In 1988, an act of Congress established National Stuttering Awareness Week. This year, the observance runs from May 13-19, and is geared towards getting the 70 million people worldwide who stutter to “speak out, fluently or not” and to help spread more information about the communication disorder. In the US, about three million people are affected; many have struggled with the disorder since childhood, when it often first develops.
“The short answer is that nobody knows what causes stuttering,” says Ludo Max, Ph.D., director of the Laboratory for Speech Physiology and Motor Control at the University of Washington. Max explains that in some cases there is a genetic component, meaning that at least one other person in their family also stutters. Evidence shows that the “pathways between various brain regions are not optimally developed” in those who stutter, he continues, and that there may also be differences in the way certain brain regions, such as those controlling motor and sensory functions, operate. These factors contribute to a type of stuttering called persistent developmental stuttering, which begins in early childhood. While it is possible to first develop a stutter as an adult, traumatic brain injury or stroke are the likely causes for what is referred to as acquired neurogenic stuttering.
Early intervention yields the best results for treatment, says Max. While there is no “cure” for stuttering—nor is there any one treatment strategy that definitively works across the board for everyone—it is beneficial to get a child immediate assistance if there are any signs of stuttering or speech problems. Max suggests finding a speech pathologist who specifically uses the Lidcombe method, a treatment plan that is conducted primarily by the parents of the child. “In preschool children, there is plenty of scientific data—collected over more than 20 years now— indicating that the Lidcombe treatment is very effective,” he says, adding that in event the treatment fails, it will not make stuttering worse, whereas a “wait-and-see” approach absolutely can.
In older children and adults, it is less likely that a stutter can be remedied, regardless of the treatment being used, he advises. Some speech pathologists will use “fluency shaping techniques,” which helps the patient learn ways to speak differently and stutter less, while others utilize a “stuttering modification approach. “In the latter, the idea is that it is much better to not try to avoid or hide the stuttering,” says Max. “It is best to work on learning how to get through stuttering moments and to focus strongly on social confidence, self-esteem, interaction skills, etc.”
Max also points out that there have been some promising recent developments regarding medication, specifically medications that help regulate dopamine in the brain. He points out that there has also been exploration into the effects of non-invasively stimulating certain brain regions to see the effects on speech, which is usually done by using electrodes in a head cap and is “provided safely and without discomfort.”
The National Stuttering Association offers a variety of resources for children, teens, and adults. These resources are provided year-round on its website and many will be highlighted this week, along with various events to help spread awareness.
– Megan Messana