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The exact cause of stuttering remains to be determined. Recent studies suggest that genetic factors play a role in the disorder. It is thought that many, if not most, individuals who stutter inherit traits that predispose them to develop stuttering. The exact nature of these traits is presently unclear. Whatever the traits are, they obviously impair the individual's ability to string together the various muscle movements that are necessary to produce sentences fluently.
According to current thinking, not everyone who is predisposed to stutter will develop the disorder. For many people who are predisposed to stutter, certain life events are thought to "trigger" fluency difficulty. One of the triggers for developmental stuttering may be the acquisition of grammar skills. Between the ages of 2 and 5 years, children acquire many of the grammatical rules of language. These rules allow children to transform immature messages (Mommy candy.) into lengthy sentences that require considerable coordination to produce fluently (Mommy put the candy in my backpack.). Thus, a child who is predisposed to stutter may have no difficulty speaking fluently when the sentences he or she produces are all one or two words long. However, when the child becomes capable of producing longer, more complex sentences and then attempts to use such sentences in daily settings, he or she may find that the speech system is not quite up to the challenge - and disfluent speech results.
After stuttering has begun, other factors may act to maintain or aggravate fluency difficulty. For example, a child who is easily frustrated may be more likely to tighten or tense speech muscles when disfluencies occur and such tension may increase the length of time a disfluency lasts. Listeners' responses to stuttering (e.g., teasing) can aggravate fluency difficulties as well. Speakers who stutter vary widely in how they react to the disfluencies in their speech. Some appear to be minimally concerned. Others - especially those who have encountered unfavorable reactions from listeners - may develop emotional responses to stuttering that hinder speech production further. Examples of these emotions include shame, embarrassment, and anxiety.
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