What Causes Stuttering?
Experts think that a variety of factors contribute to stuttering, including:
- Genetics: About 60% of those who stutter have a close family member who stutters.
- Other speech and language problems or developmental delays.
- Differences in the brain’s processing of language: People who stutter process language in different areas of the brain. And there’s a problem with the way the brain’s messages interact with the muscles and body parts needed for speaking.
- High/increased activity level.
- Rapid rate of speech.
Early Signs of Stuttering
The first signs of stuttering tend to appear when a child is about 18-24 months old as there is a burst in vocabulary and kids are starting to put words together to form sentences. To parents, the stuttering may be upsetting and frustrating, but it is natural for kids to do some stuttering at this stage. It’s important to be as patient with your child as possible.
A child may stutter for a few weeks or several months, and the stuttering may be sporadic. Most kids who begin stuttering before the age of 5 stop without any need for interventions such as speech or language therapy.
However, if your child’s stuttering is frequent, continues to get worse, and is accompanied by body or facial movements, an evaluation by a speech-language therapist around (instead of before) age 3 is a good idea.
The School Years
Usually, stuttering drops to very low levels when kids enter elementary school and start sharpening their communication skills. A school-age child who continues to stutter is likely aware of the problem and may be embarrassed by it. Classmates and friends may draw attention to it or even tease the child.
If this happens with your child, talk to the teacher, who can address this in the classroom with the kids. The teacher also may be able to decrease the number of stressful speaking situations for your child until speech therapy begins.
When to Seek Help
If your child is 5 years old and still stuttering, talk to your doctor and, possibly, a speech-language therapist. You also may want to consult a speech therapist if:
- repetitions of whole words and phrases become excessive and consistent
- sound and syllable repetitions start happening more often
- there is an increase in the prolongations of words
- speech starts to be especially difficult or strained
- you notice increased facial tension or tightness in the speech muscles
- you notice vocal tension resulting in rising pitch or loudness
- your child tries to avoid situations that require talking
- your child changes a word for fear of stuttering
- your child has facial or body movements along with the stuttering
- you have other concerns about your child’s speech
Most schools will offer testing and appropriate therapy if you have been concerned about the stuttering for 6 months or more.
What Parents Can Do
Try these steps to help your child:
- Don’t require your child to speak precisely or correctly at all times. Allow talking to be fun and enjoyable.
- Use family meals as a conversation time. Avoid distractions such as radio or TV.
- Avoid corrections or criticisms such as “slow down,” “take your time,” or “take a deep breath.” These comments, however well-intentioned, will only make your child feel more self-conscious.
- Avoid having your child speak or read aloud when uncomfortable or when the stuttering increases. Instead, during these times encourage activities that do not require a lot of talking.
- Don’t interrupt your child or tell him or her to start over.
- Don’t tell your child to think before speaking.
- Provide a calm atmosphere in the home. Try to slow down the pace of family life.
- Speak slowly and clearly when talking to your child or others in his or her presence.
- Maintain natural eye contact with your child. Try not to look away or show signs of being upset.
- Let your child speak for himself or herself and to finish thoughts and sentences. Pause before responding to your child’s questions or comments.
- Talk slowly to your child. This takes practice! Modeling a slow rate of speech will help with your child’s fluency.
Kids might need speech-language therapy for a variety of reasons, including:
- hearing impairments
- cognitive (intellectual, thinking) or other developmental delays
- weak oral muscles
- excessive drooling
- chronic hoarseness
- birth defects such as cleft lip or cleft palate
- motor planning problems
- respiratory problems (breathing disorders)
- feeding and swallowing disorders
- traumatic brain injury
Therapy should begin as soon as possible. Children enrolled in therapy early (before they’re 5 years old) tend to have better outcomes than those who begin therapy later.
This does not mean that older kids can’t make progress in therapy; they may progress at a slower rate because they often have learned patterns that need to be changed.
Finding a Therapist
It’s important to make sure that the speech-language therapist is certified by ASHA. That certification means the SLP has at least a master’s degree in the field and has passed a national examination and successfully completed a supervised clinical fellowship.
Sometimes, speech assistants (who usually have a 2-year associate’s or 4-year bachelor’s degree) may assist with speech-language services under the supervision of ASHA-certified SLPs. Your child’s SLP should be licensed in your state and have experience working with kids and your child’s specific disorder.
You might find a specialist by asking your child’s doctor or teacher for a referral or by checking local directories online or in your telephone book. State associations for speech-language pathology and audiology also maintain listings of licensed and certified therapists.
Helping Your Child
Speech-language experts agree that parental involvement is crucial to the success of a child’s progress in speech or language therapy.
Parents are an extremely important part of their child’s therapy program and help determine whether it is a success. Kids who complete the program quickest and with the longest-lasting results are those whose parents have been involved.
Ask the therapist for suggestions on how you can help your child. For instance, it’s important to help your child do the at-home stimulation activities that the SLP suggests to ensure continued progress and carry-over of newly learned skills.
The process of overcoming a speech or language disorder can take some time and effort, so it’s important that all family members be patient and understanding with the child.
A speech disorder refers to a problem with the actual production of sounds, whereas a language disorder refers to a difficulty understanding or putting words together to communicate ideas.
Speech disorders include:
- Articulation disorders: difficulties producing sounds in syllables or saying words incorrectly to the point that listeners can’t understand what’s being said.
- Fluency disorders: problems such as stuttering, in which the flow of speech is interrupted by abnormal stoppages, repetitions (st-st-stuttering), or prolonging sounds and syllables (ssssstuttering).
- Resonance or voice disorders: problems with the pitch, volume, or quality of the voice that distract listeners from what’s being said. These types of disorders may also cause pain or discomfort for a child when speaking.
- Dysphagia/oral feeding disorders: these include difficulties with drooling, eating, and swallowing.
Language disorders can be either receptive or expressive:
- Receptive disorders: difficulties understanding or processing language.
- Expressive disorders: difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.