Stuttering myths, causes and treatments

By BoiseHealth.com writers. Not doctor reviewed. Read disclaimer.

Question: When talking with someone who stutters, which of the following actions is most appropriate and helpful:

1. Relieve pressure by completing the other person's words or sentences for them.
2. Offer that the other person calm themselves, take a deep breath, and start again.
3. Suggest that the other person think through what they want to say before speaking.
4. Remain calm, attentive and listen patiently.

While we may be acting from the best intentions with the first three answers (trying to to provide relief to what we view as an awkward situation), each of those options may increase the speaker's self-consciousness and actually make the situation worse. Though anxiety is not an underlying cause of stuttering, it can exacerbate the problem. The best answer is D.

This misunderstanding - that stuttering is just an outward sign of anxiety - stems from the fact that many of us can recall stressful situations when we've become tongue-tied. Incorrectly, we assume that extreme anxiety is what causes others to stutter. In reality, the real cause of stuttering is still a mystery but we know that genetics often plays a role and that structural changes to the brain may contribute to stuttering. Other common myths that can be dispelled are that stutters are less intelligent, lack social skills or probably suffered trauma as children.

What we commonly refer to as stuttering -- rapidly repeating sounds (pa-pa-pa-pretty), getting stuck on certain sounds (prrrretty), or hesitating before certain words or syllables is often accompanied by other, noticeable signs of struggling with communication, such as blinking, head jerking or lip trembling. Symptoms can vary throughout the day or depending on events, such as public speaking or talking on the phone, and may be less pronounced when singing, reading aloud or speaking in unison with others.

It is estimated that stuttering affects about 3 million Americans (1% of the population) with boys being twice as likely as girls to stutter as children and 3-4 times as likely as adults.

The most common form of stuttering, called developmental stuttering, affects about 1 in 20 children, normally ages 2 to 5. The wonderful news is that 75%-85% of children affected by juvenile stuttering outgrow it by adulthood, either as their communication skills continue to develop normally or through speech therapy. Stuttering that begins later in childhood (after ages 8-10) is less likely to be outgrown. While it is impossible to prevent stuttering, once symptoms appear, it is important to address stuttering early -- before life-long vocal spasm and self-esteem problems develop. A second, but much more rare form of stuttering, called neurogenic stuttering or acquired stuttering, occurs after stroke, head trauma or other types of brain injury.

Therapy for stuttering

The goals of therapy are to decrease the frequency of stuttering, prevent fear of speaking or situations, provide support, lessen anxiety during stuttering instances, and develop effective communication skills (eye-contact, phrasing, etc.). What causes stuttering to perpetuate or grow worse is usually different than what initially prompted stuttering to begin.

For Children: a speech-language pathologist should be consulted if any of the following applies...

1. Stuttering continues for 3 or more months
2. There are outward signs of struggling with speech
3. There is a family history of stuttering.

Common therapies for children include:

• Provide a relaxed home environment where the child has plenty of time and opportunity to speak.
• Offer supportive, gentle corrections and praise for fluent speech. Never punish or embarrass the child and do not press him or her to speak in situations that are uncomfortable for them. Children with mild symptoms may not even be aware that they are stuttering.
• Speak slightly slower and in a relaxed manner when conversing with the child. This can help the child to relax.
• Listen attentively. Do not try to complete the child's sentences for him or her.
• Talk openly with the child if they choose to discuss stuttering and assure them that stuttering does not make their thoughts and input any less valuable.

For teens and adults: treatments include...

• Help find ways to minimize stuttering. Possibilities include speaking slowly, controlling breathing, and gradually building from simple responses to increasingly difficult words and complex sentences.
• Address the anxiety and self-consciousness issues that may have developed as a result of stuttering. For this, some find self-help groups to be beneficial.
• At this time, there are no safe, reliable medications or devices that have demonstrated a high rate of success across a wide population.

To learn more about the causes of stuttering, how to recognize the signs and possible treatments to consider, visit:

The stuttering home page at Minnesota State University Mankato
http://www.nidcd.nih.gov/health/voice/pages/stutter.aspx
http://newsinhealth.nih.gov/issue/Feb2011/Feature2
http://www.westutter.org/whoWeHelp/Stuttering-Info-employers.htm
http://www.stutteringhelp.org/Default.aspx?tabid=122
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC340949/
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002400/