Stuttering most often begins in early childhood, during the preschool years. Studies typically define this as between the ages of two and five years old. While it can be alarming when a young child begins to struggle with speaking, most people know that this is relatively common among young children. Next steps are easy to figure out: talk to your doctor, consult a speech-language pathologist. In most cases, children will naturally recover without the need for therapy.
But what if a person starts to stutter when they are twelve? Fifteen? Nineteen? What’s that about? Stuttering doesn’t just happen suddenly to adolescents or young adults...right?
The short version: Yes, sometimes stuttering does start in adolescence-- even the late teen years. NO, this isn’t always psychogenic (a result of trauma) or neurogenic (result of a brain injury). Sometimes it’s just regular, garden-variety, childhood onset stuttering that decided to show up later than usual.
It can be tricky to track down information on the cause of a newly stuttering teenager. Families who find themselves in this situation can be panicked, seeking MRIs from neurologists to rule out brain tumors, and desperate for answers when the doctors say everything looks normal. This is not normal!
So. Let’s talk about this. Late-childhood onset stuttering.
Why is this happening?
While it’s upsetting to see a preschooler suddenly have a hard time with speaking, it can be bewildering and even terrifying when a 13-year-old develops a stutter seemingly out of nowhere. Isn’t speech development pretty well done by the time you’re studying algebra?
Speech development is, of course, part of brain development. The human brain is still developing well into the twenties. Even when development is complete, the brain continues to change throughout our lifetime. Life experiences work in conjunction with neuroplasticity until the day we die. One day to the next, our brains are never quite the same.
Early childhood is a period of significant brain development, cognitively, emotionally, and physically. Parents and pediatricians pay attention to milestones like walking, talking, eating, and social engagement. Because there is so much change happening, it’s common for small kids to experience some hiccups during this period. But adolescents and even adults are not clear of hazards, either.
The Tapestry Analogy
I like to use a metaphor of weaving a tapestry to explain brain development, and how and why things can go wrong. Let’s say you are sitting down to weave a beautiful, intricate, LARGE tapestry. You have many, many, many threads, all different colors and textures. This is a LARGE tapestry, so your threads are very long.
Because you have so many threads and all the threads are so long, it may be cumbersome to manage them all when you are just starting to weave the tapestry. It is very easy to accidentally mis-weave a thread. But if you catch it quickly, it’s not too much work to undo your mistake and return to the original design.
This “beginning tapestry” phase can be analogous to early childhood brain development. There’s a LOT going on, and a lot to learn. It’s not uncommon for threads to get a bit off-track, but this is often temporary. Preschoolers often have “phases” that they go through, but their neurons ultimately figure out how to get back to the “typical” track.
Let’s say we get through the first section of our tapestry. The final pattern is now clearly visible, and an observer can picture how the final product will appear. The threads are somewhat more manageable now, as there are fewer loose threads and more of the existing tapestry to keep them in place.
We still have a long way to go, however. As long as we are still going, there’s a chance that a thread may be woven in the wrong spot. As the tapestry nears completion and the threads become easier to manage, it IS still possible to mis-weave.
Yairi & Ambrose (2013) briefly comment on stuttering that begins in adolescence:
“Hence, in general, surveys that cover [a narrow 24-month window between the 2nd and 4th birthday] provide a better indication of life-time incidence than those that begin coverage at more advanced ages. Looking at a 24-month window between the 15th and 17th birthday, however, the prevalence of stuttering will exceed its incidence because, as we know, new onsets are minimal for that time-window.”Yairi, E., & Ambrose, N. (2013). Epidemiology of stuttering: 21st century advances. Journal of fluency disorders, 38(2), 69.
“New onsets are minimal.” But they do happen.
This review is specifically in regards to stuttering that begins in parallel with the developmental process - not stuttering that arises in clear direct response to a neurological and/or traumatic event. Of course, when these events do happen during the developmental period, there can be considerable impact on long-term patterns. But detours on the developmental path are also sometimes just part of development.
Puberty and adolescence are also a significant period in brain development. There is an explosion of neural pruning and neural growth that occurs during these years. In our tapestry analogy, imagine that you’re about halfway through your project. You’re in a comfortable flow and weaving with a rhythm. But then a construction site sets up across the street from you, you have new upstairs neighbors who love to blast loud music all day, and all the lights in your house decide to randomly turn off and on for the next several weeks. To top it all off, your roommate has adopted a kitten who loves to play with the loose threads and constantly wants to use the completed portion of your tapestry as a scratching post. In the midst of all this, you have to keep weaving and finish your project (while fending off the kitty). Your experience and skill enables you to continue even with all these challenges, but you’ll likely have a few more errant threads than previously.
The brain has a lot to deal with in adolescence. Considering the above, we shouldn't be too surprised when something that seemed like it was previously "all set" starts to show some changes. Speech included.
What To Do When A Teenager Starts To Stutter
The big takeaway here is that while late-childhood onset stuttering is uncommon and unexpected, it does not mean that a young person has a brain tumor or is experiencing tremendous psychological trauma. Parents and professionals should not assume that late-childhood onset stuttering is surefire evidence that a serious external event has occurred. As always, consult the relevant professionals when there is a sudden change in health status -- but be wary of "diagnosis shopping" because of a preconceived assumption.
Because late-childhood onset stuttering is unusual, it may be worth pursuing tests or consultations to rule out possible neurogenic or psychogenic causes. This is different from how we handle stuttering that begins in early childhood, when it’s assumed to be developmental.
However, if and when an MRI or psychological assessment indicates that all underlying systems are healthy and functional...that’s a solid indicator that this is simply late-childhood onset stuttering.
Supporting Teenagers Who Stutter
Teens who stutter need support, whether they’ve been stuttering for sixteen years or sixteen days. Speech therapy can help teens speak more easily, confidently, and reduce negative emotions associated with stuttering. Support organizations that promote learning about stuttering and connecting with others who stutter are vital resources. Stuttering can be isolating and confusing, especially if a teenager is new to stuttering. Getting connected and communicating openly are the most powerful ways to help teenagers who stutter.
National Stuttering Association: support groups for families and adults around the country
Friends, the National Association of Young People Who Stutter: programs and conferences for families and young people who stutter
For Parents: Top Ten “To Dos” for Parents of Teens Who Stutter (from the National Stuttering Association)
Shared Voices: Chicago community events for families and adults who stutter
Looking for speech therapy for a teen who stutters? Our speech IRL team has multiple stuttering specialists with extensive stuttering experience. Contact us to set up a free consultation or learn more.