Stuttering

==Characteristics==

===Audible disfluencies===
Common stuttering behaviors are observable signs of speech disfluencies, for example: repeating sounds, syllables, words or phrases, silent blocks and prolongation of sounds.   
*Repeated movements
** Syllable repetition—a single syllable word is repeated (for example: on—on—on a chair) or a part of a word which is still a full syllable such as "un—un—under the&nbsp;..." and "o—o—open".
** Incomplete syllable repetition—an incomplete syllable is repeated, such as a consonant without a vowel, for example, "c—c—c—cold".
** Multi-syllable repetition—more than one syllable such as a whole word, or more than one word is repeated, such as "I know—I know—I know a lot of information."
* Prolongations
** With audible airflow—prolongation of a sound occurs such as "mmmmmmmmmom".
** Without audible airflow—such as a block of speech or a tense pause where no airflow occurs and no phonation occurs.

=== Outward physical behaviors ===
People who stutter may have reactions, avoidance behaviors, or secondary behaviors related to their stuttering that may look like struggle and tension in the body. These could range anywhere from tension in the head and neck, behaviors such as snapping or tapping, or facial grimacing. 

=== Behavioral reactions ===
These behavioral reactions are those that might not be apparent to listeners and only be perceptible to people who stutter. Some people who stutter exhibit covert behaviors such as avoiding speaking situations, substituting words/phrases when they know they are going to stutter, or use other methods to hide their stutter.<ref name=":0" />

===Feelings and attitudes===
Stuttering could have a significant negative cognitive and affective impact on the person who stutters. [[Joseph Sheehan]] described this in terms of the [[analogy]] to an [[iceberg]], with the immediately visible and audible symptoms of stuttering above the [[waterline]] and a broader set of symptoms such as negative [[emotion]]s hidden below the surface.<ref>{{harvnb|Kalinowski|Saltuklaroglu|2006| p=17}}</ref> Feelings of [[embarrassment]], [[shame]], [[frustration]], [[fear]], [[anger]], and [[guilt (emotion)|guilt]] are frequent in people who stutter, and may increase tension and effort.<ref name="Guitar16–7">{{harvnb|Guitar|2005|pp=16–7}}</ref> With time, continued negative experiences may crystallize into a negative self-concept and self-image. People who stutter may project their own attitudes onto others, believing that the others think them nervous or stupid. Such negative feelings and attitudes may need to be a major focus of a treatment program.<ref name="Guitar16–7"/>

The impact of discrimination against stuttering can be severe. This may result in fears of stuttering in social situations, self-imposed isolation, anxiety, stress, shame, low self-esteem, being a possible target of bullying or discrimination, or feeling pressured to hide stuttering. In popular media, stuttering is sometimes seen as a symptom of anxiety, but there is no direct correlation in that direction.<ref>{{Cite journal|vauthors=Constantino CD, Campbell P, Simpson S |date=March–April 2022 |title=Stuttering and the social model |url=https://www.sciencedirect.com/science/article/abs/pii/S0021992422000193 |journal=Journal of Communication Disorders |volume=96 |page=106200 |doi=10.1016/j.jcomdis.2022.106200 |pmid=35248920 |s2cid=247096437 |issn=0021-9924 }}</ref>

Alternatively, there are those who embrace [[stuttering pride]] and encourage other stutterers to take pride in their stutter and to find how it has been beneficial for them.

=== Associated conditions ===
Stuttering can co-occur with other disabilities. These associated disabilities include:
{{div col|colwidth=22em}}
*[[attention deficit hyperactivity disorder]] (ADHD);<ref>{{Cite journal|last1=Sroubek|first1=Ariane|last2=Kelly|first2=Mary|last3=Li|first3=Xiaobo|date=2013-02-01|title=Inattentiveness in attention-deficit/hyperactivity disorder|url= |journal=Neuroscience Bulletin|language=en|volume=29|issue=1|pages=103–110|doi=10.1007/s12264-012-1295-6|issn=1995-8218|pmc=4440572|pmid=23299717}}</ref> the prevalence of ADHD in school-aged children who stutter is {{clarify span|text=around 4–50%|explain=4% to 50%, or 40% to 50%?|date=August 2022}}.<ref>{{Cite journal|last1=Druker|first1=Kerianne|last2=Hennessey|first2=Neville|last3=Mazzucchelli|first3=Trevor|last4=Beilby|first4=Janet|date=2019-03-01|title=Elevated attention deficit hyperactivity disorder symptoms in children who stutter|url=https://www.sciencedirect.com/science/article/pii/S0094730X18300779|journal=Journal of Fluency Disorders|volume=59|pages=80–90|doi=10.1016/j.jfludis.2018.11.002|pmid=30477807|s2cid=53733731|issn=0094-730X}}</ref><ref>{{Cite journal|last1=Donaher|first1=Joseph|last2=Richels|first2=Corrin|date=2012-12-01|title=Traits of attention deficit/hyperactivity disorder in school-age children who stutter|url=https://www.sciencedirect.com/science/article/pii/S0094730X12000800|journal=Journal of Fluency Disorders|series=Special Issue: 9th Oxford Dysfluency Conference|volume=37|issue=4|pages=242–252|doi=10.1016/j.jfludis.2012.08.002|pmid=23218208|issn=0094-730X}}</ref><ref>{{Cite journal|last1=Arndt Jennifer|last2=Healey E. Charles|date=2001-04-01|title=Concomitant Disorders in School-Age Children Who Stutter|url=https://pubs.asha.org/doi/10.1044/0161-1461%282001/006%29|journal=Language, Speech, and Hearing Services in Schools|volume=32|issue=2|pages=68–78|doi=10.1044/0161-1461(2001/006)|pmid=27764357}}</ref><ref>{{Cite journal|last1=Riley Jeanna|last2=Riley Johnetta G.|date=2000-10-01|title=A Revised Component Model for diagnosing and Treating Children Who Stutter|url=https://pubs.asha.org/doi/10.1044/cicsd_27_F_188|journal=Contemporary Issues in Communication Science and Disorders|volume=27|issue=Fall|pages=188–199|doi=10.1044/cicsd_27_F_188}}</ref>
*[[dyslexia]];<ref>{{Cite journal|last1=Peterson|first1=Robin L|last2=Pennington|first2=Bruce F|date=May 2012|title=Developmental dyslexia|url= |journal=The Lancet|volume=379|issue=9830|pages=1997–2007|doi=10.1016/s0140-6736(12)60198-6|issn=0140-6736|pmc=3465717|pmid=22513218}}</ref> the prevalence rate of childhood stuttering in dyslexia is around 30–40%, while in adults the prevalence of dyslexia in adults who stutter is around 30–50%.<ref>{{Cite journal|last1=Blood|first1=Gordon W|last2=Ridenour|first2=Victor J|last3=Qualls|first3=Constance Dean|last4=Hammer|first4=Carol Scheffner|date=November 2003|title=Co-occurring disorders in children who stutter|url=https://linkinghub.elsevier.com/retrieve/pii/S0021992403000236|journal=Journal of Communication Disorders|language=en|volume=36|issue=6|pages=427–448|doi=10.1016/S0021-9924(03)00023-6|pmid=12967738}}</ref><ref>{{Cite journal|last1=Arndt|first1=Jennifer|last2=Healey|first2=E. Charles|date=April 2001|title=Concomitant Disorders in School-Age Children Who Stutter|url=http://pubs.asha.org/doi/10.1044/0161-1461%282001/006%29|journal=Language, Speech, and Hearing Services in Schools|language=en|volume=32|issue=2|pages=68–78|doi=10.1044/0161-1461(2001/006)|pmid=27764357|issn=0161-1461}}</ref><ref>{{Cite journal|last1=Elsherif|first1=Mahmoud M.|last2=Wheeldon|first2=Linda R.|last3=Frisson|first3=Steven|date=2021-03-01|title=Do dyslexia and stuttering share a processing deficit?|url=https://www.sciencedirect.com/science/article/pii/S0094730X20300826|journal=Journal of Fluency Disorders|language=en|volume=67|pages=105827|doi=10.1016/j.jfludis.2020.105827|pmid=33444937|s2cid=231611179|issn=0094-730X}}</ref>
*[[autism]]<ref name="briley">{{Cite journal |last1=Briley |first1=Patrick M. |last2=Ellis |first2=Charles |date=2018-12-10 |title=The Coexistence of Disabling Conditions in Children Who Stutter: Evidence From the National Health Interview Survey |url=http://pubs.asha.org/doi/10.1044/2018_JSLHR-S-17-0378 |journal=Journal of Speech, Language, and Hearing Research |volume=61 |issue=12 |pages=2895–2905 |doi=10.1044/2018_JSLHR-S-17-0378 |pmid=30458520 |s2cid=53946065 |issn=1092-4388}}</ref> 
* intellectual disability<ref name="Healey">Healey, E. C., Reid, R., & Donaher, J. (2005). Treatment of the child who stutters with co-existing learning, behavioral, and cognitive challenges. In R. Lees & C. Stark (Eds.), The treatment of stuttering in the young school-aged child (pp. 178–196). Whurr Publishers.</ref>
* language or learning disability<ref>{{Cite journal |last1=Ntourou |first1=Katerina |last2=Conture |first2=Edward G. |last3=Lipsey |first3=Mark W. |date=August 2011 |title=Language Abilities of Children Who Stutter: A Meta-Analytical Review |journal=American Journal of Speech-Language Pathology |language=en |volume=20 |issue=3 |pages=163–179 |doi=10.1044/1058-0360(2011/09-0102) |issn=1058-0360 |pmc=3738062 |pmid=21478281}}</ref>
* seizure disorders<ref name="briley" />
* [[social anxiety disorder]]<ref>{{Cite journal |last1=Iverach |first1=Lisa |last2=Rapee |first2=Ronald M. |date=June 2014 |title=Social anxiety disorder and stuttering: Current status and future directions |journal=Journal of Fluency Disorders |language=en |volume=40 |pages=69–82 |doi=10.1016/j.jfludis.2013.08.003|pmid=24929468 |doi-access=free }}</ref> 
* [[speech sound disorder]]s<ref>{{Cite journal |last1=St. Louis |first1=Kenneth O. |last2=Hinzman |first2=Audrey R. |date=October 1988 |title=A descriptive study of speech, language, and hearing characteristics of school-aged stutterers |url=https://linkinghub.elsevier.com/retrieve/pii/0094730X88900034 |journal=Journal of Fluency Disorders |language=en |volume=13 |issue=5 |pages=331–355 |doi=10.1016/0094-730X(88)90003-4}}</ref>
* other developmental disorders<ref name="briley" />
{{div col end}}