Stuttering as a symptom

What Is Stuttering? Diagnosis & Treatment

What is stuttering?

Stuttering is a speech disorder characterized by repetition of sounds, syllables, or words; prolongation of sounds; and interruptions in speech known as blocks. An individual who stutters exactly knows what he or she would like to say but has trouble producing a normal flow of speech. These speech disruptions may be accompanied by struggle behaviors, such as rapid eye blinks or tremors of the lips. Stuttering can make it difficult to communicate with other people, which often affects a person’s quality of life and interpersonal relationships. Stuttering can also negatively influence job performance and opportunities, and treatment can come at a high financial cost.

Symptoms of stuttering can vary significantly throughout a person’s day. In general, speaking before a group or talking on the telephone may make a person’s stuttering more severe, while singing, reading, or speaking in unison may temporarily reduce stuttering.

Stuttering is sometimes referred to as stammering and by a broader term, disfluent speech.

Who stutters?

Roughly 3 million Americans stutter. Stuttering affects people of all ages. It occurs most often in children between the ages of 2 and 6 as they are developing their language skills. Approximately 5 to 10 percent of all children will stutter for some period in their life, lasting from a few weeks to several years. Boys are 2 to 3 times as likely to stutter as girls and as they get older this gender difference increases; the number of boys who continue to stutter is three to four times larger than the number of girls. Most children outgrow stuttering. Approximately 75 percent of children recover from stuttering. For the remaining 25 percent who continue to stutter, stuttering can persist as a lifelong communication disorder.

How is speech normally produced?

We make speech sounds through a series of precisely coordinated muscle movements involving breathing, phonation (voice production), and articulation (movement of the throat, palate, tongue, and lips). Muscle movements are controlled by the brain and monitored through our senses of hearing and touch.

What are the causes and types of stuttering?

The precise mechanisms that cause stuttering are not understood. Stuttering is commonly grouped into two types termed developmental and neurogenic.

Developmental stuttering

Developmental stuttering occurs in young children while they are still learning speech and language skills. It is the most common form of stuttering. Some scientists and clinicians believe that developmental stuttering occurs when children’s speech and language abilities are unable to meet the child’s verbal demands. Most scientists and clinicians believe that developmental stuttering stems from complex interactions of multiple factors. Recent brain imaging studies have shown consistent differences in those who stutter compared to nonstuttering peers. Developmental stuttering may also run in families and research has shown that genetic factors contribute to this type of stuttering. Starting in 2010, researchers at the National Institute on Deafness and Other Communication Disorders (NIDCD) have identified four different genes in which mutations are associated with stuttering. More information on the genetics of stuttering can be found in the research section of this fact sheet.

Neurogenic stuttering

Neurogenic stuttering may occur after a stroke, head trauma, or other type of brain injury. With neurogenic stuttering, the brain has difficulty coordinating the different brain regions involved in speaking, resulting in problems in production of clear, fluent speech.

At one time, all stuttering was believed to be psychogenic, caused by emotional trauma, but today we know that psychogenic stuttering is rare.

How is stuttering diagnosed?

Stuttering is usually diagnosed by a speech-language pathologist, a health professional who is trained to test and treat individuals with voice, speech, and language disorders. The speech-language pathologist will consider a variety of factors, including the child’s case history (such as when the stuttering was first noticed and under what circumstances), an analysis of the child’s stuttering behaviors, and an evaluation of the child’s speech and language abilities and the impact of stuttering on his or her life.

When evaluating a young child for stuttering, a speech-language pathologist will try to determine if the child is likely to continue his or her stuttering behavior or outgrow it. To determine this difference, the speech-language pathologist will consider such factors as the family’s history of stuttering, whether the child’s stuttering has lasted 6 months or longer, and whether the child exhibits other speech or language problems.

How is stuttering treated?

Although there is currently no cure for stuttering, there are a variety of treatments available. The nature of the treatment will differ, based upon a person’s age, communication goals, and other factors. If you or your child stutters, it is important to work with a speech-language pathologist to determine the best treatment options.

Therapy for children

For very young children, early treatment may prevent developmental stuttering from becoming a lifelong problem. Certain strategies can help children learn to improve their speech fluency while developing positive attitudes toward communication. Health professionals generally recommend that a child be evaluated if he or she has stuttered for 3 to 6 months, exhibits struggle behaviors associated with stuttering, or has a family history of stuttering or related communication disorders. Some researchers recommend that a child be evaluated every 3 months to determine if the stuttering is increasing or decreasing. Treatment often involves teaching parents about ways to support their child’s production of fluent speech. Parents may be encouraged to:

  • Provide a relaxed home environment that allows many opportunities for the child to speak. This includes setting aside time to talk to one another, especially when the child is excited and has a lot to say.
  • Listen attentively when the child speaks and focus on the content of the message, rather than responding to how it is said or interruptng the child.
  • Speak in a slightly slowed and relaxed manner. This can help reduce time pressures the child may be experiencing.
  • Listen attentively when the child speaks and wait for him or her to say the intended word. Don't try to complete the child’s sentences. Also, help the child learn that a person can communicate successfully even when stuttering occurs.
  • Talk openly and honestly to the child about stuttering if he or she brings up the subject. Let the child know that it is okay for some disruptions to occur.

Stuttering therapy

Many of the current therapies for teens and adults who stutter focus on helping them learn ways to minimize stuttering when they speak, such as by speaking more slowly, regulating their breathing, or gradually progressing from single-syllable responses to longer words and more complex sentences. Most of these therapies also help address the anxiety a person who stutters may feel in certain speaking situations.

Drug therapy

The U.S. Food and Drug Administration has not approved any drug for the treatment of stuttering. However, some drugs that are approved to treat other health problems—such as epilepsy, anxiety, or depression—have been used to treat stuttering. These drugs often have side effects that make them difficult to use over a long period of time.

Electronic devices

Some people who stutter use electronic devices to help control fluency. For example, one type of device fits into the ear canal, much like a hearing aid, and digitally replays 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 another person. In some people, electronic devices may help improve fluency in a relatively short period of time. Additional research is needed to determine how long such effects may last and whether people are able to easily use and benefit from these devices in real-world situations. For these reasons, researchers are continuing to study the long-term effectiveness of these devices.

Self-help groups

Many people find that they achieve their greatest success through a combination of self-study and therapy. Self-help groups provide a way for people who stutter to find resources and support as they face the challenges of stuttering.

What research is being conducted on stuttering?

Researchers around the world are exploring ways to improve the early identification and treatment of stuttering and to identify its causes. For example, scientists have been working to identify the possible genes responsible for stuttering that tend to run in families. NIDCD scientists have now identified variants in four such genes that account for some cases of stuttering in many populations around the world, including the United States and Europe. All of these genes encode proteins that direct traffic within cells, ensuring that various cell components get to their proper location within the cell. Such deficits in cellular trafficking are a newly recognized cause of many neurological disorders. Researchers are now studying how this defect in cellular trafficking leads to specific deficits in speech fluency.

Researchers are also working to help speech-language pathologists determine which children are most likely to outgrow their stuttering and which children are at risk for continuing to stutter into adulthood. In addition, researchers are examining ways to identify groups of individuals who exhibit similar stuttering patterns and behaviors that may be associated with a common cause.

Scientists are using brain imaging tools such as PET (positron emission tomography) and functional MRI (magnetic resonance imaging) scans to investigate brain activity in people who stutter. NIDCD-funded researchers are also using brain imaging to examine brain structure and functional changes that occur during childhood that differentiate children who continue to stutter from those 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.

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

Use the following keywords to help you find organizations that can answer questions and provide information on stuttering:

  • Stuttering
  • Speech-language pathologists
  • Physician/practitioner referrals

NIDCD Information Clearinghouse
1 Communication Avenue
Bethesda, MD 20892-3456
Toll-free voice: (800) 241-1044
Toll-free TTY: (800) 241-1055
Email: [email protected]

Causes of Stuttering - National Stuttering Association

No one speaks perfectly all the time—we all experience disruptions in our speech. For people who stutter, these disruptions, or disfluencies, are more severe and experienced more consistently. For some, stuttering goes away in childhood, for others, it persists throughout adulthood. Why is this?

Researchers currently believe that stuttering is caused by a combination of factors, including genetics, language development, environment, as well as brain structure and function[1]. Working together, these factors can influence the speech of a person who stutters.

:: Causes ::

Stuttering and Language Development

Stuttering most often begins between the ages of two and eight, when children’s language abilities are rapidly expanding. Many children who stutter may know exactly what they want to say, but their motor pathways aren’t quite ready to get the words out.

As children produce longer and more complex sentences, their brain experiences higher demand. This increased demand can affect the motor control necessary to produce speech. When motor pathways can’t keep up with language signals, stuttering can occur.

While the rapid language development occurring in young children makes them more susceptible to disfluencies, all children develop differently. Some children who stutter may have co-existing disorders such as speech and language delays, ADHD, and learning disabilities. For developing children, a genetic disposition to stuttering combined with environmental factors may cause their disfluencies to increase over time and persist into adulthood.

Brain Activity in People Who Stutter

While no one factor determines stuttering, the predominate theory suggests that a combination of genetics, language development, and the environment can influence the brain activity of people who stutter.

The areas of the brain responsible for language may look and work differently in people who stutter. Findings from brain imaging studies indicate that there is more right hemisphere activity in adults who stutter, with less activity in the left hemisphere areas typically responsible for speech production. Some people who stutter have more difficulty processing auditory information and slower reaction times on sensory-motor tasks. In general, research has shown that the pathways in the brain responsible for language look and function differently when stuttering occurs.

Genetic Factors

Family histories of stuttering demonstrate that stuttering runs in families and is influenced by genetic factors. Children who stutter, for example, often have relatives who stutter. Identical twins sharing the exact same genetic makeup have more similar patterns of stuttering than fraternal twins. We also know that stuttering affects males more than females and that females are less likely to continue stuttering as adults.

Researchers haven’t pinpointed a specific gene that’s solely responsible for stuttering. However, it’s possible that if you carry certain genetic material, you may be more likely to stutter.

Emotions and the Environment

As children become aware of their disfluencies, negative feelings related to speaking may increase tension and further affect their ability to communicate. Depending on their temperament, some children may experience more emotional arousal and anxiety when speaking than others.

Emotional factors are difficult to measure, and cannot be considered the primary cause of stuttering. However, negative emotions may place an additional cognitive burden on children who stutter during a critical period of language development.

Acquired Stuttering

Most people who stutter begin stuttering in childhood, during the developmental period in which they are learning to communicate. In more rare cases, stuttering is the result of brain injury or severe psychological trauma. This form of stuttering, known as “acquired” stuttering, differs from developmental stuttering in both its causes and manifestations.

Common Myths

There are many Common Myths that include theories about what causes stuttering. It’s important to remember that no single cause has been found for stuttering:

  • Stuttering is not caused by children’s parents
  • Stuttering is not caused by pointing out a child’s disfluencies
  • Stuttering is not a psychological problem (although it may have psychological effects)
  • Stuttering is not a sign of brain injury or reduced intelligence
  • Stuttering is not caused by learning another language (although it may present differently in bilinguals)

Most importantly, stuttering is no one’s fault!

Original material provided by: Leslee Dean, M. A. in Latin American Studies, MS-SLP student at Florida International University and Angela M. Medina, Ph.D., CCC-SLP.

[1] Smith, A. & Weber, C. (2017). How stuttering develops: The multifactorial dynamic pathways theory. Journal of Speech, Language, and Hearing Research60(9), 2483-2505.

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The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor. nine0027 For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Stuttering: causes of occurrence, in what diseases it occurs, diagnosis and methods of treatment.


Oral speech is a complex multicomponent process, which involves not only the structures of the maxillofacial apparatus, but also the centers of the brain located in the cerebral cortex. It is in these structures that in most cases certain pathological processes leading to the development of stuttering are localized. nine0003

Stuttering (stammering) is understood as a feature of speech, which is characterized by frequent repetition or prolongation of sounds, syllables or even words in combination with frequent pauses, which disrupts the smoothness of oral speech.

Today, different figures are given that characterize the number of people who stutter - from 1 to 5%. However, all experts are unanimous that among males stuttering occurs 4 times more often than among females, and also that in 90-95% of stuttering cases occur between the ages of 2 and 7.

This speech defect often leads to communication problems, which consist not only in the difficulty of perceiving such speech on the part of the listener, but are also associated with the internal emotional experiences of a stuttering person.

Varieties of stuttering

The following types of stuttering are distinguished:

  • Neurotic stuttering, the development of which is usually based on some psychotraumatic factor. This type of stuttering is psychogenic and is not based on structural damage to the brain or peripheral parts of the speech apparatus. nine0006
  • Neurosis-like stuttering - unlike neurotic, it develops against the background of an organic lesion of the nervous system.
  • Mixed stuttering - develops against the background of both a psychogenic factor and a true lesion of the nervous system.

Possible causes of stuttering

Stuttering is based on various spasms of the muscles of the speech apparatus. They develop due to abnormal impulses emanating from the motor speech centers of the brain. The cause of the pathological work of these parts of the central nervous system can be both structural and functional disorders. The latter are characterized by the presence in some part of the brain of a focus of excitation, which activates the motor speech center and leads to the development of convulsive readiness of the muscles involved in articulation and voice formation. nine0003

In the case of the development of tonic convulsions, a prolonged muscle spasm occurs, resulting in speech delay. Unlike tonic, clonic convulsions are a series of short-term convulsions, leading to involuntary repetition of sounds or syllables.

Both types of seizures lead to impaired fluency and stuttering.

Diseases that cause stuttering

Among the factors affecting the development of stuttering, doctors identify the following diseases and conditions:

  • emotional lability and autonomic nervous system dysfunction;
  • mental trauma;
  • traumatic brain injury;
  • infectious lesion of the brain;
  • stroke;
  • perinatal damage to the central nervous system of a child, usually associated with impaired oxygen supply to brain structures in the prenatal period of development, during childbirth and in the first hours or days of life. nine0006

Which doctors to contact for stuttering

Traditionally, the initial examination of a patient with stuttering is carried out


. After a detailed questioning of the patient, the purpose of which is to clarify the circumstances of the appearance of stuttering, possible provoking factors, the doctor specifically examines the nervous system for other signs of neurological abnormalities. In the treatment of stuttering, doctors resort to the help of a speech therapist, a psychologist. Often, for the treatment of stuttering, especially in the absence of an organic lesion of the nervous system, a neurologist refers the patient to a psychiatrist's consultation in order to identify some mental abnormalities that lead to the development of stuttering. nine0003

Diagnostics and examinations for stuttering

Diagnosis of stuttering begins with a neurological examination, during which a neurologist may suspect the presence of a structural brain lesion or, conversely, not receive any evidence of the presence of organic damage. In this case, the doctor resorts to the methods of additional laboratory and instrumental diagnostics in order to confirm or exclude various organic lesions. EEG and neuroimaging methods come to the fore. nine0003

Electroencephalography (EEG) is one of the integral methods of additional examination of a patient with stuttering. EEG helps to differentiate neurotic and neurosis-like stuttering, revealing signs of convulsive activity in certain areas of the brain.

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Computed tomography and magnetic resonance imaging (MRI) of the brain are extremely useful for detecting organic brain damage: intracranial hemorrhages, tumor and inflammatory processes in the brain and structures surrounding it.

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Since the neurotic form of stuttering is often associated with emotional lability against the background of dysfunction of the autonomic nervous system, it is useful to conduct an electrocardiographic study (ECG) and, if necessary, a Holter study in order to identify heart rhythm disturbances that may indicate the predominant activation of one or another division of the autonomic nervous system. nine0003

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24-hour Holter ECG monitoring

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Laboratory studies do not carry such great diagnostic value.

How to deal with stuttering

A person with stuttering, regardless of the form of the disorder, needs the help of specialists.

Before contacting a specialist, it is necessary, if possible, to protect a person from psycho-traumatic situations.

Treatment of stuttering

Since stuttering often develops against the background of neurotic disorders, depression, drugs that affect mental processes, such as sedatives, are effective. In addition, psychotherapy methods are widely used in the complex therapy of stuttering. nine0003

In case of detection of structural (organic) pathology in the corresponding centers of the brain, therapy is used to normalize metabolic processes in the brain, for example, complexes of vitamins and metabolites. Lokhov M.I., Missulovin L.Ya., Fesenko Yu.A. Stuttering: the possibilities of pedagogical correction. Bulletin of the Leningrad State University. A.S. Pushkin. 2013. S. 48-57. nine0011 Fesenko Yu.A., Lokhov M.I. Stuttering: history and review of the current state of the problem. Bulletin of St. Petersburg State University. Ser. 11. 2015. Issue. 3. S. 93-107.


The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes. nine0003


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signs, symptoms, causes, diagnosis and treatment of the disease

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The information provided on this page should not be used for self-treatment or self-diagnosis. If you suspect a disease, you should seek help from a qualified specialist. Only your doctor can diagnose and prescribe treatment.

What is stuttering?

Stuttering is a speech disorder characterized by multiple repetitions of words, syllables and their lengthening. There are also stops during speech, which destroy its rhythmic flow. nine0003

Stuttering is classified into:

  • tonic form - with this form there are frequent stops during speech and lengthening of words and syllables;
  • clonic form - it is characterized by the presence of repetitions when pronouncing sounds, syllables, words;
  • mixed form - both components are present.

In addition, there are:

  • neurotic type - occurs when severe stress or emotional shock has been suffered; nine0006
  • neurosis-like type - the occurrence is associated with the presence of a neurological lesion.

Most often this pathology affects children, namely boys. The incidence of such a disorder in them is several times higher than in girls.

Predisposing factors of development include:

  • heredity;
  • condition of the central nervous system;
  • suffered mental trauma; nine0006
  • past intrauterine infections and injuries;
  • features in the general process of speech formation.


The formation of stuttering occurs spontaneously and tends to gradually develop and progress.

There are 4 phases of stuttering syndrome formation:

1st phase - gradual appearance of stuttering episodes, which are rare;

Phase 2 - the number of stuttering increases, accompanying gestures join;

Phase 3 - permanent presence of convulsive syndrome. Emotional stability of the patient during a conversation;

4th phase - there is a sharp fear of talking, the patient begins to avoid verbal contacts.

The most common symptoms are:

  • increase in hesitation when pronouncing words;
  • adding extra words to speech that have no semantic load; nine0006
  • impaired coordination of the tongue, lips;
  • presence of convulsions in the hands and face;
  • fear of a long conversation;
  • expiratory shortening;
  • decrease in attentiveness, memory, fatigue.


Diagnosis of the disease is carried out on the basis of the clinical picture. If the above symptoms do not disappear within three months, then stuttering is diagnosed. In this case, the patient needs to consult a speech therapist and a neurologist. nine0003

In order to exclude concomitant diseases of the central nervous system, the following is performed:

  • MRI diagnostics;
  • rheoencephalography;
  • EEG brain.


The approach to the treatment of stuttering is complex and includes the following activities:

  • sessions with a speech therapist;
  • psychotherapy sessions;
  • tranquilizers as indicated in minimal doses; nine0006
  • antispasmodics;
  • physiotherapy and massage.


Preventive measures include:

  • good nutrition;
  • mode of balanced physical activity;
  • full-fledged development of speech in a child with the help of books, games, walks;
  • avoidance of stressful situations.

Article published : 09/05/2016
Last update : 11/06/2022

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