How you can support me with stammering

Make me feel safe to speak without pressure

Sophia Williams, consultant child and adolescent psychiatrist, Brighton and Hove Child and Adolescent Mental Health Services and Learning Disability Child and Adolescent Mental Health Services, says, “Stammering is a neurodevelopmental speech fluency disorder, usually with genetic and neurophysiological underpinnings, including atypical activation in brain areas involved in speech planning and motor control.

“Contrary to popular belief, it is not caused by anxiety, although a high pressured clinical environment can increase the challenge to be fluent. Working in medicine with a stammer can be daunting, particularly in hierarchical teams where fluency is often equated with competence. From early on in my training I found it essential to be open about my stammer as masking made it harder, despite feeling more vulnerable at times as a result.

“Stammering is frustratingly unpredictable. I can be fluent one minute and not the next. I might repeat single letters, sounds, parts of words, or block entirely when nothing comes out. You may see muscular tension around the mouth and nostrils if I’m trying to get a word out. If I remain silent it doesn’t necessarily mean that I lack an opinion.

“In addition to having background knowledge about stammering, there are practical steps you can take to support me or anyone else with a stammer at work.

“Firstly, please don’t finish my sentences. Don’t ask me beforehand whether I’ll be fluent when giving a presentation, equally please don’t praise me for not stammering. Instead, focus on what I’m saying.

“If possible, offer a quiet space for phone calls—open plan offices can be tricky to navigate. Using the raised hand function in online meetings allows me to speak without interruption and without having to be fluent enough to ‘speak into the gap’ during a millisecond conversation pause.

“Avoid rapid fire questioning in ward rounds or teaching settings, which can be particularly difficult. Using door entry phones and calling patients from clinic waiting rooms can present challenges so alternatives like swipe cards or support from reception staff can help.

“Above all please remember that I, like other colleagues with stammers, work best when feeling safe to speak without pressure. We can bring insight, empathy, and resilience to our roles.

“We’re not fluent all the time—nevertheless, doctors with stammers are fully capable and thoughtful. Communication is about connection, not perfection. There is so much more to being a good doctor than speaking without pauses.”

Never guess what someone is saying

David Goldmeier, retired consultant in sexual medicine, Imperial College Healthcare NHS Trust, says, “Stammering has little to do with dysfluency but everything to do with socially stigmatised speech that may not be accepted by colleagues. The stammerer may therefore be open to covert punishment or negative bias by colleagues for violating the concept of the doctor as a fluent speaker.

“It’s uncomfortable to listen to a stammerer so the listener should be as aware as possible that their own negative responses can exacerbate the stammer. Understand that beneath the dysfluency there is more than likely a doctor who understands emotional pain and compassion.

“Never guess what someone with a stammer is saying and never attempt to finish the sentence for them. Some parts of speech, such as nouns, verbs, and adverbs, are more difficult than the definite article. Some situations may be particularly difficult, such as saying one’s own name or talking on the phone. Formal interviews may make the stammer worse—so assess the candidate informally before the interview.

“Feedback on content of talks is always welcome. Not the diction. An educational supervisor’s one-to-one session is a good place to discuss a stammer and enquiring what can be done to make life easier for a resident doctor with a stammer is helpful.

“My own journey to being a consultant with an expertise helped me, because I knew that patients and colleagues wanted to hear the content of my talks. They disregarded the diction. Being a doctor with a stammer means you are brave, determined, and a very special person.”

Don’t tell me to take a breath

Ian Medlicott, radiology nurse team leader, Leeds Teaching Hospitals NHS Trust, says, “Try not to complete a stammerer’s sentence if they are struggling with the flow of their speech. Although you’re trying to help, it’s frustrating for the stammerer, making them feel incompetent and disheartened for failing to converse adequately.

“Most of the time the non-stammerer will incorrectly guess the word the stammerer is struggling with, which then requires the stammerer to start the sentence again. This can be exasperating and add more pressure on the stammerer which in turn makes it harder to pronounce the ‘difficult’ word.

“Please don’t offer advice to slow down, relax, or take a breath as this feels patronising regardless of the intention of the colleague. The stammerer has been dealing with their speech impediment for a number of years and is trying their best in the only way they know how. This advice can also create more pressure and anxiety and puts a spotlight on the stammerer, making them the centre of attention.

“Be patient. I’ve stuttered for 38 years and those that know me well understand that I’m trying my hardest to get a sentence out. Some days the stammer is worse than others and I have to remove myself from the interaction and come back when I’m ready to continue. Allowing the stammerer time to speak is essential for them to know they aren’t being rushed. If the stammerer goes silent they are not ignoring you, they’re trying to rejig words in their head before they speak to avoid a problematic word.

“It may come as a surprise to find out that a colleague has a stammer because they have found ways to avoid certain words. Unfortunately, if ‘difficult’ words are patient names or medical terminology they can’t be altered, and it’s at this point, often in front of other healthcare professionals, that a covert stammerer is revealed.”