WHAT ARE THE CORE AND SECONDARY SYMPTOMS OF STUTTERING?
Core stuttering behaviors include disordered breathing, phonation (vocal fold vibration), and articulation (lips, jaw, and tongue). Typically these muscles are overtensed, making speech difficult or impossible. Secondary stuttering behaviors are unrelated to speech production. Such behaviors include physical movements such as eye-blinking or head jerks; avoidance of feared words, such as substitution of another word; interjected starter sounds and words, such as “um,” “ah,” “you know,” and vocal abnormalities to prevent stuttering, such as speaking in a rapid monotone, or affecting an accent. Much of what constitutes stuttering cannot be observed by the listener; this includes such things as sound and word fears, situational fears, anxiety, tension, shame, and a feeling of loss of control during speech. The emotional state of the individual who stutters in response to the stuttering often constitutes the most difficult aspect of the disorder.
