Stuttering: Fumbling With the Normal Flow of Speech
"I couldn't wait until Cooper could talk. Now, every time he speaks I'm a nervous wreck," admits Susan, a mother of a seven-year-old stutterer. "Everyone kept telling me he would outgrow it (]]>stuttering]]>), but he didn't. Soon after his fifth birthday, I knew I had to get help."
One of the great joys of parenting is listening to your child learn to speak. But for some, this process causes concern, frustration, and social isolation.
Speech: A Complex Process
Learning to speak isn't easy. Speech requires rapid and intricate movements of the tongue, lips, jaw, vocal cords, and teeth. In addition, precise timing of the muscles for breathing and sound production is necessary to a child's ability to speak. Many factors can interrupt these processes.
Most children will speak normally by the time they enter kindergarten, but some will continue to have a speech or language disorder. A speech disorder occurs when a child has difficulty putting sounds together to form words. Stuttering is one of several speech disorders that cause disfluency in a person's ability to speak.
What Does Stuttering Sound Like?
Stuttering is characterized by a repetition of sounds or syllables, usually at the beginning of words. For example, "Mommy went to the s-s-store", or "That ba-ba-baby is crying." These repetitions and prolongations are often accompanied by tightness in the speech muscles, changes in the pitch or volume of the voice, and facial expressions of fear. Frequent occurrence of such behaviors is considered stuttering.
This type of disruption in the flow of speech most often develops between the ages of two and five when a child's vocabulary is developing at a rapid rate. However, as a child begins to reach school age, stuttering becomes less evident.
The Speech Foundation of America has identified the following criteria as warning signs of disfluency associated with stuttering:
- Frequent sound and syllable repetition
- Syllable repetition in which an "uh" vowel replaces the correct vowel in the word ("puh-puh-peach rather than "pe-pe-peach")
- Frequent prolongations of sounds that become longer in duration
- Tremors (trembling of muscles) around the mouth and jaw during speech
- Rises in the pitch or loudness of the voice during the prolongation of sounds
- Tension and struggling while saying certain words
- A look of fear on the child's face while saying a word
- Avoidance of or delay in saying certain words
What Causes Stuttering?
There are multiple reasons a child will stutter and several practices that may exacerbate an existing stuttering problem.
- Development—As mentioned earlier, rapid development of language during the preschool years is a common cause. The child has many thoughts to express and is quickly making decisions about the appropriate words to use that will correctly communicate what he wishes to say. This is often referred to as developmental stuttering, which is often outgrown.
- Coordination—Another reason is a lack of coordination in the movement of the lips, tongue, jaw, and vocal cords, causing them to miss the rapid movements required for speech. This can be due to a lack of maturity and can also be outgrown, or can be caused by a neurogenic disorder.
- Genetics—There is some speculation that a predisposition to stuttering is genetic. There is currently no evidence to support this. However, some research indicates that stuttering tends to be more prominent within certain families.
- Parenting—A common misconception is that poor parenting or a negative home environment causes stuttering. There is no evidence that the way a child is raised is the cause. However, stuttering can be affected by the way people respond to the stutterer and the child's anxiety concerning his stuttering.
- Stress—Although stress does not cause stuttering, existing stuttering can be aggravated by stressful circumstances. When a child feels pressure to perform, find the correct words, construct appropriate sentences, and coordinate their speech muscles to form words, they are likely to be disfluent in their speech.
As a parent, if you are concerned about your child's speech, ask your pediatrician for advice and a referral to a speech-language pathologist—a professional trained to test and treat individuals with speech, language, and voice disorders. This is especially appropriate if your child's stuttering persists for more than six months.
Early identification and treatment of speech and language disorders is very important to improving communication skills. The goal of early intervention therapy is to build a foundation for fluent speech by helping the child to view speaking as easy and enjoyable instead of difficult and dreadful.
Many children outgrow stuttering without therapy. But it is difficult to determine who will and who won't. If the nature of the problem is associated with a physical tension of the speech muscles, it is less likely to be outgrown.
At this time there is no cure for stuttering. However, early intervention and continued therapy can control the stuttering, resulting in a normal flow of speech. Most therapy programs will focus on specific speech techniques as well as the psychological issues associated with stuttering.
As a parent you play a significant role in your child's speech and language development. The way you communicate with your child is very important. A child who stutters needs extra patience and encouragement. But the results are worth it!
Here are a few tips to keep in mind when having a conversation with your child:
- Provide a relaxed environment for communication.
- Speak slowly and easily, without tension.
- Use consistent and direct eye contact when your child is speaking.
- Don't discuss your child's stuttering with others when your conversation can be overheard.
- Pause for a short time before responding to your child's comments. This provides time for him to say something else without feeling rushed.
- Avoid interruptions and don't complete your child's sentence.
- Set aside at least a few minutes each day to talk one-on-one with your child.
- Avoid criticism or direction when your child speaks, such as "Slow down and think about what you want to say."
- Avoid having them speak to perform, such as "Tell grandma what you're learning in school." Allow the child to initiate the conversation.
Share these tips with the child's siblings, teachers, and caregiver.
The more you understand your child's stuttering, the more you can help. With patience and understanding, you can help eliminate much of the frustration and anger associated with stuttering, and encourage your child's communication.
The National Stuttering Association
The Stuttering Foundation
Canadian Stuttering Association
Institute for Stuttering Treatment and Research
National Stuttering Institute website. Available at: http://www.nsastutter.org/. Accessed March 26, 2008.
Last reviewed February 2010 by ]]>Brian Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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