Most people think of stuttering as a speech problem. But when it occurs in an adult who has no history of stuttering, there are a variety of possible causes.
Here’s what stuttering can mean if you or a loved one experiences it in adulthood…*
Every word that you speak is preceded by thousands of neuromuscular events. Anything that interrupts this complex—and lightning-fast—progression of steps can interrupt the normal flow of speech.
When researchers looked at adults who began stuttering, stroke was found to be the main cause. Adult-onset stuttering can also be caused by head injuries, brain tumors or neurodegenerative diseases such as Parkinson’s disease and multiple sclerosis (MS). The stuttering in these cases develops as the disease progresses.
A number of drugs also can affect the brain’s ability to coordinate the different components involved in speech. There have been reports of new-onset stuttering in adults taking a stimulant, such as methylphenidate (Ritalin), as well as selective serotonin reuptake inhibitor (SSRI) antidepressants, such as sertraline (Zoloft). Once the drug is discontinued, the stuttering typically stops.
If you experience a sudden change in speech: Always discuss it with your doctor so that he/she can investigate the cause.
Adult-onset stuttering may sometimes be similar to the developmental stuttering that occurs during childhood—but there are some differences. When an adult stutters, it may…
• Affect any part of a word. Children with a stutter usually trip over the first letter: “I want to g-g-go.” With adults, stuttering can occur on the second, third or fourth syllables: “I like that rest-t-aurant.”
• Be marked by interjections. Some adults who stutter begin using interjections in their speech. For example, a sentence might be peppered with extraneous (nonword) sounds, such as “ahhh.” An interjection can also be a long silence or hesitation between words or within a word.
• Include rapid bursts of speech. With neurological disorders, speech may be affected in this way. These bursts of speech might be unintelligible…or include the repetition of certain words or phrases.
If the underlying problem improves, the stuttering will naturally get better—but it can take a long time. Someone who’s had a mild stroke will probably regain normal speech within a few months. It can take much longer for those with more serious types of brain injuries. It might never go away in patients with MS, Parkinson’s or other progressive neurodegenerative disorders.
If you have a stutter that’s caused by a neurological problem, including stroke, MS or Parkinson’s disease, your doctor will probably refer you to a speech-language pathologist who specializes in stuttering. Sessions usually last about an hour and may be covered by insurance.
In addition to guiding a patient through strategies such as those described below, a therapist may help him identify disruptions in speech patterns and instruct him in the use of more appropriate patterns. If the patient has anxiety about his speech, therapy may include counseling to help change harmful perceptions about stuttering.
What helps most…
• Speak slowly. This is among the most effective ways to deal with a stutter. Super-slow speech will make you less likely to stumble over initial sounds. It can also help you reduce the frequent (and often unconscious) use of “filler” sounds, such as “um” or “ahh.”
• Ask others to slow down. Many neurological diseases slow the rate at which you process information. It’s easy to become overwhelmed when you’re faced with a barrage of rapid speech from others—and you’ll also tend to reciprocate with your own rapid-fire speech. Encourage people to speak more slowly. Take your time when you’re listening as well as speaking.
Also, minimize background noise whenever possible to avoid getting overwhelmed by sounds—for example, keep the volume of the TV and radio in your home on low.
• Maintain eye contact when speaking. This will help both the person who stutters and the listener tune in to the conversation.
• Use short sentences. It will help your speech keep pace with your thoughts. Avoid complex sentences, such as, “I really like the food at the new Chinese restaurant, and it’s only three miles away, so let’s go.” Keep it short—“I like the new Chinese restaurant. It’s close. Let’s go.”
• Ease into words. Word initiation can be a challenge for adults who stutter. My last name, “Fraser,” will often come out “F-F-Fraser.” You can get past this with a technique called easy onset. Speaking slowly, you say the first letter gently, then ease into the rest of the word—keep your lips slightly parted, as though you’re puffing out a breath of air. The words will sound “softer,” but they’ll be easier to get out.
• Loosen up. If your posture feels tense, loosen up. And consciously relax the muscles in your face and throat. Breathe normally—and softly—while you speak.
• Speak more. It’s natural to want to interact less with people when you’re embarrassed about your speech. But the fact is, you need to speak more to overcome a stutter.
When you meet someone new, tell him that speech is a challenge. Say something like, “I have MS and a bit of a stutter. I need to speak slowly. OK?” You’ll probably get an encouraging smile. Acknowledging your disability up front will make you feel less self-conscious.
*For more information on stuttering, call The Stuttering Foundation’s toll-free hotline at (800) 992-9392 or check the website at StutteringHelp.org.
