Stuttering Covertly: What to Do When the Person Who Stutters Appears Fluent

Stuttering can be confusing. It’s often associated with a range of disfluencies, such as prolongations, repetitions, and blocks. But in some cases, these surface-level disfluencies may not always be present.

Researchers Eric Jackson, Robert Quesal, and J. Scott Yaruss define stuttering as “a neurobiological lack of integration of the underlying processes of planning and producing language and speech that, upon verbal execution, can lead to interruptions in the acoustic speech signal (e.g., blocks, part-word repetitions, disfluencies) and physical struggle (e.g., tension).”¹

These researchers also go on to add, “These surface behaviors may not be present, however, when the speaker exhibits communicative avoidance (e.g., circumlocutions, fillers).”

What Is Covert Stuttering?

The key to covert stuttering is communicative avoidance. A person who stutters covertly may hide the overt features of stuttering by changing words (known as substitution), going around the word or phrase (called circumlocution), or even simply not speaking.

Unfortunately, this tactic can quickly escalate into fear and the avoidance of speaking, certain situations, parties, the telephone, and even the pursuit of certain career paths.

Unhelpful Avoidance Strategies

Some of the ways people have told me they practice communicative avoidance include:

• “I changed my name to one that was easier to say.”
• “I hurt my hand in class in order to avoid introducing myself.”
• “I took an F for a school project because it required an oral presentation.”
• “The store clerk thought I was having a seizure, so I went along with it.”

Evaluating a Person Who Stutters Covertly

1. Ask them about their strategies.

• Do you change words?
• Do you avoid certain situations?
• Do people know you stutter?
• Do you discuss your stuttering with others?

2. Give the Overall Assessment of the Speaker’s Experience of Stuttering (OASES).²

This questionnaire measures the impact of stuttering on a person’s life. The authors of the OASES state, “Unlike other instruments, which focus mainly on the observable stuttering events, this brief, yet comprehensive self-report measure allows you to assess the impact of stuttering in multiple life situations.”

The OASES is available for adults, teens, and school-age children.

Helping People Who Stutter Covertly

I recommend using the following principles from Avoidance Reduction Therapy:³

• Creating a fear hierarchy
• Practicing self-disclosure
• Participating in group therapy
• Letting stuttering out (up the fear hierarchy) and voluntarily stuttering
• Desensitizing feared words and situations (up the fear hierarchy)

Your client may start stuttering more. This is okay and an expected step of the process.

Ask yourself—are they talking more? Are they saying what they want to say? Are they no longer letting stuttering hold them back from participation in life?

How You Can Try It for Yourself

While it isn’t possible to truly reproduce the stuttering experience in someone who does not stutter, you can try this exercise to get an idea of how it works. Practice reading the following paragraph out loud, but with one change—for every the, substitute a.

Many speech-language pathologists, particularly those who are unfamiliar with the implications of stuttering disorders, may not identify the person who stutters covertly as a candidate for therapy. Avoidance behaviors may be difficult to recognize. In the rare cases where a person who stutters covertly and self-report prompts his or her addition to the caseload, the Speech Language Pathologist may find it hard to develop appropriate therapy goals and activities. The difficulty in identifying avoidance strategies and in “catching” stuttering moments results in a dearth of the empirical data by which speech-language pathology intervention is usually supported. Thus, these people who “occasionally” stutter may actually get less help and be given fewer tools both as children and adults.

What ensued? Anticipation? One almost has to anticipate in order to complete this exercise.

How much brain power and effort did that take?

It’s easy to see how challenging it can be to simply live your life when you’re constantly thinking about when and how you’re going to say something. Hopefully this exercise allowed you to better relate to your clients as you find solutions that will work for their needs.