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NIDCD Fact Sheet | Voice, Speech, and Language

Stuttering

What is stuttering? this gender difference increases; the number of boys

who continue to stutter is three to four times larger than
Stuttering is a speech disorder characterized by repetition the number of girls. Most children outgrow stuttering.
of sounds, syllables, or words; prolongation of sounds; Approximately 75 percent of children recover from
and interruptions in speech known as blocks. An stuttering. For the remaining 25 percent who continue to
individual who stutters exactly knows what he or she stutter, stuttering can persist as a lifelong communication
would like to say but has trouble producing a normal flow disorder.
of speech. These speech disruptions may be accompanied
by struggle behaviors, such as rapid eye blinks or How is speech normally produced?
tremors of the lips. Stuttering can make it difficult to
communicate with other people, which often affects a We make speech sounds through a series of precisely
person’s quality of life and interpersonal relationships. coordinated muscle movements involving breathing,
Stuttering can also negatively influence job performance phonation (voice production), and articulation (movement
and opportunities, and treatment can come at a high of the throat, palate, tongue, and lips). Muscle
financial cost. movements are controlled by the brain and monitored
through our senses of hearing and touch.
Symptoms of stuttering can vary significantly throughout
a person’s day. In general, speaking before a group or What are the causes and types of
talking on the telephone may make a person’s stuttering stuttering?
more severe, while singing, reading, or speaking in unison
may temporarily reduce stuttering. The precise mechanisms that cause stuttering are not
understood. Stuttering is commonly grouped into two
Stuttering is sometimes referred to as stammering and by types termed developmental and neurogenic.
a broader term, disfluent speech.
} Developmental stuttering
Who stutters? Developmental stuttering occurs in young children while
they are still learning speech and language skills. It is
Roughly 3 million Americans stutter. Stuttering affects the most common form of stuttering. Some scientists
people of all ages. It occurs most often in children and clinicians believe that developmental stuttering
between the ages of 2 and 6 as they are developing occurs when children’s speech and language abilities
their language skills. Approximately 5 to 10 percent are unable to meet the child’s verbal demands. Most
of all children will stutter for some period in their life, scientists and clinicians believe that developmental
lasting from a few weeks to several years. Boys are 2 to stuttering stems from complex interactions of multiple
3 times as likely to stutter as girls and as they get older

NIDCD...Improving the lives of people with communication disorders

 factors. Recent brain imaging studies have shown of the treatment will differ, based upon a person’s
consistent differences in those who stutter compared age, communication goals, and other factors. If you
to nonstuttering peers. Developmental stuttering may or your child stutters, it is important to work with a
also run in families and research has shown that genetic speech-language pathologist to determine the best
factors contribute to this type of stuttering. Starting in treatment options.
2010, researchers at the National Institute on Deafness
and Other Communication Disorders (NIDCD) have Therapy for children
identified four different genes in which mutations are
For very young children, early treatment may prevent
associated with stuttering. More information on the
developmental stuttering from becoming a lifelong
genetics of stuttering can be found in the research
problem. Certain strategies can help children learn to
section of this fact sheet.
improve their speech fluency while developing positive
} Neurogenic stuttering attitudes toward communication. Health professionals
Neurogenic stuttering may occur after a stroke, head generally recommend that a child be evaluated if he or
trauma, or other type of brain injury. With neurogenic she has stuttered for 3 to 6 months, exhibits struggle
stuttering, the brain has difficulty coordinating the behaviors associated with stuttering, or has a family
different brain regions involved in speaking, resulting in history of stuttering or related communication disorders.
problems in production of clear, fluent speech. Some researchers recommend that a child be evaluated
every 3 months to determine if the stuttering is increasing
At one time, all stuttering was believed to be or decreasing. Treatment often involves teaching parents
psychogenic, caused by emotional trauma, but today we about ways to support their child’s production of fluent
know that psychogenic stuttering is rare. speech. Parents may be encouraged to:
} Provide a relaxed home environment that allows many
How is stuttering diagnosed? opportunities for the child to speak. This includes
setting aside time to talk to one another, especially
Stuttering is usually diagnosed by a speech-language
when the child is excited and has a lot to say.
pathologist, a health professional who is trained to test
and treat individuals with voice, speech, and language } Listen attentively when the child speaks and focus on
disorders. The speech-language pathologist will consider the content of the message, rather than responding to
a variety of factors, including the child’s case history how it is said or interrupting the child.
(such as when the stuttering was first noticed and under } Speak in a slightly slowed and relaxed manner. This
what circumstances), an analysis of the child’s stuttering can help reduce time pressures the child may be
behaviors, and an evaluation of the child’s speech and experiencing.
language abilities and the impact of stuttering on his or
her life. } Listen attentively when the child speaks and wait for
him or her to say the intended word. Don’t try to
When evaluating a young child for stuttering, a speech- complete the child’s sentences. Also, help the child learn
language pathologist will try to determine if the child that a person can communicate successfully even when
is likely to continue his or her stuttering behavior or stuttering occurs.
outgrow it. To determine this difference, the speech- } Talk openly and honestly to the child about stuttering if
language pathologist will consider such factors as the he or she brings up the subject. Let the child know that
family’s history of stuttering, whether the child’s stuttering it is okay for some disruptions to occur.
has lasted 6 months or longer, and whether the child
exhibits other speech or language problems. Stuttering therapy

How is stuttering treated? Many of the current therapies for teens and adults who
stutter focus on helping them learn ways to minimize
Although there is currently no cure for stuttering, stuttering when they speak, such as by speaking more
there are a variety of treatments available. The nature slowly, regulating their breathing, or gradually progressing

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from single-syllable responses to longer words and more What research is being conducted
complex sentences. Most of these therapies also help on stuttering?
address the anxiety a person who stutters may feel in
certain speaking situations. Researchers around the world are exploring ways
to improve the early identification and treatment of
Drug therapy stuttering and to identify its causes. For example,
The U.S. Food and Drug Administration has not approved scientists have been working to identify the possible
any drug for the treatment of stuttering. However, some genes responsible for stuttering that tend to run in
drugs that are approved to treat other health problems— families. NIDCD scientists have now identified variants in
such as epilepsy, anxiety, or depression—have been used four such genes that account for some cases of stuttering
to treat stuttering. These drugs often have side effects in many populations around the world, including the
that make them difficult to use over a long period of time. United States and Europe. All of these genes encode
proteins that direct traffic within cells, ensuring that
Electronic devices various cell components get to their proper location
within the cell. Such deficits in cellular trafficking are a
Some people who stutter use electronic devices to help newly recognized cause of many neurological disorders.
control fluency. For example, one type of device fits into Researchers are now studying how this defect in cellular
the ear canal, much like a hearing aid, and digitally replays trafficking leads to specific deficits in speech fluency.
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 Researchers are also working to help speech-language
another person. In some people, electronic devices may pathologists determine which children are most likely to
help improve fluency in a relatively short period of time. outgrow their stuttering and which children are at risk
Additional research is needed to determine how long such for continuing to stutter into adulthood. In addition,
effects may last and whether people are able to easily use researchers are examining ways to identify groups of
and benefit from these devices in real-world situations. individuals who exhibit similar stuttering patterns and
For these reasons, researchers are continuing to study the behaviors that may be associated with a common cause.
long-term effectiveness of these devices.
Scientists are using brain imaging tools such as PET
Self-help groups (positron emission tomography) and functional MRI
(magnetic resonance imaging) scans to investigate brain
Many people find that they achieve their greatest success activity in people who stutter. NIDCD-funded researchers
through a combination of self-study and therapy. Self- are also using brain imaging to examine brain structure
help groups provide a way for people who stutter to and functional changes that occur during childhood that
find resources and support as they face the challenges differentiate children who continue to stutter from those
of stuttering. 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.

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Where can I find additional For more information, additional addresses and phone
numbers, or a printed list of organizations, contact us at:
information about stuttering?
The NIDCD maintains a directory of organizations that NIDCD Information Clearinghouse
provide information on the normal and disordered 1 Communication Avenue
processes of hearing, balance, taste, smell, voice, Bethesda, MD 20892-3456
speech, and language. Visit the NIDCD website at Toll-free Voice: (800) 241-1044
Toll-free TTY: (800) 241-1055
http://www.nidcd.nih.gov to search the directory.
Fax: (301) 770-8977
Use the following keywords to help you find Email: nidcdinfo@nidcd.nih.gov
organizations that can answer questions and provide http://www.nidcd.nih.gov
information on stuttering:
Follow the NIDCD on Twitter at @NIDCD
} Stuttering
} Speech-language pathologists
} Physician/practitioner referrals
The NIDCD supports and conducts research and
Visit the NIDCD website at http://www.nidcd.nih.gov research training on the normal and disordered
to read, print, or download publications. processes of hearing, balance, taste, smell, voice,
speech, and language and provides health information,
based upon scientific discovery, to the public.

Stuttering
NIH Pub. No. 97-4232
February 2016

NIH...Turning Discovery Into Health®