What causes a stammer

Stammering - NHS

Stammering, also sometimes referred to as stuttering, is a relatively common speech problem in childhood, which can persist into adulthood.

What is stammering?

Stammering is when:

you repeat sounds or syllables – for example, saying "mu-mu-mu-mummy"
you make sounds longer – for example, "mmmmmmummy"
a word gets stuck or does not come out at all

Stammering varies in severity from person to person, and from situation to situation. Someone might have periods of stammering followed by times when they speak relatively fluently.

Find out more about how stammering can affect you.

Types of stammering

There are 2 main types of stammering:

developmental stammering – the most common type of stammering that happens in early childhood when speech and language skills are developing quickly

acquired or late-onset stammering – is relatively rare and happens in older children and adults as a result of a head injury, stroke or progressive neurological condition. It can also be caused by certain drugs, medicines, or psychological or emotional trauma

The information here focuses on developmental stammering.

What causes stammering?

It is not possible to say for sure why a child starts stammering, but it is not caused by anything the parents have done.

Developmental and inherited factors may play a part, along with small differences in how efficiently the speech areas of the brain are working.

Speech development

Speech development is a complex process that involves communication between different areas of the brain, and between the brain and the muscles responsible for breathing and speaking.

When every part of this system works well, the right words are spoken in the right order, with correct rhythm, pauses and emphasis.

A child learning to construct simple sentences needs practice to develop the different speech areas in the brain and create the "wiring" (neural pathways) needed for the different parts to work well together.

Talking problems can happen if some parts of this developing system are not co-ordinated. This can cause repetitions and stoppages, particularly when the child has lots to say, is excited, or feels under pressure.

As the brain continues to develop, some of these problems resolve or the brain can compensate, which is why many children "grow out" of stammering.

Sex differences and genes

Stammering is more common in boys than girls. It is unclear why this is.

Genes are also thought to have a role. Around 2 in 3 people who stammer have a family history of stammering, which suggests the genes a child inherits from their parents might make them more likely to develop a stammer.

When to get help

You should get advice if you have any concerns about your child's speech or language development.

Treatment for stammering is often successful in pre-school age children, so it's important to be referred to a specialist as soon as possible.

Talk to a GP or health visitor about your concerns. If necessary, they may refer your child to a speech and language therapist (SLT) for an assessment.

In many areas, you can phone children's speech and language services directly and refer your child yourself.

Stamma (The British Stammering Association) has more information and support for people who stammer and parents of stammering children. You can call the helpline on 0808 802 0002 from Monday to Friday 10am to midday and 6pm to 8pm to find out about the services available in your area.

If you're an adult who stammers and it's having a significant impact on your social and work life, you may want to ask a GP to refer you to an SLT.

Treatments for stammering

There are different speech and language therapy approaches that can help people who stammer to speak more easily.

You'll work with a therapist to choose a suitable plan tailored to your child or you.

This may involve:

creating an environment where your child feels more relaxed and confident about talking
strategies to increase fluency and develop communication skills
working on feelings associated with stammering, such as fear and anxiety

Electronic devices to reduce stammering are also available and can help some older children and adults, but they're not usually available on the NHS.

Find out more about treating stammering.

Who's affected

Studies suggest around 1 in 12 young children go through a phase of stammering.

Around 2 in 3 children who stammer will grow out of it, although it's difficult to predict when this will happen in a particular child.

It's estimated that stammering affects around 1 in 100 adults, with men being around 3 to 4 times more likely to stammer than women.

Page last reviewed: 15 November 2019
Next review due: 15 November 2022

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.

Stuttering:
Explained
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Treatment
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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 have additional problems that may contribute to disfluency, 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 Research, 60(9), 2483-2505.

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

Definition

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.

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.
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.

In the case of the development of tonic convulsions, a prolonged spasm of the muscles 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 influencing the development of stuttering, doctors distinguish the following diseases and conditions:

emotional lability and dysfunction of the autonomic nervous system;
mental injury;
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.

Which doctors to contact for stuttering

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

neurologist

. 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.

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.

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.

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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.

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.

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.

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This disease is treated by Neurologist

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, their lengthening. There are also stops during speech, which destroy its rhythmic flow.

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;
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;
past intrauterine infections and injuries;
features in the general process of speech formation.

Symptoms

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;
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

Diagnosis of the disease is based on 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.

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

MRI diagnostics;
rheoencephalography;
EEG brain.

Treatment

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;
antispasmodics;
physiotherapy and massage.

Prevention

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