Stuttering is a disorder of speech fluency that interrupts the forward flow of speech. All individuals are disfluent at times, but what differentiates the person who stutters from someone with normal speech disfluencies is the kind and amount of the disfluencies.

Types of Stuttering.

• Repetition of sounds (e.g., b-b-b-ball), syllables (e.g., mo-mo-mommy), parts of words (e.g., basket-basket-basketball), whole words, and phrases.
• Prolongation, or stretching, of sounds or syllables (e.g., r-----abbit)
• Tense pauses, hesitations, and/or no sound between words
  
• Speech that occurs in spurts, as the client tries to initiate or maintain voice
  
• Related behaviors: reactions that accompany stuttering such as tense muscles in the lips, jaw, and/or neck; tremor of the lips, jaw, and/or tongue during attempts to speak; foot tapping. eye blinks, head turns, etc. [to try to escape from the stuttering]; etc. There are many related behaviors that can occur and vary from person to person.
  
• Variability in stuttering behavior, depending on the speaking situation, the communication partner(s), and the speaking task. A person who stutters may experience more fluency in the speech-language pathologist' s office than in a classroom or workplace. There may be no difficulty making a special dinner request at home, but extreme difficulty ordering a meal in a restaurant. Conversation with a spouse may be easier, and more fluent, than that with a boss. A person may be completely fluent when singing, but experience significant stuttering when talking on the telephone.
  
• A feeling of loss of control. The person who stutters may experience sound and word fears, situational fears, anticipation of stuttering, embarrassment, and a sense of shame. Certain sounds or words may be avoided. One word may be substituted for another that is thought to be harder to say. Or, certain speaking situations may be avoided altogether. For example, a person who stutters may always wait for someone else to answer the phone. Or, he or she may walk around a store for an hour rather than ask sales staff where an item can be found. These reactions to stuttering occur in more advanced stages.
  

The Numbers

Unkown

Cure

The goals of speech-language pathology treatment are improved fluency and success in communication. There are a variety of successful approaches for accomplishing these goals. There are no published scientific data that indicate the general superiority of any one approach.

Prior to treatment, the speech-language pathologist will conduct a detailed evaluation. This assessment may include:

• a developmental and behavioral history of speech and language by interviewing family members and/or the person who stutters
  
• a structured speech sample (e.g., a recording of the person describing a picture, reading a passage aloud, or describing a job or favorite activity)
  
• speech samples in different everyday communication situations
  
• determination of variables that may affect speech fluency through interviews and review of video- and/or audiotapes
  
• experimentation with different fluency strategies to assess how they may improve speech
  
• observation of articulation, expressive and receptive language skills, cognitive skills, voice, hearing and vision
  
• information from other professionals, as necessary, to help plan treatment.

Fluency strategies may include:

• reducing the rate of speech and using slow, smooth speech movements
  
• easing into voicing of speech sounds
  
• voicing continuously during utterances
  
• articulating lightly
  
• starting air flow for speech before any other muscle movement
  

Special equipment or a computer may be used to teach these strategies or give immediate feedback on how well these strategies are being used.

The person who stutters may also be taught different things to do when he or she has a stuttering block or feels that one is about to occur. Reducing tension in specific muscle groups and substituting a bouncing kind of speech are examples of this kind of strategy.

The speech-language pathologist may also provide suggestions and counseling on modifying the speaking situation. Parents and other communication partners may be asked to modify their behaviors by talking more slowly or not interrupting. The person who stutters may want to tell a stranger, "I stutter. It may take me longer to say a sentence than what you are used to." Such a statement reduces the time pressure to speak and makes it easier to use slower, more relaxed speech. In general, the speech-language pathologist and the person who stutters will discuss different speaking situations and determine together the best way to handle them, even those that are feared or have been avoided by the person who stutters.