Heather Gross, M.S., CCC-SLP
Has this ever happened to you? You’re speaking rapidly, or you’re feeling stressed, and your speech doesn’t come out as smoothly as usual. If this sounds familiar, you’re in good company.
But interjecting a few “ums” or pausing while you speak isn’t the same thing as stuttering. Read on to learn what it means when a stutter comes on suddenly later in life (called adult onset stuttering), and what you can do to manage it.
How do you know if it’s a stutter?
We all have moments when we don’t speak smoothly. We might add filler words, such as “like” or “um.” We might pause, lose our train of thought, make revisions to our speech, or repeat a word or phrase. These are called disfluencies, and they happen to everyone. We are human beings with complex thoughts, feelings, and emotions. No one is 100% fluent all the time (unless they’re a robot!).
Stuttering, however, is more than disfluencies. Stuttering, also known as stammering, may cause tension or negative feelings or thoughts associated with speaking. People who stutter may also demonstrate avoidance behaviors. These are attempts to avoid a situation where you might stutter. You might avoid saying certain words or phrases. Or you might stay away from situations like making a phone call or ordering in a restaurant.
Stuttering may cause tension or negative feelings or thoughts associated with speaking.
Stuttering also changes from day to day. You may have one day where you feel particularly fluent, and another day where you have more disfluencies.
So, what happens when a stutter comes out of nowhere, persists, and causes tension and negative feelings?
What causes sudden stuttering in adults?
Many children stutter while they’re learning and developing speech and language. When stuttering lasts past childhood, it’s referred to as childhood onset stuttering.
When stuttering starts later in life past childhood, it’s referred to as adult onset stuttering, which is not quite as common. Also called acquired stuttering, there are multiple types and causes.
Neurogenic stuttering
This is the most common form of stuttering found in adults. Neurogenic stuttering is often caused by a traumatic incident, such as a cerebrovascular accident (stroke) or traumatic brain injury (TBI). After an incident like this, a stutter may be present for a few hours or days, or it may last longer. In at least 50% of cases, neurogenic stuttering coexists with other speech and language concerns, such as aphasia (loss of speech) or dysarthria (motor-speech disorder).
Stuttering from childhood reoccurring
If you stuttered as a child, your stuttering can come and go, and it can reappear in adulthood. If you don’t have a record or memory of your stuttering in early childhood, it may seem like a sudden onset.
Stress- or trauma-related stuttering
This is referred to as “psychogenic stuttering.” Psychogenic stuttering usually occurs after an emotionally traumatic event. In these cases, it’s important to rule out other factors that could be impacting speech, such as genetic predispositions to stuttering, prescription medications, or an underlying neurological condition.
Pharmacogenic stuttering
Drugs such as the bronchodilator theophylline, selective serotonin reuptake inhibitors (SSRIs), and tricyclic antidepressants can cause stuttering-like disfluencies in adults as a side effect, according to medical research.
What do the different types of stuttering sound like?
As we’ve discussed, stuttering is defined as a disruption to the flow of speech. There are many different aspects of stuttering and ways it can appear in a person’s speech and communication patterns. Three types of stuttering are considered to be the most common:
Repetitions are when a person repeats the first sound or syllable of a word at least three times more than is needed. It may sound like this: “C-c-c-ould you h-h-h-elp me?”
Prolongations are when a person holds out a sound for too long, to where the speech sounds abnormal. It may sound like: “Wwwwwwhere did you go?”
Blocks are when a person is unable to move their mouth and use their voice to continue speaking. No voice or sound comes out during a block. The block may occur at the level of the throat (vocal cords) or the mouth (articulators). An example of a block might be: “Look…..over there!”
People who stutter may also have secondary behaviors. These are body or facial movements that occur with stuttering, including:
Physical tension in the face, neck, or anywhere else in the body
Facial grimacing
Eye blinking
Movement of another part of the body, such as the arm, leg, or foot
Avoiding eye contact or turning away from the conversation partner
Changes in vocal pitch or volume
When should you be concerned about a sudden stutter?
The reasons for sudden stuttering depend on a variety of factors, including your medical history or history of childhood stuttering, prescription medications, genetic predispositions to stuttering, or history of emotional/psychological trauma.
It’s important to talk with a medical professional if you have concerns about medication side effects, or if you have a history of brain injury, neurodegenerative disease, or surgeries.
What should you do if a stutter starts later in life?
If you are struggling to get your words out and feeling a lot of tension around speaking, it’s helpful to talk with a speech-language pathologist, also known as a speech therapist. Speech therapists are educated, trained, and licensed to assess a person’s speech and formally diagnose or rule out a stutter.
Keep in mind that not every person who stutters wants to reduce their stutter. There is a critical need for holistic treatment for people who stutter, supporting each person’s unique experiences and needs. Speech therapy goals and treatment plans must be personalized to the person who stutters. A speech therapist can evaluate your speech and create an individualized plan to help you find your voice!
The goal of speech therapy isn’t to “fix” a stutter
Along those lines, stuttering is not something that needs to be “cured” or “stopped.” It is a diverse way of speaking.
As a society, it’s our duty to change our beliefs about stuttering. We can think about stuttering in terms of verbal diversity–different people have different ways of speaking–and not simply as a condition that needs to be “fixed.”
Verbal diversity means different people have different ways of speaking.
Speech therapists know firsthand that stuttering is a misunderstood condition. Many people have been taught to avoid stuttering at all costs. They may steer clear of certain social situations, not order what they want at a restaurant, or avoid an entire career because it requires a high amount of verbal communication. These are just a few examples of how stuttering can affect a person’s life.
Through speech therapy, people who stutter can learn to:
Use techniques to increase fluency, or ease of speech
Use techniques to reduce tension while speaking
Reduce the negative feelings associated with stuttering
Retrain the brain to associate positive feelings with speaking
Decrease avoidance behaviors
Finally, working with an experienced speech therapist can help you feel more confident and empowered. That way you can advocate for yourself in all sorts of situations as a person who stutters.
