Anatomy of a Stutter
New findings from brain studies and genetics are illuminating the causes of this ancient affliction
The hardest word for Kurt Salierno to say is his own name. On a good day, the 42-year-old Atlanta carpenter and minister manages to squeeze out, "Kkkkkkk . . . kkkkkk . . . kkkkkurttt!" without spraying his neighbors. But more often, Salierno stalls and stumbles until he gives up and settles for the name that rolls most easily off his tongue. "Most people I meet know me as George," he says, chuckling.
When Salierno jumbled his speech as a child, his teachers decided he was mentally retarded. One therapist speculated that he harbored unresolved anger toward his father; another advised him simply to relax. In some ways, it's no easier today. When Salierno tried to order pizza a few weeks ago, the clerk thought it was a prank and hung up on him. Security guards recently surrounded him at a Wal-Mart because an employee mistook him for mentally ill. And last year, when he stood up to toast his father at a banquet, he knew full well what he wanted to say, but not a single word would come out. "It's like I'm trapped in a glass capsule," he explains. "I can see out, but there's no way to get out."
Like Salierno, more than 3 million people in the United States--and 55 million around the world--wrestle with this devastating and isolating disorder every day. A 39-year-old physical therapy technician in San Antonio, Diane Tijerina only wants simple things, like being able to ask where groceries are stocked without fearing that the word flour will come out mangled. David Berger, a 26-year-old doctoral student at the University of Pittsburgh, can write eloquently about ancient philosophers but needs 10 seconds to say the word hello on the telephone. And Stephen Essman, an eighth grader in Oceanside, Calif., has adjusted well in middle school but still has to face classmates who call him a "scratched CD."
What causes these people to trip up? "The simplest 4-year-old is more fluent than you," says Gerald Maguire, a psychiatrist who has stuttered for most of his 35 years. Indeed, the vagaries of the disorder have stumped scientists for generations. Why, for instance, do whispering, acting, talking to pets, and singing often make the disability disappear? Why does it occur roughly four times as often in men as in women? And why do some children eventually outgrow it?
A small yet energized group of researchers is now making headway toward a new scientific understanding of this ancient affliction. Coming from a variety of fields, including neuroscience and radiology, genetics and speech pathology, these scientists have begun to uncover the biological roots of this enigmatic disorder. "For a long time, stuttering was thought to be psychogenic, rooted purely in psychology," says Allen Braun of the National Institute on Deafness and Other Communication Disorders. "That's clearly not the case now."
Genetic quirk? Now the focus is on genes and the inner workings of the brain. Investigators announced last November at the American Speech-Language-Hearing Association meeting that they had found the first tangible evidence of a genetic aberration underlying at least some cases of stuttering. What's more, new PET imaging studies have revealed striking differences in the brain physiology of stutterers and nonstutterers. Stutterers, it turns out, may be using the wrong side of their brains when they speak. "The right hemisphere seems to be interrupting or interfering with the left hemisphere," says Peter Fox, neurologist and director of research imaging at the University of Texas Health Science Center.
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