Is Stuttering caused by Anxiety ?

Anxiety is a feeling of unease, such as a worry or fear that can be mild or severe. Everyone can feel anxious in situations such as giving presentations, an oral exam or going for an interview. These anxious feelings are normal. Anxiety is not always ‘bad’. It can make us feel uncomfortable but it is also a really important function - we should feel anxious when we have an exam coming up as anxiety motivates us to study. Anxiety motivates us to prepare and take action. It is sometimes confused with excitement. Anxiety becomes difficult when it stops allowing you to do the things you enjoy in life and affects you everyday.

In the past, stuttering was thought to be due to psychological factors such as anxiety. We now know the cause of stuttering is not due to anxiety. Rather, it is regarded as having a neurological cause - differences have been found in areas of the brain involved in talking for those who stutter compared with those who do not stutter. In addition, stuttering has a genetic or hereditary component and tends to run in families. 

Do I stutter because I am an anxious? Am I anxious because I stutter?

Research has shown us that pre-school children who stutter show no difference in shyness or anxiety compared with pre-school children who do not stutter. People who stutter are no different to people who do not stutter in terms of their personalities. However, research has shown that as a group people who stutter present with higher levels of anxiety and are more likely to present with social anxiety disorder compared with people who do not stutter. The age at which anxiety symptoms begin to appear is not yet clear, however some studies have suggested that higher anxiety is shown in stuttering children from the age of 7 years and increases over time.  

Indeed, it is not surprising that stuttering is associated with increased levels of anxiety. The experience of stuttering is often difficult and people who stutter describe having a variety of negative emotional reactions to their talking including feelings of embarrassment and shame. They can also experience negative reactions to their stuttering from others.  We know that children who stutter are more likely to be bullied and to be viewed negatively by their peers and adults describe stigma and discrimination both socially and in their place of work. The anxiety demonstrated by people who stutter is regarded as being the result of living with stuttering and is not the cause of stuttering.  You don’t stutter because you are an anxious person.

How does anxiety or nervousness impact stuttering? 

Although people vary, we know that when someone is feeling anxious or nervous, they tend to stutter more. You might be feeling anxious about stuttering in front of others or concerned about how your listener will react, or what they will think if they hear you stutter. When we feel anxious or nervous, it is usually because we are expecting the worst to happen. You might be saying things to yourself like “I won’t be able to say my name” or “They’ll think there’s something wrong with me” This may lead you to tense your muscles, may distract you from focusing on what you want to say as you try hard either to be fluent or to hide your stuttering.  This can all lead to more stuttering. You may feel like you have suddenly started stammering.  It is important to remember that while you may stutter more when you are feeling anxious or nervous, these feelings are not the cause of stuttering.  

How can Speech and Language Therapy help with Stuttering? 

We know that learning more about your stuttering and what influences it can reduce your anxiety about it.  Speech and Language Therapy can be effective in reducing the impact that stuttering is having on your day to day life.  You can develop your confidence to communicate, learn how to respond differently to your thoughts and feelings about stuttering and to learn strategies to make talking easier and more comfortable. 

Stuttering does not have to hold you back. 

We are Clinical Specialists in Stuttering and are very happy provide you with more information regarding our reasonably priced fees via email.

What is cluttering?

Cluttering is speech that sounds either overly rapid or sounds irregular in its speed. Should you be regarded by others as speaking quickly, then you may present with cluttering.

However, in order to meet the criteria for having cluttered speech, your speech will also need to include one or more of the following features:

- frequent disfluencies such repetitions of words/phrases, the use of fillers words such as ‘um’ or ‘uh’ or the use of revisions (where you change what you are going to say mid-sentence). Whilst these features occur in the speech of all speakers, the speech of those who clutter show them a lot more frequently.

- the number of syllables in longer words are deleted or blended together (e.g. so a word like ‘computer’ may sound like “comter”)

- pauses in places that are different to what you would expect or the use of less pausing than you would expect which affects a person’s overall speech rhythm. This can result in your speech being described as “jerky” or “spurty”.

These features combined impact upon a speaker’s overall clarity. Often, those who clutter are told by others that they mumble and are often asked to repeat what they have said. They may also come across as having difficulties planning and organising what they are trying to say.

So a fast rate of speech alone does not give us the diagnosis of cluttering - there are many fast speakers that have no problems with people understanding them. The main difference is that those who clutter are regarded as speaking faster than their system can handle and this results in their speech becoming unclear due to the combined features described above.

We often work with adults that have been unaware of any difficulties in their teenage years, but now they find that their speech is impacting upon them within work or in social environments. Managers may reports concern that their clarity of speech is impacting on their performance, presentation or leadership skills at work.

What causes cluttering in speech?

There are many theories of the causes of cluttering. It is considered to be hereditary (others in your family may present with similar speech) and to do with differences in brain function. It is sometimes associated with Attention Deficit Hyperactivity Disorder (ADHD) or Autistic Spectrum Disorder, however not everyone who clutters has any co-occurring conditions.

What does therapy for cluttering involve?

The focus of therapy will vary from client to client and will depend on what aspects of your talking are impacting on your ability to communicate effectively. During therapy, you will become more skilled at monitoring your own speech and identifying what is affecting your overall clarity. For some, we may focus on reducing their rate of speech and developing their use of pausing. For others we may need to practice saying longer words and ensuring that all the syllables in the word are fully articulated. We may also focus on using appropriate word & syllable rhythms.

As you may be experiencing concerns with being misunderstood in various situations or you may have developed a fear of speaking, we may focus on helping you manage your emotions associated with your speech. Our main aim is to improve your confidence to communicate effectively in a variety of situations.

What is the difference between stuttering and cluttering?

Stuttering and cluttering often co-occur together in a person’s speech. However, the features of stuttering tend to be repetitions of sounds/syllables and single syllable words, prolongations and blocking of a sound in speech. Cluttering is rapid speech, that is often described as ‘jerky’ with unusual pauses and rhythm which affects a person’s overall clarity.

Can cluttering be cured?

While there is no cure for cluttering, Speech and Language Therapy can be effective in reducing the impact that cluttering is having on your day to day life. You can develop your confidence to communicate, learn strategies to make your talking easier and clearer, and to reduce the negative thoughts and feelings you have about your speech. Cluttering does not have to hold you back.

Our Clinical Specialist Speech Therapists are Specialists in Cluttering. Book a free 15 minute consultation or email thespeechnetwork@hotmail.com

How do you support students who stutter with oral exams & presentations ?

In an episode of the weekly podcast ‘This American Life – Made to be broken’, Poet Jerome Ellis explained “A time limit assumes that all people have equal access to time through their speech. For me, stuttering is unpredictable and I do not know how long it will take, until I have to say it”

For a Person who Stutters, performance on timed oral assessments at university can impact on a persons ability to demonstrate their knowledge. Examples of these might be presentations, oral exams or the Objective Structured Clinical Examination (OSCE).

Is stuttering a disability?

Stuttering can be viewed as a disability for a person if it ‘has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities'. (Equalities Act, 2010).  ‘Reasonable adjustments’ are ways that the university can prevent disabled people being put at a disadvantage. Reasonable adjustments are changes that the university can make to reduce the impact of the stammer that are specific to you.

How can online Speech Therapy support students who stammer with oral exams?

Some universities require medical evidence about your stammer. We have supported students by completing an assessment and a provided a written report suggesting ways for the university to support students who stutter in their studies. This might be by recommending extended time, identifying barriers, and recommend strategies to make these examinations easier.

How might extra time in oral exams help me?

A recent medical student shared what he gained from a block of Speech Therapy

 “I'm much less anxious when participating in group discussions. Additionally, when talking to people I haven't met before, I'm not bothered by their perception of me as a stammerer than I used to before starting therapy sessions. When slowing down my speech, I stammer much less. This technique has really helped me, especially in harder situations such as public speaking and group discussions”

Despite changes of how he felt about his stutter, and having strategies to make talking easier in certain situations, he requested support for his upcoming OSCE exam and explained why having extra time would be helpful:

“I'm requesting extra time for the OSCE (objective structured clinical examination) exams to ease some of the time pressure off of me. An OSCE exam is essentially a simulated clinical environment where I can be asked anything from performing a medical examination to taking a history from a model patient. Since this is a timed exam, I'm naturally under pressure to speak quickly in order to complete the task in the allocated time. I've completed several practice runs of OSCEs before, and most of the time I finish on time.  However, there were instances where I ran overtime and I would have benefited from the extra 25% that's granted for those with extra time. The extra time would allow me to take things a bit slower and would really ease the pressure off of me, hence contributing to a bit of extra fluency”. 

After he was given extra time he explained how it was helpful:

He felt that having the extra time reduced his nerves since he knew that he had more time to complete everything and that he wouldn't need to rush through the exam. He felt that he stammered less as a result. He felt it made huge difference and he passed his OSCEs with flying colours.

How can Speech Therapy for Stuttering help?

We can provide therapy to improve your confidence, help you manage difficult thoughts and feelings about stuttering to help you with oral exams and presentations.

Our Clinical Specialist Speech Therapists are Specialists in Stuttering. Book a free 15 minute consultation or email thespeechnetwork@hotmail.com

Why have I suddenly started stuttering?

Many people contact us to tell us that they have suddenly started stuttering. It may be that they stuttered as a child but the stutter either resolved or it was not having an impact on their lives. Rather than starting to stutter suddenly, their earlier stuttering may have come back unexpectedly.

It may be that you are feeling stressed or anxious – that you are having changes in your life such as interviews for a new job, going on dates with new people, or making a wedding speech. These situations may lead you to tense your muscles and lead to more stuttering, or that you are noticing the stutter more than before, in the preparation to these important events.  

It may be that work situations have changed – since the Pandemic, many people are working from home using video conferencing which may have been something you previously avoided. People report seeing themselves on videoconferencing has made them stutter more and to become more aware of the stutter.  

For a few people, stuttering does suddenly start in adulthood as a result of a neurological event, such as a stroke, and is called a neurogenic stammer. Stuttering may also start as a result of an emotional trauma, commonly known as psychogenic stuttering.  

Should you start to stutter suddenly in adulthood, following assessment we may need to make an onward referral to rule out a neurological diagnosis or to seek additional psychological support.

Speech Therapy can support you in increasing your confidence, reducing your stress and anxiety around stuttering and developing strategies to make talking easier. Click on the contact us button to arrange a free consultation or email us for more information.

Should I tell my job interviewer that I stutter?

We see many people embracing change and applying for new jobs. They are often thinking about the impact the stutter might have on the interview. Its important to remember that you have been invited to interview because they have been impressed by your CV or application – you have met all the essential criteria.

Its also important to remember communication skills are not just about fluency – employers are looking for an ability to listen, problem-solve, be positive, work in a team and be flexible. They will often ask for examples of these skills within the interview questions. Many people who stutter are exceptional communicators – try to focus on your strengths.

There are also some practice interview events for people who stutter such as 50 Million voices

https://www.50millionvoices.org/

 Should I tell my interviewer prior to the interview that I stutter?

You may have thoughts regarding whether you should tell your employer whether you stutter. By telling the employer beforehand, this might reduce the pressure you feel in the interview. This is called self-advertising. We can discuss the pros and cons of this in your therapy session. You can additionally ask the employer for adjustments such as extra time. There is more information regarding this on Stammering Law

https://www.stammeringlaw.org.uk/employment/recruitment-promotion/should-i-tell-employer-i-stammer/

 What jobs can I do with a stutter?

You are not limited by the stutter. You can do any job. We treat people that are working successfully as teachers, psychologists, actors, radio presenters and many more professions that require public speaking.

 If you are not offered a job, it is useful to request feedback from your employers. Some people who stutter may assume it is because of the stutter that they are not offered the job. However, there is a set marking criteria that interviewers use and they can give you the ideal answers to support you in future interviews. This may help increase your confidence as most interviewers are keen to give positive feedback.

Speech Therapy can support you in preparation for an important job interview – to increase your confidence so that you are able to relax and perform your very best.

Here is some additional advice for interviews or employment:

 Insider secrets from a human resources professional who stutters

https://westutter.org/wp-content/uploads/ace_your_next_job_interview_july2019.pdf

 Reasonable adjustments for people who stutter

https://stamma.org/sites/default/files/2019-06/19%20Reasonable%20Adjustments%20at%20work.pdf

 Resources for employers

https://stamma.org/resources/professionals/employers