Any disruption in the forward flow of speech is called a fluency disorder or a "disfluency". When young children are learning language they often have disfluencies. These are normal disfluencies, typically in the form of:
• Whole word repetitions: Example: But but I want the ball
• Phrase repetitions or reformulations: Example: The cow I mean the horse, the horse said…
• Interjections: Example: Mom can I umm go to the uh park
One fluency disorder that does need a speech therapist's attention is called "stammering". In the United States it is referred to as "stuttering".
What is stammering?
Stammering is characterized by blocks in speech. These disfluencies can be of different types:
• Part word repetitions: Example: b..b..book
• Whole word repetitions: Example: Mom, mom, mom where is my book?
• Sound prolongations: Example: s..sun
• Silent intervals: This is a few second pause before a word is said
What is the cause of stammering?
Researchers have not identified a single cause of stammering. However, below is some information about stammering to keep in mind as your child grows:
1. There is a strong genetic basis. Stammering usually runs in families
2. Its 3-4 times more common in boys than in girls
3. 85% of boys spontaneously recover from it by age 3
4. Researchers believe that between 2 ½ – 3 ½ years of age, children go through a growth spurt. They learn a lot of new vocabulary as well as motor skills. At this time their speech goes through a hesitating bumpy pattern. Some kids grow out of it. The ones that don't have a neurological predisposition to stammer.
5. Research has shown that emotional factors such as directive parenting, moving homes, emotional upheaval, change of school, and so on do not cause stammering. They may, however, aggravate a pre-exisiting stammer.
6. Children usually do not stammer whilst singing a song as the words are pre-learnt.
7. Stammering in children waxes and wanes. There will be cycles of fluency and disfluency. There maybe days/weeks when there are no disfluencies. However this does not mean that the disfluency isn't there.
8. Young children with stammering can be extroverts or introverts. The personality of a child is not determined by their stammering, nor is their personality determined by the fact that they stammer.
9. Stammering can not be caused by imitation. i.e. imitating another child or a cartoon character
When should I see a speech therapist?
• If your child has a higher percentage of stammering-like disfluencies than normal disfluencies
• If your child has persistent disfluencies beyond age 3 ½
• If there is a family history of stammering.
What is the treatment for stammering?
Stammering is not a disease, therefore it can not be "cured." There is no medical or surgical procedure for it. It is a speech condition and not a psychological problem. There are several methods to treat stammers. Stammers can only be treated by a speech therapist with experience in managing fluency disorders.
Please be wary of treatments that advertise a quick "cure" (e.g. "cure stammer in 10 days"). These are not effective, since most of them teach the child to speak in a different tone/accent. In these cases, disfluencies often disappear when the child is focusing on speaking in a different or novel way. The disfluencies will re-appear once the child gets used to the new accent/tone.
The most effective treatment method is coordinating breathing and speaking. For children this can be done in several fun ways as teaching them the difference between "smooth" and "bumpy" speech. The important thing is for children to recognize for themselves when they have disfluencies and then smoothen them out.
Interacting with a stammering child: Do's and Don'ts
1. Don't finish the child's utterance or talk for the child.
2. Don't tell the child to talk slowly or think before they talk.
3. Don't ignore his disfluencies. If the child is aware of them, acknowledge his feelings. By ignoring it, the child may think its something that needs to be hidden. Hiding or avoiding disfluencies increase their frequency.
4. Don't avoid giving the child speaking roles in plays etc. but don't force them either. A young child who stammers is usually aware of his disfluencies but is not bothered by them and thus should be encourged to participate in activities.
5. Do talk slowly to your child and around your child to each other in the house so that your child matches his speech rate with yours.
6. Do sit down and give your child time to talk. Don't rush them by talking when you are leaving to go out or doing something else.
7. Avoid demand speech. i.e. do not force your child to answer a question or sing a song in somebody else's presence.
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