Effective communication is important for meaningful relationships and personal success. If you or a loved one struggles with stuttering, it's important to understand that speech therapy can help. By exploring the connection between stuttering and anxiety, learning practical speech strategies, and finding ways to support each other, you can make significant strides toward more confident and fluent speech.
In this blog post, we'll discuss:
Understanding Developmental Stuttering
Childhood-onset fluency disorder, also called developmental stuttering, is a speech disorder that affects about 3 million Americans. While most children begin to stutter between 2 and 6 years old, sometimes they start stuttering as older children.
No one is entirely sure what causes developmental stuttering, but here is what we know:
Neurological causes play a significant role. Speaking primarily involves parts of the left side of the brain, including areas called the basal ganglia and thalamus. These parts work together in a loop called the "cortico-basal ganglia-thalamo-cortical loop." This feedback loop helps create internal timing cues for smooth speech, which people who stutter often have trouble with. Researchers have found that children who stutter have weaker brain connections in certain areas and struggle more with tasks that need precise timing compared to children who don't stutter. Those with the weakest brain connections in these areas tend to stutter the most severely.
Genetics also contribute to the likelihood of stuttering. It is more likely to occur in individuals with a family history of the disorder.
Why Am I Stuttering All of a Sudden?
Neurogenic stuttering is less common and can occur in adults due to brain injury. The most common causes are stroke and brain injuries from sports, concussions, or motor vehicle accidents. Any neurological event affecting the nervous system related to speech production can cause stuttering. This type of stuttering has been associated with:
Recreational drug use
Medication side effects
Degenerative diseases like Parkinson’s or Multiple Sclerosis
Cysts or brain tumors
Epilepsy
COVID-19
Encephalitis
Hypoglycemia related to bulimia
Psychogenic or Functional Stuttering
Psychogenic stuttering, also known as functional stuttering, is even rarer. It affects people without an obvious physical cause and is often linked to psychological events or emotional trauma.
Have you ever gotten a headache when you're stressed? Sometimes, our bodies react physically to stress or traumatic events, and stuttering can be one of those reactions.
Symptoms of Stuttering
Speech disruptions: These can include repetition of sounds, syllables, words, phrases (repetitions), stretching out a sound (prolongation), or having a hard time getting a word out (blocks).
Symptoms of Stuttering a Listener May Not See: Increased tension, Avoidant behaviors, fear of certain syllables or words, Feelings of anxiety, fear, sadness, or other emotions
Differentiating Between Neurogenic and Functional Stuttering- The Evaluation
Because neurogenic stuttering is more common, stuttering evaluations first focus on identifying or ruling out neurogenic stuttering. Only after ruling this out will the speech therapist consider functional stuttering.
Detailed History
The speech therapist will ask about when the stuttering began, where and when it happens, and how the person describes their stutter. They will also be asked about recent medication changes.
Any Neurological Incident?
The speech pathologist will determine whether a neurological incident could have caused the stuttering. This can be challenging because sometimes neurogenic stuttering occurs after a minor brain event with no clear injury, or it might start months after a serious brain injury. Stuttering can also be the first symptom of a condition like a degenerative disease, tumor, or a side effect of medication.
Evaluation of the Stuttering's Impact on a Person
The therapist will want to know how stuttering affects the person. They may ask about the person's awareness of their stutter and how they respond to stuttering moments. Typically, people with developmental stuttering are aware of their stuttering and may feel anxious about specific words or sounds. In contrast, people with neurogenic stuttering may have little to no awareness of their stutter unless they had developmental stuttering before or have been stuttering for a while before seeking help from a stuttering therapist.
Assess the Type of Disfluencies
Developmental Stuttering | Neurogenic Stuttering |
More likely on content words (nouns, verbs, adjectives, adverbs) | Occurs on both content and function words (prepositions, articles, pronouns, auxiliary verbs) |
Repetitions, prolongations, blocks, and interjections | Mostly repetitions, fewer blocks |
Often at the beginning of words or phrases | Can appear in any position within words or phrases |
Secondary behaviors (e.g., eye blinking, fist clenching) often present and linked to stuttering moments | Few or no secondary behaviors, and they are not linked to stuttering moments |
Rote tasks (counting, days of the week) are typically fluent; severity varies across different tasks | Stuttering is consistent across most speaking tasks |
Fluency improves during tasks like singing or reading aloud in a group | Stutter persists even in fluency-inducing conditions |
Fewer stuttering moments with repeated readings | Little or no improvement with repeated readings |
May show aphasia-like disfluency patterns (word retrieval/language production problems) or motor speech-type disfluencies (apraxia of speech) | Less likely to present in these specific ways but may co-occur with ADHD and language impairment |
Consideration of Functional Stuttering
If the stuttering pattern doesn’t match developmental or neurogenic stuttering, consider functional stuttering. Here are some signs:
Sudden Onset
Multiple repetitions of all sounds in a word, facial grimaces, nodding, or tremor-like movements.
Stuttering remains consistent across different speech tasks and may worsen with simpler tasks.
Stuttering may increase with repeated readings.
Follows a fixed stuttering pattern.
Atypical voice quality.
Agrammatical or telegraphic sentences (e.g., "me no like...").
Onset linked to a significant stress, trauma, or life event.
May seem emotionally indifferent to speech changes but show generalized anxiety.
May have a history of anxiety or depression
Fluency may improve after expressing emotional information.
Unusual movements (e.g., head, eyes) not related to speech.
Quick improvement with trial fluency shaping techniques (e.g., easy onset, phrasing, prolonged speech). Significant changes are often seen within 1-2 sessions.
The Connection Between Stuttering and Anxiety
How Anxiety Affects Stuttering
While stress and anxiety do not cause stuttering, they can make it worse and more difficult to communicate. Situations like public speaking, ordering at a restaurant, or participating in work meetings can make someone who stutters feel more nervous.
How to Stop Stuttering When Nervous
Breathing Techniques: Taking deep breaths can help manage stress. A deep breath sends a message to your brain that it does not need to be in fight-or-flight mode. Acceptance and Commitment Therapy (ACT): If you struggle with stuttering, ACT can help you accept your feelings about it rather than trying to avoid or fight them. You might learn to recognize that feeling anxious about stuttering is normal but doesn’t have to stop you from speaking. The goal is to keep speaking and living according to what matters to you, even if you feel nervous. Cognitive Behavioral Therapy (CBT): CBT helps people change the way they think and behave to feel better. It works on the idea that our thoughts affect our feelings and actions. By changing negative thoughts about stuttering, you can lessen anxiety and improve your speech.
Speech Therapy Strategies for Managing Stuttering and Improving Speech Fluency
There is an increased likelihood of stuttering when speaking faster or louder, so changing those two elements can improve speech fluency.
Reducing Speech Rate and Modifying Speech Volume
Speaking slowly gives your speech muscles time to organize thoughts and reduces the chances of disfluent speech.
Purposeful pauses allow you to breathe, think ahead, give your listeners time to absorb what you’re saying, and allow your speech muscles a chance to say what you want to say.
Prolonging sounds in words can reduce frequency of stuttering.
Slow and Mindful Speech
Practicing mindfulness and self-compassion can help you speak fluently and more confidently. When more attentive to the words you're saying, you are more likely to be fluent.
Shifting your mindset and replacing negative thoughts with positive affirmations can help you speak more smoothly.
How Can I Help My Loved Ones Who Stutter?
Stuttering can significantly affect a person's self-esteem. Here are some ways you or a family member can provide support:
Listen Attentively: Pay close attention to what they are saying, not how they are saying it. This shows that you value their message and helps build their confidence.
Be Patient: Give them time to express themselves without interrupting or finishing their sentences. Let them speak at their own pace.
Maintain Eye Contact: This shows that you are engaged and interested in what they have to say, not their stutter.
Encourage and Support: Avoid criticizing or correcting their speech. Offer to attend support groups with them for additional encouragement.
Create a Relaxed Environment: Help reduce pressure by fostering a calm and supportive atmosphere.
Educate Yourself: Learn about stuttering to better understand their experience and provide informed support.
By listening attentively and adopting these supportive behaviors, you can help your loved ones feel more confident and comfortable in their communication.
Mastering Your Speech with Confidence from a Speech- Language Pathologist
The path to confident speech is full of hope and opportunities for growth. Understanding how stuttering and anxiety are connected, embracing mindset changes, and applying practical strategies can help you speak more smoothly.
Remember, every voice has value. By working with speech-language pathologists and focusing on speaking slowly, taking brief pauses, and embracing your own voice, each step forward is a victory in your journey toward self-improvement.
Frequently Asked Questions
What is the most common type of stuttering?
The most common type of stuttering is called developmental stuttering, which usually begins between the ages of 2 and 6.
What makes stuttering worse?
Social anxiety and other forms of anxiety can worsen stuttering. While it's not possible to completely prevent stuttering, practices such as breath control, deep breathing exercises, and mindfulness meditation can help reduce anxiety and improve speech fluency.
Is it possible to stop stuttering or overcome stuttering?
There is currently no cure for stuttering, but therapy can help manage it. Speech-language pathologists work with individuals to improve their speech and build confidence, making it easier to communicate effectively.
Gain Confidence in Your Speech Again Near Skokie, IL
As a speech-language pathologist in Skokie, I specialize in helping people who stutter find confidence in their speech again. I’ll create a personalized stuttering treatment program just for you, focusing on strategies to improve your speech fluency and reduce stuttering symptoms. Many people who stutter have specific fears, like speaking in public, making phone calls, or talking in social settings. I’ll help you work through these fears and gradually become more comfortable with speaking.
I’ll also teach you techniques to handle feelings of loss of control and the physical symptoms of stuttering. This may include practices from holistic therapy approaches like self-compassion, Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Acceptance and Commitment Therapy (ACT). We might also create a list of speaking situations, starting with the easiest and gradually working up to the more challenging ones, to build your confidence and skills.
Online Speech Therapy for Stuttering Across Illinois, New Jersey, and New York
As a speech therapist specializing in stuttering disorders, I offer online therapy sessions for both children and adults throughout Illinois, New York, and New Jersey.
For those who stutter, the goal often extends beyond simply being understood; it’s about finding ways to speak more smoothly and confidently. I am dedicated to helping you or your loved one achieve this.
My approach focuses on:
Improving Speech Fluency: Working on strategies to make your speech smoother and more controlled.
Managing Emotions: Addressing feelings of tension or fear related to speaking.
Building Confidence: Developing a positive attitude towards communication.
Expanding Capabilities: Ensuring stuttering does not limit your opportunities.
Reducing Negative Impact: Minimizing the adverse effects stuttering might have on your daily life.
Additional Speech Therapy Services at Speak with Stephanie
At Speak with Stephanie, we offer comprehensive speech therapy services tailored to the needs of both children and adults. For children, we address language disorders and speech production challenges. For adults, we provide support for a range of communication difficulties, including language disorders, articulation issues, and aphasia.
We are committed to delivering personalized care that ensures effective improvement in communication skills. Our holistic approach supports significant progress, helping clients excel in their daily interactions and achieve their communication goals.
About the author:
Stephanie Jeret is a Speech-Language Pathologist and the owner of Speak with Stephanie LLC. She obtained her Bachelor's and Master's degree from the City University of New York. She has practiced speech therapy in a number of settings including outpatient rehabilitation, telepractice, skilled nursing facilities, schools, and a private practice. She specializes in the evaluation, diagnosis, and treatment of a variety of communication disorders including articulation disorders, receptive/expressive language disorders, and fluency disorders. Information is available by emailing her at stephanie@speakwithstephanie.com or by visiting www.speakwithstephanie.com.