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What causes stuttering in children?

Stuttering Therapy Clinician: Dr Lauren Crumlish (PhD) 8 min read

A smiling father carries his young son on his shoulders in a green field, with hills and a cloudy sky behind them.

Nothing a parent did causes stuttering. Research points to two things a family cannot choose: the genes a child inherits, and a difference in how the brain handles the fast, fine work of producing speech.

The Australian Stuttering Research Centre describes stuttering as a physical condition. It is not caused by nervousness, stress, parenting practices or the way parents talk with their children when they are young. This guide separates what causes stuttering from what only makes it show more, and explains what a family history does and does not tell you.

Did I cause my child’s stuttering?

No. Stuttering is not caused by parenting, and the main Australian and overseas bodies all say so. Speech Pathology Australia states that stuttering is not caused by a specific event, tiredness, anxiety, parenting style or any type of psychological problem. The NHS says it is not caused by anything the parents have done.

The idea that parents are to blame has a history. For much of the last century it was assumed that anxious parents mistook a small child’s normal hesitations for stuttering, corrected them, and so produced the real thing. Victoria’s Better Health Channel, which describes that old theory, is clear about where it ended up: there is no evidence that anything parents do, or do not do, can cause a child to stutter.

The same goes for the events families often point to. STAMMA, the British stammering charity, names being told off, a new brother or sister and parents separating as things that do not cause it. Stuttering is not copied from another child and cannot be caught, and it has nothing to do with intelligence.

What causes stuttering, according to research?

Stuttering has more than one contributing factor, and the two with the strongest support are genetics and the way the brain processes speech. The Australian Stuttering Research Centre describes stuttering as involving a problem with the neural processing, meaning the brain activity, that supports speech production. Brain imaging studies have found consistent differences between people who stutter and people who do not, and those differences have been found in children as well as adults.

It is fair to say what is not yet known. Speech Pathology Australia’s fact sheet says plainly that the cause of stuttering is still not known, only that it is related to brain activity.

What causes a stammer is the same question with the same answer, because stammering is the British word for stuttering.

Why did my child’s stuttering start now?

Stuttering usually starts between the ages of two and five, around the time a child begins joining words into short sentences. The Australian Stuttering Research Centre reports that in a study following a group of Australian infants, 8 per cent had begun to stutter by age three and 12 per cent by age four.

The start can be gradual or sudden. The Australian Stuttering Research Centre notes that in a few children stuttering arrives so quickly and so strongly that parents think their child is seriously ill. A sudden start is one reason families look for an event to explain it: whatever happened that week, a new baby, a move or the first days at childcare, looks like the cause. Speech Pathology Australia’s position is that stuttering is not caused by a specific event.

Is stuttering genetic?

Yes, in large part. A stutter is hereditary in the sense that stuttering runs in families. About 60 per cent of people who stutter report a relative who stutters, and stuttering is more common in children with a parent, brother or sister who stutters. Twin studies point the same way. Identical twins are more often both affected than non-identical twins, and many of those studies estimate that inherited factors explain most of the difference between people who stutter and people who do not.

Genes are not the whole answer, though. There are pairs of identical twins where one stutters and the other does not. Researchers have linked four genes to stuttering so far, and by their own estimate those genes account for at most about one in five cases of persistent stuttering. Stuttering is most likely inherited through many genes acting together, not passed on by a single one, so it cannot be traced neatly from one relative to the next.

So is stuttering genetic or environmental? Mostly genetic, with other factors that have not been identified, and there is no evidence that parenting or home life is one of them.

What does a family history of stuttering predict?

A family history of stuttering raises the chances; it does not decide the outcome for any one child. This table sets out what the published figures do and do not support.

Question a parent asks What family history tells you What it cannot tell you
Will my child start to stutter? Stuttering is more common in children with a parent, brother or sister who stutters Whether this particular child will
Will my child’s stuttering go away without therapy? Children with a family history were 1.89 times more likely to keep stuttering than children without one Which individual child will recover and which will not
Does it matter which relative? A relative whose stuttering continued is counted as a risk factor for stuttering that continues A timeline, or how severe a child’s stuttering will be
There is nobody in our family who stutters About four in ten people who stutter report no relative who does, so a child with no family history can still stutter Whether this child’s stuttering will pass on its own

The practical use of a family history is to mention it. A speech pathologist asks about relatives who stutter, and whether their stuttering stopped or carried on, as one part of the assessment. The other signs are set out in the guide on when to worry about stuttering.

What makes stuttering show more without causing it?

Tiredness, excitement, stress and hurry can all make a child stutter more on a given day, and none of them is a cause. Australian health sources list the same moments: when a child is tired, excited, nervous, angry, arguing, rushing to get words out or trying to say something complicated.

The difference matters. A cause is why a child stutters at all. A trigger is why Tuesday was harder than Monday. A child who stutters more at a birthday party does not stutter because of the party, and a child whose speech is smooth through a quiet week at home has not stopped stuttering. Speech Pathology Australia describes stuttering as unpredictable: it can change in how it sounds and when it happens, and in young children it can disappear and then come back.

Does anxiety cause stuttering, or does stuttering cause anxiety?

Anxiety does not cause stuttering; stuttering can cause anxiety. That is the Australian Stuttering Research Centre’s position, and it adds that anxiety can then make stuttering worse, which can make the anxiety worse again.

The order of events supports this. Young children who stutter are not more anxious than other children when the stuttering begins, according to the Michael Palin Centre for Stammering in London. Worry about speaking tends to arrive later, after a child has met people who react badly to the way they talk, for example by teasing. The Australian Stuttering Research Centre notes that social anxiety disorder starts to emerge in children soon after seven years of age, which is one of its reasons for recommending treatment in the preschool years.

A speech pathologist assesses and treats the stuttering. When worry about speaking is keeping a child out of ordinary school and social life, a psychologist is the right person for the anxiety, working alongside the speech pathologist.

Can an injury or illness cause stuttering?

Rarely. Almost all stuttering in children is the developmental kind, which begins in early childhood with no injury or illness behind it. Stuttering that begins after a head injury, a stroke or another neurological condition is called acquired or neurogenic stuttering, and it is uncommon.

A sudden start alone is not a sign of illness, because developmental stuttering often begins suddenly. Stuttering that starts after a blow to the head, or together with other new symptoms, is a reason to see a doctor.

Some children who stutter also have another speech, language or developmental difference. That does not change the cause, but it can change the plan, and the guide to stuttering with other conditions covers it.

If the cause cannot be changed, what can?

A child’s genes and the way their brain handles speech cannot be changed. The Australian Stuttering Research Centre says that because genetics is involved it is not right to think in terms of a cure. What can change is how much a child stutters and how they feel about talking. Nobody can yet tell which children will stop stuttering without help, so the Centre recommends therapy for every child who begins to stutter in the preschool years.

The overview of stuttering in children explains how stuttering and its treatment change with age, and the page on stuttering in toddlers and preschoolers covers the years when it usually starts. Dr Lauren Crumlish (PhD) is a Certified Practising Speech Pathologist who treats stuttering in children and teenagers by video across Australia, and a parent or guardian can apply to work with Dr Lauren.

Sources

Topics

  • Causes
  • Genetics
  • Family history
  • Anxiety

Fees

Sessions are $193. The first step is an initial assessment, from $590. Medicare rebates are available with a doctor's referral. The practice is not NDIS registered: self-managed and plan-managed participants are welcome; NDIA-managed funding cannot be used. See fees and Medicare

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