Most Frequently Asked Questions:
Q: What is stuttering?
A: Stuttering is a communication disorder involving involuntary disruptions, or disfluencies, in the flow of speech. Stuttering is what happens when you have too much tension in the muscles that help you produce speech. Abnormal disfluencies include: part-word repetitions (ma-ma-ma mommy), prolongations (llllll ladybug), consonant blocks, which are sounds that cannot be produced due to complete obstruction of air flow or voice, and secondary behaviors, such as facial grimacing or eye blinking. Fluent speech happens when your brain, lungs, vocal cords, lips, and tongue coordinate together in an effortless, smooth, rapid manner, resulting in a continuous, uninterrupted, forward flow of speech. Normal dysfluencies include: whole-word repetitions (mommy, mommy), interjections and fillers (i.e., um, well) and phrase revisions (I want, I need).
Q: How does my child feel when he/she stutters?
A: Children often feel like their speech muscles are “out of control” when they are stuttering. The child may feel rushed to take a turn in conversation, for fear of being “left out.” If so, he/she may seem in a hurry all the time. Children’s communication difficulties can contribute to feelings of insecurity, loneliness, frustration, or shame. Children also react to the expectations of parents, teachers, and others who want them to speak fluently. Avoidance of speaking situations, words, or sounds can result from the child’s desire to meet to these expectations. Many children will go to great lengths to hide their stuttering and prevent their private struggle from becoming a public one.
Q: What can I do to help my child speak more fluently?
A: Be patient and allow your child to finish his/her own words or thoughts. Be a good listener, maintain normal eye contact, stay calm, and do not seem impatient, embarrassed, or alarmed. Try to avoid showing concern through body tension or facial expressions. Finishing sentences and filling in words is not generally helpful. Even though you may be trying to help, this can put even more time pressure on the child. Remember that time pressure and frequent interruptions make it harder for children to speak fluently. Is your child rushing to keep up with your speaking rate? Try to model more “pausing” in your own speech and after he/she finishes a sentence, pause to before your respond, to give your child a little “breathing room.” Ask close ended questions rather than open ended questions. Try not to give advice such as; “Slow down,” “Take a breath,” “Stop, and start over” or “Relax.” These are simplistic responses to a complex problem. When they get “stuck” ask them if they want your help. Remember that your child will have more trouble talking when he/she is excited, upset, tired, or sick. Be sure your child gets enough rest, remove time pressures, and find time to do relaxing activities together. Set up family rules for turn-taking at meals and other family gatherings. Give everyone a chance to speak without interruptions. Set aside a special time each day to be alone with your child. During this time, you can model pausing while he/she has your undivided attention. Finally, watch for handedness. Do not persist in right-handedness when left-handedness asserts itself.
Q: What caused my child to stutter?
A: Approximately 1% of the population stutters. Current estimates put the total number of people who stutter in the U.S. at about 3 million with a 3/1 boy to girl ratio. There is no single reason that someone starts stuttering and parents and teachers are not to blame; it is no one’s fault that a child stutterers. A child who stutters often has a genetic predisposition to stuttering, with an environmental trigger. Those environmental triggers can be demanding questions, frequent interruptions and competition for talking time, fast-paced, unpredictable lifestyles, major life changes, unrealistic demands, and negative responses to disfluency. Stuttering often develops when the demands to produce fluent speech exceed the child’s physical and learned capacities. We know that stuttering is not caused by psychological or physical trauma, and it is not an emotional disorder. They do not have higher or lower intelligence levels because they stutter. However, research has shown that children who stutter tend to be more sensitive and perfectionistic.
Q: How will the Speech and Language Pathologist evaluate my child’s stuttering?
A.Early assessment, diagnosis, and treatment are critical for ensuring the child’s long-term communication success. A licensed Speech and Language Pathologist will elicit a detailed language sample from your child and record the frequency, duration, and type of stuttering. The language sample will then, be collected and analyzed using standardized assessment tools such as: The Stuttering Severity Instrument-3 (SSI-3), Stuttering Predication Instrument (SPI) and The Oral Motor Sensory Analysis (OSMA) to determine the overall severity.
Q: How can a Speech and Language Pathologist help my child become more fluent?
A: Recent studies indicate that early intervention can have a profoundly positive impact on a child who stutters as it relates to their fluency and overall self-image as a person who stutters. Of course, improved fluency is important; however, it is only part of the process. Therapy also helps to prevent negative emotions or avoidance behaviors from becoming part of the child’s stuttering. This means that even when a child cannot speak fluently, he can still speak freely and say what he wants to say. Successful therapy fulfills two important roles in the child’s life: it focuses on reducing the frequency and duration of stuttering episodes as well as creating positive beliefs and feelings about themselves. Therapy for the young child may include the following strategies: exposure to the language concepts of: “slow/fast” “bumpy/smooth” and “stuck/easy,” role playing emotions with puppets, easy onset with “I want” and “my/your turn” phrases, exposure to “fast, bumpy speech” with a bumpy bunny versus “slow, smooth speech” with a turtle, and pausing to slow down the rate of speech.
Q: What advice do you have for my child’s teacher?
A: Like their classmates, children who stutter are often asked to participate in oral reading and oral presentations during everyday classroom activities. These activities may present unique challenges for children who stutter, as the increased speaking demand and time pressure of the activities may significantly increase the child’s likelihood of stuttering. These factors make it more likely they will take a longer time to get through the same amount of content as their classmates. The teacher may want to avoid calling on the student to answer questions and providing classroom accommodations such as untimed oral reading tests.
Q: Will my child ever outgrow stuttering?
A: While there are no cures of “quick fixes” for stuttering, it is important to acknowledge that with help, a child can make significant gains in his ability to speak more fluency and to communicate freely and easily. We cannot predict which children will develop normal fluency and which will continue to stutter. Rather than 100% fluency, our goal is functional, efficient communication with less than 3% stuttered syllables. A child’s prognosis depends on many variables including: genetic history, age of onset, environmental factors, and severity. Research from nine studies indicate that efficacy of speech therapy intervention is up to 91% success rate with preschool children and 61% success rate with school aged children.
For more information on Stuttering, please visit www.westutter.org, www.stutteringhelp.org, or www.asha.org.