Obama “Stutters” Revisited

Who would know that a simple question over dinner would lead to an extended exchange of ideas over the Internet. Such is life in the new millennium.

A commenter named Hilary has latched onto the developmental etiology of “Stuttering” and won’t let it go. So … I thought I would bring the topic out of the bowels of “comments” and “revisit” it.

After I responded to one of his/her posts:

“Your article is great but relates to only one of the four potential causes of stuttering”,

Hilary followed with:

“Yes, by the way, the most prevalent. Although the majority of people continues believing that stuttering is mainly psychogenic, it isn’t.”

Quite frankly, I haven’t found any statistics on the prevalence of any of the four causes of “stuttering” to be considered in the differential diagnosis. In review, they are: 1)developemntal, 2)neurogenic, 3)psychogenic and 4)malingering as delineated in the following abstract:

Differential diagnosis of stuttering for forensic purposes.

Hilary’s comment that “the majority of people continues believing that stuttering is mainly psychogenic” is a statement that I have found no evidence to support or disprove and can only presume that it is, for what ever reason, simply Hilary’s “assumption” unless Hilary has some data to support it. I, personally, don’t know what the majority of people “believe” about stuttering.

As previously mentioned, I have yet to find any statistical data to delineate the prevalence of any one of the four causes of stuttering. The only references I have found suggesting a numerical weight to any cause are the following statements in various sources:

Most early childhood or developmental stuttering resolves by the fifth or sixth year of life.”

And, in a Neuroanatomy and Neurology text:

“Stuttering is frequently of psychogenic origin.”

The 70 year old man who has stuttering after a stroke which affected the speech center or speech pathways, doesn’t have stuttering based in “abnormal early childhood development”. Neither does the auto accident victim who suffered massive head trauma and is experiencing new onset stuttering. Both of their etiologies is “neurogenic”.

The shell-shocked war veteran without a history of head trauma who comes home with new onset stuttering has a “psychogenic” etiology.

Also, some children who have persistent stuttering beyond the “normal” time when stuttering usually resolves, can have a “psychogenic” basis for their stuttering which may have nothing to do with a previously existent abnormality of early childhood development. It may have become a maladaptive form of coping.

Obama stutters. When? He stutters when he gets asked questions which are outside of his well polished retinue of “talking points”.

Did he have stuttering as a part of his early childhood development? I don’t know. Could it have been a maladaptive form of coping from stresses of a difficult childhood? Revisit his history, not only the version that he’s presented but what investigators have uncovered. It was Obama who referred to his grandmother as a “typical white person”. That sentiment can cover a lot of territory and rolled off his lips without the slightest hint of stuttering.

I knew a surgeon who did have stuttering which was the result of an abnormality of early childhood development. His stuttering was persistent and at times severe. People did not judge him on his speaking ability but his proven medical knowledge and his extremely experienced and skilled hands.

Barack Obama, to an unusually large degree, is being judged on his oratory skills … alone. When not protected by the podium, he doesn’t do quite as well. The Democratic “debates” were little more that gentle massages for his unchallenged ego.

When confronted with openly hostile questioning, how does Barack Obama handle it? Frequently, he stutters. Hillary Clinton … side steps … when she can. John McCain … attacks.

It’s been an interesting exercise. Standard medical texts such as Beeson and McDermott, Hurst, Conn and Conn as well as Harrison’s neatly jump from staghorn calculi to staphylococcal infections leaving a lot of territory in between unexplored.

When I first heard Barack Obama’s hesitant and repetitive speech, I decided to look up “stuttering” to make sure that’s actually what it was and it seems to fit the definition. I personally thought it was amazing that someone with such touted oratory skills had dysphonic problems. With what little people actually do know about his past, I think the childhood psychiatric etiology is of particular interest. Being familiar with several people who do have stuttering which is of a developmental etiology, I would be more inclined to classify Obama’s stuttering as psychogenic in origin.

I haven’t come across any information which delineates the prevalence of stuttering in the general population much less the prevalence of each of the etiologies to consider in the differential. And, quite frankly, I’m not going to simply take Hilary’s word for it. Neither should you.


One Response

  1. I’m correcting myself before someone else catches my “overstatement”. Stating absolutes in medicine can be fraught with traps. I didn’t feel quite comfortable with the particular paragraph when I finished it but couldn’t put my finger on the cause of my discomfort at the time.

    That shell-shocked war veteran “most likely” has new onset stuttering of “psychogenic” origin. There is still a small possibility that he has a previously undiagnosed tumor or some other undiagnosed intracranial abnormality causing the new onset stuttering which would then give it a “neurogenic” etiology. Still, a developmental etiology is highly unlikely, ergo, new onset.

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