NIDCD Fact Sheet

voice, speech, language

Stuttering

language
U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES ∙ NATIONAL INSTITUTES OF HEALTH ∙ NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

Structures involved in speech

What is stuttering?
and voice production
Stuttering is a speech disorder in which sounds,
syllables, or words are repeated or prolonged,
disrupting the normal flow of speech. These speech
disruptions may be accompanied by struggling
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.

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 three million Americans stutter. Stuttering

affects people of all ages. It occurs most often in
children between the ages of 2 and 5 as they are How is speech normally produced?
developing their language skills. Approximately
5 percent of all children will stutter for some period We make speech sounds through a series of precisely
in their life, lasting from a few weeks to several years. coordinated muscle movements involving breathing,
Boys are twice as likely to stutter as girls; as they get phonation (voice production), and articulation
older, however, the number of boys who continue to (movement of the throat, palate, tongue, and lips)
stutter is three to four times larger than the number (see figure). Muscle movements are controlled by the
of girls. Most children outgrow stuttering. About brain and monitored through our senses of hearing
1 percent or less of adults stutter. and touch.
 NIDCD Fact Sheet
Stuttering
voice, speech

language

What causes stuttering? noticed and under what circumstances), an analysis

of the child’s stuttering behaviors, and an evaluation
Although the precise mechanisms are not of the child’s speech and language abilities and the
understood, there are two types of stuttering that impact of stuttering on his or her life.
are more common. (A third type of stuttering, called
psychogenic stuttering, can be caused by emotional When evaluating a young child for stuttering, a
trauma or problems with thought or reasoning. At one speech-language pathologist will try to predict if the
time, all stuttering was believed to be psychogenic, but child is likely to continue his or her stuttering behavior
today we know that psychogenic stuttering is rare.) or outgrow it. To determine this difference, the speech-
language pathologist will consider such factors as
Developmental stuttering the family’s history of stuttering, whether the child’s
Developmental stuttering occurs in young children stuttering has lasted six months or longer, and whether
while they are still learning speech and language the child exhibits other speech or language problems.
skills. It is the most common form of stuttering. Some
scientists and clinicians believe that developmental
stuttering occurs when children’s speech and language
How is stuttering treated?
abilities are unable to meet the child’s verbal demands.
Developmental stuttering also runs in families. In 2010, Although there is currently no cure for stuttering, there
for the first time, NIDCD researchers isolated three are a variety of treatments available. The nature of
genes that cause stuttering. More information on the the treatment will differ, based upon a person’s age,
genetics of stuttering can be found in the research communication goals, and other factors. If you or your
section of this fact sheet. child stutters, it is important to work with a speech-
language pathologist to determine the best treatment
Neurogenic stuttering
options.
Neurogenic stuttering may occur after a stroke, head
trauma, or other type of brain injury. With neurogenic For very young children, early treatment may prevent
stuttering, the brain has difficulty coordinating the developmental stuttering from becoming a lifelong
different components involved in speaking because problem. Certain strategies can help children learn to
of signaling problems between the brain and nerves improve their speech fluency while developing positive
or muscles. attitudes toward communication. Health professionals
generally recommend that a child be evaluated if he
or she has stuttered for three to six months, exhibits
How is stuttering diagnosed? struggle behaviors associated with stuttering, or has a
family history of stuttering or related communication
Stuttering is usually diagnosed by a speech-language disorders. Some researchers recommend that a child
pathologist (SLP), a health professional who is trained be evaluated every three months to determine if the
to test and treat individuals with voice, speech, and stuttering is increasing or decreasing. Treatment often
language disorders. The speech-language pathologist involves teaching parents about ways to support their
will consider a variety of factors, including the child’s child’s production of fluent speech. Parents may be
case history (such as when the stuttering was first encouraged to:
• Provide a relaxed home environment that allows therapies also help address the anxiety a person who
many opportunities for the child to speak. This stutters may feel in certain speaking situations.
includes setting aside time to talk to one another,
especially when the child is excited and has a lot Drug therapy
to say.
The U.S. Food and Drug Administration (FDA) has not
approved any drug for the treatment of stuttering.
• Refrain from reacting negatively when the child
However, some drugs that are approved to treat
stutters. Instead, parents should react to the
other health problems—such as epilepsy, anxiety, or
stuttering as they would any other difficulty the
depression—have been used to treat stuttering. These
child may experience in life. This may involve
drugs often have side effects that make them difficult
gentle corrections of the child’s stuttering and
to use over a long period of time. In a recent study
praise for the child’s fluent speech.
funded by the National Institute on Deafness and
• Be less demanding on the child to speak in a Other Communication Disorders (NIDCD), researchers
certain way or to perform verbally for people, concluded that drug therapy has been largely
particularly if the child experiences difficulty during ineffective in controlling stuttering. Clinical trials of
periods of high pressure. other possible drug treatments are currently underway.

• Speak in a slightly slowed and relaxed manner. Electronic devices

This can help reduce time pressures the child may
Some people who stutter use electronic devices to
be experiencing.
help control fluency. For example, one type of device
fits into the ear canal, much like a hearing aid, and
• Listen attentively when the child speaks and wait
digitally replays a slightly altered version of the wearer’s
for him or her to say the intended word. Don’t
voice into the ear so that it sounds as if he or she
try to complete the child’s sentences. Also, help
is speaking in unison with another person. In some
the child learn that a person can communicate
people, electronic devices help improve fluency in a
successfully even when stuttering occurs.
relatively short period of time. Nevertheless, questions
• Talk openly and honestly to the child about remain about how long such effects may last and
stuttering if he or she brings up the subject. Let whether people are able to easily use these devices in
the child know that it is okay for some disruptions real-world situations. For these reasons, researchers
to occur. are continuing to study the long-term effectiveness of
these devices.
Stuttering therapy
Self-help groups
Many of the current therapies for teens and adults
who stutter focus on learning ways to minimize Many people find that they achieve their greatest
stuttering when they speak, such as by speaking success through a combination of self-study and
more slowly, regulating their breathing, or gradually therapy. Self-help groups provide a way for people
progressing from single-syllable responses to longer who stutter to find resources and support as they face
words and more complex sentences. Most of these the challenges of stuttering.

more
 NIDCD supports and conducts research and research training on the
voice, speech, language

normal and disordered processes of hearing, balance, smell, taste,

voice, speech, and language and provides health information, based

hearing, balance
upon scientific discovery, to the public.

smell, taste
What research is being conducted
Where can I find additional information?
on stuttering?

Researchers around the world are exploring ways The NIDCD maintains a directory of organizations
to improve the early identification and treatment of that provide information on the normal and
stuttering and to identify its causes. For example, disordered processes of hearing, balance, smell, taste,
scientists have been working to identify the possible voice, speech, and language. Please see the list of
genes responsible for the types of stuttering that tend organizations at http://www.nidcd.nih.gov/directory.
to run in families. NIDCD scientists have identified
Use the following keywords to help you search for
three such genes—one on chromosome 12 and two on
organizations that can answer questions and provide
chromosome 16—that are the source of stuttering in
printed or electronic information on stuttering:
some study participants in Pakistan, England, and the
United States. The three genes, called GNPTAB, GNPTG, • Stuttering
and NAGPA, work together to help in the breakdown
• Speech-language pathologists
and recycling of cellular components. Interestingly,
other mutations in GNPTAB and GNPTG are tied to two
For more information, additional addresses and phone
serious metabolic disorders, called mucolipidosis (ML) II
numbers, or a printed list of organizations, contact:
and III, which are also caused by problems with cellular
NIDCD Information Clearinghouse
recycling. Researchers are now studying how this defect
1 Communication Avenue
in the recycling of cell components leads to specific
Bethesda, MD 20892-3456
deficits in speech fluency.
Toll-free Voice: (800) 241-1044
Toll-free TTY: (800) 241-1055
Researchers are working to help speech-language
E-mail: nidcdinfo@nidcd.nih.gov
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 Stuttering
individuals who exhibit similar stuttering patterns and NIH Pub. No. 07-4232
March 2010
behaviors that may be associated with a common cause. Reprinted December 2014
For more information, contact:
Scientists are using brain imaging tools such as PET
NIDCD Information Clearinghouse
(positron emission tomography) and functional MRI
1 Communication Avenue
(magnetic resonance imaging) scans to investigate Bethesda, MD 20892-3456
brain activity in people who stutter. NIDCD-funded Toll-free Voice: (800) 241-1044
researchers also are looking at brain imaging as a way to Toll-free TTY: (800) 241-1055
Fax: (301) 770-8977
help treat people who stutter. Researchers are studying E-mail: nidcdinfo@nidcd.nih.gov
whether volunteer patients who stutter can learn Internet: http://www.nidcd.nih.gov
to recognize, with the help of a computer program, The NIDCD Information Clearinghouse is a service of the
specific speech patterns that are linked to stuttering and National Institute on Deafness and Other Communication
Disorders, National Institutes of Health, U.S. Department
to avoid using those patterns when speaking. of Health and Human Services.