U.S. DEPARTMENT OFHEALTH &HUMANSERVICES ∙ voice, speech, language 1 percent orlessofadultsstutter. of girls.Mostchildren outgrow stuttering.About stutter isthree tofourtimeslargerthanthenumber older, however, thenumberofboyswhocontinueto Boys are twiceaslikelytostuttergirls;theyget in theirlife,lastingfrom afewweekstoseveralyears. 5 percent ofallchildren willstutterforsomeperiod developing theirlanguageskills.Approximately children betweentheagesof2and5astheyare af Roughly three millionAmericansstutter. Stuttering Who stutters? by abroader term,disfluentspeech. Stuttering issometimesreferred toasstammeringand reduce stuttering. reading, orspeakinginunisonmaytemporarily a person’s stutteringmore severe, whilesinging, before agroup ortalkingonthetelephonemaymake throughout aperson’s day. Ingeneral,speaking Symptoms ofstutteringcanvarysignificantly quality oflife. with otherpeople,whichoftenaffects aperson’s lips. Stutteringcanmakeitdifficult tocommunicate behaviors, suchasrapideyeblinksortremors ofthe disruptions maybeaccompaniedbystruggling disrupting thenormalflowofspeech.Thesespeech syllables, orwords are repeated orprolonged, Stuttering isaspeechdisorder inwhichsounds, What isstuttering? fects peopleofallages.Itoccursmostoftenin

anguagel NATIONAL INSTITUTES OFHEALTH ∙ Stuttering Stuttering NIDCD Fact Sheet NATIONAL INSTITUTE ONDEAFNESSANDOTHERCOMMUNICATION DISORDERS We make speechsoundsthrough aseriesofpr and touch. brain andmonitored through oursensesofhearing (see figure). Musclemovementsare controlled bythe (movement ofthethroat, palate,tongue,andlips) phonation (voiceproduction), andarticulation coordinated musclemovementsinvolvingbreathing, How isspeechnormallyproduced? Structures involvedinspeech and voiceproduction ecisely NIDCD Fact Sheet Stuttering voice, speech language

What causes stuttering? noticed and under what circumstances), an analysis of the child’s stuttering behaviors, and an evaluation Although the precise mechanisms are not of the child’s speech and language abilities and the understood, there are two types of stuttering that impact of stuttering on his or her life. are more common. (A third type of stuttering, called psychogenic stuttering, can be caused by emotional When evaluating a young child for stuttering, a trauma or problems with thought or reasoning. At one speech-language pathologist will try to predict if the time, all stuttering was believed to be psychogenic, but child is likely to continue his or her stuttering behavior today we know that psychogenic stuttering is rare.) or outgrow it. To determine this difference, the speech- language pathologist will consider such factors as Developmental stuttering the family’s history of stuttering, whether the child’s Developmental stuttering occurs in young children stuttering has lasted six months or longer, and whether while they are still learning speech and language the child exhibits other speech or language problems. skills. It is the most common form of stuttering. Some scientists and clinicians believe that developmental stuttering occurs when children’s speech and language How is stuttering treated? abilities are unable to meet the child’s verbal demands. Developmental stuttering also runs in families. In 2010, Although there is currently no cure for stuttering, there for the first time, NIDCD researchers isolated three are a variety of treatments available. The nature of genes that cause stuttering. More information on the the treatment will differ, based upon a person’s age, genetics of stuttering can be found in the research communication goals, and other factors. If you or your section of this fact sheet. child stutters, it is important to work with a speech- language pathologist to determine the best treatment Neurogenic stuttering options. Neurogenic stuttering may occur after a stroke, head trauma, or other type of brain injury. With neurogenic For very young children, early treatment may prevent stuttering, the brain has difficulty coordinating the developmental stuttering from becoming a lifelong different components involved in speaking because problem. Certain strategies can help children learn to of signaling problems between the brain and nerves improve their speech fluency while developing positive or muscles. attitudes toward communication. Health professionals generally recommend that a child be evaluated if he or she has stuttered for three to six months, exhibits How is stuttering diagnosed? struggle behaviors associated with stuttering, or has a family history of stuttering or related communication Stuttering is usually diagnosed by a speech-language disorders. Some researchers recommend that a child pathologist (SLP), a health professional who is trained be evaluated every three months to determine if the to test and treat individuals with voice, speech, and stuttering is increasing or decreasing. Treatment often language disorders. The speech-language pathologist involves teaching parents about ways to support their will consider a variety of factors, including the child’s child’s production of fluent speech. Parents may be case history (such as when the stuttering was first encouraged to: • Provide a relaxed home environment that allows therapies also help address the anxiety a person who many opportunities for the child to speak. This stutters may feel in certain speaking situations. includes setting aside time to talk to one another, especially when the child is excited and has a lot Drug therapy to say. The U.S. Food and Drug Administration (FDA) has not approved any drug for the treatment of stuttering. • Refrain from reacting negatively when the child However, some drugs that are approved to treat stutters. Instead, parents should react to the other health problems—such as epilepsy, anxiety, or stuttering as they would any other difficulty the depression—have been used to treat stuttering. These child may experience in life. This may involve drugs often have side effects that make them difficult gentle corrections of the child’s stuttering and to use over a long period of time. In a recent study praise for the child’s fluent speech. funded by the National Institute on Deafness and • Be less demanding on the child to speak in a Other Communication Disorders (NIDCD), researchers certain way or to perform verbally for people, concluded that drug therapy has been largely particularly if the child experiences difficulty during ineffective in controlling stuttering. Clinical trials of periods of high pressure. other possible drug treatments are currently underway.

• Speak in a slightly slowed and relaxed manner. Electronic devices This can help reduce time pressures the child may Some people who stutter use electronic devices to be experiencing. help control fluency. For example, one type of device fits into the ear canal, much like a hearing aid, and • Listen attentively when the child speaks and wait digitally replays a slightly altered version of the wearer’s for him or her to say the intended word. Don’t voice into the ear so that it sounds as if he or she try to complete the child’s sentences. Also, help is speaking in unison with another person. In some the child learn that a person can communicate people, electronic devices help improve fluency in a successfully even when stuttering occurs. relatively short period of time. Nevertheless, questions • Talk openly and honestly to the child about remain about how long such effects may last and stuttering if he or she brings up the subject. Let whether people are able to easily use these devices in the child know that it is okay for some disruptions real-world situations. For these reasons, researchers to occur. are continuing to study the long-term effectiveness of these devices. Stuttering therapy Self-help groups Many of the current therapies for teens and adults who stutter focus on learning ways to minimize Many people find that they achieve their greatest stuttering when they speak, such as by speaking success through a combination of self-study and more slowly, regulating their breathing, or gradually therapy. Self-help groups provide a way for people progressing from single-syllable responses to longer who stutter to find resources and support as they face words and more complex sentences. Most of these the challenges of stuttering. more voice, speech, language genes r scientists havebeenworkingtoidentifythepossible stuttering andtoidentifyitscauses.Forexample, to improve theearlyidentificationandtreatment of Researchers ar to avoid using those patterns when speaking. to avoidusing thosepatterns thatarespecific speechpatterns linkedtostutteringand to recognize, withthehelpofa computerprogram, whether volunteerpatients whostuttercanlearn help treat peoplewhostutter. Researchers are studying researchers alsoare lookingatbrainimagingasawayto brain activityinpeoplewhostutter. NIDCD-funded (magnetic resonance imaging)scanstoinvestigate (positron emissiontomography)andfunctionalMRI Scientists are usingbrainimagingtoolssuchasPET behaviors thatmaybeassociatedwithacommoncause. and individuals whoexhibitsimilarstutteringpatterns researchers are examining waystoidentifygroups of for continuingtostutterintoadulthood.Inaddition, outgrow theirstutteringandwhichchildren are atrisk pathologists determinewhichchildren are mostlikelyto Researchers are workingtohelpspeech-language deficits inspeechfluency. in therecycling ofcellcomponentsleadstospecific recycling. Researchers are nowstudyinghowthisdefect and III,whichare alsocausedbyproblems withcellular serious metabolicdisorders, calledmucolipidosis(ML)II other mutationsinGNPTAB andGNPTGare tiedtotwo and recycling ofcellularcomponents.Interestingly, and NAGPA, worktogethertohelpinthebreakdown United States.Thethree genes,calledGNPTAB, GNPTG, some studyparticipantsinPakistan,England,andthe chromosome 16—thatare thesource ofstutteringin three suchgenes—oneonchromosome 12andtwoon to runinfamilies.NIDCDscientistshaveidentified on stuttering? What researchisbeingconducted esponsible forthetypesofstutteringthattend ound theworldare exploringways

hearing, balance

smell, taste Where canIfindadditionalinformation? T Toll-free V Bethesda, MD20892-3456 1 CommunicationAvenue NIDCD InformationClearinghouse numbers, oraprintedlistoforganizations,contact: For more information,additionaladdresses andphone printed orelectronic informationonstuttering: organizations thatcananswerquestionsandprovide Use thefollowingkeywords tohelpyousearch for organizations athttp://www.nidcd.nih.gov/directory. voice, speech,andlanguage.Pleaseseethelistof disordered processes ofhearing,balance,smell,taste, that provide informationonthenormaland The NIDCDmaintainsadirectory oforganizations E-mail: [email protected] • • upon scientificdiscovery, tothepublic. voice, speech,andlanguageprovides healthinformation,based normal anddisordered processes ofhearing,balance,smell,taste, NIDCD supportsandconductsresearch andresearch trainingonthe oll-free TTY: (800)241-1055 of HealthandHuman Services. Disorders, National InstitutesofHealth,U.S. Department National InstituteonDeafnessand OtherCommunication The NIDCDInformationClearinghouse isaserviceofthe Internet: E-mail: Fax: (800)241-1044 T Toll-free Voice: Bethesda, MD20892-3456 1 CommunicationAvenue NIDCD InformationClearinghouse For more information,contact: Reprinted December2014 March 2010 NIH Pub.No.07-4232 Stuttering Speech-language pathologists Stuttering oll-free TTY: oice: (800)241-1044 http://www.nidcd.nih.gov [email protected] (301) 770-8977 (800) 241-1055