Stuttering

Definition

Stuttering is a speech disorder in which sounds, syllables, or words are repeated or last longer than normal. These problems cause a break in the flow of speech called disfluency.

Alternative Names

Children and stuttering; Speech disfluency; Stammering; Childhood onset fluency disorder; Cluttering; Physical concomitants

Causes

Stuttering usually affects children ages 2 to 5 years and is more common in boys. It may last for several weeks to several years.

For a small number of children, stuttering does not go away and may get worse. This is called developmental stuttering and it is the most common type of stuttering.

Stuttering tends to run in families. Genes that cause stuttering have been identified.

There is also evidence that stuttering may be a result of brain injuries, such as stroke or traumatic brain injuries.

In rare cases, stuttering is caused by emotional trauma (called psychogenic stuttering).

Stuttering persists into adulthood more in boys than in girls.

Symptoms

Stuttering may start with repeating consonants (k, g, t). If stuttering becomes worse, words and phrases are repeated.

Later, vocal spasms develop. There is a forced, almost explosive sound to speech. The person may appear to be struggling to speak.

Stressful social situations and anxiety can make symptoms worse.

Symptoms of stuttering may include:

Other symptoms that might be seen with stuttering include:

Children with mild stuttering are often unaware of their stuttering. In severe cases, children may be more aware. Facial movements, anxiety, and increased stuttering may occur when they are asked to speak.

Some people who stutter find that they do not stutter when they read aloud or sing.

Exams and Tests

Your health care provider will ask about your child's medical and developmental history, such as when your child started stuttering and its frequency. The provider will also check for:

No testing is usually necessary. The diagnosis of stuttering may require consultation with a speech pathologist.

Treatment

There is no one best treatment for stuttering. Most early cases are short-term and resolve on their own.

Speech therapy may be helpful if:

Speech therapy can help make the speech more fluent or smooth.

Parents are encouraged to:

Taking medicine has not been shown to be helpful for stuttering.

It is not clear whether electronic devices help with stuttering.

Self-help groups are often helpful for both the child and family.

Support Groups

More information and support for people with stuttering and their families can be found at:

Outlook (Prognosis)

In most children who stutter, the phase passes and speech returns to normal within 3 or 4 years. Stuttering is more likely to last into adulthood if:

Possible Complications

Possible complications of stuttering include social problems caused by the fear of teasing, which may make a child avoid speaking entirely.

When to Contact a Medical Professional

Contact your provider if:

Prevention

There is no known way to prevent stuttering. It can be reduced by speaking slowly and by managing stressful conditions.

References

Feldman HM, Messick C. Language and speech disorders. In: Feldman HM, Elias ER, Blum NJ, Jimenez ME, Stancin T, eds. Developmental-Behavioral Pediatrics. 5th ed. Philadelphia, PA: Elsevier; 2023:chap 44.

National Institute on Deafness and Other Communication Disorders website. Stuttering. www.nidcd.nih.gov/health/stuttering. Updated March 6, 2017. Accessed February 22, 2024.

Simms MD. Language development and communication disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 52.

Trauner DA, Nass RD. Developmental language disorders. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 53.


Review Date: 2/17/2024
Reviewed By: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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