NeuroVoices: Gerald Maguire, MD, on Raising Awareness of the Neurobiology of Stuttering

The Stuttering Treatment and Research Society (STARS), a nonprofit volunteer organization focused on investigating the neurologic basis of stuttering through neuroscience research and comprehensive treatment approaches, was launched earlier this year. Under the leadership of stuttering expert Gerald Maguire, MD, who serves as the director of residency training in Psychiatry at College Medical Center, in Long Beach, California, the main goal of STARS is to accelerate interdisciplinary research, expand access to evidence-based treatments, and increase public awareness as well as acceptance around stuttering.¹

The organization recently announced the successful completion of its first annual Research & Education Conference, held September 14, 2025, in Laguna Niguel, California, for health care professionals. Cosponsored by Saint Louis University School of Medicine, the full‑day event offered continuing medical education dedicated to stuttering, applicable to all licensed health care professionals including physicians, psychologists, speech‑language pathologists, and nurses. Overall, the conference provided a forum where heath care professionals and researchers could come together to share the latest neuroscience research and discuss interdisciplinary approaches to treatment.

To bring light towards International Stuttering Awareness Day, held October 22, 2025, NeurologyLive® sat down withMaguire, president and founder of the STARS, who spoke on the importance of better understanding and addressing stuttering. As part of a new iteration of NeuroVoices, Maguire highlighted ongoing efforts through STARS to raise awareness, develop clinical guidelines, and investigate potential neurobiological and immunological mechanism that underlie stuttering. He also underscored the importance of early interdisciplinary intervention to identify subtypes, manage comorbid conditions, and explore emerging pharmacologic treatments targeting the dopamine system.

NeurologyLive: From your clinical perspective, what is the importance of International Stuttering Awareness Day?

Gerald Maguire, MD: Stuttering has occurred throughout prerecorded history. It’s labeled in the International Classification of Diseases by the medical community, and it’s listed in the DSM-5 by the psychiatric community. Yet most individuals, including health care professionals such as physicians, neurologists, and psychiatrists, know very little about this condition. It’s important, and I’m really thankful for the opportunity to speak about raising awareness for stuttering. Over 4% of all children and over 1% of all adults struggle with this condition, and we in the medical community need to understand it better so we can help our patients with stuttering.

What is the process of diagnosing a patient with stuttering?

We all think, “Well, this is easy.” The child—often a little boy—begins stuttering, most notably and most commonly in childhood. And often at times, people think, “Well, just wait and see, you’ll outgrow it.” That’s not always true.

First of all, the diagnosis—even the little child or the parents know something is there—but we don’t want to stop there. As we understand now, there are different subtypes of stuttering. The key is to work in an interdisciplinary team and begin to partner with a speech-language pathologist, because we know early intervention is key. But we shouldn’t leave it there, and that’s why we’re commissioning physician guidelines through STARS to help our fellow physicians understand stuttering.

Firstly, look to see if this child, if it begins in childhood, may be on other medications that could be exacerbating stuttering. We know stuttering coexists with other neuropsychiatric conditions such as attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and social anxiety disorder. So, we as physicians can help treat those, and we also want to make sure that we are not exacerbating stuttering with the treatments we’re using for those conditions. That’s the first thing.

Secondly, we now understand that we need more data on this, but there seems to be a minority subset of individuals, especially children, who have the onset of stuttering from an immune response. We’re working with other pediatric neurologists and others to understand whether, in some cases—not the majority—this could be related to an inflammatory or autoimmune process. I want to thank my colleague Per Alm, PhD, a researcher at Uppsala University in Sweden, who’s joining our medical advisory board, for his work in this area.

Let’s work this up. Let’s look for other signs, family history, and other factors. The key is diagnosing, recognizing, and then working closely with speech-language pathologists, who are individuals trained in this area, with early intervention. But we must work together, because we know that our interventions can potentially worsen stuttering if we’re treating other coexisting conditions improperly.

We also work with them to help treat those coexisting conditions—such as ADHD or OCD—in an appropriate manner that helps relieve symptoms of stuttering overall, such as avoidance, and help foster acceptance. So, working closely as a team is essential.

That’s why International Stuttering Awareness Day and the STARS, founded this year, are so important. This is our first year as a nonprofit volunteer organization leading efforts to uncover the neurobiology of stuttering, develop better neuroscience-based treatments for this condition, and raise awareness among all health care professionals. The goal is to work as an interdisciplinary team with early intervention to help both children and adults who stutter. We also know that stuttering can begin in adulthood, which is likely a different condition—and we’ll talk about that too.

Is there anything else that you wanted to highlight for International Stuttering Awareness Day?

We are developing newer treatments for stuttering, and I hope that physicians, nurse practitioners, and physician assistants listening today understand that we do have data suggesting that agents affecting the dopamine system, such as partial agonists or dopamine antagonist agents, may be beneficial.

Many of these are the same types of medications we use for Tourette syndrome (TS), and stuttering and TS have a lot in common. They both begin in childhood, tend to wax and wane, and often coexist with ADHD and OCD. So, our interventions for TS—dopamine antagonist and partial agonist medicines—have shown in quite a few studies that they can help relieve the symptoms of stuttering.

We are also developing other medications that are currently in clinical trials, so stay tuned. I believe we can begin to offer some relief today as we continue to advance the science.

Fortunately, we had a wonderful celebratory kickoff just this past September here in California. We welcomed leading scientists from around the world, along with individuals who stutter, to come together in this educational program. We were fortunate to have the most inspirational speaker I’ve ever heard on stuttering. A gentleman who stutters himself and, not arguably, one of the greatest athletes of our time, Bo Jackson, who gave a stirring, emotional, touching, and inspiring speech for those of us who stutter.

Transcript edited for clarity. Click here to view more coverage of STARS 2025.

REFERENCES
1. STARS (Stuttering Treatment and Research Society) Announces Successful Inaugural Research & Education Conference. News release. Stuttering Treatment and Research Society. September 18, 2025. Accessed October 21, 2025. https://www.prnewswire.com/news-releases/stars-stuttering-treatment-and-research-society-announces-successful-inaugural-research--education-conference-302559900.html