Talking to people can be hard if you stutter. You may get stuck on certain words or sounds. You may feel tense or uncomfortable. You might change words to avoid stuttering. Stuttering is a communication disorder in which the flow of speech is broken by repetitions (li-li-like this), prolongations (lllllike this), or abnormal stoppages (no sound) of sounds and syllables. There may also be unusual facial and body movements associated with the effort to speak. Stuttering is also referred to as stammering. As ASHA Explains:
“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.
More than 70 million people worldwide stutter, which is about 1% of the population. In the United States, that’s over 3 million Americans who stutter. Stuttering affects four times as many males as females. Source
There is no one cause of stuttering. Possible causes include the following:
You cannot always know which children will continue to stutter, but the following factors may place them at risk:
The following typical disfluencies happen to many of us and are not stuttering:
The following types of disfluencies happen when someone stutters:
You may also notice other behaviors like 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.
There are different ways to help with stuttering. Treatment will depend on one or more of the following:
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.
One of the main consequences of stuttering is the false impressions and stigma associated with the disorder. When one is able to eliminate the rate of frequency of their stuttering, they are also able to eliminate these false ideas, such as:
What is it? **All content below quoted from the American Speech Language and Hearing Association (ASHA).** A voice disorder occurs when voice quality, pitch, and loudness differ or are inappropriate for an individual’s age, gender, cultural background, or geographic location (Aronson & Bless, 2009; Boone, McFarlane, Von Berg, & Zraik, 2010; Lee, Stemple, Glaze, & Kelchner, 2004). A voice disorder is present when an individual expresses concern about having an abnormal voice that does not meet daily needs—even if others do not perceive it as different or deviant (American Speech-Language-Hearing Association [ASHA], 1993; Colton & Casper, 1996; Stemple, Glaze, & Klaben, 2010; Verdolini & Ramig, 2001). A number of different systems are used for classifying voice disorders. ASHA classifies voice disorders as follows:
Learn more about specific voice disorders here:
Voice disorders have been estimated to be present in between 3% and 9% of the U.S. population (Ramig & Verdolini, 1998; Roy, Merrill, Gray, & Smith, 2005). However, information from a large U.S. claims database (Cohen, Kim, Roy, Asche, & Courey, 2012) indicates the point prevalence (i.e., the number of individuals with the condition in the database at the time that data were retrieved) of voice disorders is 0.98% in a treatment-seeking population. This likely suggests that a large number of those individuals with voice disorders do not seek treatment. The prevalence of voice disorders among treatment-seeking individuals has been shown to be affected by gender, age, and occupation: Gender
Age
Occupation
A disturbance in one of the three subsystems of voice production (i.e., respiratory, laryngeal, and subglottal vocal tract) or in the physiological balance among the systems may lead to a voice disturbance. Disruptions can be due to organic, functional, and/or psychogenic causes.
Recognizing associations among these factors, along with patient history, may help in identifying the possible causes of the voice disorder. Even when an obvious cause is identified and treated, the voice problem may persist. For example, an upper respiratory infection could be the cause of the dysphonia, but poor or inefficient compensatory techniques may cause dysphonia to persist, even when the infection has been successfully treated.
The generic term dysphonia encompasses the auditory-perceptual symptoms of voice disorders. Dysphonia is characterized by altered vocal quality, pitch, loudness, or vocal effort. Signs and symptoms of dysphonia include
Other signs and symptoms include
Signs and symptoms can occur in isolation or in combination. As treatment progresses, some may dissipate, and others may emerge as compensatory strategies are eliminated. Auditory-perceptual quality of voice in individuals with voice disorders can vary depending on the type and severity of disorder, the size and site of lesion (if present), and the individual’s compensatory responses. The severity of the voice disorder cannot always be determined by auditory-perceptual voice quality alone.
Treatment Approaches Norms within different settings are considered when determining vocal needs and establishing goals. For example, vocal norms and needs within the workplace may be different from those within the community (e.g., home and social settings). SLPs often incorporate aspects of more than one therapeutic approach in developing a treatment plan. Approaches can be direct or indirect.
A therapeutic plan typically involves the use of at least one of the direct approaches and one or more of the indirect approaches based on the patient’s condition and goals. Some clinicians concentrate on directly modifying the specific symptoms of the inappropriate voice, whereas others take a more holistic approach, with the goal of balancing the physiologic subsystems of voice production—respiration, phonation, and resonance. Many clinicians begin by
See ASHA information for professionals on the Practice Portal’s Voice Disorders page.
To provide high-quality speech and language therapy, occupational therapy, evaluations, accent modification, and educational psychology services to clients of all ages.
