For anyone paying attention to politics in the United States, it is no mystery that Secretary of Health and Human Services Robert F. Kennedy Jr. has a speech condition that results in staggered speaking.

That condition is called spasmodic dysphonia, which occurs when the vocal folds cramp closed when someone is speaking, creating an interruption in the sound, according to speech pathologist Gwen Merrick.

“The vocal folds have a small muscle as one of the layers of the vocal fold,” she told HuffPost. “That muscle… goes into spasm, which interrupts the flow of the voice.”

She said the cause of the spasm is neurological — the wiring from the brain isn’t sending a consistent signal — so the muscle has a little cramp.

Kennedy first noticed a change in his voice when he was 42 in 1996, teaching at Pace University School of Law in White Plains, New York, according to the Los Angeles Times.