Stuttering: understanding and supporting fluency disorders
Stuttering is a speech fluency disorder that affects about 1% of the population. It is characterized by repetitions, prolongations, and blocks that disrupt the natural flow of speech. This comprehensive guide presents the mechanisms of stuttering, current therapeutic approaches, and practical advice for those around the individual.
📋 In this article
What is stuttering?
Stuttering is a fluency disorder characterized by involuntary interruptions in verbal flow. The person knows exactly what they want to say but cannot produce it fluently. It is not an issue of intelligence, thought, or language: it is specifically the motor production of speech that is disrupted.
Stuttering is much more than just a surface symptom. It is often accompanied by muscle tension, avoidance behaviors (avoiding certain words, certain situations), negative emotions (shame, frustration, anxiety), and can have a major impact on quality of life and social participation.
🔬 Prevalence and evolution
5% of children exhibit stuttering at some point in their development, usually between 2 and 5 years old. In 80% of cases, this stuttering disappears spontaneously or with early intervention. 1% of the adult population has persistent stuttering. The ratio is 4 boys for 1 girl.
Types of disfluencies
It is important to distinguish between normal disfluencies (which everyone produces) and typical stuttering disfluencies:
| Normal disfluencies | Typical stuttering disfluencies |
|---|---|
| Hesitations, filled pauses ("uh") | Sound repetitions: "p-p-p-papa" |
| Repetitions of words or whole phrases | Syllable repetitions: "pa-pa-papa" |
| Revisions, reformulations | Prolongations: "ssssserpent" |
| Interjections | Blocks: inability to produce the sound |
Secondary behaviors
Over time, secondary behaviors may appear:
- Visible tensions: facial tightness, blinking, head movements
- Avoidance behaviors: changing words, avoiding speaking
- Escape behaviors: finger snapping, tapping foot to "unblock"
Causes and risk factors
Stuttering is a multifactorial disorder. One does not inherit stuttering, but some children are born with a predisposition that, combined with environmental factors, can trigger stuttering.
Predisposing factors
- Genetic: stuttering has a significant hereditary component (60% risk if a parent stutters)
- Neurobiological: differences in the brain circuits of speech
- Temperament: more sensitive, reactive, perfectionist children
Triggering or aggravating factors
- Rapid language development: vocabulary explosion around 2-3 years
- Stressful events: moving, birth, starting school
- Communicative pressure: interruptions, too rapid questions
- Fatigue, excitement
⚠️ What does NOT cause stuttering
Stuttering is not caused by emotional shock, trauma, poor upbringing, or lack of intelligence. These persistent beliefs are false and guilt-inducing. Stuttering has neurobiological and genetic bases.
Developmental stuttering
Most stutterings appear between 2 and 5 years, a period of language explosion where the child's brain intensely develops the speech circuits. This is developmental stuttering, to be distinguished from acquired stuttering (following a head injury or stroke, much rarer).
Possible evolution
- Spontaneous remission: in 75-80% of cases, stuttering disappears before puberty
- Persistence: in 20-25% of cases, stuttering persists into adulthood
- Fluctuation: stuttering varies according to periods, situations, fatigue
When to worry and consult?
All children exhibit normal disfluencies during the language acquisition period. However, certain signs should raise concern:
| Warning signs | Indicators of risk of persistence |
|---|---|
| Repetitions of sounds or syllables (not whole words) | Family history of persistent stuttering |
| Audible prolongations | Boy (more at risk of persistence) |
| Visible blocks with effort | Stuttering lasting more than 6-12 months |
| Visible muscle tensions | Onset after 3 and a half years |
| The child is bothered, frustrated, avoids speaking | Presence of secondary behaviors |
| High frequency (>10% of words affected) | Progressive worsening |
If in doubt, consult a speech therapist. An early consultation allows for assessing the situation and providing advice to those around, even if rehabilitation is not immediately necessary.
Speech therapy management
The management of stuttering has evolved significantly. It no longer aims to "make stuttering disappear" at all costs, but to reduce the impact of the disorder on communication and quality of life.
In young children (2-6 years)
- Lidcombe Program: behavioral approach with parental involvement
- Parental guidance: modifying the communicative environment to reduce pressure
- Indirect approach: no direct work on speech but on environmental factors
In older children and adolescents
- Fluency techniques: slowed rate, gentle start, breathing
- Desensitization: reducing negative reactions to stuttering
- Working on emotions and cognitions: acceptance, self-confidence
- Combined approaches
In adults
- Stuttering modification techniques: stuttering more easily
- Fluency modification techniques: speaking more fluently
- Cognitive-behavioral therapy: working on social anxiety, acceptance
- Speech groups: sharing with others who stutter
Advice for those around
✅ What to do
- Maintain natural and kind eye contact
- Listen patiently until the end, without interrupting
- Slow down your own speech rate (without exaggerating)
- Give time to respond, do not finish sentences
- Respond to the content of the message, not the form
- Value what the child says, not how they say it
- Talk about stuttering if the child brings it up, without taboo
❌ What to avoid
- Say "slow down", "breathe", "calm down": increases pressure
- Finish sentences for them
- Look away or show impatience
- Ask rapid-fire questions
- Make them repeat to say it "correctly"
- Praise when they are not stuttering (implies that stuttering is bad)
- Talk about stuttering in front of them as if it were a shameful problem
Our downloadable tools
🌬️ Breathing and speech
Breathing exercises adapted for speech. To learn to coordinate breath and voice without tension.
Download🧘 Relaxation exercises
Relaxation techniques suitable for children. Release tensions that may worsen stuttering.
Download💬 Communication supports
Cards and supports to promote calm communication: turn-taking, active listening.
Download📝 Guide for those around
Summary sheet of good attitudes to adopt in the face of stuttering. For parents and teachers.
DownloadFrequently asked questions
At this age, disfluencies are common and often transient. Observe the evolution over a few weeks. If the stuttering persists for more than 3-6 months, worsens, or if the child shows signs of discomfort, consult a speech therapist. In any case, adopt good attitudes (patient listening, calm rate) from now on.
In children, 75-80% of stutterings disappear spontaneously or with early intervention. In adults, stuttering generally does not "completely disappear," but it can be very well controlled with appropriate therapy. The goal often becomes to accept stuttering and communicate effectively despite it.
Stress does not cause stuttering, but it can worsen it. Stuttering has neurobiological and genetic bases. However, stressful situations (oral presentations in class, interviews) often increase disfluencies. This is why working on anxiety is part of the management.
Yes, if the child is aware of it or brings it up themselves. The taboo is more harmful than open conversation. Use simple and neutral terms: "Sometimes words have trouble coming out, it's normal, it happens to other children too." Show that you are listening to them for what they say, not how they say it.
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Discover all the tools →Article written by the DYNSEO team in collaboration with specialized speech therapists. Last updated: December 2024.
