Children's Health Children's Diseases and Conditions

When Words Fail: A Conversation with Stuttering Expert Dr. Barry Guitar

Every day, over three million Americans struggle with stuttering. For some it is a mild, intermittent problem. For others, stuttering is a source of constant fear and frustration, and becomes a central factor in choices about work and relationships.

Dr. Barry Guitar, of the University of Vermont, is familiar with the isolating effects of stuttering. As a recognized expert in research and treatment of this condition, he has worked with people from preschool to adulthood, and has written two books and many articles on stuttering therapy. And like many renowned stuttering experts, Guitar is also a person who stutters.

Can you describe what is happening when a person stutters?
The person knows just what they want to say, but the word seems to be stuck. It can happen in a couple ways. Either you make a sound over and over again, but you can't seem to move to the next sound, "Li, li, li, li like this," or the sound seems to go on and on, "LLLLLLLLike this," and you can't move to the next sound. Or you can't seem to get anything out at all. In that case, there is just silence, and your muscles are holding back the sound.

Do experts know what is happening in the brain when a person stutters?
Not really. Doctors know that the brain of adults who stutter is different from other adults, in terms of the localization of speech processing. The right side of the brain in people who stutter seems to be more active than in normal speakers. It is as if the person is trying to re-route the signals around a problem on the left side of the brain, which is the side that normal speakers use. But when the moment of stuttering happens, doctors don't know exactly what is going on in the brain that keeps speech from flowing forward.

At what age does stuttering ordinarily develop?
It almost always happens between the ages of 2 and 5-years-old, when kids are learning to talk. There is so much language and speech development going on in the brain at that time, it is almost more than they can handle. It is especially overwhelming if children are very advanced in language, or have too much to say, and want to make sentences longer and talk faster than the actual motor system can handle.

Alternately, if the child has a bit of a delay in language, some of the language processes are slower than others so there is a kind of 'disynchrony'. It shows up when the person speaks and the words don't flow very smoothly.

What causes stuttering?
In a little more than half of the kids who stutter, there is a family history of stuttering. But there are also kids who stutter who do not have a family history. There may be an inherited factor there, but that the other family members never developed the stutter.

In other cases, there is nothing inherited, but difficult birth conditions may make the brain develop a little bit differently, so it would be due to a congenital factor.

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