Stuttering

Symptoms

Stuttering involves irregular and interrupted speech patterns. Characteristics of typical speech patterns include:^{2, 3}

• Repetitions of sounds, syllables, or short words. These may occur as:
  • False starts: "c-c-cold."
  • One-syllable words: "I-I hear you."
  • Entire words that have more than one syllable: "Giraffes-giraffes are tall!"
  • Phrases: "I want-I want to go too."
• Pauses:
  • With word interruptions (interjections): "How do I—um—get up there?"
  • Within a word (broken words): "I am hun ... [pause] ... gry."
  • With lips together or mouth open but no words are produced.
• Word substitutions (circumlocution) to avoid trying to say difficult words.
• Complete changes of words or thoughts: "I found my—Do you want to eat?"
• Drawn-out words (prolongations), usually at the beginning of sentences: "M-m-m-m-m-mommy, you have ice cream."

You may notice that your child stutters more when excited, anxious, overwhelmed, or tired. For example, talking to someone who does not appear interested or asking or answering questions may trigger or increase stuttering. In addition, stuttering often gets worse when a child tries to explain something complex.

Stuttering may also occur with repetitive gestures or unusual mannerisms, such as exaggerated blinking or tension around the mouth. This is more likely to occur when stuttering is severe or getting worse. These symptoms often indicate that the speaker is aware of and embarrassed by his or her stuttering.

Types of stuttering

Stuttering can be categorized into three main types according to when it begins, its typical pattern, and whether it resolves on its own.

• Normal disfluency is stuttering that occurs during early childhood, when speech is rapidly developing, but resolves without treatment before puberty. This type of stuttering may appear sporadically and gradually decrease until it no longer occurs. The irregular speech may be infrequent, and the child usually does not notice or is not bothered by it.
• Developmental stuttering generally requires treatment to improve. Speech problems most often first appear around age 5 during the critical stages of language development but can occur any time between about 2 and 7 years of age. Symptoms can range from mild to severe.
  • Mild developmental stuttering and normal disfluency can be difficult to tell apart. In general, mild stuttering causes more frequent symptoms. It may also recur after a temporary improvement or become worse. Children with mild developmental stuttering often become frustrated and bothered by their speech problem.
  • Severe developmental stuttering affects almost every sentence of speech in all situations. Children usually become frustrated, upset, and embarrassed by their stuttering and often cover their mouths with their hands while attempting to speak. They may also develop mannerisms such as nodding the head or closing, blinking, or frequently moving the eyes in an exaggerated way. Severe stuttering most often affects older children, but it can occur in very young children as well.³ Speech therapy and other forms of treatment are needed to improve severe stuttering, especially if it has lasted 18 months or longer.
• Acquired stuttering may result from an injury or condition that damages the brain, such as a stroke or Alzheimer's disease. Less often, stuttering begins after experiencing an emotional trauma. Typically, a person with acquired stuttering repeats or draws out sounds, syllables, or word patterns. The speaker maintains normal eye contact, does not seem anxious or bothered by his or her speech problems, and doesn't have unusual mannerisms, such as grimacing or eye-blinking.⁴

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Author:	Amy Fackler, MA Debby Golonka, MPH	Last Updated: September 15, 2006
Medical Review:	Michael J. Sexton, MD - Pediatrics Robert M. Kroll, BSc, MSc, PhD - Speech Pathology
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