Why Do People Stutter?
“I spoke normally—beautifully—until I was eight years old,” said Dr. Seth Schwartz, professor of public health sciences at the University of Miami Miller School of Medicine. “I suddenly started to stutter one day while I was away at camp in 1979. At the time, my family was going through a nasty custody battle. The judge asked me in front of everyone who I wanted to live with. That was a traumatic, emotional experience, and nine months later, I started having this speech problem."
What is stuttering?
Also called stammering, stuttering is a speech language pattern disorder that interrupts the flow of speech with sound or syllable repetitions (li-li-like this or like like like this), prolongations (lllllike this), or the momentary inability to produce vocal sound. At times, a stutter is accompanied by unusual facial and body movements caused by the effort to speak.
People don't understand the exact causes of stuttering. Yet about 3 million Americans, 1% of the population, speak with a stutter. Most researchers consider it to be a neurological and/or physiological condition (not a psychological disorder), according to The National Stuttering Association. It affects more males than females.
“I’ve learned that the most challenging kind of stutter is the type I’m dealing with,” Schwartz said. “It’s based in the breath, which makes it hard to get the air out as I speak. There’s a place in my abdomen where I can feel tension as I’m trying to talk.”
Some researchers say this stuttering speech disorder may be genetic. Approximately 60% of those who stammer have a family member with the disorder. But, Schwartz doesn’t have a known family member with a similar issue.
Having lived with this condition for 40 years, the UM professor published a book about his experience with stuttering called Reaching for Resilience. He has been teaching classes and lecturing around the world for more than 20 years with a focus on the intersection between psychology, public health, culture, and immigration.
“My stutter is not a form of self-handicapping that I can just ‘get over.’ But I believe it can be treated.”
Expert Answers: Dr. Schwartz on overcoming stuttering
“I saw a number of speech therapists as a child, but it didn’t help much. I was asked to read words slowly and form my words carefully. These early approaches were focused on the mechanics of speech and the shape of my mouth as I talk, but that wasn’t the source of the problem.
I had an incorrect diagnosis early on, and different kinds of stutters respond to different techniques. My problem is with air management, not my mouth. Sometimes speech therapy worked for me in the office, and I could speak wonderfully in that controlled setting, but it didn’t translate to the real world."
Mastering your airflow
"When I was 19, a speech pathologist taught me how to manage the tension in my body that blocks my air flow as I try to speak. It was helpful, in part, because he didn’t ask me to just read passages in his office. He put me into the very situations that gave me anxiety. He encouraged me to practice the breathing techniques while I was in a store or on the phone because answering questions provoked a lot of anxiety for me. When someone asked me to repeat what I had just said, my body would tense up and I couldn't get the words out.
"It’s a behavioral technique—trying to shape someone’s behavior by having them respond in real-life situations. And it really did help me.
"The only other treatment that has worked for me is the SpeechEasy device. Worn like a hearing aid, it slightly delays and alters the pitch of my voice in my ears. The device makes it sound like my voice is speaking along with me, like a chorus, as I talk. This auditory experience helps those who stutter. When I talk while wearing this device, I stretch out the syllables a bit, which helps control my breathing. The tense feeling in my gut dissipates, and my speech fluency greatly improves. It’s reported that the device can immediately, and in the long term, reduce one’s stutter by 40%.
"I don’t use the SpeechEasy device at home because you’re not supposed to use it all the time. Your brain gets used to it, which reduces its efficiency over time. I use it every day to work, while giving a talk, or at a conference or a meeting. A device like this wasn’t even available when I was a child."
The fluency of speech
"My stutter was a lot worse when I was younger. Now, I can actually speak decently some of the time. Yet, the fluency of my speech still goes up and down without any sort of rhyme or reason. When I’m stressed, sometimes I can speak better than when I’m not stressed. If someone asks me to repeat what I just said, it trips me up because I’m suddenly focusing on what I said and what I’m saying. Usually, if I’m just reading words off a page, I’m better. When speaking in front of an audience, I know within the first minute if I’m going to have a lot of problems. If I feel fluent at the beginning, I’ll be fine.
"To improve my fluency, I should practice reading words slowly. I had a book full of sentences with lots of sounds with the same letter, and there was a time when I practiced with that book every day. I was at a conference and, at the time, I couldn’t get out more than six words in a row. I was demoralized, but I pulled out that book and practiced every night. That helped me a bit and would probably continue to help me if I kept up with it. But I don’t often do this.
"After a lifetime of living with a condition like this, it starts to feel comfortable. Many speech-language pathology patients stop practicing their techniques or using their devices because they get used to their stutter."
Know someone who is living with a stutter? Patience is key
"If you have a child with an issue—whether it’s a speech disorder, ADHD, addiction, or some other challenge—you’re likely to get frustrated and won’t understand why this continues to be a problem for your child. Calm down and support the person unconditionally, even if it’s uncomfortable. I know it’s very frustrating to listen to and be close to someone who stutters. But, don’t try to finish their sentences, look down, or look away. That doesn’t make me or others with a stutter feel better.
"When I get stuck, my wife holds my hand and tells me it’s okay, to calm down. That really helps me. I don’t expect my colleagues or students to do that. But, even someone looking at you with a sense of compassion and patience, someone who says it’s okay, that kind of support is helpful. In social situations with people I don’t know well, some people just continue to listen to me stammer. When I finally get through my statement, they’re like, ‘okay.’ And I try to do that for others when I see them struggling to speak fluently.
"If you’re dealing with a stutter or any other issue, really, be patient with yourself. It’s okay if you slip up. Trying to be perfect is the best way to make a mistake. Everyone has something they’re struggling with or trying to control. Sometimes it’s more obvious, like my situation. Other times, it’s more private.”
Dana Kantrowitz is a contributing writer for UMiami Health News.