In the progression of stuttering, which behaviors are typically observed first?

In the progression of stuttering, escape behaviors are typically observed first as individuals begin to demonstrate reactions to moments of stuttering. These behaviors are manifest when a person who stutters becomes aware of their stuttering and attempts to escape from it during speech. This may include physically moving their head, using interjections like “um,” or switching words as they sense the impending stuttering moment.

Individuals may develop these escape behaviors as a way to manage or mitigate their feelings of tension or difficulty during speech. The awareness of stuttering often leads to an increased sense of anxiety and frustration, prompting them to employ strategies to avoid the stuttering moment.

Higher levels of struggle behaviors generally develop later as the individual becomes more frustrated and entrenched in the cycle of stuttering—more explicitly trying to force through or will themselves to speak fluently. Avoidance behaviors can also manifest later in the progression, where individuals consciously attempt to avoid stuttering situations altogether, often steering clear of certain words or speaking altogether.

Fluent behaviors, in contrast, refer to speech patterns that proceed without stuttering. While these may be present in a typical speech context, they do not specifically indicate an individual's response to the experience of stuttering itself. Therefore, escape behaviors represent an early and