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tuttering, with its characteristic approaches are now giving us clues to but the term stuttering usually refers to
disruption in verbal fluency, has causes and better treatments. both the disorder and symptom.
been known for centuries; earliest Developmental stuttering evolves
descriptions probably date back to the What Is Stuttering? before puberty, usually between two
Biblical Moses’ “slowness of speech Stuttering is a disruption in and five years of age, without apparent
and tongue” and his related avoidance the fluency of verbal expression brain damage or other known cause
behavior (Exodus 4, 10–13). Stuttering characterized by involuntary, audible (“idiopathic”). It is important to
occurs in all cultures and ethnic groups or silent, repetitions or prolongations distinguish between this persistent
(Andrews et al. 1983; Zimmermann et of sounds or syllables (Figure 1). These developmental stuttering (PDS),
al. 1983), although prevalence might are not readily controllable and may be which we focus on here, and acquired
differ. Insofar as many of the steps in accompanied by other movements and stuttering. Neurogenic or acquired
how we produce language normally are by emotions of negative nature such stuttering occurs after a definable brain
still a mystery, disorders like stuttering as fear, embarrassment, or irritation damage, e.g., stroke, intracerebral
are even more poorly understood. (Wingate 1964). Strictly speaking, hemorrhage, or head trauma. It is
However, genetic and neurobiological stuttering is a symptom, not a disease, a rare phenomenon that has been
observed after lesions in a variety of
brain areas (Grant et al. 1999; Ciabarra
et al. 2000).
The clinical presentation of
developmental stuttering differs
from acquired stuttering in that it is
particularly prominent at the beginning
of a word or a phrase, in long or
meaningful words, or syntactically also many stutterers who, despite component. The concordance rate
complex utterances (Karniol 1995; their disorder, have become famous. is about 70% for monozygotic twins
Natke et al. 2002), and the associated For instance, Winston Churchill had (Andrews et al. 1983; Felsenfeld et al.
anxiety and secondary symptoms are to rehearse all his public speeches to 2000), about 30% for dizygotic twins
more pronounced (Ringo and Dietrich perfection and even practiced answers (Andrews et al. 1983; Felsenfeld et al.
1995). Moreover, at repeated readings, to possible questions and criticisms to 2000), and 18% for siblings of the same
stuttering frequency tends to decline avoid stuttering. Charles Darwin also sex (Andrews et al. 1983). Given the
(adaptation) and to occur at the stuttered; interestingly, his grandfather high recovery rate, it may well be that
same syllables as before (consistency). Erasmus Darwin suffered from the the group abnormalities observed in
Nonetheless, the distinction between same condition, highlighting the fact adults reflects impaired recovery rather
both types of stuttering is not strict. In that stuttering runs in families and is than the causes of stuttering (Andrews
children with perinatal or other brain likely to have a genetic basis. et al. 1983).
damage, stuttering is more frequent The incidence of PDS is about 5%,
than in age-matched controls, and and its recovery rate is up to about Changing Theories
both types of stuttering may overlap 80%, resulting in a prevalence of PDS Over the centuries, a variety of
(Andrews et al. 1983). in about 1% of the adult population. As theories about the origin of stuttering
recovery is considerably more frequent and corresponding treatment
Who Is Affected? in girls than in boys, the male-to-female approaches have been proposed. In
PDS is a very frequent disorder, ratio increases during childhood ancient Greece, theories referred
with approximately 1% of the and adolescence to reach three or to dryness of the tongue. In the
population suffering from this four males to every one female in 19th century, abnormalities of the
condition. An estimated 3 million adulthood. It is not clear to what extent speech apparatus were thought to
people in the United States and 55 this recovery is spontaneous or induced cause stuttering. Thus, treatment
million people worldwide stutter. by early speech therapy. Also, there is was based on extensive “plastic”
Prevalence is similar in all social no good way of predicting whether an surgery, often leading to mutilations
classes. In many cases, stuttering affected child will recover (Yairi and and additional disabilities. Other
severely impairs communication, Ambrose 1999). treatment options were tongue-
with devastating socioeconomic The presence of affected family weights or mouth prostheses (Katz
consequences. However, there are members suggests a hereditary 1977) (Figure 2). In the 20th century,