Secondary Characteristics of Stuttering
September 6, 2020
American Institute for Stuttering
At the American Institute for Stuttering (AIS), we know a great deal about what causes stuttering.
Things like the impact of genetics, family history, neurobiology, the male to female ratio, differences between the left and right hemisphere of the brain, the impact of stuttering and language development in preschool children, the role of speech therapy for stuttering, and many other contributing factors are all considered when discussing the nature of persistent stuttering.
However, the impact that stuttering has on daily living is most understood through the differences between primary, surface behaviors of stuttering and secondary behaviors of stuttering.
Typically, the primary, surface behaviors of developmental stuttering are divided into three major categories: sound repetitions, sound prolongations, and blocks in speech.
However, in addition to any of these behaviors, many people who stutter also experience secondary behaviors.
Secondary behaviors can take many forms, with some common features being physical movements (e.g, throat clearing, eye blinking, foot stomping, etc.) or changes in communication meant to avoid stuttering entirely (e.g., word substitutions, sentence revisions, increasing speech rate in order to "beat" a stutter before it happens, choosing not to talk) used to escape the moment of stuttering.
Oftentimes, classifications like "severe stuttering" may be related more to the frequency of secondary behaviors, and the immense effort and struggle that goes into trying to break free of the moment.
These behaviors are also universal across all ages - they can impact young children in the midst of early stuttering, while oftentimes increasing as an individual grows with stuttering.
Here are three important points to consider when learning more about secondary behaviors of stuttering:
While they may have an overall negative impact on a person's communication experience, they are there for a reason! As we know, stuttering can create a variety of stressful situations for people who stutter, with many describing the feeling of stuttering as an overall "loss of control".
If there is one thing we know about humans, it is that we have a hard time losing control. In many cases, even the simple possibility of stuttering is a trigger for the "fight or flight" response, so it makes sense that someone would do anything they could to regain that control and "break through" the stuck feeling as quickly as possible.
These physical behaviors take many forms, but common examples include: eye blinks, loss of eye contact, facial grimacing, jaw jerking, fist clenching, body movements, and many other behaviors meant to help the individual through any stressful speaking situations. Even if these secondary behaviors appear uncomfortable or create more physical struggle, they become habitual and automatic for the person who stutters.
The more that a person who stutters understands this dynamic, the more they can work towards reducing these behaviors, in favor of less discomfort when speaking. Not because there is a "right" or "wrong" way of talking, but because they know that they do not have to avoid or escape stuttering in order to be an excellent communicator.
In most cases, choosing to "just stutter" can actually drastically improve the efficiency and power of their communication skills!
At first, secondary behaviors may "work" to distract the brain and help an individual escape the moment of stuttering in an attempt to achieve fluent speech.
Naturally, this feels good!
We receive an instant reward when we are able to escape or avoid showing stuttering, so our bodies quickly became well-oiled machines in repeating this new behavior whenever a stutter is about to occur.
Over time, though, this stops working - the brain "catches up" and doesn't allow the stutter to be suppressed. But since our bodies are so used to relying on the avoidance behaviors, they stick around and become a part of the "stuttering pattern".
Many kids, teens, or adults who stutter share that they are not always choosing to rely on secondary behaviors, and because of this process, they are right!
When we say the statement "stuttering is okay", we mean it! Stuttering. is. okay.
However, some people who stutter may find it to be empowering to know they have the choice to reduce secondary behaviors, particularly if they cause physical tension, low self esteem, or a speaking style that hinders confident communication. It can be helpful to understand how speech therapy can help support individuals and other family members in understanding the physical struggle of stuttering, and the impact it may have on an individual's life.
So, how can people who stutter understand and make changes to their own secondary characteristics of stuttering?
After talking with a speech language pathologist who understands how to treat stuttering holistically, receiving an individualized treatment plan, and connecting with the larger stuttering community, many clients share that they begin to wonder how they developed such a negative relationship with stuttering in the first place.
So, get curious!
Consider some of the following questions:
Many factors can be at play, but it is a common experience for people who stutter to feel that stuttering is a secret that they should hide at all costs. And if they can't always hide it, then they should try to fight back.
In many ways, this makes sense - we live in a world that doesn't always understand stuttering, and nobody should feel ashamed for doing the best they can to adapt.
But what if we didn't have to view stuttering like a mortal enemy? Throughout the process of speech therapy, individuals can take action to feel empowerment, confidence, and joy in their communication skills by being more open with others about stuttering, desensitizing to listener reactions, learning from and connecting with others who share the stuttering experience, and making active decisions to not hide stuttering.
This can serve to promote less reliance on physical struggle, while also promoting a greater sense of emotional well-being for the person who stutters.
Due to the automatic nature of secondary behaviors, it is important for an individual to take concrete action towards becoming more aware of them in real time.
In the process of speech therapy for stuttering, clients take time to become "detectives" for their own stuttering behaviors. They are able to make clearer distinctions between overt stuttering characteristics and learned struggle behaviors that do not promote efficient, comfortable stuttering.
By becoming clear about these differences, the individual can learn how to lean into the different types of stuttering behaviors (e.g., sound/syllable repetitions, prolongations, or blocks), without adding additional pressure or struggle to suppress them. Naturally, as an individual puts up less of a fight against stuttering, the physical act of speaking becomes easier.
Further, by speaking to speech language pathologists, clients can receive a differential diagnosis to ensure that secondary behaviors are indeed related to stuttering, rather than from a different underlying cause (e.g., tics, psychogenic stuttering, etc.).
If stuttering is the pink elephant in the room of your life, it makes sense that it becomes harder and harder to bring up over time. The longer we successfully hide or avoid the conversation, the harder it is to make the decision to share it.
However, while it may seem like a scary challenge, we have found countless stories of clients being glad they took that first step towards being more authentic and open about their experience, especially with their loved ones. Many people find that talking about stuttering can significantly reduce feelings of shame and fear, while also empowering them to normalize the idea of stuttering more and more in their own life.
Further, normalizing stuttering can also help to support reducing physical tension and avoidance behaviors. After all, the need for an individual to substitute words or use different body movements to escape a stuttering moment is reduced when they are in a "stutter-friendly" environment.
This process can be a challenging one! It can be helpful to start small (e.g. sharing with close friends and family), and gradually work your way up to more challenging speaking situations. Many clients have discussed beneficial ways to disclose stuttering at work, in relationships, and in most any place you can imagine.
Every journey must begin with the first step, and we are here to help with exactly that.
Want to learn more about how the American Institute for Stuttering's stuttering therapy services help pre-schoolers, kids, teens, and adults speak freely, and live fearlessly — contact us online or call (212) 633-6400.
