Stuttering: an overview.

Speech dysfluency (stuttering) is common in children. Although stuttering often resolves before adulthood, it can cause significant anxiety for children and their families. Stuttering speech patterns are often easily identifiable; when a child is learning to talk, repetition of sounds or words, prolonged pauses, or excessively long sounds in words usually occur. Secondary behaviors (e.g., eye blinking, jaw jerking, involuntary head or other movements) that accompany stuttering can further embarrass the child, leading to a fear of speaking. The etiology of stuttering is controversial, but contributing factors may include cognitive abilities, genetics, sex of the child, and environmental influences. Research has shown that more than 80 percent of stuttering cases are classified as developmental problems, although stuttering can also be classified as a neurologic or, less commonly, psychogenic problem. The initial assessment of patients who stutter addresses the severity of dysfluency; secondary behaviors; and the impact of stuttering, such as patient distress. Further testing is useful in assessing the need for therapy. Pharmacologic therapy has not been shown to improve stuttering. Encouraging patients to talk slowly and the use of fluency-shaping mechanisms such as delayed auditory feedback devices to slow the speech rate can help minimize or eliminate stuttering. For patients with persistent stuttering, controlled fluency or stuttering modification therapy may be effective.