What to Know About Stuttering


For a few minutes Thursday the sprawling, virtual National Democratic Convention seemed to hold its collective breath as 13-year-old Brayden Harrington of Concord, NH, addressed the nation on his own bedroom, occasionally stumble upon his words. "I'm a normal kid," he said into a home camera, and a recent meeting with the candidate "gave me confidence in something that has bothered me all my life."

Joe Biden and Mr. Harrington had to deal with stuttering, and the sight of the teenager openly resisting several words, including "stuttering," was a remarkable reminder of how language disorder drove sociability Can destroy relationships and even identity. Films like "The King's Speech" and books like Philip Roth's "American Pastoral" examine how consistent treatment of the disorder can be, just like Mr. Biden's own story.

The basic numbers are known: about every tenth child shows signs of stuttering – it usually starts between the ages of 2 and 7 – and 90 percent of them grow out of it before adulthood. Around 1 percent of the population struggle with language problems for a large part of their lives. For reasons that were not understood, boys stutter twice as often and almost four times as often into adulthood. And it is often fear that triggers verbal stumbling blocks – which in turn creates a barrage of self-conscious stress.

When Mr. Harrington on the "s" in "Stutter" for a few seconds, he turned his head and his eyes fluttered – an embodiment of physical and mental exertion – before saying, "It's really amazing that someone like me could get advice from a presidential candidate.

About half of children who stutter are related to someone else who does, but it is impossible to predict who will develop the language disorder. There are no genes to stutter; and scientists do not know what could happen during development after conception, which causes children to struggle with speaking in this way.

Studies on brain imaging offer some clues, at least as to what happens when people stumble upon their words. In these studies, stutterers typically read words or passages while in a brain scanner. Your moment-to-moment brain activity is then compared to that of non-stutterers reading the same selection. In an analysis of such studies, researchers from Texas and California found two differences between the groups: the areas of brain motor skills associated with language tended to be more active in those who stutter than in those without language problems, and those who stutter appeared to be deficient in hearing their own language to have.

These results confirm neurochemical studies of the disorder. In several cases, researchers have found evidence of increased dopamine circulation. Dopamine is an activating brain messenger and is involved in the coordination of motor skills. A language system somehow prepared to experience chemical surges could partially explain the verbal tics of “members of the same club,” a phrase Mr. Biden uses to connect with Mr. Harrington.

Drugs such as Xanax, an anti-anxiety drug, and Celexa, an antidepressant, have been tried for stuttering, but with little benefit.

Other behavioral approaches are considered more effective. For children, versions of so-called reaction-dependent therapy seem to be most helpful. The child receives instant feedback on what they are saying: positive feedback if it goes smoothly (“great job, no bumps”), gradually increasing the length of the sentence; and gently correcting if a stutter occurs ("Oops, let's try again").

For adults, the best approaches tend to address either the management of language anxiety or the language cadence itself, and ideally both. Therapy for management is often the same as that used for social anxiety: a course called cognitive behavioral therapy that teaches people to discover and defuse unconscious assumptions about social interaction. (For example, “I always maim conversations” or “I'm just not a social person.”) Therapies that address speech patterns often focus on slowed speech, using deliberate changes in cadence to reduce tripping hazards.

In his address to the nation, Mr. Harrington said that Mr. Biden recommended exactly what the candidate himself practiced – poems by William Butler Yeats. It's unlikely that Yeats therapy will be examined under a brain scanner anytime soon. But it now has two prominent followers.


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