Stuttering: What you should know and when to be concerned

Stuttering is a communication disorder that affects the fluency of speech. It’s characterized by repetitions, prolongations, and abnormal stoppages that can make the flow of speech in normal conversation difficult and stressful, both for the speaker and the listener. Statistics estimate that nearly 70 million people are afflicted with stuttering worldwide. In the U.S., approximately 3 million suffer with the disorder, of which 1 percent are children. Stuttering occurs four times as often in males over females.

The underlying mechanism of stuttering is unknown but genetics is a factor. Some research suggests that brain physiology and the layout of neural pathways is different in stutterers compared to non-stutterers. According to Barry Guitar, author of Stuttering: An Integrated Approach to Its Nature and Treatment, the “neural pathways to talking may have bottlenecks, dead-ends, or other obstacles to the rapid flow of information.” And those pathways and how they’re arranged has a base in genetics. In fact,  in 2010, the National Institute of Deafness and Communicative Disorders reported that three genes, linked to stuttering, had been identified. But other factors contribute to the onset of stuttering too. Children with developmental disabilities may be more prone to stuttering. Children who process speech and language differently may have a greater tendency. And stress, family dynamics, and emotional trauma can play a role.

What is the progression of stuttering?

There are three types of stuttering: developmental stuttering, neurogenic, and psychogenic. Developmental stuttering,  occurs in children as speech patterns and language acquisition is developing. It tends to occur between ages two and five. According to the Stuttering Foundation, nearly 75 percent of children who initially stutter will stop on their within a few months.. When it doesn’t, it’s beneficial to consult with a speech pathologist who can do a full evaluation. Stuttering can be a symptom of a more complex developmental delay or a processing disorder.

The progression of stuttering is based on the individual. Some children show difficulty with speech fluency with the initial onset. Other children develop symptoms over a periods of months; and symptoms can vary with stressors. Generally speaking, disfluency may improve or worsen with certain activities. For example, fluency might worse during the school day except during recess. Or, if the family dynamics are fast-paced and intense, symptoms might worse at home and alleviate at school.

How does stuttering affect the child?

Chronic stuttering can make it difficult to communicate and over time, can negatively affect educational achievement, social interactions, and mental health.

What are treatments for stuttering?

Health professionals generally discourage treatment for stuttering in preschool children. The concern is that therapy might heighten a child’s awareness on his/her own speech impediment and make it worse. If however the stuttering lasts for longer than three to six months, then a parent should seek out an evaluation by a licensed speech pathologist (LSP). In young children, the objective of therapy is to improve fluency while fostering positive attitudes toward communication.

Initial treatment by a speech pathologist might be intensive, a couple hours per day. For older children, the goal is to improve the timing of speech. Children might be taught how slow down or stretch out sounds or exercises that promote relaxation and reduce stress and muscle tension during speech.

Other therapies used include:

Neuro-Linguistic Programming (NLP): NLP is a type of cognitive behavioral therapy developed by Bob Bodenheimer, author Mastering Blocking and Stuttering. The crux of the therapy is for stutterers to revisit certain experiences, to re-evaluate them, and to reframe or revise them. The notion is that by reframing experiences and evaluating them with input, a stutterer can draw different conclusions. This is especially helpful for children who have had painful experiences.

Assistive Devices: A number of assistive devices are worn behind the ear of the stutterer. The device delivers input from the speaker at a timed delay or at a higher or lower pitch. By hearing his or her own speech, the child received immediate feedback and can try to correct the speech.

Self-Help and Support Groups: In addition to treatment provided by speech pathologists, self-help and support groups are very helpful. By having peers with similar problems to share stories with, it can help a child who stutters cope with the everyday struggles.

For kids and teens, talking with other peers who stutter can alleviate stress. It can also reinforce behavioral strategies learned in speech pathology and can be a place where kids feel safe to practice.

Theatre/Public Speaking/Performance: The National Stuttering Foundation does recommend Toastmasters as a therapeutic method to the improvement of fluency in speech. The organization, around for more than a century, encourages leadership, teaches publish speaking and methods to improve fluency. For children afflicted with stuttering, the organization provides behavioral guidance in a therapeutic environment.

Jane Fraser, president of the Stuttering Foundation says, “Many people have told us how helpful the [Toastmasters] organization has been for them,” she says. “Not only do they gain valuable public speaking experience in a friendly and encouraging atmosphere, they are relieved to discover that most ‘normal’ speakers are also terrified to speak in public.”

Strategies to Consider as a Parent:

Raising  child with a stuttering issue can be difficult and painful, for the child and for the parent. While most parents are well intentioned with guidance with a child, there are some techniques parents might try that can be counterproductive. The Stuttering Foundation recommends the following guidelines:

1. Refrain from correcting the child. Remarks like “Slow down,” “Take a breath,” or “Relax,” while well-intentioned, can be demeaning.

2. Show your child that you’re listening. It matters not how the child says what he speaks, rather that he says it.

3. Show patience and interest. Wait for the child to finish speaking.

4. Avoid finishing sentences for a child who struggles.

5. Speak in a slow, unhurried way. If you speak slowly, you set the tone for your child.

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