What is stammering?
Stammering is typically recognised by a tense struggle to get words out. This makes it different from the normal non-fluency we all experience which includes hesitations and repetitions. Commonly it involves repeating or prolonging sounds or words, or getting stuck without any sound (silent blocking). Sometimes people put in extra sounds or words. Often people lose eye contact.
Some people who stammer talk their way round difficult words so that you may not realise they stammer at all. This avoidance of words, and avoidance of speaking in some or many situations, is an important aspect of stammering.
Stammering varies tremendously from person to person and is highly variable for the person who stammers who may be fluent one minute and struggling to speak the next.
'Stammering is like an Iceberg'
Most people who stammer agree that there is much more going on "under the surface" for them than other people realise. An American speech therapist called Sheehan, who himself stammered, described stammering as being like an iceberg. Only the tip of the iceberg shows above the surface while the bulk of it is hidden under the water. The hidden aspects of the stammer include avoidances such as those mentioned above, fear and anticipation of stammering, and other difficult - often strong - feelings about stammering such as frustration, anger, sadness, embarrassment, and shame. There is more on this in our interiorised stammering leaflet.
‘Stammering and ‘stuttering’
"Stammering" is the same as "stuttering". "Stammering" is more often used in the UK, Ireland and India. "Stuttering" is usual in the North America or Australia.
‘Stammerer’ or ‘person who stammers’
Some people consider the phrase "person who stammers" (or PWS) or "child who stammers" to be preferable to "stammerer". Stammering is something a person does. It not the most important thing about the person, let alone who he or she is.
Whilst some people who stammer and others object to the term "stammerer", there are other people who stammer who are comfortable with the term and will commonly use it themselves. BSA uses 'person who stammers' and 'stammerer' interchangeably, unless specifically referring to children where we would not use the term 'stammerer'.
Research seems to suggest that a combination of factors is involved. Stammering is at root a neurological condition, based in the wiring of the brain. Studies have shown differences in the anatomy and functioning of the brain of those who stammer compared with most other people.
Genetics are relevant, at least in many cases - see First genes found for stammering. Someone with stammering in the family seems more likely to develop a stammer themselves.
As an issue that affects communication, stammering can have a deep and lasting psychological impact - which in turn can affect and aggravate stammering.
For a statement suggested by a researcher to summarise what we know, see Should we stop saying "we don't know the cause of stammering"?
How does stammering affect people?
Stammering affects people in different ways and can vary according to the situation in which the person finds themselves: to whom the person is talking; how they are feeling about themselves and their speech; and what they want to say. Stammering can vary from adult to adult and child to child in its manner, frequency and severity - but is also highly variable for the person who stammers.
Stammering is not simply a speech difficulty but is a serious communication problem. For the child or adult who stammers it can undermine their confidence and self-esteem, and affect their interactions with others as well as their education and employment prospects. Schoolchildren who stammer are more likely to be bullied.
Various factors have an effect on the ease or difficulty with which people who stammer can speak. These can include:
A child or adult who stammers may become more dysfluent when increased demands are made of the person in speaking situations, when the person has high expectations of him or herself in certain situations and with certain people (e.g. speaking on the telephone, at an interview) or when a specific response is needed (e.g. saying one's name, address or phone number, having to use particular words) . On the other hand, in some people this stress actually increases fluency.
Children or adults who stammer do so on words which carry information and when using complex words of several syllables. They tend to stammer more at the start of sentences.
Sometimes it is more difficult for people who stammer to speak fluently, for example when they are feeling ill, stressed, tired, excited, or upset.
People who stammer may become more dysfluent depending on: their feelings about their speech; their perceptions of themselves as effective communicators; and others' reactions to their stammering.
People who stammer are normally fluent when speaking in chorus, singing or whispering.
How many people does stammering affect?
It is widely accepted that 5% or more of children under the age of five will go through a phase of stammering at some stage in their speech and language development. Up to a quarter of these children are at serious risk of developing persistent stammering without intervention during the pre-school years.
About 1% of the adult population stammers. More men stammer than women, with a ratio of about 3.5 to 4 stammering men for every woman who stammers. So around 80% of adults who stammer are men.
Published research studies indicate that these figures are consistent world-wide and that stammering occurs across all cultures and in all social groups.
Myths about stammering
Some people assume that if a person has difficulty speaking, they are less intelligent.
Research indicates that people who stammer have the same range of intelligence as people generally. A person who stammers knows what they want to say but has difficulty getting the words out.
So speed of speech should not be confused with speed of thought. A person who stammers will generally think at normal speed.
Stammering is due to nerves?
Stammering is neurological, ie. due to wiring in the brain (see above 'What causes stammering?'). People who stammer are not necessarily more nervous than anyone else.
It is true that some people who stammer will be more anxious about speaking situations. But when speaking can be difficult and fraught with risk, feeling anxious about speaking is a rational, though not always helpful, response.
People may stammer more severely if they are nervous. But there again, a person may stammer more with someone they are relaxed with, because they feel they can 'let their hair down'. It is different depending on the particular person who stammers.
It is not helpful to tell a person to ‘relax’. For tips, see In conversation with a person who stammers.
How can therapy help? Is there a cure?
Speech and language therapy has proved to be most effective with children aged under 5 years. In many cases when the problem is caught early enough (before psychological issues of anxiety and self consciousness arise) the child is able to learn to speak fluently again. This is known as ‘Early Intervention’.
BSA’s pre-school projects have promoted the message that children showing early signs of stammering should be referred to a speech and language therapist (SLT) as early as possible. Our Every Child's Chance of Fluency project demonstrated that providing an excellent service for pre-school children, a service that will offer them the best chance of complete recovery from stammering, does not have to be hugely expensive.
Older children and adults
Here the situation is more complex. Modern therapy can help improve fluency, confidence and communication skills. However, as stammering is more established by this stage it becomes more a case of learning to manage it effectively and reduce the impact stammering has on their lives. As well as speech and language therapy many people find self-help groups useful in this regard.
Not focusing on ‘fluency’
Therapy for older children and adults will not necessarily focus on ‘fluency’, though it may provide tools to help that. Therapy will often help a person who stammers not be so focused on trying to be fluent. The aim may be to communicate openly and well whether or not the person stammers.
Linked with this, therapy can help a person be more open about their stammer. The person who stammers may go into more situations that they previously avoided, and may move away from switching words, from avoiding speaking, or using other strategies to avoid stammering. An outcome of therapy may be that the person’s stammer is actually more apparent, because they are now saying what what they want to say and not holding back because of the stammer.
Is there a 'cure'?
There is no magical ‘cure’ for stammering. However, as we say above, therapy at an early age gives a young child the best chance of a complete recovery.
For older children and adults, while speech and language therapy can continue to make a positive difference, there is no magical 'cure' for stammering. See our article Is there a cure for stammering?