Irvine, School of Medicine. Maguire himself stutters, for
example, as do his mother and brother.
“There’s a strong familial history of a higher rate
of concordance, where family members have a higher
rate of risk of stuttering,” he says. So far, however, no
“stuttering gene” has been identified.
One theory holds that excess dopamine activity in the
brain may lead to stuttering via abnormal functioning of
the basal ganglia, although the research is not definitive,
says Maguire. Brain imaging studies also indicate that
stuttering could be due to a person’s having underactive
left cortical hemisphere speech areas.
What researchers do know is that people who
stutter have abnormalities in the way their speech
muscles contract when they talk. That leads their
speech to have the characteristic involuntary
repetitions, prolongation of words and broken words
— the effects that can be so stigmatizing, particularly
for children who stutter.
Adding to that stigma is the fact that many people —
including stutterers themselves — think of the condition
as a purely psychological, rather than physical, problem,
says clinical psychologist and stuttering researcher J.
Gayle Beck, PhD, of the University of Memphis.
“We have some conceptions that stuttering might be
due to some deep-seated character problems or merely
A new name for stuttering in DSM- 5
“Stuttering” is no longer an official diagnosis, according
to the DSM- 5. Instead, the name of the disorder has
been changed to Childhood-Onset Fluency Disorder.
Criteria for diagnosis have also changed in the new
DSM, most notably the removal of saying “ums,”
“ahs” and “you knows” and other interjections as
a requirement for diagnosis. “People may have
interjections as part of their speech but it may not be
stuttering,” says Gerald Maguire, MD, a professor at
the University of California, Irvine, School of Medicine,
who served as a consultant for the DSM revision.
“They may not be bothered by it, and it may not be
— JULIE COHEN
part of an underlying disorder.”
Meanwhile, anxiety and avoidance have been added
to the diagnostic criteria. “For many people, this is
what can disable them,” Maguire says. “They may
have a high level of anxiety and they avoid certain
speaking situations or certain words and they focus
so much of the time around the avoidance and the
anxiety. It’s really a key focus.”
BY JULIE COHEN
Psychologists are helping people who stutter gain
mastery over their symptoms and associated anxiety.