Stuttering − also referred to as stammering − is defined as a speech disorder involving frequent and significant problems with normal fluency and flow of speech.
We all have moments where we stumble over words. But for children who stutter, expressing themselves is a real challenge. They typically experience trouble starting a word, phrase or sentence. They may also repeat or prolong sounds, syllables or words, stretch sounds out or have brief silences for certain syllables or words. Tension, tightness or movement of the face or upper body to produce a word can accompany stuttering as well.
What causes stuttering?
Stuttering usually begins between the ages of 2 and 6 years. Many children go through normal periods of disfluency (interruptions in the regular flow of speech) lasting less than 6 months.
Although there is no one cause of stuttering, children with a family history of stuttering are more likely to stutter than children who do not. Boys are also more likely to stutter than girls. Parenting style or family environment does not cause stuttering. Stuttering is also not caused by copying others or by an intellectual disorder.
Is anxiety one of the causes of stuttering?
Although anxiety is prevalent in adults who stutter, it is not a cause for the onset of stuttering in children.
How do I know if my child has a stuttering problem?
The following characteristics are signs to look out for in children who stutter:
- Word repetitions – "Go-go-go-go home now."
- Part-word repetitions – "I w-w-want the apple."
- Prolonged sounds – "Sssssee you tomorrow."
- Blocks or stops – "I want the (pause) biscuit."
Other behaviours such as head nodding, eye blinking or body movements may also be present. A child may also show negative reactions towards talking or avoid certain sounds or words.
What is the difference between disfluency and stuttering? And why is it important to differentiate between the two?
As children grow and develop language, they may show “typical disfluencies” in their speech. These disfluencies are natural as a child’s language is emerging and the speech system is working hard to put together new words in a variety of ways.
The following are typical disfluencies and are not stuttering:
- Adding a sound or word, called an interjection – "I um need to go home."
- Repeating whole words – "Milo milo and biscuits."
- Repeating phrases – "He is–he is my teacher."
- Changing the words in a sentence, called revision – "I had–I lost my tooth."
- Not finishing a thought – "I want the. . . I forgot."
When children are learning a lot of words or new speech sounds, you may notice some of these typical disfluencies. This is normal.
On the other hand, stuttering is a speech disorder characterized by repetition of sounds, syllables, or words; prolongation of sounds; and blocks (interruptions in speech such as pauses). People who stutter know what they want to say but have difficulty producing the words.
It is important to differentiate between the two as the distinction helps us identify if a child requires therapy for stuttering. For parents who are unsure or are worried about their child’s fluency, a consultation with a speech and language therapist is recommended to assess the child and determine if therapy is warranted.
When should I worry about my child stuttering?
Typically, it is a good idea to monitor your child’s severity of stuttering for at least 6 months, especially if your child is less than 4 years old at onset.
It is recommended to consult a speech therapist if:
- The stuttering has continued for more than 6 months.
- The stuttering started after 3 to 4 years of age.
- The stuttering has increased in severity or frequency.
- There is a family history of stuttering that continued past early childhood.
- The child gets frustrated or upset by the stuttering.
- The child has other speech or language problems.
Can a child grow out of stuttering?
Children who begin stuttering before age 3 ½ are more likely to outgrow stuttering within 6 months. Between 75% and 80% of all children who begin stuttering will stop within 12 to 24 months without speech therapy.
If the child has been stuttering longer than 6 months, he or she may be less likely to outgrow it. If the stuttering lasts longer than 12 months, there is an even smaller likelihood he or she will outgrow it without intervention.
What are some ways for parents to manage stuttering in young children?
If a child appears to be normally disfluent, parents should be reassured that these disfluencies are normal and accept them. To manage stuttering, what parents can do best is not to focus on the stuttering and to be patient and supportive.
The following strategies are recommended:
- Set aside “talk time”. Provide a relaxed environment that allows many opportunities for the child to speak. Set aside a fixed time to talk to one another every day. This “talk time” should be a special time where parents give the child their undivided attention, without any phones, TV or other distractions.
- Listen attentively. Focus on the content of the child’s message rather than how it is said. Listen attentively when the child speaks and wait for him or her to say the intended word.
- Slow down. Speak in a slightly slowed and relaxed manner to reduce time pressures the child may be experiencing. Pause frequently and wait a few seconds after the child speaks before talking again.
- Ask less questions. This can help to reduce communication stress and put less pressure on a child in a speaking situation. Parents can do this by commenting and waiting instead of asking a question (e.g., Comment and wait after saying “I had nuggets for my snack” instead of asking “What did you eat?”). Questions can also be rephrased as comments (e.g., "You played outside today at school. That sounds fun!" instead of "What did you do at school?")
- Practice patience. Give children time to finish what they are saying. Don't rush or interrupt them. Don't tell them to "slow down" or "think about what you want to say." Phrases such as those are generally not helpful to children who stutter.
What should parents avoid for children who stutter?
- Do not tell the child to think before speaking.
- Maintain eye contact and show that you are interested in what your child is saying. Try not to look away or show signs of frustration.
- Give the child time to speak and time to finish thoughts and sentences. Do not interrupt or try to complete the child’s sentences.
- Avoid using prompts or giving reminders such as “slow down,” “take your time,” or “take a deep breath.” Although we often have good intentions for giving these prompts, it may make a child feel more self-conscious about speaking.
Why is proper intervention important for children who exhibit signs of early stuttering?
Without proper intervention, children who exhibit signs of early stuttering are more at risk for continued stuttering. Factors to consider include the child’s gender (boys are at a higher risk), time since onset (greater than 6 to 12 months is higher risk), age of onset (children who start stuttering at age 3 ½ or later are at higher risk), and overall speech and language skills.
Early intervention is essential because children under 6 years old who stutter face the risk of being bullied or teased by their peers. Additionally, if stuttering persists into the school years, treatment for stuttering becomes more difficult.
How does speech and language therapy at Thomson Kids support children who stutter?
The type of treatment implemented depends on the age of the child and the severity of their stutter. For preschool children under the age of 6, the Lidcombe Program is recommended. This is a well-researched behavioural treatment which is effective for treating stuttering in young children.
For older children over 6 years of age, the Westmead Program may be recommended. This involves teaching the child to change their speech pattern by using syllable-timed-speech (STS) to reduce stuttering.
Other stories you may like…