Stuttering in Adulthood
Description of Adult Stuttering
Description of Adult Stuttering
Approximately 1% of adults stutter. Adults who stutter may have persistent developmental stuttering – their stuttering started in childhood and it did not naturally resolve or improve completely with treatment. Others experience onset of stuttering in adulthood. This acquired stuttering may be a result of a neurogenic condition such as Parkinson’s disease, traumatic brain injury, or a stroke. This is termed neurogenic stuttering or stuttering associated with acquired neurogenic disorder (SAAND). Others may acquire psychogenic stuttering following a traumatic event or severe stress.
Adults who stutter can improve with treatment with a speech-language pathologist (S-LP). Although it is rare for persistent developmental stuttering to naturally resolve in adulthood, intervention can result in significant improvement. Neurogenic and psychogenic stuttering can also be improved with intervention.
An assessment is completed before starting treatment. The purpose of assessment is to characterize the nature of the stuttering symptoms, secondary behaviours (e.g., muscle tension, blinking), emotional and cognitive reactions, and measure the severity of the stutter. This information informs the development of the treatment program and provides a baseline to measure progress. An additional purpose for those with acquired stuttering is differential diagnosis – to determine whether an individual is presenting with neurogenic or psychogenic stuttering, as the cause determines the treatment approach.
During assessment, the S-LP will ask the individual to complete specific tasks to measure stuttering symptoms. These tasks may include conversation, reading a passage, describing a picture, and speaking on a topic. A detailed case history will also be collected through interview. The S-LP will also ask the person to complete various questionnaires and scales related to their experience of stuttering. This data will be analyzed by the S-LP and summarized in a written assessment report. The S-LP will explain the results of the assessment either during a debriefing appointment (in person or by phone) or at the beginning of the first treatment session, depending on the needs of the individual client.
Treatment is carried out with an S-LP. At Shoreline, these appointments are carried out in the office or by videoconference in some cases. Depending on the person, treatment may involve the following:
Reducing/eliminating secondary behaviours - learned behaviours that an individual has developed over time to help them cope with their stuttering, albeit ineffectually (e.g., blinking, pinching oneself);
Dealing with emotional responses to stuttering (e.g., anxiety associated with specific speaking situations such as using the phone);
Working through cognitive responses to stuttering (e.g., negative thoughts about one's speaking skills, worth, or ability to exert control over their speech);
When appropriate, a referral to a psychologist to address these emotional and cognitive responses;
Learning fluency shaping techniques to reduce the likelihood of stuttering episodes occurring;
Learning stuttering modification techniques to regain control during stuttering episodes.
In addition to sessions in the clinic, clients will need to commit to daily home practice (about 10 minutes a day) and complete weekly carryover assignments - intentionally applying fluency shaping and stuttering modification techniques in daily activities such as a specific phone call or when checking out at the grocery store. Home practice and carryover assignments are critical to making progress and clients must be ready to commit to these components before initiating treatment.
The length and frequency of appointments can vary depending on a person’s needs and constraints. Clients can expect to commit to one 60-minute session in the clinic per week at a minimum. Client also have the option of longer sessions (90-minutes) and more frequent appointments (e.g., two per week). These options will be discussed during the debrief after assessment. For those who live outside of the HRM, have the necessary computer equipment and competency, and have a reliable internet connection, treatment sessions can also be conducted via videoconference (WebEx).
To learn more, please contact us.
Resources and Links
"When I Stutter" Documentary
Canadian Stuttering Association
"Top 3 Things When Meeting Someone who Stutters"
"5 Common Myths About Stuttering Debunked (It's Not Psychological!)"
Char Adams ("The Stuttering Journalist")
Halifax Support Group for People Who Stutter