WHAT IS STUTTERING/DISFLUENCY?
Stuttering is an interruption within the normal flow of one’s speech. Everyone demonstrates a natural level of disfluency in their speech and children can display higher amounts of “normal” disfluency as their language skills emerge. The types of stuttering and frequency of the disfluencies dictate how “fluent” a person’s speech is perceived to be.
What is considered typical?
There are two general categories for disfluent speech. Typical disfluencies refer to interruptions that are considered “normal” within speech. Atypical disfluencies refer to stutter-like behaviors perceived by listeners as excessive interruption within speech or abnormal tension associated with speech production. As children develop speech and language, variations of disfluencies can appear and disappear. Paying attention to the time since the onset and the types of stuttering can be helpful in deciding whether or not an evaluation is needed.
Typical (Non-Stuttered) DisfluenciesAtypical (Stuttered) Disfluencies
Hesitations (pause)*Repetitions of sounds or syllables (“Li-li-li-like this”) [typically repeated four or more times]
Interjections (filler words: uh, um, like)Prolongations (“L_L_L_Like this”) [prolongation of one sound]
Revisions (“I want…I need that”)Blocks (“L—–ike this) [word is stuck without moving air]
*Repetitions of whole words or phrases [typically repeated three times or less]
NOTE: “Non-stuttered” disfluencies can be used to avoid or postpone stuttering (e.g., “I uh, you know, uh, I want, um, to go with you.”)*Often has associated tension
Is this developmental?
Developmental stuttering is stuttering that appears in early childhood and naturally diminishes over time. Persistent stuttering is stuttering that continues past the early childhood years.
Developmental stuttering typically emerges in early childhood years (2-6 years old) and lasts less than 6 months. Research shows that if a child begins to stutter before age 3, there is a high probability (up to 75%) that he/she will spontaneously stop stuttering. If stuttering emerges after age 3 or has persisted over 6 months since the initial onset, an evaluation with a speech-language pathologist would be recommended.
Important factors for determining a therapy recommendation include: family history, age of onset, gender, length of time stuttering has persisted, types and frequency of disfluencies observed, reactions or emotions associated with stuttering, and other present speech-language and/or attentional, sensory, or neurological disorders.
What happens in therapy?
Stuttering therapy typically includes integrating strategies to increase fluency and decrease tension, however, the key in properly treating stuttering is to also address associated thoughts, feelings and social impact.
Our main goals in therapy include:
(1) Making talking easier
(2) Developing healthy attitudes and feelings about talking
Making talking easier is achieved by learning speech tools. These tools help the speaker to produce speech in a different way, such as reducing the amount of tension in the speech system, beginning a sentence with more air, or stuttering in an easier way.
Developing healthier attitudes and feelings about talking is achieved by learning to respond to speaking situations with less anxiety, become more confident in the ability to use speech tools, and use problem solving skills for difficult speaking situations.
Not everyone needs to change how they feel about talking. Many kids and teens are confident and willingly talk to others. For some, however, talking can produce feelings of anxiety or fear, even guilt and shame. Overcoming these negative attitudes and feelings can be just as important as learning to talk more easily.
Families also play an important role in the management of stuttering in children. Therapy is characterized by parental involvement and direct treatment as well as providing an environment that encourages slow and relaxed speech and allows the child time to talk
Talking more fluently is only one part of being a good communicator. Learning to take turns, not interrupt, and using eye contact when speaking are also important communication skills.
What can I do to help?
* Speak with your child in an unhurried way, pausing frequently. Wait a few seconds after your child finishes before you begin to speak. Your own easy relaxed speech will be far more effective than any advice such as “slow down” or “try it again slowly. For some children, it is also helpful to introduce a more relaxed pace of life for a while.
* Try to increase those times that you give your child your undivided attention and are really listening. This does not mean dropping everything every time she speaks.
* Asking questions is a normal part of life – but try to resist asking one after the other. Sometimes it is more helpful to comment on what your child has said and wait.
* Help all members of the family take turns talking and listening. Children find it much easier to talk when there are fewer interruptions.
* Use descriptive praise to build confidence. An example would be “I like the way you picked up your toys. You’re so helpful,” instead of “that’s great.” Praise strengths unrelated to talking as well such as athletic skills, being organized, independent, or careful.
* Set aside a few minutes at a regular time each day when you can give your undivided attention to your child. This quiet calm time – no TV, iPad or phones – can be a confidence builder for young children. As little as five minutes a day can make a difference.
* Don’t finish his/her sentences. Children who stutter know what they want to say and generally don’t like it when their sentences are completed for them. It elevates their stress levels, possibly increasing instances of stuttering.
* Wait patiently for a child to finish. Don’t rush a child who stutters. Provide adequate wait time for him/her to complete the thought.
* Watch your body language. Children are very aware of your non-verbal reactions to their speech. Keep your face neutral, with an unchanged expression when the child stutters.
* Educate others about the child’s disorder. Children in the class will be curious about the child’s speech. Sometimes they will tease the child about his/her speech. If you teach them about the disorder in a fun, educational way, this may alleviate some of the discomfort.
* Keep an open door. Allow the child to come to you at any time to talk about school, family, or any other issues he/she might have.
* Monitor the child’s classroom achievement. Some children who stutter begin to do poorly in the classroom setting. They may stop volunteering to answer questions or speak in front of the class. Make sure you notice any changes in the child’s classroom performance and notify parents if changes occur.
DO YOU HAVE ANY RESOURCES FOR ME?
Meeting people face to face is a great way to learn that if you stutter, you are not alone. There is currently a National Stuttering Association (NSA Kids) family support group being developed in Reno designed for young children who stutter and their families, led by one of the Speech-Language Pathologists at Sierra Therapy Group. This group will occur the 3rd Tuesday of each month from 6:30-8:30 p.m. and the first meeting will be on June 16th. For more information or if you are interested in joining this support group, please contact Ashley at (775) 852-6323.
In addition, be sure to check the following reputable and research-based online resources:
- National Stuttering Association (NSA): http://www.westutter.org/what-is-stuttering/stuttering-info/
- The Stuttering Foundation: http://www.stutteringhelp.org/resources
- Stuttering Center of Western Pennsylvania: http://www.stutteringcenter.org/stuttering-center-forms.html