Stuttering affects speech fluency through disruptions like repetitions, prolongations, and blocks. It typically emerges between ages 2-13 and can have physiological causes in the respiratory, phonatory, and articulatory systems, as well as psychological factors like negative emotions, teasing, and avoidance. Treatments aim to establish strategies for fluent speech and increase patient confidence through techniques like fluency shaping, rate control, and positive self-talk. National organizations provide more information on stuttering.

1. National StutteringNational Stuttering
Awareness WeekAwareness Week
Speech- Language Pathology DepartmentSpeech- Language Pathology Department
FMH Rose Hill RehabilitationFMH Rose Hill Rehabilitation
May 2010May 2010

2. What isWhat is StutteringStuttering??
 Stuttering affects the fluency of speech. ItStuttering affects the fluency of speech. It
is characterized by disruptions withis characterized by disruptions with
speech sounds and words such asspeech sounds and words such as
repetition, laryngeal blocks, andrepetition, laryngeal blocks, and
prolongations.prolongations. (ASHA)(ASHA)

3. What are signs and symptoms ofWhat are signs and symptoms of
stuttering?stuttering?
Core (Primary) BehaviorsCore (Primary) Behaviors
1.1. Laryngeal BlocksLaryngeal Blocks
2.2. RepetitionsRepetitions
• SyllableSyllable
• WordWord
• PhrasePhrase
3.3. ProlongationProlongation
Secondary BehaviorsSecondary Behaviors
11.. AvoidanceAvoidance
** CircumlocutionsCircumlocutions
** StartersStarters
** Not entering fearedNot entering feared
contexts.contexts.
2.2. Escape/DisguiseEscape/Disguise
** Head nods/jerksHead nods/jerks
** Eye blinksEye blinks
** hand/foot tappinghand/foot tapping

4. What age does stuttering occur?What age does stuttering occur?
2-4 years2-4 years
7-9 years7-9 years
11-13 years11-13 years

5. Stuttering in Two Perspectives:Stuttering in Two Perspectives:
A. PhysiologicalA. Physiological B. PsychologicalB. Psychological
(muscles, breathing, voice, speech) (emotions, feelings)(muscles, breathing, voice, speech) (emotions, feelings)

6. What causes stuttering?What causes stuttering?
 Stuttering occursStuttering occurs
when 1 out of the 3when 1 out of the 3
subsystems is NOTsubsystems is NOT
functioning properlyfunctioning properly
for fluent speech.for fluent speech.
These include:These include:
 RespirationRespiration
 PhonationPhonation
 ArticulationArticulation
Respiration
(The Lungs and Abdomen)
Articulation
(Lips, Tongue, Jaw)
Phonation
(The Larynx)

7. a. Physiology: Respirationa. Physiology: Respiration
 The child, adolescent,The child, adolescent,
and adult must take inand adult must take in
enough air using theenough air using the
muscles of themuscles of the
abdomen andabdomen and
thoracic cavities.thoracic cavities.
When this does notWhen this does not
happen, the patienthappen, the patient
will experience lack ofwill experience lack of
breathingbreathing CONTROLCONTROL..

8. a. Physiology: Phonationa. Physiology: Phonation
The vocal folds of theThe vocal folds of the
larynx must move in alarynx must move in a
“easy-flowing” motion“easy-flowing” motion
to produce properto produce proper
controlcontrol andand
comfortablecomfortable voicing.voicing.
When this does notWhen this does not
happen, the vocalhappen, the vocal
folds become closed,folds become closed,
causing blocks.causing blocks.

9. a. Physiology: Articulationa. Physiology: Articulation
 The tongue, jaw, and lipsThe tongue, jaw, and lips
must feelmust feel comfortablecomfortable andand
underunder controlcontrol to produceto produce
accurate speech. Whenaccurate speech. When
this does not happen, allthis does not happen, all
speech muscles becomespeech muscles become
“tight” resulting in tension“tight” resulting in tension
and blocks.and blocks.

10. b. Psychological: Negativeb. Psychological: Negative
EmotionsEmotions
 When stutteringWhen stuttering
occurs, the patientoccurs, the patient
may feel frustrated,may feel frustrated,
guilty, embarrassed,guilty, embarrassed,
and most of all,and most of all,
negative aboutnegative about
him/herself, thushim/herself, thus
resulting in lack ofresulting in lack of
confidence.confidence.

11. b. Psychological: Teasing andb. Psychological: Teasing and
BullyingBullying
 Preschool and school-Preschool and school-
aged children may dealaged children may deal
with other kids teasingwith other kids teasing
and bullying about theirand bullying about their
speech, making them feelspeech, making them feel
uncomfortable and mostuncomfortable and most
of all, developing a lowof all, developing a low
self-esteem ofself-esteem of
themselves.themselves.

12. b. Psychological: Avoidanceb. Psychological: Avoidance
 Negative emotions associated withNegative emotions associated with
stuttering include anxietystuttering include anxiety
 Fear of entering certain speakingFear of entering certain speaking
situationssituations
 Sense of humiliation in certain difficultSense of humiliation in certain difficult
speaking situationsspeaking situations
 Avoidance may occur with certain sounds,Avoidance may occur with certain sounds,
words, resulting in circumlocutionwords, resulting in circumlocution

13. What treatments are available forWhat treatments are available for
stuttering?stuttering?
Patients will learn to usePatients will learn to use
strategies to producestrategies to produce
fluent speech such as:fluent speech such as:
1.1. Easy onsetEasy onset
2.2. Light Loose ContactLight Loose Contact
3.3. Fluency ShapingFluency Shaping
TechniqueTechnique
4.4. Monitoring rateMonitoring rate
Patients will learn toPatients will learn to
“change” their lifestyle to“change” their lifestyle to
increase theirincrease their
confidence and comfortconfidence and comfort
levels such as:levels such as:
1.1. Using positive self talkUsing positive self talk
2.2. Self-AdvertisingSelf-Advertising
3.3. MeditationMeditation

14. Being a HERO to oneself is aBeing a HERO to oneself is a
wonderful feelingwonderful feeling
Respiration
Phonation
Articulation
Confidence
ControlComfort

15. Are there organizations that haveAre there organizations that have
more information on stuttering?more information on stuttering?
 American Speech-Language-HearingAmerican Speech-Language-Hearing
AssociationAssociation
 The American Institute for StutteringThe American Institute for Stuttering
 National Stuttering AssociationNational Stuttering Association
 Stuttering Foundation of AmericaStuttering Foundation of America
 International Stuttering AssociationInternational Stuttering Association
 Stuttering Home PageStuttering Home Page

16. ReferencesReferences
Rosenberry-McKibbin, C. and Hegde, M.N. (2000).Rosenberry-McKibbin, C. and Hegde, M.N. (2000). An AdvanceAn Advance
ReviewReview of Speech-Language Pathologyof Speech-Language Pathology..
American Speech-Language Hearing Association. (1997-2009).American Speech-Language Hearing Association. (1997-2009).
Miranda, R.E. (2007)Miranda, R.E. (2007) Standing Up and Speaking OutStanding Up and Speaking Out. ASHA Leader,. ASHA Leader,
September 4 edition.September 4 edition.