Since our president elect @JoeBiden #stutters I am getting a lot more questions about my stuttering in clinic. Never before has anyone been interested, so this may be progress
Let’s talk #stuttering
A Thread 🧵
(disclaimer- I am not a speech pathologist, just a simple bone MD)
What is Stuttering?

Communication disorder referring to problems in fluency and flow of speech, but can also involve physical tension as they struggle to speak.

I know what I want to say, but cannot say it.
Is is common?

It affects about 1% of the population. Males 3-4X > Females.

Affects children often when language is developing, but most grow out of it with time. Starts around age 3 1/2
Symptoms:
-Difficulty starting / saying a word
-Prolonged sounds
-Repeating sounds / words
-Silence before sounds (blocks)
-Adding extra words like “um” when difficulty is anticipated
-Excess body tension (eye blinks, head jerks, etc)
- changing words
Causes:
-Nobody knows – genetics play a role
-Stuttering is neurological and physiological, not psychological
Effects:
Embarrassment, frustration, anxiety. Perceived as less capable. Childhood bullying.
A study of > 200 adult stutterers reported that >70% impacted ability to be hired, 33% said it affected job performance, 20% had turned down promotions because of stuttering
Treatment:
Speech therapy – about control, patience, understanding.
Stuttering gets worse with excitement, nervousness, tired, stressed, self-conscious, when pressed for time, speaking in front of groups or talking on the phone.

Public speaking = public enemy #1
Fluency:
-Stutterers do not stutter when they curse (see @SamuelLJackson )
-They are fluent when singing (Ed Sheeran, BB King, Mel Tillis)
-Fluent when speaking in unison
A few famous people who stutter:
-Emily Blunt
- @WayneBrady
- Steve Harvey
- @SamuelLJackson
- @JAMESEARL3
- Nicole Kidman
- BB King
- Mel Tillis
- Ed Sheeran
- @JohnStossel
- Winston Churchill
- Bruce Willis
What is it like growing up stuttering?
Teasing. Bullying. Dreading getting called on in class. Making decisions based on avoidance of speaking at all cost. Being unable to effectively communicate what you want to say, when you want to say it.
What helped me?
I watched an episode of 20/20 years ago that @JohnStossel aired about stuttering. He reported on a program at Hollins College for stuttering that changed his life - and it made a drastic impact in mine.
Of note - I had never met another stutterer until getting into medicine, and I find them everywhere in the medical field. It certainly made me a better listener and growing up wanting to help people. I know there are a few more of us out there on #medtwitter
What Not to do to a stutterer:
- rush them
- say " spit it out " or "cat got your tongue "
- complete sentences for them
- assume they are unprepared or do not know content because they may not communicate as effectively
You can follow @jointdocShields.
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