Stuttering

Stuttering is a speech disorder characterized by disturbance in the normal fluency and time patterning of speech (inappropriate for the individual's age). Symptoms include frequent occurrences of one or more of the following:

• Sound and syllable repetitions.

• Sound prolongations.

• Interjections.

• Broken words (e.g., pauses within a word).

• Circumlocutions (word substitutions to avoid problematic words).

• Words produced with an excess of physical tension.

• Monosyllabiv whole-word repetitions (e.g., "I-I-I-I see him").

The disturbance in fluency interferes with academic or occupational achievement or with social communication.

If a speech-motor or sensory deficit is present, the speech difficulties are in excess of those usually associated with these problems.

Prevalence

The prevalence of Stuttering in prepubertal children is 1% and drops to 0.8% in adolescence. The male-to-female ratio is approximately 3:1.

Course

Retrospective studies of individuals with Stuttering report onset typically between ages 2 and 7 years (with peak onset at around age 5 years). Onset occurs before age 10 years in 98% of cases. The onset is usually insidious, covering many months during which episodic, unnoticed speech dysfluencies become a chronic problem.

As the disorder progresses, there is a waxing and waning course. The dysfluencies become more frequent, and the Stuttering occurs on the most meaningful words or phrases in the utterance. As the child becomes aware of the speech difficulty, mechanisms for avoiding the dysfluencies and emotional responses may occur. Research suggests that some proportion recover; estimates range from 20% to 80%. Some individuals with Stuttering recover spontaneously, typically before age 16 years.

Diagnostic criteria summarized from:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.