While trauma in the form of emotional distress can aggravate stuttering, it has not been found to cause it. Rather than a cause, stuttering is a trigger-- something that sets off a disorder in individuals who are genetically predisposed to developing the disorder. If trauma had caused stuttering, psychotherapy should be effective in treating it; yet psychotherapy has been unsuccessful. (https://www.stutteringhelp.org/stress-stuttering)

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You could use singing as a stepping stone. Stuttering tends to magically disappear when an individual sings as the maintenance of airflow and voicing during singing allows sounds to come out easily. You could also try stretching and connecting the words you have to say, as it tends to be the initial sounds of words that individuals have difficulty with. In stretching and connecting the sounds, making your words seem like a single word, you can bypass this hurdle. 

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There are several ways to reduce stutters in speech. One way is to use a light contact of your oral muscles to ensure there is no tension. These oral muscles include your tongue and lips. For a sound like /p/, one can choose to make the contact between lips light so that the release of the /p/ sound is less explosive and more focused on airflow. Another way to speak without stuttering is to stretch the initial sound, if the sound can be stretched. For example, rather than jumping into the /m/ sound in may, one can hum the sound-- having the sound come out of the nose. By establishing an airflow before producing the sound with one’s lips, the speaker can achieve greater control and thus fluency. 

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In North America, stuttering is treated by speech-language pathologists. You may also see the initialisms SLP (which stands for speech-language pathologist), SLT (speech-language therapist, used in the UK), or ST (speech therapist).

These professionals hold degrees and have completed supervised training in the assessment and treatment of speech, language, communication and swallowing disorders. They are typically registered with a college (a regulatory body that protects the public), and can only provide services for clients in the area in which they are registered. This means that you will be limited to working with speech-language pathologists near you (typically, either residing in the province where you live or jointly registered in both their place of work and your residence).

To find these SLPs (or SLTs), there are a few avenues that you can try:

• Google “stuttering speech therapy [city name]” or “stuttering speech therapy [province name]” to find private practices advertising stuttering services in your area. Searching by country, or without a location, is likely to generate results showing popular speech therapy clinics that you will be unable to access, as you may receive listings for clinics in other jurisdictions.

• Ask your family doctor/GP (or your teacher, if you are still in the school system), who may refer you to a clinician that they are aware of in the community.

• Search for the college of speech-language pathologists in your area (to start, try googling “speech language college [province name]”). These college websites typically include a public listing of practitioners that you can contact to look for a good fit. Some of these listings are searchable, in which case you can search specifically for a clinician with experience treating stuttering (AKA fluency).

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A case report completed by Perino et al (2000) reported that a woman had come into clincin with a migraine and stuttering. The women appeared to not have any other symptoms. The women had also not taken any medications that could cause stuttering and the women and her family reported no emotional trauma that could have triggered a stutter. Researchers  believed that the imbalances of neurotransmitters during a migraine could cause a stuttering episode that disappears once the migraine is over just like the onset of aphasia may also occur and then disappear during a migraine. The reported that they suggest that suttering should be added to the list of neurological systems that may occur when someone experiences a migraine attack.   

Another study Rodriguez-Castro et al (2020) reported that a 16-year old boy had come into the hospital with a headache that was associated with facial and limb tingling and later developed into an intense stutter. Within 10 hours symptoms resolved and 5 months later the boy experiences a similar episode. The study suggests that stuttering also be added to a list of neurological systems that may be caused by a migraine with aura.   

• https://headachejournal.onlinelibrary.wiley.com/doi/pdf/10.1046/j.1526-4610.2000.00025.x

• https://pubmed.ncbi.nlm.nih.gov/32141076/

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Stuttering can develop later in life due to psychological or neurological trauma. It has been found that  people who have had any form of brain injury such as stroke or TBI (traumatic brain injury) can develop stuttering. It has also been found that when people go through an emotional trauma such as the death of a family member, and they are not able to cope, they can also develop a stutter. There have also been medications tested such as antidepressants that have been found to develop a stutter in adults.

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Stuttering may develop in children at a young age. This is often either caused by genetics or children trying to use their speech without  their speech apparatus being fully developed in order to produce certain sounds, which may end up causing a stutter. A lot of children do grow out of a stutter, but on occasion they do not and then may require speech therapy to help overcome their difficulties. Once someone has a stutter at an older age there is no cure, though speech therapy and counselling can provide strategies to help minimize the severity of a sutter.

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There doesn't seem to be only one person that discovered stuttering but knowing what it is and what causes it developed through time. In the 6th Century Aetius of Amida was a physician who believed that stuttering was caused by the tongue. He recommended division of the frenum and surgery remained popular for the next few centuries. Johan Frederick Dieffenbach (1795-1847) a German surgeon came up with surgery to treat speech defects in which he would cut a portion of the tongue to help release nerves that cause muscle spasms.  In France in 1830 an author named H. de Chegoin believed that people who stutter had tongues that were disproportionate. J.M.G Itard believed that stuttering was caused by muscular debility. This was treated by putting a fork like object in the lower cavity of the jaw to help support the tongue.  Around the same time in New York, Yaes was studying stuttering and he believed that it was caused by spasms in the glottis. Treatment suggested that patients keep their tongue elevated to the upper palate while speaking. Charles Canon Kingsley  (1819- 1875) believed that stuttering could be traced back to conscious or unconscious imitation. He believed that stuttering could also be due to have the upper teeth sit over the lower teeth. For this he recommended dumbbell exercise,  and placing cork on the back of the teeth. He also believed that boxing was the best sport for someone who stutters. Moses Mendlessohn (1729- 1786) believed that the main reason for stuttering was psychological due to too many thoughts colliding in the brain. Erasmus Darwin (1731-1802) believed emotions such as bashfulness interrupted the movements of the speech articulators.  Joseph Frank (1911) had many beliefs to the cause of stuttering, one being cerebral lesions and the other sexual excess.  In the late 1800’s stuttering was believed to be a neurosis and treated by psychoanalysis.  In 1898 Sandow believed that stuttering was caused by the dread of speaking or the eagerness to speak. Children might stutter when they have physical discomfort or fear and will be fluent when feeling comfortable and at ease.  In 1908 Steckel described stuttering as fear hysteria, with anxiety neurosis beginning in childhood. 

In the 20th Century stuttering was believed to be a psychogenic disorder. As psychoanalysis was being used for trestement, it was stopped around the 1960’s as it was showing to be ineffective.  Today, it is believed that those who stutter have a neuro physical dysfunction that affects the timing required to produce speech. It has also been found that those who stutter have difficulties coordinating their breath and articulation.  The role of genetics in the last few decades has also been studied. In 2010 Dr. Dennis drayna and his team identified the first three genes for stuttering.     

• https://www.asha.org/uploadedFiles/0689ashamag1.pdf

• https://www.stutteringhelp.org/brief-history#:~:text=Genetic%20Research&text=Dennis%20Drayna%20of%20the%20National,first%203%20genes%20for%20stuttering

• https://www.mnsu.edu/comdis/kuster/history/quesalyaruss.pdf

• https://www.aafp.org/afp/1998/0501/p2175.html

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The World Health Organization does not specifically define stuttering, or propose a treatment plan for stuttering. It does, however, present a framework that can be immensely helpful to understand the impact of stuttering on any given person: the International Classification of Function, Disability, and Health (the WHO ICF; 2001). It offers a framework of stuttering assessment and treatment which is important in several ways:

• Assessments include not only a description of the behaviour itself (e.g. what happens when the person stutters) but also attitudinal and environmental factors (e.g. how others react to their stutter, how their school or workplace is set up to minimize or maximize their success, their own thoughts and feelings about stuttering). For a person who stutters to function well in their life, all of these things must be considered in developing a treatment plan.

• Treatment targets are selected based on the client’s needs, rather than determined by their clinicians. Clients whose normal interpersonal activities are more demanding (e.g. a professional voice user), or who use their voices for unique tasks (e.g. a voice actor) may have different requirements than people who work in jobs that do not require much speaking, or who are introverted and prefer to socialize less often.

• Treatment is not based on the stuttering itself, but based on improving how well people can function in their day-to-day lives. For example, a person who can control their stutter using fluency shaping strategies may not stutter during a presentation, but may experience severe anxiety about whether or not they will lose control of their speech. A person who stutters heavily during a presentation but is not made anxious or uncomfortable by their stuttering may not feel impacted at all by their stuttering, even if an evaluation would determine that they have a severe fluency disorder.

The WHO ICF itself can be accessed at https://www.who.int/classifications/icf/icfbeginnersguide.pdf?ua=1 for those interested in learning more about this model of care.

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Some medications have been found to cause stuttering. When a client goes to see a doctor about their sudden onset of stuttering a doctor will often ask what type of medications the person is taking. Some medications such as antidepressants and antipsychotics have been found to cause a stutter. These types of drugs target various neurotransmitters which may increase the risk of a sudden onset of stuttering. Drugs that have been found to increase risk of stuttering: “Drugs targeting the cholinergic systems (tricyclic antidepressants), dopaminergic systems (bupropion, methylphenidate, antipsychotics), noradrenergic systems (propranolol, theophylline), serotonergic systems (selective serotonin reuptake inhibitors) and NMDA systems (memantine).”

• Practice tip: medication-induced stuttering in psychiatric patients

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