persist over time, and are characterized by frequent and marked occurrences of the following symptoms:
- Sound and syllable repetitions
- Sound prolongations of consonants and vowels
- Broken words (pauses within a word)
- Audible or silent blocking (filled or unfilled pauses in speech)
- Circumlocutions (word substitutions to avoid problematic words)
- Words produced with an excess of physical tension
- Monosyllabic whole-word repetitions (e.g., “I-I-I-I see him”)
These disturbances cause anxiety about speaking or limitations in effective communication, social participation, or occupational performance. Stuttering can occur as a result of a nerve of traumatic brain injury (neurogenic), or begin suddenly after severe emotional trauma or stress (psychogenic). Late or adult onset stuttering occurs when the symptoms are not attributed to a speech-motor or sensory deficit, or dysfluency associated with a neurological insult (e.g., stroke, tumor, trauma).
Adults who stutter may also exhibit secondary, or avoidance, behaviors that may impact their fluent communication. These may include:
- Distracting sounds (e.g., throat clearing, insertion of unintended sound)
- Facial grimaces (e.g., eye blinking, jaw tightening)
- Reduced verbal output due to speaking avoidance
- Head or body movements (e.g., head nodding, leg tapping, fist clenching)
- Avoidance of social situations
- Fillers to mask moments of stuttering