Joe Biden’s Speech Impediment: What To Know About Stuttering

A stutter can be an extremely debilitating and frustrating speech disorder, but it hasn't held Joe Biden back. In December 2019, President Biden revealed on Twitter that he had worked his whole life to overcome a stutter and has mentored children with the same speech disorder.

President Biden stuttered several times during a presidential primary debate in Atlanta in November 2019. Shortly afterward, President Biden spoke to The Atlantic about living with a stutter since he was a young child. Stuttering "can't define who you are," President Biden told writer John Hendrickson, who also has a stutter.

Here's what you should know about stuttering—including what causes the disability, how to manage it, and organizations that can help.

What Is Stuttering?

Stuttering, sometimes called stammering or dysfluent speech, causes repetition, prolongation of sounds, and interruptions in speech, known as blocks.

A person who stutters knows what they want to say but has difficulty with the flow of the words. For example, they might say the word "chair" as "ch-ch-chair" or "chhhhair." In some cases, they may experience rapid eye blinks or lip tremors with stuttering.

"The signs and symptoms of stuttering are easily recognizable," Avivit Ben-Aharon, MSEd, founder and clinical director of Great Speech, Inc., told Health. "Stutterers tend to repeat syllables, parts of words, and make some words or sounds longer. Some stutterers can produce words but with excessive physical difficulty."

Stuttering affects nearly three million people in the United States. The disability is common in children between ages 2–6, which is when they develop language skills. In fact, in 2013, the American Psychiatric Association updated the Diagnostic and Statistical Manual of Mental Disorders (DSM), changing the diagnostic term from "stuttering" to "childhood-onset fluency disorder."

Around 95% of children who stutter show signs before 5, explained Ben-Aharon. Boys are up to three times as likely to stutter as girls. That gap becomes even wider as they get older.

What Causes Stuttering?

Researchers don't know what exactly causes stuttering. But a combination of multiple factors may contribute to the disability. 

"Research indicates that genetics, family history, neuromuscular development, and the child's environment, including family dynamics, all play a role in the onset of stuttering," said Ben-Aharon.

One of the most common causes of stuttering is a family history of the disability. Many people who stutter have a family member who actively or previously stutters. President Biden's uncle on his mother's side—known as "Uncle Boo-Boo"—stuttered his whole life, President Biden told The Atlantic.

Some people think people who stutter have emotional problems or were raised under stressful conditions. However, that's not the case. Stress can make stuttering worse, but it isn't considered a cause. People may stutter more if they have to speak in public or on the telephone, which can be stressful, added Ben-Aharon.

When stuttering begins as an adult, it's called adult-onset fluency disorder. Two types of stuttering can occur in adulthood: neurogenic and psychogenic stuttering. Neurogenic stuttering may result from a stroke, trauma to the head, or a brain injury. In contrast, psychogenic stuttering occurs after emotional or psychological trauma.

How To Manage Stuttering

"If stuttering persists in children for more than six months, speech therapy is generally needed to learn strategies and techniques that are helpful in managing their stuttering," explained Ben-Aharon. "The therapeutic process focuses on relaxation and breathing strategies to reduce tension as well as slowing down the rate of speech to minimize the dysfluency."

There's no cure for stuttering. But there are many options for managing the disability, which includes:

• Stuttering therapy: This therapy helps minimize stuttering as people speak and reduce anxiety in speaking situations. People learn to speak slowly and regulate their breathing. They may also practice saying words with just one syllable, later progressing to long words and sentences.
• Cognitive behavioral therapy (CBT): With CBT, a person learns to cope with and challenge their negative feelings about something, like stuttering.
• Electronic devices: There are electronic devices that fit into the ear, like a hearing aid, that may help with stuttering. Those devices digitally replay a slightly altered version of the stutter into their ears, which sounds like they're speaking in unison with another person.
• Medications: As of December 2022, the Food and Drug Administration has not approved any drug for treating stuttering. But drugs used to treat other health problems—such as epilepsy, anxiety, or depression—are off-label treatments for stuttering.
• Support groups: People who stutter may benefit from engaging with and seeking support from others in the same situation.
• Acceptance therapy: This focuses on accepting stuttering and not trying to stifle it. Acceptance therapy may help alongside speech therapy.
  

Does a Stutter Ever Go Away on Its Own?

Approximately 75% of children outgrow stuttering. But the longer someone stutters, the less likely they are to make a full recovery. 

No more than one-quarter of people who still stutter at 10 will be completely free from the disorder in adulthood. Like President Biden, children who continue to stutter may have the disorder for the rest of their lives.

“Whether a child who stutters continues stuttering through the adult years often depends on the age the child begins to stutter and whether there is a family history of stuttering,” said Ben-Aharon.

Can Stuttering Affect a Person's Mental Health?

Stuttering can have a huge impact on quality of life and interpersonal relationships. People greatly rely on communication with others. Also, the stigma attached to stuttering may make it difficult for a person to get a job or have other opportunities.

“Stuttering can affect socialization, causing anxiety and depression in those who are struggling to communicate,” said Ben-Aharon. “When individuals who stutter feel rushed or sense the impatience of others who try to finish their sentences, their anxiety often increases—while their inclination to socialize decreases.”

But some people don’t seem emotionally impacted by their stuttering, said Ben-Aharon. In contrast, others see it as a challenge to overcome. 

“They embrace the techniques and strategies offered through speech therapy to maximize communication,” noted Ben-Ahron. “And in our practice, we are noticing greater acceptability around stuttering, and less of our patients are reporting bullying or negative responses in school.”

How to Talk to Someone Who Stutters

Knowing how to listen to and talk to someone who stutters without getting frustrated can be challenging. But the following tips may help:

• Don't tell the person to "relax" or "slow down."
• Be patient. Avoid trying to finish the person's sentences or fill in words.
• Speak naturally. Don't patronize the person by speaking too slowly. They do not struggle with listening to someone else.
• Be aware that people who stutter often have difficulty talking on the phone.
• Treat a child who stutters like any other child regarding rules and discipline.

Stuttering Resources

Several organizations offer support and coping strategies for people of all ages who struggle with stuttering, including:

• The National Stuttering Association, which has chapters across the United States.
• The National Association of Young People Who Stutter (FRIENDS), which offers online virtual support groups for children, adolescents, adults, and parents.
• The Stuttering Foundation offers free online resources.
• The National Institute on Deafness and Other Communication Disorders (NIDCD) maintains a directory of organizations that can provide information on speech disorders like stuttering.

A Quick Review

In 2019, President Biden shared that he has stuttered since childhood. Stuttering is common among children, and many outgrow the disability. But the longer someone stutters throughout childhood, the more likely they will retain the disability in adulthood. 

Although there's no cure for stuttering, therapy, medicines, and organizations can help manage it.