When the Academy Awards ceremony aired on Sunday, Texas speech therapist Lana Dodgen was rooting for 鈥淭he King鈥檚 Speech,鈥� up for a dozen Oscars for its depiction of British King George VI鈥檚 struggle with stuttering.
Ms. Dodgen, who runs the Mesquite Independent School District鈥檚 chapter of the 鈥檚 children鈥檚-support group, said she and other advocates hope the film will bring awareness to stuttering the way 鈥淩ain Man鈥� did to autism. The movie has already drawn broad interest to the disorder, which affects about 5 percent of preschoolers at some point in their language development and leaves 1 percent, or more than 3 million Americans, permanently struggling to speak.
Yet new findings discussed at a Feb. 20 research symposium on stuttering, held in Washington during the annual conference of the American Association for the Advancement of Science, suggest educators are just beginning to understand the interconnected causes of the condition.
Anne Smith, the director of Purdue University鈥檚 Speech Neurophysiology Lab, in West Lafayette, Ind., said researchers no longer think the root of stuttering lies in any one problem.
鈥淭he causal factors are many: linguistic factors, cognitive factors, psychosocial factors, and genetic factors,鈥� she said during the symposium. 鈥淚t鈥檚 emergent; there are a number of underlying factors, and it鈥檚 the way they interact that produces stuttering.鈥�
Mismatch in the Brain
It鈥檚 common for a stutterer鈥檚 speech to . In a published in the journal NeuroImage in November, Luc F. de Nil, a professor of speech-language pathology at the University of Toronto, found that when someone stutters, even purposely, it overactivates and mistimes parts of the cerebellum associated with integrating sense perception with body movements, which may contribute to a mismatch between thinking a phrase and speaking it.
All children a bit like the way they learn to ride a bike, wobbly at first and becoming smoother with practice. According to a series of 2010 studies co-written by Ms. Smith鈥攑art of 20 years of ongoing research on adult and child stutterers underwritten by the National Institutes of Health鈥攁bout 60 percent of preschool children had in their ability to clap in time with a rhythm and in both their jaw movements and sounds when they repeated a sentence like 鈥淏uy Bobby a puppy鈥� 10 times.
鈥淭he King鈥檚 Speech鈥� Trailer
Speech consistency doesn鈥檛 come until puberty, yet even when speaking clearly, young children and adults who stutter vary more widely in their physical and voice movements than nonstutterers.
鈥淪tuttering isn鈥檛 just these behaviors you see,鈥� Ms. Smith said. 鈥淚t鈥檚 a symptom in young children of a profound difference in the way the brain is developing.鈥�
That difference may in part be genetic, suggests by Dennis T. Drayna, a section chief for the Laboratory of Molecular Genetics at the National Institute on Deafness and Other Communication Disorders, in Bethesda, Md.
Building on prior studies of identical twins, Mr. Drayna鈥檚 team found in studies of families last year that stuttering is highly heritable.
At least three different genes have been associated with increased stuttering. Mr. Drayna is now experimenting with mice that have been injected with the faulty gene to determine if they have changes in their own vocalizations that could help pinpoint the cause.
Outgrowing the Disorder
Ms. Smith said half of those who stutter at the start of school within a few years. Her team has identified 72 4- and 5-year-olds who stutter, along with 45 peers who do not, and will run each through a two-day battery of language tests once a year for five years to track differences between children who continue to stutter and those who become fluent on their own or with speech therapy.
Braden Barber, 17, is among the 1 percent whose stuttering has persisted. Diagnosed at age 2, he went through several speech pathologists in elementary and middle school, but he said he stopped seeing the last one a year ago and hasn鈥檛 used many of the anti-stuttering strategies, 鈥渂ecause most of them don鈥檛 really work for me.鈥�
鈥淚鈥檓 not really looking for a cure for stuttering,鈥� he said. 鈥淚 try to control it as much as I can. 鈥�. I try to talk very slowly so I can keep up with my words and know what I鈥檓 going to say.鈥�
In the process, Mr. Barber, now a junior at The Colony High School in The Colony, Texas, said he鈥檚 stopped following research on stuttering and started just getting more involved in the community. He has joined the Dallas-area Teens Who Stutter group, and developed an informational letter for students who stutter to give to their teachers, describing the disorder and ways the teacher can support the student in class by encouraging him or her to speak without applying pressure.
His advice echoes that of many researchers and advocates for stuttering students.
鈥淭he biggest mistake is telling the child, 鈥楯ust slow down, take your time, and you鈥檒l get it out,鈥欌�� said Tommie L. Robinson Jr., the director of the Scottish Rite Center for Childhood Language Disorders in the Children鈥檚 Hearing and Speech Center at Children鈥檚 National Medical Center in Washington. He is the immediate past president of the American Speech-Language-Hearing Association.
鈥淚f teachers model fluid, easy talking, that鈥檚 far more powerful,鈥� Mr. Robinson said.
Keith Adams, the principal at West Mesquite High School in Texas and a stutterer since early childhood, said he tries to reach out to students who stutter, both through the school district support group and individually.
鈥淲hat we want to try to do with the district support group is to show kids it鈥檚 OK to be a stutterer,鈥� Mr. Adams said. 鈥淚t鈥檚 something you have to manage, but it鈥檚 part of you.鈥�
