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April 12, 2021

The Impact of Stuttering—Hiding in Plain Sight

Author Affiliations
  • 1Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina
  • 2Department of Health Services and Information Management, East Carolina University, Greenville, North Carolina
JAMA Neurol. 2021;78(6):646-647. doi:10.1001/jamaneurol.2021.0633

While the grandeur of the US presidency has historically been accompanied by eloquent speeches and a confident demeanor, President Joe Biden has the potential to shatter this guise of perfection. Often criticized as “hiding in plain sight,” Biden’s mental stamina and intellectual fortitude have also been questioned. Less attention has been given to his long-standing issue with stuttering and the substantial stigma associated with the condition. Stuttering is a communication disorder that poses difficulty in the processes of speech for millions of people living in the US and is now part of the core of President Biden’s journey as a man who is perceived by many as the most powerful person in the world. With that power comes significant responsibility and criticism that will ultimately revitalize interest in this multifaceted disorder.

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1 Comment for this article
Hiding Medical Causes in Plain Sight?
Beat Meyer, M.D. | Internist, teaching hospital and practice
In an old democracy like Switzerland, politicians are not perceived as the most powerful people in their country but judged on how they serve the people. Although public figures are expected to give eloquent speeches in the roman-greek tradition, Swiss people tend to assess state executives by their action, thus lowering the tension and the high expectations of speaker and listener, respectively.

What if stuttering were not only a communication disorder? For an internist stuttering is a symptom which should trigger a medical differential diagnosis. Given the recent motor and gait disturbances of the current US President, stroke, cerebral
trauma following falls, post encephalitis sequelae, dementia or Pick’s encephalopathy need to be considered as further causes in his age-group.

Thus, successfully managing the challenges associated with stuttering depends on the diagnosis and treatment of an underlying condition. Hiding it in plain sight does not serve the American people nor the world expecting transparency.