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Arnold School of Public Health


Treating stuttering at the USC Speech and Hearing Research Center

October 16, 2015 | Erin Bluvas, bluvase@sc.edu 

Stuttering, which is characterized by involuntary stoppages in the forward flow of speech, is a low-incidence disorder affecting approximately 1 percent of the population worldwide. Roughly 5 percent of children will go through a period of stuttering that lasts six months or more, most of whom recover by late childhood—leaving 1 percent with a long-term problem. It impacts all races and ethnicities equally; however, there are four males who stutter for every one female.

Despite the low-incidence rate of this speech disorder, the USC Speech and Hearing Research Center, in the Arnold School of Public Health’s Department of Communication Sciences and Disorders (COMD), has treated numerous stuttering patients over their 45-year history. Patients and their family members, teachers, speech-language pathologists and physicians find their way to the Center because of its unique expertise and experience on both common and rare communication challenges. These patients are looking for the most experienced and informed clinicians, and they are looking for innovative research and interventions. They are looking for people like Clinical Assistant Professor Charley Adams.

 Stuttering is everything we do trying not to stutter.

-Charles Van Ryper

Adams first developed his connection with stuttering when he was a doctoral candidate in the COMD department at USC. He was approached to take on a caseload of stuttering patients and teach a graduate course on the topic for a faculty member who was retiring. “That was about 15 years ago, and I’m very fortunate to still be doing both,” he says. “I’ve met so many fascinating and interesting people who stutter and who work with stuttering.”

Adams can easily list many well-known individuals from history and popular culture who have stuttered—many of whom have spoken publically about the condition (see inset). He points out that building awareness is important because people who stutter have been mocked, teased and bullied for decades. “Some listeners have mistakenly jumped to a variety of inaccurate conclusions when they hear someone stuttering, ranging from ‘you’re stupid’ to ‘you must be lying’ to ‘you don’t know what you’re talking about’,” says Adams. “Importantly, attitudes are changing and awareness and understanding of stuttering have improved in recent years, and things have really ramped up ever since the film, The King’s Speech, came out in 2010.” There is even an International Stuttering Awareness Day observed each year (October 22, 2015).

Part of this awareness includes when stuttering arises, and how long it might last. Stuttering can begin as early as 18 months of age and as late as puberty. Onset is most common while kids are experiencing rapid growth of both language and motor skills, usually between the ages of two and five. Many who start to stutter will grow out of it, some will hang on to it for a year or two or three, and some will continue to stutter into adulthood. However, assuming that stuttering will improve on its own can be a mistake.

“Well-meaning pediatricians often tell parents not to worry that their child has begun to stutter, and that s/he will outgrow it,” says Adams, who has been routinely invited to speak to residents at the USC School of Medicine about stuttering during their pediatric rotation. “Many do, of course, but some don’t; and by the time a parent finally seeks help in spite of that advice, the optimal time frame with the best outcomes may have passed.”

Stuttering therapy looks very different depending on the age of the patient, according to Adams. “With young patients, our expectation is normal fluency upon completion of treatment,” he says. At this age, therapy focuses on facilitating more fluent speech and guiding young children to learn how to select easier, “unstruggled” talking.

With older kids and adults, milder stuttering with control may be a more realistic outcome goal. “This therapy will focus on control techniques to employ when the patient needs them, and we also target the fear and avoidance that can come with years of stuttering,” says Adams.

When schedules permit, the Center clinicians will often utilize group therapy in addition to individual therapy. For adults, they usually recommend attending a monthly support group as well, which is sponsored by the National Stuttering Association.

Clinicians like Adams, and the graduate students they are training to become future speech-language pathologists and COMD researchers, engage in a range of activities to stay informed of the latest research and treatment for stuttering. “By teaching and giving workshops on stuttering, I stay current so that I can be sure to share best practices in stuttering intervention,” he says.

Working with groups such as the Stuttering Foundation of America and the National Stuttering Association, the Center has hosted or co-sponsored a variety of workshops for people who stutter as well as continuing education opportunities for speech-language pathologists. For example, they have held one-day events for kids who stutter, their parents and their speech-language pathologists.

“We work hard to expose our students to a variety of disorders, including stuttering, but numerous surveys have documented that stuttering remains a disorder that graduating students feel least confident treating,” Adams says. To help bridge the gap, he encourages current and former students to devote some of their continuing education to stuttering and offers his expertise to previous students who now work as speech-language pathologists. “I often get phone calls and emails from former students asking for advice working with patients who stutter,” Adams says. He even helps colleagues who stutter.

He also has some advice for the other 99% of the population—for those of us who don’t stutter. “It’s important that people not respond any differently when someone is stuttering,” he says. Giving advice or trying to finish a sentence isn’t helpful.  “Simply pay attention and respond to the message, not how it’s being said,” he adds. “Be a good listener, and maintain eye contact.”

Some people are more comfortable with their stuttering than others, so don’t ask about it unless they bring it up.  “And never tell them that you stutter sometimes, too – unless you have the disorder, it’s not the same thing,” he says. “People who stutter don’t need your advice or empathy; they just need your patience.”

People Who Stutter

  • Emily Blunt, Actress
  • Joe Biden, U.S. Vice President
  • Samuel L. Jackson, Actor
  • Bruce Willis, Actor
  • Lewis Carroll, Author (Alice in Wonderland)
  • Winston Churchill, British Prime Minister
  • Marilyn Monroe, Actress
  • Charles Darwin, Naturalist
  • Elvis Presley, Musician
  • Alan Turing, Father of Computer Science
  • Jack Welsh, CEO, General Electric
  • James Earl Jones, Actor
  • Bo Jackson, Baseball/Football Player