http://medslpcollective.com Neurogenic Stuttering 101 Sound/syllable repetitions: “M-m-m-my dog ran a-a-away.” Whole word repetitions: “My-my-my dog ran-ran away.” Audible sound prolongations: “Mmmmmmmy dog ran aaaaaaway.” Inaudible sound prolongations (or blocks): “My d___og ran a___way.” What is neurogenic stuttering? Neurogenic stuttering (also known as “acquired stuttering”, or, even more specifically, “stuttering associated with acquired neurological disorders” [SAAND]) is the term for a new onset or exacerbation of a difficulty with speech fluency. Speech fluency is the smooth, forward flow of speech, and stuttering is the term for when one experiences involuntary stuttering-like disfluencies (SLDs): These are often accompanied by a sensation of being stuck on a certain sound or word and an experience of a loss of control as one attempts to keep moving forward (Tichenor & Yaruss, 2019). Five characteristics are central to neurogenic stuttering/acquired stuttering/SAAND (Van Borsel et al., 1997):
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MedSLPCollective Handout - Neurogenic Stuttering 101Sound/syllable repetitions: “M-m-m-my dog ran a-a-away.” Whole word repetitions: “My-my-my dog ran-ran away.” Audible sound prolongations: “Mmmmmmmy dog ran aaaaaaway.” Inaudible sound prolongations (or blocks): “My d___og ran a___way.”
The presence of SLDs
A diagnosis of a neurological disturbance or disease
The occurrence of stuttering symptoms for the first time in life or an aggravation of an
existing stuttering speech pattern
A direct correlation between the neurological disturbance and the onset of stuttering
symptoms
Onset at any age
What is neurogenic stuttering? Neurogenic stuttering (also known as “acquired stuttering”, or, even more specifically, “stuttering associated with acquired neurological disorders” [SAAND]) is the term for a new onset or exacerbation of a difficulty with speech fluency. Speech fluency is the smooth, forward flow of speech, and stuttering is the term for when one experiences involuntary stuttering-like disfluencies (SLDs):
These are often accompanied by a sensation of being stuck on a certain sound or word and an experience of a loss of control as one attempts to keep moving forward (Tichenor & Yaruss, 2019). Five characteristics are central to neurogenic stuttering/acquired stuttering/SAAND (Van Borsel et al., 1997):
Lesion localization for neurogenic stuttering has not been found for any one specific brain
area, but instead can be found anywhere in the cortical-basal ganglia-thalamic-cortical
network consisting of the inferior frontal cortex, superior temporal cortex, intraparietal cortex,
basal ganglia, superior longitudinal fasciculus and internal capsule (Theys et al., 2011).
With Contributions from Stephen Groner, MS, CCC-SLP
http://medslpcollective.com
How common is neurogenic stuttering?
Neurogenic stuttering can be caused by many kinds of neurological disturbances but is most
commonly caused by cerebrovascular accidents (strokes), traumatic brain injuries, and
degenerative disorders, among others. (Theys et al., 2011; Van Borsel et al., 1997).
5.3% of patients who experience a cerebrovascular accident (or about 1 in 20) present with
neurogenic stuttering (Theys et al., 2011). They often present with other concomitant
disorders, with 65% also having aphasia, 53% also having dysarthria, and 12% also having
apraxia of speech (Van Borsel et al., 1997).
It can be difficult to tell the disfluencies in neurogenic stuttering, nonfluent aphasia, and
apraxia of speech apart, however, repetitions in apraxia of speech tend to be deliberate when
trying to hone in on the proper motor program, whereas repetitions in neurogenic stuttering
are involuntary (Van Borsel et al., 1997).
Neurogenic stuttering also tends to differ from developmental stuttering in many ways. There
is often a lack of overt accessory movement secondary behaviors like head bobbing, facial
grimaces, or arm and leg movements. Patients’ negative speech attitudes and speech anxiety
may not be severe relative to the severity of their behavioral stuttering presentation (Ringo &
Dietrich, 1995).
That being said, patients may still be annoyed or irritated by their speech (in up to 70% of
patients) and may avoid certain speaking situations because of it (König, n.d.). Stuttering may
be present on function and content words, and may not be limited to just the initial syllables of
a word or utterance in neurogenic stuttering (Ringo & Dietrich, 1995).
What’s the prognosis for neurogenic stuttering?
While 5.3% of stroke patients present with neurogenic stuttering directly following their stroke,
only 2.5% still present with neurogenic stuttering 6 months later, meaning 50% of patients
recover spontaneously (Theys et al., 2011). In Theys et al.’s (2011) study of 17 participants with
neurogenic stuttering, there was a better chance for recovery after 6 months for women (5 out
of 7, or 71%) in comparison to recovery for men (4 out of 10, or 40%).
http://medslpcollective.com
How is neurogenic stuttering treated?
While the research is still out on the best way to treat neurogenic stuttering, König (n.d.)
surveyed 89 speech pathologists in Germany who treated clients with neurogenic stuttering
and found that they used stuttering modification and fluency shaping techniques (e.g. Easy
Onsets, Reducing Speech Rate, and Rhythmic Speech).
Due to the lack of research evidence in this area, the clinician’s clinical judgment and client’s
preferences may be the stronger legs of the evidence-based practice triad to rely on.
References:
König, K. (n.d.). Possibilities in neurogenic stuttering treatment: An empirical study on
therapists’ experiences. Presentation for the European Clinical Specialization in Fluency
Disorders Conference.
Ringo, C. C., & Dietrich, S. (1995). Neurogenic stuttering: An analysis and critique. Journal of Medical Speech-Language Pathology, 3(2), 111-122.
Theys, C., Van Wieringen, A., Sunaert, S., Thijs, V., & De Nil, L. F. (2011). A one year prospective
study of neurogenic stuttering following stroke: Incidence and co-occurring disorders.
Journal of Communication Disorders, 44(6), 678-687.
The presence of SLDs
A diagnosis of a neurological disturbance or disease
The occurrence of stuttering symptoms for the first time in life or an aggravation of an
existing stuttering speech pattern
A direct correlation between the neurological disturbance and the onset of stuttering
symptoms
Onset at any age
What is neurogenic stuttering? Neurogenic stuttering (also known as “acquired stuttering”, or, even more specifically, “stuttering associated with acquired neurological disorders” [SAAND]) is the term for a new onset or exacerbation of a difficulty with speech fluency. Speech fluency is the smooth, forward flow of speech, and stuttering is the term for when one experiences involuntary stuttering-like disfluencies (SLDs):
These are often accompanied by a sensation of being stuck on a certain sound or word and an experience of a loss of control as one attempts to keep moving forward (Tichenor & Yaruss, 2019). Five characteristics are central to neurogenic stuttering/acquired stuttering/SAAND (Van Borsel et al., 1997):
Lesion localization for neurogenic stuttering has not been found for any one specific brain
area, but instead can be found anywhere in the cortical-basal ganglia-thalamic-cortical
network consisting of the inferior frontal cortex, superior temporal cortex, intraparietal cortex,
basal ganglia, superior longitudinal fasciculus and internal capsule (Theys et al., 2011).
With Contributions from Stephen Groner, MS, CCC-SLP
http://medslpcollective.com
How common is neurogenic stuttering?
Neurogenic stuttering can be caused by many kinds of neurological disturbances but is most
commonly caused by cerebrovascular accidents (strokes), traumatic brain injuries, and
degenerative disorders, among others. (Theys et al., 2011; Van Borsel et al., 1997).
5.3% of patients who experience a cerebrovascular accident (or about 1 in 20) present with
neurogenic stuttering (Theys et al., 2011). They often present with other concomitant
disorders, with 65% also having aphasia, 53% also having dysarthria, and 12% also having
apraxia of speech (Van Borsel et al., 1997).
It can be difficult to tell the disfluencies in neurogenic stuttering, nonfluent aphasia, and
apraxia of speech apart, however, repetitions in apraxia of speech tend to be deliberate when
trying to hone in on the proper motor program, whereas repetitions in neurogenic stuttering
are involuntary (Van Borsel et al., 1997).
Neurogenic stuttering also tends to differ from developmental stuttering in many ways. There
is often a lack of overt accessory movement secondary behaviors like head bobbing, facial
grimaces, or arm and leg movements. Patients’ negative speech attitudes and speech anxiety
may not be severe relative to the severity of their behavioral stuttering presentation (Ringo &
Dietrich, 1995).
That being said, patients may still be annoyed or irritated by their speech (in up to 70% of
patients) and may avoid certain speaking situations because of it (König, n.d.). Stuttering may
be present on function and content words, and may not be limited to just the initial syllables of
a word or utterance in neurogenic stuttering (Ringo & Dietrich, 1995).
What’s the prognosis for neurogenic stuttering?
While 5.3% of stroke patients present with neurogenic stuttering directly following their stroke,
only 2.5% still present with neurogenic stuttering 6 months later, meaning 50% of patients
recover spontaneously (Theys et al., 2011). In Theys et al.’s (2011) study of 17 participants with
neurogenic stuttering, there was a better chance for recovery after 6 months for women (5 out
of 7, or 71%) in comparison to recovery for men (4 out of 10, or 40%).
http://medslpcollective.com
How is neurogenic stuttering treated?
While the research is still out on the best way to treat neurogenic stuttering, König (n.d.)
surveyed 89 speech pathologists in Germany who treated clients with neurogenic stuttering
and found that they used stuttering modification and fluency shaping techniques (e.g. Easy
Onsets, Reducing Speech Rate, and Rhythmic Speech).
Due to the lack of research evidence in this area, the clinician’s clinical judgment and client’s
preferences may be the stronger legs of the evidence-based practice triad to rely on.
References:
König, K. (n.d.). Possibilities in neurogenic stuttering treatment: An empirical study on
therapists’ experiences. Presentation for the European Clinical Specialization in Fluency
Disorders Conference.
Ringo, C. C., & Dietrich, S. (1995). Neurogenic stuttering: An analysis and critique. Journal of Medical Speech-Language Pathology, 3(2), 111-122.
Theys, C., Van Wieringen, A., Sunaert, S., Thijs, V., & De Nil, L. F. (2011). A one year prospective
study of neurogenic stuttering following stroke: Incidence and co-occurring disorders.
Journal of Communication Disorders, 44(6), 678-687.
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