms that cause stuttering are not understood. Stuttering is commonly grouped into two types termed developmental and neurogenic.
Developmental stuttering occurs in young children while they are still learning speech and language skills. It is the most common form of stuttering. Some scientists and clinicians believe that developmental stuttering occurs when children’s speech and language abilities are unable to meet the child’s verbal demands.
Most scientists and clinicians believe that developmental stuttering stems from complex interactions of multiple factors. Recent brain imaging studies have shown consistent differences in those who stutter compared to nonstuttering peers.
Developmental stuttering may also run in families and research has shown that genetic factors contribute to this type of stuttering. Starting in 2010, researchers at the National Institute on Deafness and Other Communication Disorders (NIDCD) have identified four different genes in which mutations are associated with stuttering.
More information on the genetics of stuttering can be found in the research section of this fact sheet.
Neurogenic stuttering may occur after a stroke, head trauma, or other type of brain injury. With neurogenic stuttering, the brain has difficulty coordinating the different brain regions involved in speaking, resulting in problems in production of clear, fluent speech.
At one time, all stuttering was believed to be psychogenic, caused by emotional trauma, but today we know that psychogenic stuttering is rare.
How is stuttering diagnosed?
Stuttering is usually diagnosed by a speech-language pathologist, a health professional who is trained to test and treat individuals with voice, speech, and language disorders.
The speech-language pathologist will consider a variety of factors, including the child’s case history (such as when the stuttering was first noticed and under what circumstances), an analysis of the child’s stuttering behaviors, and an evaluation of the child’s speech and language abilities and the impact of stuttering on his or her life.
When evaluating a young child for stuttering, a speech-language pathologist will try to determine if the child is ly to continue his or her stuttering behavior or outgrow it.
To determine this difference, the speech-language pathologist will consider such factors as the family’s history of stuttering, whether the child’s stuttering has lasted 6 months or longer, and whether the child exhibits other speech or language problems.
How is stuttering treated?
Although there is currently no cure for stuttering, there are a variety of treatments available. The nature of the treatment will differ, based upon a person’s age, communication goals, and other factors. If you or your child stutters, it is important to work with a speech-language pathologist to determine the best treatment options.
Therapy for children
For very young children, early treatment may prevent developmental stuttering from becoming a lifelong problem. Certain strategies can help children learn to improve their speech fluency while developing positive attitudes toward communication.
Health professionals generally recommend that a child be evaluated if he or she has stuttered for 3 to 6 months, exhibits struggle behaviors associated with stuttering, or has a family history of stuttering or related communication disorders. Some researchers recommend that a child be evaluated every 3 months to determine if the stuttering is increasing or decreasing.
Treatment often involves teaching parents about ways to support their child’s production of fluent speech. Parents may be encouraged to:
- Provide a relaxed home environment that allows many opportunities for the child to speak. This includes setting aside time to talk to one another, especially when the child is excited and has a lot to say.
- Listen attentively when the child speaks and focus on the content of the message, rather than responding to how it is said or interruptng the child.
- Speak in a slightly slowed and relaxed manner. This can help reduce time pressures the child may be experiencing.
- Listen attentively when the child speaks and wait for him or her to say the intended word. Don't try to complete the child’s sentences. Also, help the child learn that a person can communicate successfully even when stuttering occurs.
- Talk openly and honestly to the child about stuttering if he or she brings up the subject. Let the child know that it is okay for some disruptions to occur.
Many of the current therapies for teens and adults who stutter focus on helping them learn ways to minimize stuttering when they speak, such as by speaking more slowly, regulating their breathing, or gradually progressing from single-syllable responses to longer words and more complex sentences. Most of these therapies also help address the anxiety a person who stutters may feel in certain speaking situations.
The U.S. Food and Drug Administration has not approved any drug for the treatment of stuttering. However, some drugs that are approved to treat other health problems—such as epilepsy, anxiety, or depression—have been used to treat stuttering. These drugs often have side effects that make them difficult to use over a long period of time.
Some people who stutter use electronic devices to help control fluency. For example, one type of device fits into the ear canal, much a hearing aid, and digitally replays a slightly altered version of the wearer’s voice into the ear so that it sounds as if he or she is speaking in unison with another person.
In some people, electronic devices may help improve fluency in a relatively short period of time. Additional research is needed to determine how long such effects may last and whether people are able to easily use and benefit from these devices in real-world situations.
For these reasons, researchers are continuing to study the long-term effectiveness of these devices.
Many people find that they achieve their greatest success through a combination of self-study and therapy. Self-help groups provide a way for people who stutter to find resources and support as they face the challenges of stuttering.
What research is being conducted on stuttering?
Researchers around the world are exploring ways to improve the early identification and treatment of stuttering and to identify its causes. For example, scientists have been working to identify the possible genes responsible for stuttering that tend to run in families.
NIDCD scientists have now identified variants in four such genes that account for some cases of stuttering in many populations around the world, including the United States and Europe.
All of these genes encode proteins that direct traffic within cells, ensuring that various cell components get to their proper location within the cell. Such deficits in cellular trafficking are a newly recognized cause of many neurological disorders.
Researchers are now studying how this defect in cellular trafficking leads to specific deficits in speech fluency.
Researchers are also working to help speech-language pathologists determine which children are most ly to outgrow their stuttering and which children are at risk for continuing to stutter into adulthood. In addition, researchers are examining ways to identify groups of individuals who exhibit similar stuttering patterns and behaviors that may be associated with a common cause.
Scientists are using brain imaging tools such as PET (positron emission tomography) and functional MRI (magnetic resonance imaging) scans to investigate brain activity in people who stutter.
NIDCD-funded researchers are also using brain imaging to examine brain structure and functional changes that occur during childhood that differentiate children who continue to stutter from those who recover from stuttering. Brain imaging may be used in the future as a way to help treat people who stutter.
Researchers are studying whether volunteer patients who stutter can learn to recognize, with the help of a computer program, specific speech patterns that are linked to stuttering and to avoid using those patterns when speaking.
The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.
Use the following keywords to help you find organizations that can answer questions and provide information on stuttering:
- Speech-language pathologists
- Physician/practitioner referrals
For more information, contact us at:
NIDCD Information Clearinghouse1 Communication AvenueBethesda, MD 20892-3456Toll-free voice: (800) 241-1044Toll-free TTY: (800) 241-1055
Stuttering | Stammer
URL of this page: https://medlineplus.gov/stuttering.html
Stuttering is a speech disorder. It involves interruptions in the flow of speech. These interruptions are called disfluencies. They may involve
- Repeating sounds, syllables, or words
- Stretching out a sound
- Suddenly stopping in the middle of a syllable or word
Sometimes, along with the stuttering, there may be nodding, rapid blinking, or trembling lips. The stuttering may be worse when you are stressed, excited, or tired.
Stuttering can be frustrating, because you know exactly what you want to say, but you have trouble saying it. It can make it difficult to communicate with people. This can cause problems with school, work, and relationships.
What causes stuttering?
There are two main types of stuttering, and they have different causes:
- Developmental stuttering is the more common type. It starts in young children while they are still learning speech and language skills. Many children stutter when they first start talking. Most of them will outgrow it. But some continue to stutter, and the exact cause is unknown. There are differences in the brains of people who continue to stutter. Genetics may also play a role, since this type of stuttering can run in families.
- Neurogenic stuttering can happen after someone has a stroke, head trauma, or other type of brain injury. Because of the injury, the brain has trouble coordinating the different parts of the brain involved in speech.
Who is at risk for stuttering?
Stuttering can affect anyone, but it is much more common in boys than girls. Younger children are most ly to stutter. About 75% of children who stutter will get better. For the rest, stuttering can continue their whole lives.
What are the treatments for stuttering?
There are different treatments that can help with stuttering. Some of these may help one person but not another. You need to work with the speech-language pathologist to figure out the best plan for you or your child.
The plan should take into account how long the stuttering has been going on and whether there are any other speech or language problems. For a child, the plan should also take into account your child's age and whether he or she is ly to outgrow the stuttering.
Younger children may not need therapy right away. Their parents and teachers can learn strategies to help the child practice speaking. That can help some children.
As a parent, it's important to be calm and relaxed when your child is speaking. If your child feels pressured, it can make it harder for them to talk.
The speech-language pathologist will probably want to evaluate your child regularly, to see whether treatment is needed.
Speech therapy can help children and adults minimize stuttering. Some techniques include
- Speaking more slowly
- Controlling breathing
- Gradually working up from single-syllable responses to longer words and more complex sentences
For adults, self-help groups can help you find resources and support as you face the challenges of stuttering.
There are electronic devices to help with fluency, but more research is needed to see whether they really help over the long term. Some people have tried medicines that usually treat other health problems such as epilepsy, anxiety, or depression. But these medicines are not approved for stuttering, and they often have side effects.
NIH: National Institute on Deafness and Other Communication Disorders
- ClinicalTrials.gov: Stuttering (National Institutes of Health)
The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.
We all have times when we do not speak smoothly. We may add «uh» or «you know» to what we say. Or, we may say a sound or word more than once. These are called disfluencies.
People who stutter may have more disfluencies and different types of disfluencies. They may repeat parts of words (repetitions), stretch a sound out for a long time (prolongations), or have a hard time getting a word out (blocks).
Stuttering is more than just disfluencies. Stuttering also may include tension and negative feelings about talking. It may get in the way of how you talk to others. You may want to hide your stuttering. So, you may avoid certain words or situations. For example, you may not want to talk on the phone if that makes you stutter more.
Stuttering can change from day to day. You may have times when you are fluent and times when you stutter more. Stress or excitement can lead to more stuttering.
Signs and Symptoms of Stuttering
The following typical disfluencies happen to many of us and are not stuttering:
- Adding a sound or word, called an interjection – «I um need to go home.»
- Repeating whole words – «Well well, I don’t agree with you.»
- Repeating phrases – «He is–he is 4 years old.»
- Changing the words in a sentence, called revision – «I had–I lost my tooth.»
- Not finishing a thought – «His name is . . . I can't remember.»
When children are learning a lot of words or new speech sounds, you may notice some of these typical disfluencies. This is normal.
The following types of disfluencies happen when someone stutters:
- Part-word repetitions – «I w-w-w-want a drink.»
- One-syllable word repetitions – «Go-go-go away.»
- Prolonged sounds – «Ssssssssam is nice.»
- Blocks or stops – «I want a (pause) cookie.»
You may also notice other behaviors head nodding or eye blinking. Sometimes people who stutter use these behaviors to stop or keep from stuttering. They may also avoid using certain words or use different words to keep from stuttering.
Feelings and attitudes can affect stuttering. For example, frustration or tension can cause more disfluencies. Being excited or feeling rushed can also increase disfluencies. A person who stutters may also stutter more if others tease them or bring attention to their speech. Stuttering may cause a person to be embarrassed and make them feel nervous about talking.
Causes of Stuttering
Stuttering usually starts between 2 and 6 years of age. Many children go through normal periods of disfluency lasting less than 6 months. Stuttering lasting longer than this may need treatment.
There is no one cause of stuttering. Possible causes include the following:
- Family history. Many people who stutter have a family member who also stutters.
- Brain differences. People who stutter may have small differences in the way their brain works during speech.
You cannot always know which children will continue to stutter, but the following factors may place them at risk:
- Gender. Boys are more ly to continue stuttering than girls. Data are currently limited to individuals who identify as male or female.
- Age when stuttering began. Children who start stuttering at age 3½ or later are more ly to continue stuttering.
- Family recovery patterns. Children with family members who continued to stutter are also more ly to continue.
Seeing A Professional
If you think your child stutters, get help from an SLP as early as possible. Early help can reduce the chances that your child will keep stuttering. Contact an SLP if any of the following things happen:
- Your child's stuttering has lasted for 6–12 months or more.
- Your child starts to stutter late (after 3½ years old).
- Your child starts to stutter more often.
- Your child tenses up or struggles when talking.
- Your child avoids talking or says it is too hard to talk.
- There is a family history of stuttering.
Testing For Stuttering
It's not easy to tell if your child stutters. Stuttering is more than disfluencies, so it is important to see an SLP for testing. The SLP will look at the following things:
- The types of disfluencies (typical and stutter-).
- The number of disfluencies that are the stuttering type.
- How your child reacts when they stutter – do they get upset?
- How your child tries to «fix» their speech – do they start over or stop talking?
The SLP will ask if your child’s stuttering affects the way they play with others, or if stuttering makes it harder for them to participate in school. The SLP will use all of this information to decide if your child stutters or not.
The SLP will also test your child's speech and language. This includes how your child says sounds and words, how well they understand what others say, and how well they use words to talk about their thoughts.
Treatment For Stuttering
There are different ways to help with stuttering. A treatment team usually includes you, your child, other family members, and your child's teacher. Treatment will depend one or more of the following:
- How much your child stutters
- How your child reacts when stuttering
- How stuttering impacts your child's everyday life
- How others react to your child when they stutter
- Your child's age
Treatment For Preschool Children Who Stutter
For preschool children, treatment may include the use of direct or indirect strategies.
- Direct strategies help your child change how they speak.
- Indirect strategies are ways to help make it easier for your child to talk. These strategies can include slowing down your own speech and asking fewer questions.
You are an important part of your child's treatment. The SLP can help you learn more about how to respond when your child stutters and what to do to improve how your child feels about talking.
Treatment For Older Children and Adults Who Stutter
For older children and adults, treatment focuses on managing stuttering. An SLP will help them feel less tense and speak more freely in school, at work, and in different social settings. The SLP will also help the person face speaking situations that make them fearful or anxious. This might include speaking on the phone or ordering food at a restaurant.
Some adults who started stuttering as a child may want to see an SLP every once in a while. The SLP will talk to the person about how stuttering affects their everyday life and can help the person practice ways to manage stuttering.
Children and adults who stutter may want to look into local support groups, where they can talk with others who stutter and learn about other helpful resources.
See ASHA information for professionals on the Practice Portal's Fluency Disorders page.
This list does not include every website on this topic. ASHA does not endorse the information on these sites.