What’s the Difference Between Neurogenic & Developmental Stuttering?

Contributor: Chantel McAlonan, S-LP, Reg. CASLPO and PWS

Stuttering is more than repetition, prolongation, or blocking. It is an individualized experience that shapes how someone communicates and navigates the world. While many people know about childhood-onset stuttering, known as developmental stuttering, fewer are aware that stuttering can also begin later in life after a stroke, head injury, a reaction to certain medications, or as part of neurodegenerative disorders. This is known as acquired stuttering, an umbrella term that neurogenic stuttering falls under.

By understanding both developmental and neurogenic stuttering, people who stutter, their families, and allies can deepen awareness and advocate for more inclusive communication spaces. It also reflects what research shows: that stuttering is multifactorial, influenced by genetics, neurology, motor coordination, language, and the environment.

What is Developmental Stuttering?

Developmental stuttering is the most common type of stuttering. It typically begins between the ages of 2 and 6, likely due to rapid language development when children learn to construct more complex sentences. Around 5-10% of children will experience stuttering at some point. Many of these children develop fluent speech and a smaller group will continue to stutter into adolescence and adulthood.

The causes of developmental stuttering are complex. Despite common myths, research has shown that it is not due to nervousness or poor parenting. Instead, it is linked to differences in how the brain coordinates speech planning and motor control. Genetics also plays an important role, with stuttering often appearing across multiple generations of a family.

Children who stutter may also have subtle co-occurring differences in neurological processing, speech and language planning, emotional reactivity, or regulation of attention and executive functioning. These differences reflect the complex nature of stuttering and how it can interact with other aspects of development.

Developmental stuttering usually follows a gradual course. The stuttering often appears at the beginning of words, phrases, or sentences and is typically more noticeable on content words like nouns and verbs. However, this pattern does not occur in all cases, and some children may stutter on function words, like “and or “the”, especially in the early stages of developmental stuttering. Children may repeat sounds or syllables, stretch out certain sounds, or become momentarily blocked when trying to speak. Over time, some children and adults develop physical tension, secondary characteristics (e.g., eye blinks, avoiding eye contact), or avoidance behaviors (e.g., changing words) as ways of coping with moments of stuttering. These learned reactions reflect how stuttering involves both involuntary speech patterns and the effortful strategies people develop to manage them.

Living with developmental stuttering can shape a person’s confidence, social choices, and willingness to speak in front of others. This is why early support matters so much. Speech therapy can provide helpful tools to become a more effective and confident communicator, while emotional support from family, teachers, and peers helps reduce stigma. Just as important is community: finding a space where stuttering is understood, such as National Stuttering Association (NSA) Chapters, allows people to feel accepted for who they are.

What is Neurogenic Stuttering?

Neurogenic stuttering begins after a neurological change in the brain. Someone who has never stuttered before may suddenly develop stuttering after experiencing a stroke, a traumatic brain injury, a brain tumor, a degenerative neurological condition, or as a reaction to certain medications.

Neurogenic stuttering can occur more evenly across a person’s speech. Stuttering may appear on both content words and function words, such as “the” or “and.” Stuttering may also be heard at the beginning, middle, and end of words. Unlike developmental stuttering, it often does not lessen during singing or choral reading.

Because neurogenic stuttering arises suddenly and is usually tied to a significant health event, people may not immediately develop the coping strategies commonly seen in developmental stuttering. However, neurogenic stuttering frequently coexists with other communication or motor challenges, such as aphasia, apraxia of speech, or difficulties with executive functioning, memory, and attention. This can make communication more complex and requires a comprehensive approach in therapy.

When stuttering appears as a side effect of medication, doctors may consider adjusting or replacing the medication. In some cases, reducing or stopping the drug lessens the stuttering. Antipsychotics such as clozapine, some antidepressants, anticonvulsants, and other central nervous system medications are among the best-documented causes of drug-induced stuttering.

In situations where medication changes are not possible, speech-language pathologists (SLPs) can support individuals by helping them develop coping strategies, improve communication confidence, and explore fluency techniques if desired. In these cases, therapy focuses on effective, comfortable communication rather than achieving perfect fluency.

Key Differences at a Glance

Living with a Neurogenic Stutter: Elizabeth Minton’s Story

Elizabeth Minton, from Greensboro, North Carolina, is in her second year of graduate school for speech-language pathology and hopes to one day earn her doctorate so that she can one day research neurogenic stuttering.

“I’ve been involved with the NSA for over four years,” Elizabeth said. “I discovered the NSA after a homework assignment! I went back to school and I took a class with a professor who stutters. He gave us an assignment that mentioned the NSA. I looked it up and went to my first Annual Conference in 2022. I am a member of the Young Adults Committee and I’ve loved every minute.”

Elizabeth began to stutter suddenly on August 8, 2020. 

“I began a new medication (gabapentin) and began to stutter within 48 hours. I stopped the medication within 6 days, but the stutter never went away.”

But at first, she didn’t think anything of it. Because her stutter was due to a medication, there was the assumption that it would go away and that it was just a side effect. But after the days turned to weeks and weeks into months, that’s when Elizabeth started to panic.

“I was convinced my life was over,” Elizabeth said. 

The COVID-19 pandemic made things harder for Elizabeth since seeing doctors at that time, as she described, was “very difficult.”

“I have to explain the difference [between developmental and neurogenic stuttering] often,” Elizabeth said. “This usually happens with speech therapists who did not get a thorough explanation of acquired stuttering in school and have never seen a case before. I have to explain that neurogenic stutters are acquired later in life due to some type of change in the brain. We stutter on all syllables, not just the initial one. Traditional therapeutic techniques don’t work on acquired stutters.”

She’s also had to clarify that emotional and physical reactions can be part of the stuttering experience.

“Just because the textbooks say that people with acquired stutters don’t develop emotional issues and secondary behaviors, it doesn’t mean you shouldn’t ask about them. I developed secondaries. I developed major emotional issues.”

Outside of professional circles, her explanations sound a little different. 

“I’ve also had to explain the difference to random people in my life,” she said. “This is mainly because I’ve had to explain to people why I went from totally fluent to sounding like a lawnmower (according to a toddler I knew a few years ago!). Those explanations are usually simpler than the ones I give to speech professionals. Thankfully, most people are understanding!”

But Elizabeth realized that her voice could still have power. She went back to school in 2022 because her initial degree was in Communications Studies (which she calls ironic). She decided to recreationally take an Intro to Communication Disorders class to try to learn more about stuttering.

She didn’t expect her professor to be a person who stuttered. 

“In that moment, I thought, ‘Wait, he has a job where he talks all the time. And no one cares. He’s got a job and a life,’” she said. “That was when I realized I could have that too. My voice could still be worth it.”

After that, she took two years of speech therapy once a week. She said her therapy included a lot of desensitization and Acceptance and Commitment Therapy (ACT). She had the opportunity to speak to a group of mostly strangers. Bravely, she spoke for 15 minutes in front of people who didn’t even know her. 

“And that was when I really knew that my voice was worth listening to,” Elizabeth said. “Now, I speak to all kinds of people. I work with students who stutter, as well as other students. I speak to other classes. I’m a regular on my friend’s livestream. I talk just as much as I used to. It just takes me longer (and half the time it’s longer because of all the dumb jokes I say).”

When asked if the stuttering community has space for neurogenic experiences, Elizabeth said it does. 

“I was welcomed with open arms when I joined,” she said. “Despite having no experience in the community, I was able to dive right in. I have never felt othered in the community for having a different kind of stutter.”

Here’s her message to the general public, clinicians, and allies:

“First, please don’t dismiss someone’s experience because it’s something you’ve never heard of! My case is incredibly rare, but that doesn’t mean it’s in my head or anything like that! I’m not faking (believe me, I’m way too lazy to fake it). I’m not cold. I’m not unintelligent (trust me, I’ve been in school way too long to be unintelligent). My voice is worth hearing and if you aren’t willing to take the time to wait, then you probably aren’t worth the effort it takes for me to speak in the first place. I am valid. My voice is valid.”

Treatment & Support for Stuttering

Both developmental and neurogenic stuttering can benefit from speech therapy, but the goals and approaches are tailored to the individual. In developmental stuttering, therapy may focus on managing moments of stuttering, building communication confidence, reducing fear or avoidance, and stuttering modification or fluency-enhancing approaches if desired. In neurogenic stuttering, therapy is similar, but often addresses the co-occurring neurological or cognitive changes that affect speech and language to improve overall participation in daily life.

In cases of medication-induced stuttering, a medical review is essential. Adjusting the prescription under a doctor’s supervision can sometimes reduce or eliminate the stuttering.

No matter the type of stuttering, it’s not simply about achieving fluent speech. It is about communication and participation in everyday life. That is why emotional support and community connection are equally important for self-acceptance and communicating with confidence.

Final Thoughts

Whether stuttering begins in early childhood or after a life-changing event, every person who stutters deserves respect and understanding. Developmental and neurogenic stuttering may differ in terms of their cause and presentation, but both require patience, understanding, and listening.

Allies play a key role in this. Waiting for someone to finish, giving them space to express themselves, and showing openness to communication differences sends a message that stuttering is just how some people speak. By listening to and learning from those with lived experiences, we build the most important skill of all, empathy.

Finding others who share the experience can be life-changing. The NSA community offers various spaces where individuals and families discover they are not alone and stuttering is celebrated.

At the NSA, we believe that every voice matters. You are not alone. Please visit our website at WeStutter.org for more information and resources about stuttering.