Most people who stutter don't know how to explain their stuttering, to themselves or others. The cause of stuttering is unknown and the subject of much speculation and misunderstanding. Some people think it is a sign of an underlying psychological disorder; stuttering is listed under mental disorders in the coding system used by the medical profession. This is truly incorrect. Nonetheless, many people who stutter live under this shadow without any means of disproving it. As a consequence, many that stutter turn these feelings inward and feel badly about themselves, as if something was drastically wrong with them. The following is offered as a way for people who stutter to think about their stuttering and talk about it with others.

Some individuals, about 1% of the population, are born with a predisposition to speak in a different manner; to stutter. This difference is appears in men about four times as frequently as it does in women. This is not an intellectual, social or academic difference, but it manifests itself in a breakdown of the fluency of speaking.

Research (utilizing Positive Emission Tomography or PET scan technology) studying how people use their brain when speaking shows us that when people who stutter speak disfluently, they use their brain differently than they do when they speak fluently and differently than people who don't stutter.

One of the differences is in the side of the brain that becomes dominant and coordinates the movements of the muscles used in speaking. For 95% of people who don't stutter, the left hemisphere of the brain takes the dominant role in speaking. When a person who stutters speaks fluently, activity predominantly in the left hemisphere is also seen. But when the person who stutters is disfluent, there is nearly equal activity in the left and right hemispheres. In other words, neither hemisphere becomes dominant and consequently, the act of speaking looses its coordination.

A second factor also is prevalent. PET scans reveal that there is considerably more activity in the cerebellum, the part of the brain that coordinates smooth muscle movements. We infer then that when we stutter, the cerebellum works much harder trying to coordinate the movements for speech.

When the internal and external demands on the speaking system are too great, the fluency of speech is disrupted. A demand is any situation that causes the individual to exceed his or her capability to speak in an effortless, coordinated, natural way. Speaking skills are exceeded when the rate of speaking or the effort used to speak increases to a point where it becomes uncoordinated. Disfluencies also result from excess tension in the muscles used in speaking and producing voice. This tension often comes from anxiety, fear or nervousness related to an individual's reaction to stuttering --embarrassment, shame, humiliation, frustration and the like. Out of their fear, many avoid words or avoid speaking situations altogether, which increases the emotional reactions to stuttering and creates greater demands on the speaking system.

Thus, stuttering is a speech disturbance with two faces - the uncoordinated movements of speaking and the emotional reactions to stuttering itself. Therapy therefore needs to address both aspects of the problem.

Clinicians should work with the client to develop their own script; a way of explaining and talking about their stuttering to others when the opportunity arises. It also provides a foundation from which to build a healthy perception of the client's own stuttering.

© Rentschler, 2001