Anticipation: Changing the Way We Think about Stuttering

Many people who stutter are able to identify a moment when they know they are about to trip up on a word or phrase.

According to Eric S. Jackson, assistant professor at NYU Steinhardt School of Culture, Education, and Human Development, that moment can be characterized as “anticipation” and is largely invisible to other people in conversation with someone who stutters. Jackson has conducted studies with adults, teens, and children who stutter and has explored the impact of anticipation on their flow of speech.^1, 2

He has found that understanding anticipation and addressing it in therapeutic modalities can aid parents, educators, and speech-language pathologists (SLPs) in understanding and empowering people who stutter in their speech development and acquisition.

If people can identify and measure anticipation, they can help those who stutter become mindful of behaviors that may cause speech blocks and, ultimately, help them speak more confidently.

Stuttering is a fluency disorder characterized by a disruption in the flow of speech; words may be prolonged or syllables repeated. Stuttering can also be a result of motor control via altered facial movements.

Roughly 70 million people worldwide stutter when they speak, but three-quarters of those who begin to stutter recover by late childhood, according to The Stuttering Foundation.

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Jackson defines anticipation as “the sense that stuttering will occur before it is physically and overtly realized.”¹ While stuttering is common, the frequency of anticipation is not as well known because many people aren’t accustomed to recognizing it, which makes it more difficult to measure.

Anticipation is not the same as anxiety or nervousness, though those feelings may develop before or after the speaker senses that stuttering is about to occur.

In a 2015 study of 30 adults who stutter, Jackson found that “all participants reported experiencing anticipation at least ‘sometimes,’ and 77 percent of the participants reported experiencing anticipation ‘often’ or ‘always.’ ”¹

For some, anticipation can foster anxiety.

“When I anticipate stuttering, I tend to grow over-conscious of the word which I am about to say,” said one participant. “I become more anxious and feel as if am putting all my energies in saying that particular word. In the process, I feel as I totally lose control of what I am speaking about, and sometimes totally forget about the content of the speech.”¹

For others, the moment draws on complicated feelings.

“Anticipating stuttering is a double-edged sword,” said another participant. “It cues my mind in to the word that I will block on. If I think fast enough, I can usually figure out a way to make it through the sentence. Oftentimes, this is not the case and I end up hesitating awkwardly.”¹

Action responses: Observable changes to the speech production process

• Avoidance strategies: Any behavioral attempt to hide or escape from the possibility of stuttering
  • Adding meaningless speech like “um” and “ah”
  • Avoiding situations
  • Not talking
  • Body movements
  • Stalling speech
  • Looking away or pretending to use a device
• Self-management strategies: Traditional therapy strategies that may vary based on a person’s experience with speech-language pathology
  • Analyzing the situation
  • Focusing on speech production
  • Changing their rate of speech
  • Incorporating pseudo-stuttering to desensitize actual stuttering
  • Breathing techniques
  • Positive self-talk
  • Changing speech volume
• Approach strategies: When a speaker makes a conscious and deliberate decision to move forward with communication even if they think they may stutter

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Non-action responses: When a speaker does not make an active choice to change their speech plan

• Experiencing anxiety or uncertainty
• Becoming physically tense
• Loss of control
• Negative emotional reactions like embarrassment, fear, and shame
• Confidence reduction
• Reduced social awareness and presence during a conversation

Jackson emphasized that anticipation can be a tool to help anyone who speaks become more attuned to their speech production process.

“Treatment as we view it focuses on facilitating productive responses to anticipation, with the sometimes indirect effect of reducing anticipation itself,” he said.

According to Jackson’s 2015 study, participants surveyed had mixed responses regarding whether anticipation is helpful or harmful for speech production. Therefore, people who stutter, in addition to their parents, SLPs, educators, and employers, should discuss how anticipation makes them feel before trying to incorporate it into behavioral change.¹

Because of the variety in individual experiences, it’s important for people to work with speakers to identify behaviors that most empower their ability to communicate freely and confidently.

SLPs and others communicating with people who stutter can guide discussions to better understand a person’s thought process when anticipating stuttering. A few questions mentioned in Jackson’s 2018 study that may prove effective for considering anticipation include:²

These questions, and how they can effectively be applied to conversation, can be explored by any person who stutters, or asked by an SLP, parent, educator, or peer who is invested in helping them identify moments of anticipation.

It’s important to remember that the point of addressing anticipation isn’t to avoid stuttering; it’s to become more comfortable with the incidence of stuttering and feel confident in one’s communicative abilities.

Citation for this content: NYU Steinhardt’s online master’s in speech-language pathology.