Stuttering
| Stuttering | |
|---|---|
| Other names | Stammering, alalia syllabaris, alalia literalis, anarthria literalis, dysphemia[1] |
| Specialty | Speech–language pathology |
| Symptoms | Involuntary sound repetition and disruption or blocking of speech |
| Usual onset | Sudden, 2–5 years old |
| Duration | Long term |
| Causes | Neurological and genetics (primarily) |
| Differential diagnosis | Cluttering |
| Treatment | Speech therapy, community support |
| Prognosis | 75–80% developmental resolves by late childhood; 15–20% of cases last into adulthood |
| Frequency | About 1% |
Stuttering, also known as stammering, is a speech disorder characterized externally by involuntary repetitions and prolongations of sounds, syllables, words, or phrases as well as involuntary silent pauses called blocks in which the person who stutters is unable to produce sounds.[2][3] Almost 80 million people worldwide stutter, about 1% of the world's population, with a prevalence among males at least twice that of females.[4] Persistent stuttering into adulthood often leads to outcomes detrimental to overall mental health, such as social isolation and suicidal thoughts.[5]
Stuttering is not connected to the physical ability to produce phonemes (i.e. it is unrelated to the structure or function of the vocal cords). It is also unconnected to the structuring of thoughts into coherent sentences inside sufferers' brains, meaning that people with a stutter know precisely what they are trying to say (in contrast with alternative disorders like aphasia). Stuttering is purely a neurological disconnect between intent and outcome during the task of expressing each individual sound. While there are rarer neurogenic (e.g. acquired during physical insult) and psychogenic (e.g. acquired after adult-onset mental illness or trauma) variants, the typical etiology, development, and presentation is that of idiopathic stuttering in childhood that then becomes persistent into adulthood.
Acute nervousness and stress do not cause stuttering but may trigger increased stuttering in people who have the disorder. There is a significant correlation between anxiety, particularly social anxiety, and stuttering, but stuttering is a distinct, engrained neurobiological phenomenon and thus only exacerbated, not caused, by anxiety.[6] Anxiety consistently worsens stuttering symptoms in acute settings in those with comorbid anxiety disorders.
Living with a stigmatized speech disability like a stutter can result in high allostatic load (i.e. adverse pathophysiological sequelae of high and/or highly variable nervous system stress). Despite the negative physiological outcomes associated with stuttering and its concomitant stress levels, the link is not bidirectional: neither acute nor chronic stress has been shown to cause a predisposition to stuttering.
- ^ Greene JS (July 1937). "Dysphemia and Dysphonia: Cardinal Features of Three Types of Functional Syndrome: Stuttering, Aphonia and Falsetto (Male)". Archives of Otolaryngology–Head and Neck Surgery. 26 (1): 74–82. doi:10.1001/archotol.1937.00650020080011.
- ^ World Health Organization ICD-10 F95.8 – Stuttering Archived 2014-11-02 at the Wayback Machine.
- ^ "Stuttering".
- ^ "Prevalence (In Percent) of Stuttering, as Determined by Examiner, in Young African American (Black) and European American (White) Boys and Girls in Illinois". 7 June 2010.
- ^ Carlson NR (2013). "Human Communication". Physiology of Behavior (11th ed.). Boston: Allyn and Bacon. pp. 497–500. ISBN 978-0-205-87194-0. OCLC 794965232.
- ^ Iverach L, Rapee RM (June 2014). "Social anxiety disorder and stuttering: Current status and future directions". Journal of Fluency Disorders. 40: 69–82. doi:10.1016/j.jfludis.2013.08.003. PMID 24929468.