'Out of the blue'
Most stammering starts in early childhood, when a child is developing its speaking skills, and is therefore referred to as developmental stammering. It is much less common for stammering to start in adult life, when it is known as acquired stammering or late onset stammering.
This leaflet gives some of the reasons why stammering may start in adult life and recommends some steps that can be taken to deal with it. Because this type of stammering is less common, it can be difficult to find information about it.
If you start stammering in adulthood, you should take it seriously and always consult your doctor.
Cases where stammering starts in adult life can be grouped into the following five categories.
1 Neurogenic stammering
The most common cause of stammering starting in adult life is neurological (brain) trauma. Within this category, the most common cause is stroke, which is a clot or bleeding, resulting in damage to a specific part of the brain.
Stammering is one of several different speech problems which can occur as a result of a stroke or other brain injury. Speech problems associated with a very minor stroke may only last a few hours, but they should not be ignored. You should seek medical advice immediately. In the case of a more severe stroke, the speech problems may persist for a longer period. In these circumstances, the treatment you receive should include referral to a speech and language therapist, who will be able to work with you to help you to regain fluent speech. Contact the Stroke Association for their factsheets about communication problems after stroke and about speech and language therapy for stroke patients (see contact details below).
Other causes of neurogenic stammering include brain tumour, head injury, Alzheimer's disease, and Parkinson's disease. Again, a speech and language therapist will be able to advise you and help you cope better with any speech problems arising from these sorts of conditions.
2 Drug-related stammering
Stammering can sometimes occur as part of an adverse reaction or side-effect whilst taking medication or other drugs. If you are taking a prescribed medicine and find you are affected by any sort of speech problem, consult your doctor immediately. Your doctor may be able to prescribe an alternative medicine, or may be able to help you adjust the dosage so that side-effects are minimised. Drug-related stammering will almost certainly disappear completely if you stop using the drug.
3 Stress-related stammering
A stressful event, or a series of events that affects you psychologically, can sometimes result in stammering, also referred to as psychogenic stammering. Common sources of stress include a major bereavement or loss of a relationship, but almost any unexpected emotional challenge can be a trigger for a speech problem. A stress-reaction can also follow after an accident, for example, a car crash, and in this sort of situation, careful investigation is required to establish whether the stammer is stress-related or, in fact, has a neurogenic cause, as a result of a head injury which may have gone undiagnosed.
This kind of stammering is likely to improve when the event or situation no longer causes you stress or anxiety. Some sources of stress, such as a bereavement, may be unavoidably long-term and, in these situations, counselling can help. Cruse is a national charity offering counselling to the bereaved - see contact details below.
Very occasionally, stress-related stammering does not disappear once the cause of stress has been removed or overcome. In these circumstances, you should seek a referral to a speech and language therapist who will be able to offer you suggestions and advice for improving your fluency.
4 Re-occurrence of a childhood stammer
Some people start stammering in early childhood, then stop stammering as they grow up (either spontaneously or with the help of speech and language therapy), but find it re-occurs at some point in their adult life. This is a complex area for several reasons. Firstly, you may not remember stammering as a child, but it could still be the case that you did go through a period of stammering but it was not significant, and you have forgotten about it. Secondly, it is a feature of stammering that it can be almost completely covert or hidden. From an early age, some people who stammer learn to cope by avoiding particular words or sounds which cause them difficulty, avoiding certain types of speaking situations and other practices which mean that their listeners are completely unaware of a problem. These habits can become so ingrained that you no longer regard yourself as someone who stammers. However, these ways of coping can sometimes break down without warning, perhaps as a result of added pressure in your life, or for reasons which can't be explained.
In whatever circumstances a childhood stammer reoccurs, it is worth trying speech and language therapy, as many adults can make significant improvements in their speech with the right sort of help. Even if you had speech and language therapy when you were younger and found that it didn't help, it is worth trying again because you may have changed and therapy has certainly changed.
5 Individual causes of stammering
Sometimes, stammering can occur which is not related to any of the reasons outlined above, and it may not be possible to find out what has caused it. It is still important to rule out any of the causes already mentioned. However, if no cause is identifiable, this is referred to as idiopathic stammering, which means it relates purely to the person concerned and does not fall into any other category. However, help is still available. Often, a speech and language therapist will be able to help you make significant improvements with your speech, and possibly help you to make a full recovery. As with any other stammer beyond early childhood, treatment is sometimes long-term, and will generally require effort and determination.
Contacting sources of help
In most parts of the UK, you can refer yourself directly to local NHS speech and language therapist, without having go to through your GP - BSA can provide you with local contact details. If you are interested in private therapy, please contact the Association of Speech and Language Therapists in Independent Practice (see below).
Because of the difficulty of determining which category of acquired stammering might be involved, we recommend that you always let your GP know that you are consulting a speech and language therapist.
The Association of Speech and Language Therapists in Independent Practice
Coleheath Bottom, Speen, Princes Risborough, Bucks HP27 0SZ
Tel 01494 488306 Email firstname.lastname@example.org, www.helpwithtalking.com
Cruse Bereavement Care
126 Sheen Rd, Richmond, Surrey TW9 1UR
Tel 020 8939 9530 Helpline 0870 167 1677 Email email@example.com, www.crusebereavementcare.org.uk
The Stroke Association
240 City Rd, London EC1V 2PR
Tel 0845 3033 100 Email firstname.lastname@example.org, www.stroke.org.uk
The Royal College of Speech and Language Therapists
2 White Hart Yard, London SE1 1NX
Tel 020 7378 1200 Email email@example.com, www.rcslt.org
Article: 'Out of the blue' - Chris Todhunter on his experience of developing a stammer later in life.