Detecting Stuttering Problems
November 4, 2011
Carl Herder, M.A., CCC-SLP, BCS-F
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Heather L. Grossman, PhD, CCC-SLP, BRS-FD Board Recognized Specialist in Fluency Disorders and Clinical Director of AIS discusses methods for detecting stuttering problems:

When parents first hear their child stutter, they typically feel panic and even fear. It's heartbreaking to hear very young children cry out in frustration, "My mouth doesn't work!" or cover their mouths with their hands--or even give up on speaking attempts altogether. One parent of a 6-year-old shared "I would hold my breath when he talked and stuttered, and my eyes would fill up with tears. I felt like I wished I could just say the words for him.” Fearing that their children may be teased for stuttering makes some parents wish they could keep them home from school.

Parents are most likely to first seek guidance from their child’s pediatrician. Doctors most commonly advise parents that they are not to worry, and that stuttering is something that children "outgrow." But that's not necessarily true.

Anywhere from 5 to 10 percent of children experience dysfluencies- disruptions in the smooth flow of speech. Most of those children (around 80%) develop fluent speech without the need for therapy. Sometimes what parents think is stuttering are actually the hesitancies and repetitions of words and phrases that are considered part of normal language development.Some children however, are at risk for true stuttering, including those whose speech contains disrupted breathing and sound prolongations or who show physical tension or emotional frustration when speaking. Children whose stuttering remains untreated often resort to strategies that impede their socialization and academic performance. Many stop participating in class discussions, pretend they don’t know the answers to questions asked of them, or adopt a falsely “shy” demeanor. Behaviors related to stuttering escalate in both frequency and severity if they are ignored. But there are many things a parent can do for children who are showing signs of stuttering.

Do I need to have my child's speech evaluated?

Because so many children do eventually grow out of speech difficulties, pediatricians often underestimate the need for professional intervention for children who stutter. If the child’s speech difficulty is noticeable enough to cause parent concern, professional consultation should be sought. A speech-language evaluation should likewise be completed for any child showing signs of physical struggle or frustration when trying to speak.One should seek a licensed speech-language pathologist who specializes in working with childhood stuttering.

What does an evaluation entail?

In addition to assessing the child’s language abilities, articulation, and fluency, the therapist gathers information about the parents’ observations and concerns. As part of this consultation, the parents are given suggestions to promote a home environment which will enhance the child’s fluent speech, without calling negative attention to the child’s normal speech dysfluencies. Parents are frequently encouraged to model slower, simpler speech as well as reduce overall language demand and time pressure. Rather than tell their children to “slow down” and “take a breath,” parents are taught healthy ways to talk openly to their child about speaking.

What is speech therapy like?

A course of speech therapy will be recommended for children showing signs of true stuttering. Therapy techniques in current practice have shown excellent results, especially when children are seen soon after onset of the speech problem. Depending on the child’s age, the therapist customizes a program that includes teaching the child techniques to encourage a smoother flow of speech. A good therapist will also suggest practical strategies for the family such as maintaining good eye contact and encouraging all family members to have their turn at speaking, without interruption.

Why do some children stutter?

Although the cause of stuttering remains a subject of debate, research has confirmed that, in simple terms, some children appear “predisposed” to stutter due to heredity. Stuttering may appear to develop rather suddenly, but for most children the onset is gradual. Adding to the puzzling nature of stuttering is its unpredictability. It seems to be severe one day, seems to disappear just as suddenly, only to reappear in full force.

You (and your child) are not alone.

Almost universal to parents of children who stutter are feelings of helplessness and isolation. But in the past decade, there's been a meteoric rise in the strength of nationwide support groups and self-help organizations for children and adults who stutter and their families. A tremendous amount of information is online, but nothing combats feelings of helplessness like the realization that there are many children and their families who are dealing quite well with stuttering. And nothing's better than for children to meet other kids who stutter and for their parents to get together and swap information and strategies.

Information and Resources

  • The American Speech-Language-Hearing Association now provides specialty recognition to professionals who specialize in stuttering. The list is sorted by state and may be accessed at: www.ausp.memphis.edu/sbfd/
  • The Stuttering Home Page: https://www.mankato.msus.edu/dept/comdis/kuster/stutter.html - Provides educational materials, links for parents, professionals and people who stutter
  • The Stuttering Foundation of America (SFA) also provides educational resources for parents, teachers, and other professionals who work with children. 1 (800) 922-9392 https://www.stuttersfa.org
  • FRIENDS: National Association of Young People who Stutter -www.FriendsWhoStutter.org (631) 858-0949 - Not for Profit self-help organization for children who stutter and their families. Sponsors national and local workshops and provides information for and by people who stutter.

Danger signs for Childhood Stuttering:

  • Word repetitions of greater than 3 units as in “Can can can can I go out?”
  • Frequent repetitions of small segments of words as in “Bu-bu-bu-basketball”
  • Prolongations of sounds as in “Rrrrrrrrrrrabbit”
  • Physical tension such as eye blinking or hard lip pressing upon speaking attempts
  • Disrupted breathing during speech resulting in periods of silence while trying to speak
  • Signs of frustration such as abandoning words

DO’s and DON’T’s for Children who Stutter

DO

  • Seek professional help if you are concerned
  • Let the child know you are listening and have time to hear what he is saying
  • Maintain normal eye contact
  • Model slower speech with extra pauses
  • Simplify your own language
  • Reduce demand for language
  • Attend to the child’s message rather than his fluency
  • Let the child know that talking is sometimes hard for everyone
  • Encourage speech turn-taking for all family members
  • Learn about stuttering
  • Attend workshops for stuttering

DON’T

  • Tell the child to slow down, take a breath, or think before speaking
  • Try to fill-in the child’s words when he has difficulty
  • Allow siblings to imitate or tease the child who stutters
  • Try to ignore the problem
  • Encourage the child to use “tricks” such as singing or tapping to get words out