Ask the Expert: Understanding stuttering in young children

"Ask the Expert" articles provide information and insights from MSU scientists, researchers and scholars about national and global issues, complex research and general-interest subjects based on their areas of academic expertise and study. They may feature historical information, background, research findings, or offer tips.

Bridget Walsh is a certified speech-language pathologist and assistant professor in the Department of Communicative Sciences and Disorders. She also directs the Developmental Speech Lab.

There are 70 million people worldwide who stutter. How does your research contribute to our understanding of what stuttering is and how it develops?

To understand the genesis of stuttering, we need to study it at its onset. Stuttering typically develops around the third year of life. This is a time when kids aren’t necessarily fluent speakers. They’re developing the sounds of their language; they’re developing the ideas of what they want to say. A lot of kids, surprisingly, up to 8% at this age – the preschool years – will go through a period of stuttering that parents may or may not be aware of because other issues going on with their speech and language development. We can expect most of the children who start to stutter, to recover or “grow out” of their stuttering. But children who persist are at greater risk for lifelong, chronic stuttering. In my lab, we study factors that portend a greater risk for stuttering persistence for some children, as well as factors that may be protective – that mitigate this risk, allowing other child to recover.

What are some common misconceptions about stuttering?

I’d say the more common misperceptions surround the cause of stuttering and that nervousness/anxiety plays a role and, relatedly, that stuttering is a psychological disorder. I also hear from parents of young children especially that they try not to talk about stuttering or use the word “stuttering” with their child because they’re afraid to draw attention to their stuttering and make it worse. There is also a great deal of societal stigma toward stuttering, unfortunately, and the mistaken belief that people who stutter should not do certain jobs that require speaking and are less capable overall.

To follow up on these misconceptions, we know that stuttering is not a psychological, but a neurodevelopmental disorder. It arises through differences in neurological development of brain regions involved in speech planning and production, and we know genetics play a role in this development. We encourage parents to be open with their kids about stuttering. Not to point out necessarily that they’re stuttering in the moment, but to be matter of fact about it. For example, “I notice that sometimes it’s hard for you to get your words out. Do you sometimes feel like talking is hard or words get stuck?” This provides an opening for the child to talk about his/her speech if they wish. The parent acknowledges the struggle their child may be having when talking but are accepting and open to talking about it.

What are some of the major projects your lab, the Developmental Speech Lab, is working on?

The research in my lab focuses on the development of stuttering in young children and furthering our understanding of why children who begin to stutter as preschoolers recover or persist and develop a life-long stuttering condition. I mentioned that stuttering is a neurodevelopmental disorder and that regions of the brain develop differently. My lab looks at brain function, or neurophysiology, supporting speech and language tasks. We use functional near-infrared spectroscopy, a non-invasive measure of blood flow to cortical regions, and electroencephalography to assess how children’s brains are “active” during speech and language tasks to yield clues regarding the development of brain function and potential risk factors for stuttering persistence.

Another important component of our research is studying the development of adverse impact in some children who persist in stuttering. We know that stuttering often leaves a lasting imprint on people who develop life-long stuttering. We don’t have a clear picture though of how and when adverse impact develops in some people who stutter. As with our brain research, we are looking at factors that portend a risk for the development of adverse impact. Identifying these factors early in children will help us mitigate stuttering’s impact by intervening sooner and by using more tailored therapy approaches.

Some public figures are known to stutter, like King George VI and President Joe Biden. What are some of the benefits of the public discourse surrounding their stuttering? What are some of the negatives?

I think the positives are that public interest in stuttering piques surrounding, for example, the release of the movie “The King’s Speech” or the last presidential campaign. The public sees that people who stutter can be famous, powerful figures. But in both cases, George VI and President Joe Biden, the public also receives the message that these individuals “overcame” their stuttering by learning strategies that helped them not to stutter.

The concern is that a “one-size-fits-all” expectation emerges. Biden saying that reading poetry helped him to stutter less is fine, but we shouldn’t expect that reading poetry is necessarily a cure and will help each person who stutters. It’s also important to keep in mind that each person who stutters is unique and may be in very different places with their stuttering. “Overcoming” stuttering to one person may mean learning strategies to speak more fluently. But “overcoming” for another person may mean something vastly different. Another person may stutter significantly, but they “overcame” feelings of shame, for example, surrounding their speech. Stuttering may always be with a person to a degree, but the goal of therapy should be to support that person in becoming an effective communicator and to help them realize that what they have to say is far more important than how they say it.

How is MSU positioned as a collaborative place to conduct stuttering research?

Being a small department, it is unusual to have two faculty, Scott Yaruss and me, who are well-known researchers in the field of stuttering. Scott is a world-renowned clinician and researcher, and we collaborate on my large developmental stuttering research project in young children. We have adjunct faculty, Soo-Eun Chang at the University of Michigan, who is also a collaborator and eminent stuttering researcher. In addition, we have collaborators and colleagues at other universities and colleges around Michigan and have even started meeting each year at the Great Lakes Stuttering Research Symposium hosted by MSU. It’s a fantastic opportunity for all of us to get together and talk about our work. Michigan has really become the hub of stuttering research!

Is there anything else the public should know about stuttering or your research?

We welcome participation in our research! Children ages 3-18 who stutter are eligible to participate in our survey research and preschool children who stutter are encouraged to participate in the in-person studies we’re starting. Reach out to us at msustutteringlab@gmail.com or through our website https://stutteringresearch.msu.edu/