Show-Me State Times

A new option on Missouri driver’s licenses now allows individuals with speech and communication differences to include a medical alert notation. This measure, effective since late August, is designed to help protect people who stutter or have other communication challenges during interactions with law enforcement and first responders.

The change follows advocacy led by Christine Rose, a speech-language pathologist at Saint Louis University (SLU), along with Jamie Saunders-Anglin, an alumna of SLU's School of Social Work and parent of a child who stutters. Their efforts were supported by Matt Kraus from the University of Missouri-Columbia’s Speech and Hearing Clinic and members of the Missouri Speech and Hearing Association.

“This designation is a critical step toward equity,” said Rose, who is also involved with the National Stuttering Association. “Verbal and nonverbal diversity has long been overlooked in public safety systems. This alert sends a clear message: speech and communication differences are real, they matter, and they must be respected—especially in moments where misunderstanding can cost lives.”

Saunders-Anglin described how her daughter Octavia’s experience at the DMV sparked the initiative: “She often has difficulty saying her name and date of birth,” Saunders-Anglin recalls. “I asked the clerk if we could include an alert stating that she has a stutter. The clerk searched every disability category—but found nothing. She looked at me and said, ‘You're right. There should be something for that.’ I told her, ‘When we come back for her driver’s license, it will be there.’”

Initially considering legislation modeled after Texas’ approach, advocates instead worked directly with the Missouri Department of Revenue to implement the change without passing new laws.

The medical alert notation is optional for any resident with qualifying conditions such as autism spectrum disorder, Alzheimer’s or dementia, or other neurological or developmental disorders affecting communication. It can be added to both driver’s licenses and state IDs after submitting a physician’s statement verifying the diagnosis; no extra fee is charged beyond standard transaction costs.

“When you're the parent of a child who stutters, there's a unique determination to control everything around them,” Saunders-Anglin said. “You can’t control the stuttering. You certainly can’t control how the police or others will react if they don’t know she has a speech difference.”

The symbol appears on the front of IDs so law enforcement can quickly recognize when someone may have difficulty communicating—a situation that could otherwise lead to misunderstandings.

Advocates hope this move will encourage similar actions in other states while raising awareness about verbal diversity.

Saint Louis University was founded in 1818 as one of America’s oldest Catholic research institutions. The university enrolls over 15,300 students each year across various programs focused on research and innovation rooted in Jesuit values.