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Joe Biden’s role as president has made stuttering a topic of conversation and has brought other public figures with stuttering out of the closet.

Biden’s glitches, like those of Trump, Obama and Bush before him, get shared eagerly by people who dislike their policies and cited as evidence that Mr. President is either stupid or losing it or both. But how can we tell when we should be worried and when we’re just hearing a normal stuttering pattern?

I asked my editor, Marian Wiggins, who just happens to be an expert on the topic. She is a retired speech-language pathologist who volunteers as an editor, as well as a tutor for immigrants who want to improve their English.

Tarico: You say you’ve known for a long time about Biden’s stuttering.

Wiggins: I’ve always known him as a person who stutters. Having treated stutterers for decades, I can see the problems he experiences and some techniques he uses.

Tarico: Rodney Gabel, a speech and language professor at State University of New York, said the same thing in an interview with Healthline. So, what is it that a speech and language professional would pick up on?

Wiggins: Biden typically exhibits initial sound repetitions, such as “b-b-b-boy.” He also uses a technique called “circumlocution,” in which the person uses another word for words they have difficulty saying.  I’ve noticed, for example, that Biden often refers to Obama as “my old boss,” and to his predecessor, Trump, as “the former guy.” Those two names have emotional significance, and it’s possible that after years of stuttering on such words, Biden simply and naturally works around them.

People often don’t recognize circumlocution as a part of stuttering. Nor do they recognize it as stuttering when Biden hesitates (as if he’s lost his train of thought, which is not the case as almost immediately becomes clear) or starts to say a word, stops abruptly and, then “appears” to go off in a different direction. These techniques to avoid stuttering are often misperceived by the general population as evidence of cognitive decline or a lack of intelligence. They’re not perceived as stuttering, but they definitely are types of stuttering behavior.

Tarico: You said earlier that people sometimes see these patterns as a sign that someone isn’t smart, or that the person doesn’t know what they are talking about.

Wiggins: I did in-services for schools. Some teachers would prejudge stutterers as not being very smart because they didn’t give a ready answer. I let them know that people who stutter are found throughout the IQ range.

I would emphasize that people who stutter can have a fear of speaking. At home or at school, when a child stutters, the parent or teacher might turn around with a concerned look. The child then gets the message they have done something wrong. Fear, stress, and tension can increase stuttering.

Due to that fear, it helps to begin requiring a response from them only in a one-to-one setting. As that becomes easier, ask them to participate verbally in a small group setting, and gradually increase the size to larger groups.

Normally stuttering is just a developmental stage of childhood, but for a small percent it persists. Then it becomes a lifelong disorder that has to be managed.

Tarico: Biden was one of the kids who kept stuttering.

Wiggins: Yes, for Biden it didn’t resolve itself. I saw an interview early on in which he said he wasn’t a stutterer anymore. I almost wrote his campaign to say, “Please tell him that every stutterer and SLP in the country knows that isn’t true. It would be helpful if he said, “I’m a stutterer,” because we can see it, and the rest of the population misinterprets it. So, it would be to his advantage to ‘fess up.

And then he did!

Last February, Biden met 13-year-old Brayden Harrington at a town hall in New Hampshire. Brayden stutters, and his parents wanted him to meet a role model who had a very successful public career despite a similar speech pattern. Biden invited them backstage. He talked about some of his strategies and said that he had 15 stutterers in his phone. He checks in with them. And he asked permission to call Brayden. With Biden’s support, Brayden spoke at the Democratic National Convention and then ended up with national television interviews.

Tarico: According to the National Stuttering Association, about one percent of Americans—three million adults—stutter. But most of the time Biden is not disfluent. Are there kinds of situations where you would expect his stuttering to retreat or come to the fore?

Wiggins: Yes. Fatigue, tension, stress, and being tired or distracted play a big role in whether a person is fluent or not—even for people who are not stutterers.

Tarico: Someone shared with me a brief clip from one of Biden’s press conferences about the COVID vaccine rollout. It was 15 minutes, and during most of that time he was fluent in a normal way. But then he hit this rough patch—about 45 seconds—which got excerpted by the right and shared almost 300,000 times on Facebook as evidence of dementia. They cut off the part before—where he was articulate—and the end of the sentence where he self-corrected. I’m curious whether you would see this as just him glitching—we all do sometimes—or whether you would have read this as part of his stuttering. It really does sound bad.

Here is a transcript of that part (time stamp 6:08):

“We expect these additional 200 million doses to be delivered this summer. And some of it will come as early, begin to come in early summer, but by the mid by the mid summer that this vaccine will be there. And the order, and-and that increases the total vaccine order in the United States by 50%, from 400 million ordered to 600 million. This i- enough vaccine to fully vaccinate 300 Americans by end of the summer, the beginning of-of the fall. But we wanna make—look—that’s–I want to repeat, it will be enough to fully vaccinate 300 Americans to beat this pandemic, 300 million Americans.”

Wiggins:  It seems that Biden was tired, in a rush, or distracted on this day. On two occasions, it looked like he skipped a line on the teleprompter, and then went back to pick up what he had skipped. The first time: “And some of it will come as early, begin to come in early summer.” The second: “And the order, and-and that increases the total vaccine order . . . .”

There clearly were examples of stuttering. Stutterers can repeat single sounds, syllables, whole words, or phrases. (From the transcript: by the mid, by the mid; and-and; of-of.)

But, as you just said, during most of that time he was fluent, but then he hit this rough patch which got excerpted by the right and shared as evidence of dementia. This is exactly what the left did with many sections of Trump’s speeches. It’s “politics as usual.”

Biden is generally a very fluent speaker for a man who, as a child, was as disfluent as he has described (couldn’t get words out, facial contortions). I’d worry about dementia if Biden exhibited these “glitches” throughout each press conference and during every interview. Even when he was “glitching,” he was able to self-correct and find the right line on the teleprompter. I’ve worked with people who stutter and with people living with dementia. When I watched this section of the video, I thought Biden’s speech to be a big nothing-burger in comparison to those clients.

Tarico: So how do people manage this? Tell me a little more about the strategies—for kids and adults.

Wiggins: Reducing fear is the first thing. Practicing, at home or with a friend, exaggerated stuttering and having fun with it can decrease the anxiety about speaking. Sing-song reading helps to keep the throat open. Singers who stutter don’t stutter when they sing. Read to the tune of a song in order to increase fluent moments. While talking with people, use “soft contacts,” gently putting the lips together for lip sounds or the tongue tip against the palate for those sounds. Sliding is a strategy that involves a slight prolonging of the stuttering moment. It can keep the muscle tension from escalating, enabling the speech to flow. 

So, another approach is to change the cadence of speech. Biden told Brayden that he used to practice poems by Yeats over and over again. He was a bright child and he played around with it. He was doing his own therapy.

Biden also told Brayden about what he does now. He showed him, “This is how I mark up my speeches so I won’t stutter as much.” I would love to see that mark-up. Maybe he puts in where to breathe, where to relax his lips, I don’t know.

Tarico: I think having Obama in the White House was incredibly powerful for black and multi-racial children around the world, and I think the same may be true of Biden and kids who stutter. What would you most want to communicate to the stuttering kids or young adults who will be looking up to Biden as a model?

Wiggins: I think Biden says it best: Don’t let it define you. By that, I think he means that stuttering isn’t who you are; it’s just something you do.

Valerie Tarico is a psychologist and writer in Seattle, Washington. She is the author of Trusting Doubt: A Former Evangelical Looks at Old Beliefs in a New Light and Deas and Other Imaginings.  Her articles about religion, reproductive health, and the role of women in society have been featured at sites including The Huffington Post, Salon, The Independent, Quillette, Free Inquiry, The Humanist, AlterNet, Raw Story, Grist, Jezebel, and the Institute for Ethics and Emerging Technologies.  Subscribe at ValerieTarico.com.