Stammering (Stuttering): Care Staff Guide to Communication

Stammering, also known as stuttering, is a difference in speech that affects millions of people, yet it is often misunderstood. People who stammer may be rushed, interrupted or judged to be nervous, when in reality the stammer is a speech difference that varies from moment to moment. This guide, based on NHS information, explains what stammering is, what is known about its causes, how it is supported, and how care and support staff can communicate respectfully. It sits alongside our guide to aphasia and communication support, as good communication practice applies to both.

What is stammering?

The NHS describes stammering as a speech condition in which a person may repeat sounds or syllables, stretch sounds out, or find that words get stuck or do not come out at all. How severe it is varies between people and between situations. Periods of stammering alternate with periods of fluent speech, and the NHS notes it is often worse when someone has a lot to say, is excited or feels under pressure.

Types and causes

Most stammering is developmental, beginning in early childhood. A rarer form, sometimes called acquired or late-onset stammering, is linked to a head injury, a stroke, other neurological conditions, certain drugs or trauma. For staff who support adults, this matters: a sudden new stammer in an adult is a change that needs medical attention. Our guide to stroke recognition with the FAST test explains why sudden speech change is a warning sign that should be treated as an emergency.

The NHS says the exact cause of developmental stammering is not known for certain. It is not caused by anything parents did. Developmental and inherited factors may play a part, and there may be small differences in how the speech areas of the brain work or in how the parts of the speech system are coordinated. About two in three people who stammer have a family history of it.

How common is it?

The NHS states that about 1 in 12 young children go through a phase of stammering, and that about 2 in 3 of those who stammer become fluent, although the timing is hard to predict. It is more common in boys. In adults, about 1 in 50 are affected, and men are around three to four times more likely than women to stammer.

Help and treatment

The NHS says the main treatment is speech and language therapy, which provides a tailored plan. It may include creating a relaxed, confident environment for talking, fluency strategies and communication skills, and addressing fear and anxiety about speaking. Electronic devices exist but are usually not available on the NHS.

The NHS advises that, if there are concerns about a child's speech, parents should seek advice early because treatment is often most successful before school age. A GP or health visitor can refer to speech and language therapy, and in some areas you can refer directly to children's services. Adults can ask their GP for a referral if stammering significantly affects social or working life.

For support, the NHS signposts STAMMA, the British Stammering Association, which supports people who stammer and their parents. Its helpline is 0808 802 0002 and it also offers webchat.

Communicating well: general good practice

The NHS page does not give detailed advice on how to talk to someone who stammers, so the points below are general good practice rather than NHS guidance. People who stammer often say that the biggest barrier is other people's reactions.

• Give time. Let the person finish in their own time. Avoid finishing their sentences or saying "slow down" or "take a breath".
• Keep natural eye contact and show you are listening to what is being said, not how it is said.
• Do not rush or interrupt, and reduce time pressure where you can, for example when taking a history or asking questions.
• Offer choices of communication. Some people prefer writing or messaging at times. Ask what suits them.
• Be mindful in group settings. Speaking in front of others can increase pressure. Offer quieter alternatives.
• Do not make assumptions about confidence, ability or intelligence based on speech.

Stammering in the workplace and care settings

Staff who stammer may need reasonable adjustments, such as extra time for handovers or alternatives to phone calls. Our guide to equality and diversity training for care and healthcare staff explains the duties employers and providers have. People receiving care may feel anxious about explaining their needs, ordering at mealtimes or using an emergency call, so build in patience and check that they have been understood.

When to seek help

Encourage a GP referral to speech and language therapy for a person whose stammer is causing distress or affecting daily life. Seek urgent medical help, and call 999 if a stroke is suspected, when a person suddenly develops slurred or new difficulty speaking, facial drooping or weakness in an arm.

Frequently asked questions

Does stammering mean someone is nervous?

No. Nerves can make it more noticeable, but stammering is a speech difference.

Will a child grow out of it?

The NHS says around two in three who stammer become fluent, but it is hard to predict, so early advice is worthwhile.

Is there a cure?

The NHS describes speech and language therapy as the main support. Therapy helps people to communicate with more confidence.

Where can staff build their knowledge?

The health and social care learning available through Learnsignal CPD can help you improve your communication skills.

This article is general information for care staff, based on NHS information, and does not replace the advice of a person's own clinicians. If you are worried about someone's health right now, contact their GP, NHS 111 or, in an emergency, call 999.