In adulthood, estimates indicate 1%-3% of the adult population experience lifelong stammering (stuttering), with stammering four times more common in men than women. Stammering is a neurodevelopmental variation that leads to an unpredictable and unique forward execution of speech. In more than 90% of cases, stammering begins early in childhood with no apparent cause when children acquire speech and language skills (developmental stammering); for others (and much more rarely) stammering is acquired later in life, such as following a brain injury.
Traditionally, stammering has been understood from a medical perspective and defined as a ‘speech disorder’. As such, the behaviours associated with stammering are viewed as interruptions to and ‘deviations’ from the natural flow of speech. This locates the problem of stammering with the individual and results in therapy approaches that work primarily with individual differences or deficits. The focus might be learning strategies to reduce tension when speaking, managing stress and anxiety, becoming more accepting to and open about stammering or responding effectively to unhelpful attitudes towards stammering from others.
The disability rights movement has led us away from understanding disability as an individual defect, but rather as a form of social discrimination against certain types of human variation. From a social model and neurodiversity perspective, stammering is affirmed as a natural form of human diversity and as such a different, legitimate and valuable way of speaking. Taking this premise, stammering is only a problem because today’s culture values fluent speech. The dysfluency pride movement questions and challenges the current fluent values of society and takes a much more empowering view of stammering. It also calls for therapy to address the attitudinal, environmental and structural barriers that people who stammer encounter in today’s society.
In order to reflect these alternative perspectives, we use varying language and ways of referring to stammering, deferring to the individual on how they wish their stammer to be talked about.
Everyone’s stammer is unique. Some people’s stammering is more visible or ‘overt’, whereas for others it is less obvious (and ‘covert’ or ‘interiorised’. While the nature of stammering varies considerably among people, common stammering behaviours include repetition or prolongations of syllables and blocking on words and sounds. Additional, secondary behaviours may be verbal (such as adding extra sounds or words to delay moments of stammering e.g. ‘er, er, er’ or ‘um, um, um’) or non-verbal (such as blinking, losing eye contact, throat clearing, facial or body movements). Avoidance of stammering is another key feature and can occur at many levels, including word avoidance or switching, choosing to stay quiet and to not speak or to avoid a feared situation or relationship.
Unhelpful and often unrealistic societal views and expectations on what it means to be an ‘effective’ communicator means that in work contexts people who stammer risk being perceived by others (and themselves) as less competent or unprofessional compared to more fluent speaking colleagues. This is often reinforced by a lack of representation of different speaking styles in the media and society’s unconscious bias towards fluency. This can place significant pressure on people who stammer to be more fluent when speaking in order to feel heard, valued and respected.