NEUROGENIC STUTTERING

What is neurogenic stuttering? Neurogenic stuttering is a type express anxiety and even depression about their difficulties
of fluency disorder in which a person has difficulty in producing speech in in speaking. This may be accompanied by other behaviors,
a smooth fashion. Individuals with fluency disorders may have speech that which may include:
sounds fragmented or halting, with frequent interruptions and difficulty • Secondary or associated behaviors, such as obvious
producing words without struggle. Neurogenic stuttering typically appears tension and struggle in speech production; movements
following some sort of injury or disease to the central nervous system i.e., of head or limbs while speaking; reduced eye contact;
the brain and spinal cord, including cortex, subcortex, cerebellar, and even
the neural pathway regions. In the majority of cases, the injury or disease • Postponement in attempting to say a word or
avoidance of words or speaking situations.
that caused the stuttering can be identified. In a small number of cases,
however, the individual may only show evidence of some form of speech These behaviors may arise from the speaker’s attempts to
disruption without any clear evidence of neurological damage. overcome or force his way through the disfluency, or from
attempts to hide that he is having difficulty producing
normal sounding speech.
Who is at risk for neurogenic stuttering? Generally
individuals experiencing neurogenic stuttering have had a history
of normal speech production prior to the injury or disease. In a few How does neurogenic stuttering differ
cases, neurogenic stuttering may occur in individuals who experienced from other types of fluency disorders? The
developmental stuttering in childhood but had apparently recovered. symptoms of neurogenic stuttering can be similar to those
Neurogenic stuttering can occur at any age; however, it appears more seen in other fluency disorders. Some communication
often in adulthood, and the highest incidence is in the geriatric population. disorders such as dysarthria, apraxia of speech, palilalia,
This profile is quite different from developmental stuttering which is not and aphasia may impair the speaker’s ability to produce
typically seen as a result of brain damage and which most commonly smooth and flowing speech production. These problems
appears in early childhood in children between 2 and 5 years of age. result from the same types of neurological injury or disease
as neurogenic stuttering, and the disorders often co-exist.
What are the primary symptoms of neurogenic A diagnosis of neurogenic stuttering might be considered
stuttering? Because it results from a very diverse set of diseases and when the disfluency pattern includes the symptoms
disorders, the symptoms of neurogenic stuttering may vary widely between described above.

Copyright 2001-2020 by Stuttering Foundation of America. All rights reserved.

different individuals. Neurogenic stuttering might be considered as a
Occasionally, some individuals may experience psychogenic
possible diagnosis if one or more of the following symptoms are observed:
disfluency. This disorder results in a disfluent speaking
• Excessive levels of normal disfluencies or interruptions in the forward pattern but no medical factors or history of developmental
flow of speech, such as interjections and revisions stuttering are present. Its appearance may be linked
to emotional stress or trauma that the individual has
• Other disfluencies, such as repetitions of phrases, words, and parts of recently experienced. The disorder whose symptoms most
words (sounds or syllables, prolongations of sounds) resemble those of neurogenic stuttering is developmental
stuttering. Developmental stuttering may persist into
• Hesitations and pauses in unexpected or inappropriate locations in an
adulthood. In some cases, its symptoms may be noticeably
utterance
worsened following injury, disease, or trauma, possibly
• Cessation of speech during the production of a word without finishing making diagnosis between the two disorders more
the word difficult. Similarly, an individual who had recovered from
developmental stuttering in childhood may experience a
• Intrusive or extraneous additional sounds during speech production re-emergence of stuttering following neurological injury
or disease. In the vast majority of cases, however, the
• Rapid bursts of speech which may be unintelligible sudden appearance of disfluent speech in an adult should
• Extraneous movements of lips, jaw, or tongue while attempting be considered abnormal. Developmental stuttering should
to speak, including posturing. only be considered as a possible cause when there is a prior
history of childhood stuttering. Apart from the obvious
Many individuals may appear to be unaware of or unconcerned about the difference in age of onset, differentiating between the two
disruptions in their speech. Others may show awareness, and possibly disorders is often difficult.

P.O. Box 11749 Memphis, TN 38111-0749 ˙ stutteringhelp.org ˙ tartamudez.org ˙ [email protected] ˙ 800-992-9392

 Some of the patterns that set the two apart include: How is neurogenic stuttering treated? Because
many conditions can cause neurogenic stuttering and affect the
• Neurogenic stuttering may occur at any point in the production of frequency with which it co-exists with other communication
a word, rather than primarily at the beginning, as is common with impairments, there is no single treatment approach that is
developmental stuttering. effective in alleviating its symptoms. Treatment is often carried
• Neurogenic stuttering often occurs on any type or class of word out by a speech-language pathologist working in conjunction
anywhere in a sentence rather than being linked to content words with the clients’ physicians. Some therapy techniques that help
such as nouns, verbs, adjectives and adverbs. reduce the symptoms of developmental stuttering may also be
effective with neurogenic stuttering. These include:
• Neurogenic stuttering may occur in any type of vocal behavior,
including singing and repeating memorized passages, such as the • Slowing speech rate (saying fewer words on each breath
pledge of allegiance. Disfluencies may occur with equal frequency in by increasing the duration of the sounds and words).
any type of a speaking situation.
• Emphasizing a gentle onset of the start of each phrase
• Neurogenic stuttering is often not alleviated by the same (starting from a relaxed posture of the speech muscles,
conditions that significantly lessen developmental stuttering. These beginning with adequate respiratory support, a slow and
include choral reading, singing, adaptation (repeated oral reading easy initiation of the exhalation and gentle onset of the
of the same passage) or speaking while under auditory masking or first sound).
delayed auditory feedback.
• Emphasizing a smooth flow of speech production and
The aforementioned patterns, however, are not universal for all use of relaxed posture, both in terms of general body
individuals experiencing neurogenic stuttering, and patterns may vary posture and for specific speech production muscles.
widely across individuals depending on the nature of the neurologic
injury or disease. • Identifying the disruptions in the speech patterns and
instructing the client in the use of more appropriate
patterns.
Can other types of communication problems
accompany neurogenic stuttering? It is not uncommon In addition, if the person is expressing anxiety or concern about
for individuals with neurogenic stuttering to experience several other his fluency, therapy may include education about the disorder
types of communication impairments. These might include: and counseling to change attitudes and perceptions. The use
of different or additional techniques and approaches may be
• Aphasia—complete or partial impairment in language indicated based on the presence of other communication and
comprehension, formulation, and use cognitive disorders and the nature of the individual’s underlying
• Dysarthria—errors in the production of the speech sounds, neurological condition. If other communication disorders are
such as slurring of sounds and words that affect the intelligibility also present, additional therapy directed at alleviating their
of the individua’s speech effects may enhance fluency as well. Physicians, nurses,
occupational, physical, and respiratory therapists may also be
• Apraxia of speech—irregularities in the timing and inaccuracies able to provide assistance in dealing with medical conditions
in the movement of the muscles used in speech production and symptoms which have an impact on speech fluency.

• Palilalia—speech disorder in which a word, phrase, or sentence Having an understanding of the disorder can help families
may be repeated several times, generally with increasing rapidity and caregivers structure communication situations to best
and decreasing distinctness help the client. This can have a significant impact on reducing
their concerns and improving communication. Strategies
• Anomia—difficulty in finding the appropriate word to use may include simplifying one’s speech, allowing more time
for response, modeling slow, easy speaking patterns, and, in
• Confusion—uncertainty as to their own identity and that of
others, their location, current time period, etc. general, reducing communication demands and expectations.
It is important to recognize that the recovery process from
the underlying neurological injury or disease will often have a
How is neurogenic stuttering diagnosed? Before getting significant impact on fluency. Also keep in mind that because
treatment, it is important that someone suspected of neurogenic recovery from neurological injury or disease may be slow,
stuttering be diagnosed accurately. It is advisable to consult with a patience will be needed.
speech-language pathologist who specializes in stuttering to make the
diagnosis. The SLP will want to seek input from the physicians involved in
the clients’ care. The evaluation will include consideration of the fluency How can I get help for neurogenic stuttering?
problem and the individual’s case history, current medical status, and The Stuttering Foundation of America can supply you
the presence of other communication impairments. The diagnosis should with the names of speech-language pathologists who
determine whether the disfluency is neurogenic in origin and whether specialize in stuttering. Call toll-free 800-992-9392
any other communication impairments are affecting fluency. or visit www.StutteringHelp.org.

P.O. Box 11749 Memphis, TN 38111-0749 ˙ stutteringhelp.org ˙ tartamudez.org ˙ [email protected] ˙ 800-992-9392