Stuttering or stammering (more generally the first in US and the second in British usage) is a speech disorder in which the flow of speech is disrupted by involuntary
repetitions and prolongations of sounds, syllables, words or phrases as
well as involuntary silent pauses or blocks in which the person who
stutters is unable to produce sounds. The term stuttering
is most commonly associated with involuntary sound repetition, but it
also encompasses the abnormal hesitation or pausing before speech,
referred to by people who stutter as blocks,and
the prolongation of certain sounds, usually vowels or semivowels.
According to Watkins et al. stuttering is a disorder of “selection,
initiation, and execution of motor sequences necessary for fluent speech
production.”
For many people who stutter, repetition is the primary problem. The
term "stuttering" covers a wide range of severity, encompassing barely
perceptible impediments that are largely cosmetic to severe symptoms that effectively prevent oral communication. In the world, approximately four times as many men as women stutter, encompassing 70 million people worldwide. To put that in perspective, about 1% of the world's population stutters.
The impact of
stuttering on a person's functioning and emotional state can be severe.
This may include fears of having to enunciate
specific vowels or consonants, fears of being caught stuttering in
social situations, self-imposed isolation, anxiety, stress, shame, being
a possible target of bullying (especially in children), having to use
word substitution and rearrange words in a sentence to hide stuttering,
or a feeling of "loss of control" during speech. Stuttering is sometimes
popularly seen as a symptom of anxiety, but there is actually no direct
correlation in that direction (though as mentioned the inverse can be
true, as social anxiety may actually develop in individuals as a result
of their stuttering).
Stuttering is generally not a problem with the physical production of speech sounds or putting thoughts into words. Acute nervousness and stress do not cause stuttering, but they can trigger stuttering in people who have the speech disorder, and living with a highly stigmatized disability can result in anxiety and high allostatic stress load (i.e., chronic nervousness and stress) that reduce the amount of acute stress necessary to trigger stuttering in any given person who stutters, exacerbating the problem in the manner of a positive feedback system; the name 'stuttered speech syndrome' has been proposed for this condition. Neither acute nor chronic stress, however, itself creates any predisposition to stuttering.
The disorder is also variable, which means that in certain situations, such as talking on the telephone or in a large group, the stuttering might be more severe or less, depending on whether or not the stutterer is self-conscious about their stuttering. Stutterers often find that their stuttering fluctuates and that they have "good" days, "bad" days and "stutter-free" days. The times in which their stuttering fluctuates can be random. Although the exact etiology, or cause, of stuttering is unknown, both genetics and neurophysiology are thought to contribute. There are many treatments and speech therapy techniques available that may help increase fluency in some people who stutter to the point where an untrained ear cannot identify a problem; however, there is essentially no cure for the disorder at present. The severity of the person's stuttering would correspond to the amount of speech therapy needed to increase fluency. For severe stuttering, long-term therapy and hard work will be required to increase fluency.
Stuttering is generally not a problem with the physical production of speech sounds or putting thoughts into words. Acute nervousness and stress do not cause stuttering, but they can trigger stuttering in people who have the speech disorder, and living with a highly stigmatized disability can result in anxiety and high allostatic stress load (i.e., chronic nervousness and stress) that reduce the amount of acute stress necessary to trigger stuttering in any given person who stutters, exacerbating the problem in the manner of a positive feedback system; the name 'stuttered speech syndrome' has been proposed for this condition. Neither acute nor chronic stress, however, itself creates any predisposition to stuttering.
The disorder is also variable, which means that in certain situations, such as talking on the telephone or in a large group, the stuttering might be more severe or less, depending on whether or not the stutterer is self-conscious about their stuttering. Stutterers often find that their stuttering fluctuates and that they have "good" days, "bad" days and "stutter-free" days. The times in which their stuttering fluctuates can be random. Although the exact etiology, or cause, of stuttering is unknown, both genetics and neurophysiology are thought to contribute. There are many treatments and speech therapy techniques available that may help increase fluency in some people who stutter to the point where an untrained ear cannot identify a problem; however, there is essentially no cure for the disorder at present. The severity of the person's stuttering would correspond to the amount of speech therapy needed to increase fluency. For severe stuttering, long-term therapy and hard work will be required to increase fluency.
Characteristics
Primary behaviors
Primary stuttering behaviors are the overt, observable signs of speech fluency breakdown, including repeating sounds, syllables, words or phrases, silent blocks and prolongation of sounds. These differ from the normal dysfluencies found in all speakers in that stuttering dysfluencies may last longer, occur more frequently, and are produced with more effort and strain. Stuttering dysfluencies also vary in quality: common dysfluencies tend to be repeated movements, fixed postures, or superfluous behaviors. Each of these three categories is composed of subgroups of stutters and dysfluencies.- Repeated movements
- Syllable repetition—a single syllable word is repeated (for example: on—on—on a chair) or a part of a word which is still a full syllable such as "un—un—under the..." and "o—o—open".
- Incomplete syllable repetition—an incomplete syllable is repeated, such as a consonant without a vowel, for example, "c—c—c—cold".
- Multi-syllable repetition—more than one syllable such as a whole word, or more than one word is repeated, such as "I know—I know—I know a lot of information.".
- Fixed postures
- With audible airflow—prolongation of a sound occurs such as "mmmmmmmmmom".
- Without audible airflow—such as a block of speech or a tense pause where nothing is said despite efforts.
- Superfluous behaviors
- Verbal—this includes an interjection such as an unnecessary uh or um as well as revisions, such as going back and correcting one's initial statements such as "I—My girlfriend...", where the I has been corrected to the word my.
- Nonverbal—these are visible or audible speech behaviors, such as lip smacking, throat clearing, head thrusting, etc., usually representing an effort to break through or circumvent a block or stuttering loop.
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