"It doesn't define you."

"It doesn't define you." - Joe Biden

Joe Biden has a stutter. He has had it all his life.

His stuttering is likely the source a big part of his deep empathy and compassion for other humans.

Stuttering usually begins in childhood, as it did for Joe Biden. Many stutterers don't "outgrow" the disorder; they learn to manage it. This is true for Joe Biden.

Joe has been open about his stuttering. But people are often surprised to hear that he has had a lifelong stutter. His stutter hasn't gone away; the truth is that he manages it well. Some of the strategies he has developed to manage his stuttering probably include starting over; revising a word or phrase; looking down at his notes; changing his gaze; slowing down his speech; or substituting a similar word or phrase. 

Stuttering is a motor speech disorder, not a language or cognitive disorder. It's not part of an intellectual disorder. Biden's stops and starts are evidence of his stuttering, NOT evidence of dementia. So you can stop that nonsense. Right now. 

But yes, communication pressures can increase dysfluencies. Bullies know that. Bullies can sniff out a person's vulnerabilities from a mile away. Talk to anyone who has had a stutter lasting past early childhood, and you will hear stories of bullying.

And so, the Bully-in-Chief's strategy during Tuesday's ugly, ugly debate was to put the pressure on and try to instigate dysfluencies. That was the chief reason for his disgraceful "performance" on that stage. There is evidence that this is true; early in September, the campaign outright told Politico that this was the tactic:

...they’re trying to identify words or phrases that trigger him to “reboot,” as one person familiar with the planning described it. Essentially, Trump aides are looking for ways to trip up Biden in an effort to spur an incoherent or unsatisfactory response — bolstering a key Trump argument against Biden built around his age.

and

One 2016 Trump campaign official said it’s a “calculated risk” to phrase things in such a way that might cause the former vice president to stammer in his response, acknowledging such a strategy could backfire if Trump deliberately appears to be messing with Biden's history of stuttering — an attribute Biden has used to demonstrate his ability to overcome challenges and his empathy for children in similar situations. One aide said Biden is a good debater and unlikely to have difficulty speaking in that environment. 

And guess what? Biden did not have difficulty speaking in that environment. Though Joe got flustered – and who wouldn't under that barrage? – he did not experience an increase in dysfluencies (and so what if he had?). And except for a couple of times ("Will you shut up, man?" and "Keep yapping, man"), he did not take the bait to sink to the orange grub's level. He was calm in the face of a bully's barrage of insults. I think this is a quality of a good leader.

Here is a wonderful piece about Joe Biden and his stutter from The Atlantic, written by a fellow stutterer. 

The fact of the matter, Joe's ability to overcome, as well as every person who stutters, should be admired, not mocked. It takes a lot of work to manage a stutter. It takes work every time the person speaks. Joe has had a lifetime of public service and public speaking. And only now is his stuttering in the limelight. It's only now that a grown-up bully has thrust it into the limelight. It's a great opportunity for education and the advancement of empathy. You probably know a person who stutters. You might not even know it. You will be showing them some grace if you keep negative comments about Joe's speech out of your own discourse. Communication disorders deserve empathy and compassion.

And this is just one more reason Joe is a truly decent guy. He understands empathy and compassion. It has it in spades, and he shares it. Just watch:

About stuttering: there's much we know about stuttering and much we don't.

We know that stuttering affects males more than females (1.6 to 2:1 at age 3 years, increasing to 3-4:1 in the teenage years); it is more prevalent in childhood; it is common in children developing their speech and language, and it is often transitory. We know that there is a subset of people for whom it is not transitory. It lasts their lifetimes. And this is true for Joe Biden.

There are a few typical types of dysfluencies that appear in a stutterer's speech. There are part- or whole-word reputations, such as saying "I want some tuh-tuh-tuh-tea," or "I - I - I am buying a car;" prolongations, such as "I have three sssssisters," or blocks, which is when the sound is initiated but the motor actions don't easily proceed. "I want a...... (lips pursed for /m/) .....marshmallow." Dysfluencies often happen with certain words or sounds, and the person managing their stutter can develop many internal strategies, including avoiding that particular phoneme. Revisions and interjections (such as "um" or "well"), though not technically dysfluencies, often accompany a dysfluent speaker's speech. There can be related motor behaviors that accompany dysfluency, such as visible tension or tics/movement in the mouth or face, or other areas of the body. Interestingly, dysfluencies often disappear when people who stutter speak to themselves, sing, speak in unison, speak with delayed auditory feedback, or speak with a fake accent or when acting. But we don't know why.

We also don't know a lot about the causes. The causes are thought to be multi-facorial. There seems to be a genetic component as well as neurophysiological factors. Environmental factors, emotional factors, and communication demands can all influence the expression of dysfluencies. 

Treatment is highly variable and treatment methods depend on the severity of the stutter, the patient's and the family's goals, the patient's age, and the presence of concomitant speech and language disorders. Treatment of fluency disorders is managed across the lifespan by Speech-Language Pathologists. 

For more information, see the American Speech-Language-Hearing Association or the Stuttering Foundation.

Thank you for reading, and for giving me another great opportunity, as a Speech-Language Pathologist, to provide a little insight into a speech disorder. 

Now, GO VOTE!