Frequently Asked Questions
Click on the following questions that may apply to you. These are basic answers to many questions received by the CSA. You can contact us for more information on any of these topics.
Please note that this FAQ page is a work in progress.
What causes stuttering
While the root cause is not fully known, brain functioning (neurology), genetics, and environmental factors all play a role. Because speaking and communication are highly complex and depend on interaction with others, many factors can make stuttering worse in some situations. These factors include high expectations, frustration, listener reactions and anxiety about stuttering.
Current brain research indicates that there are neurological differences in people who stutter. For instance, there is more brain activity during speech - especially in the right hemisphere - compared to that of a person who does not stutter. It is in dispute whether these neurological conditions cause stuttering or are caused by the brain trying to compensate for stuttering.
Is stuttering genetic?
Stuttering can run in families. About 6 out of 10 people who stutter are thought to have a family member who also stutters. Research on extended families where stuttering is predominant has found specific types of genetic mutations. These mutations are thought to cause a difference in brain functioning, which leads to stuttering. While researchers have found genetic similarities in people who stutter, no single genetic cause - or gene - has yet been clearly identified.
Can stuttering be cured?
While many people are able to speak more easily and greatly reduce the effect of stuttering on their lives, there is no actual cure for stuttering. There is specialist speech therapy for stuttering in Canada. Though therapy can be most effective for children under the age of 5 and is highly advised, speech therapy can be beneficial at any stage of life.
What are the best treatments for stuttering?
Treatments that combine methods for speaking more easily and reducing the anxiety around stuttering are usually most effective. For adults, it is very helpful to work with a specialist speech and language pathologist to set goals and deal with issues of self-identity and personal change. Two to four week courses with a small group of people who stutter generally show the best results. Sessions once a week can also be highly effective - and are often more practical.
The best treatments for children who stutter are those where parents and caregivers are closely involved under the guidance of a specialist speech and language pathologist. There are two main types of therapy, depending on the child’s needs. One type helps the child to speak more fluently and the other type aims to reduce the demands on a child to speak.
I am an adult who stutters. How do I obtain speech therapy?
Contact a speech language pathologist who has experience working with people who stutter.
The Canadian Association of Speech-Language and Audiology Canada (SAC) has a database of registered SLPs across Canada. Also contact provincial associations of speech-language pathologists, who may also be able to direct you to clinics or health centres that provides therapy.
There are two to four-week intensive therapy programs in Edmonton, Toronto, Ottawa and Montreal. For more information see our Clinics page.
Is speech therapy covered by health insurance?
Most health insurance programs cover a small portion of speech therapy costs – usually about $500 per year. This is minimal when private speech therapy costs are typically more than a $100 per hour. Many employers are beginning to offer additional insurance programs such as health spending accounts which can be used for such costs as speech therapy. Do not give up on obtaining therapy as there may be deferred payment options or scholarships available through therapy programs.
What can I expect from speech therapy? (Teen and Adult)
- To learn ways to speak more easily and to reduce anxiety and negative feelings
- To discuss your needs, fears and goals with the therapist before and during therapy
- To work closely with other people who stutter - if you are doing an intensive course. The support of others is a highly valuable part of therapy.
- Lots of taking. Expect to develop strategies for successfully dealing with stuttering, to practice speech techniques and use them in real life speaking situations.
- Particularly after an intensive course, you might see a big improvement. For the changes to be long-term and for any setbacks to be dealt with, you will need an action plan.
- Maintenance. It usually takes several months to thoroughly learn new speaking and communication skills. If you have a false sense of security and don’t work on an action plan, expect to fall back into old patterns. Many clinics offer refresher courses.
Are there drugs that can help control stuttering?
There are no medications on the market that effectively control stuttering. The medications being tested on people who stutter were developed for other conditions, but may help to improve stuttering. It is a complex area. Extensive tests on Pagoclone showed unacceptable side effects for small gains in fluency and a reduction in anxiety. There is ongoing research to test new medications which have fewer side effects.
My young child has just started stuttering, what should I do?
It is recommended that children who exhibit stuttering receive speech therapy as soon as possible. More than half of young children who stutter grow out of it, but that is little consolation for the parents of those who don't. There is no way to tell if a child's stuttering is a temporary phase that will pass or if it will be permanent.
Any registered speech-language pathologist in your community who treats children would be of help. A treatment specifically to help children who stutter, the Lidcombe method (see below), has been shown to be very effective. The CSA site features a listing of provincial associations of speech-language pathologists. You can contact them for more information about your best options for speech therapy and intensive courses for children that may be offered near you. Sometimes children can receive speech therapy through the public school system or your local general hospital, at no charge. There is usually a waiting list for these free services, if they are offered. Enquire in your community.
There is a lot you can do as a parent to help your child to communicate more easily, though it is hard when you see them struggle. Don’t panic or try to think of an event or situation that might have triggered the stuttering.
How can I help my child who stutters?
- Show you are interested in what your child is saying, and that there is no hurry.
- If you are feeling upset by seeing your child struggle, just give your full attention at that moment and be enthusiastic when acknowledging what they are trying to say.
- Share your own thoughts and opinions with your child, and give them a chance to share theirs – you don't need to ask questions all the time.
- Encourage your child to express themselves as best they can, giving plenty of time to talk.
- Try to slow down you own speech rate and pause before you answer a question.
- Reassure your child if s/he gets upset or frustrated, saying something like: ‘you had a few bumpy words there didn’t you? But that can happen when you’re learning to talk’. Don’t correct their speech at this stage. There are specific ways to model fluent speech that a speech pathologist can teach you.
What professional help is there for school-aged children?
Treatment is available for children who stutter in primary school. Contact provincial-organizations, provincial association of speech-language pathologists, for more information. Sometimes children can receive speech therapy through the public school system or your local general hospital, at no charge. Also contact provincial associations of speech-language pathologists,[check link]
What types of therapy are best for young children?
There are two main types of therapy for preschool children. In both types, parents are shown at therapy sessions how to made adjustments in the environment at home to help their child to speak more easily.
One type is called Demands and capacities, where the goal is to reduce the demands on a child’s capacity to speak fluently, and to increase the child’s level of spontaneous - or normal - fluency.
In this model, parents are encouraged to talk with their child, not to their child, and to practice asking questions in a way that reduces the pressure on the child to speak.
The other type is called Lidcombe, which focuses more directly on a child’s speech. The main part of the therapy is the feedback that parents give to children during everyday interactions, after being trained by a speech language pathologist. The results of this therapy have been very positive.
Parents learn to give appropriate feedback at specific times, with most of the attention given to stutter free speech (smooth talking) to help the child recognise smooth talking and receive positive feedback for it. Stuttering is occasionally pointing out in a positive way. The research shows that after 22 weeks, 9 out of 10 children will be almost stutter-free.
My child has been going to speech therapy for a long time but is still stuttering. Why?
Some children respond better to speech therapy than others for a variety of reasons. Ask the therapist for a time to discuss in detail your child’s overall development, and their confidence with speaking. They may have made other gains, such as increased confidence and acceptance of stuttering. Even though you may be disappointed, try to focus on the positive things about your child, and help him develop confidence in expressing himself and building relationships. Children benefit greatly from conversation and communication at home with his family. He may choose to return to therapy when he is older.
My child who stutters is having problems in school due to bullying.
School can be a challenge for children who stutter, especially at recess and lunchtimes when there is less direct supervision than in the classroom. In elementary school, first contact your child’s classroom teacher. Explain how stuttering affects your child, and describe the incidents of teasing and bullying, and the effects of these on your child. Ask how issues of bullying and aggressive behaviour are discussed within the whole class.
If you are unsatisfied with the response of the teachers, the next step is to explain your concerns to the principal. You may have to advocate for your child quite a bit, depending on the situation.
In secondary school, speak to the head of year, teachers your child likes and respects, or a guidance counsellor. Older children may be more reluctant to report incidents, but threats of violence must be reported. As well as helping your older child to develop strategies for dealing with bullying - such as using humor in response - or walking away from the bully - discuss ways to reach out to others and develop friendships.
What is the SpeechEasy device? Does it work?
The SpeechEasy is a delayed auditory feedback device (DAF) that has been shown to reduce stuttering in some people in some situations. The effect of DAF on stuttering was illustrated in the movie the King's Speech. The modern version is worn like a hearing aid, and feeds back a person's voice as he speaks with a micro-second delay. Speech pathologists recommend it be used in conjunction with speech therapy techniques. It is not a treatment per se, as the effects are not present when one is not wearing the device. The degree of effectiveness varies depending on the person and the situation.
Because it has to be personally fitted to you, the cost of the SpeechEasy is high, more than $4,000, and is not covered by provincial health care programs.
For more information:
I am an adult and I have recently started stuttering after an accident/illness/surgery/traumatic incident. Should I get speech therapy?
As therapy is expensive and time consuming, it is important to get the right kind suitable to your specific condition. Your physician can advise you. Certain kinds of brain damage can cause speech disorders and will require therapy. In some cases, it is possible that a psychologist or trauma counselor might be more effective to address late onset stuttering.
I took speech therapy for years and it didn't help. Why not?
There could be many reasons for this. It is possible that the therapist was not right for you, or perhaps it was not the right time in your life. There may have been unrecognised personal issues that got in the way. Changing how you speak requires changes in how you see yourself and how you relate to other people. Long-term benefits from therapy come from your commitment to practice new ways of speaking and thinking until they really become part of you. Change is hard work. It can be helpful to recognise that stuttering is sometimes easier - strange though that sounds. If fluency and self acceptance are important to you, there is hope that a fresh approach could be more successful.
How do I join a self-help group? What should I expect?
The CSA site has a listing of self-help groups across Canada.
Groups can have different purposes. Some provide a space to share how stuttering affects you and to discuss things that can help. Some are more structured like the Toronto Toastmasters group for public speaking, and some are purely social, like the ones associated with the meetup.com website. You should be prepared to share your own experiences and listen respectfully to people with very different ideas from your own.
Not many cities have self help groups. If you are interested in starting a group, you can advertise through the CSA website.
A guide to starting a self help group (from the British Stammering Association)
Is stuttering a disability? Am I eligible for the Canadian disability tax credit?
A person who stutters can apply for the disability tax credit by submitting the Canada Revenue Agency Form T2201. The form is jointly completed by the applicant and a qualified practitioner, such as a medical doctor or a speech language pathologist. Whether or not you qualify depends on the degree to which a disability restricts one of the basic activities of daily life. The CRA defines speaking as a basic activity.
It is important to note that a recent change to this credit allows the CRA to take into consideration the cumulative effect of restriction in two or more of the basic activities of daily life. In effect, even if you do not meet the threshold level of restriction in any one daily life activity (like speaking), a lesser degree of restriction in two or more categories may still qualify you for this credit.
Additional details about this credit can be found here.