Stuttering in Young Children

Margaret H. Briggs, Ph.D., CCC-SLP

We regularly receive calls from families who are concerned about stuttering. Below are some Frequently Asked Questions… and our answers:

What is it? Stuttering is defined as a disruption in the flow of speech. It can be characterized by repetitions (I… I… I…) prolongations (I waaaaant…), or blockages of a word or a part of a word. People who stutter may develop “tricks” in their effort to force a word out. They may blink their eyes, turn their head to one side, or their lips may tremor or strain as they struggle to speak.

What causes it? Stuttering has always been a perplexing disorder. One of the biggest mysteries has been its cause. Recently scientists, led by Dennis Drayna, Ph.D., at the National Institute on Deafness and Other Communication Disorders have discovered three genes associated with people who stutter. We have long known that stuttering tends to run in families. This is the first evidence that there may be a significant biological component to stuttering. At this point the genetic mutations have been found to account for less than 10% of those who stutter. However it helps lead research into a clearer understanding of causes and possible new treatments.

Isn’t some stuttering normal? Yes, many children between 2 ½ and 5 experience periods of what we call “normal nonfluency.” Children stumble as they’re learning to walk and have “bumps” in their speech as they learn to talk. For 75-80% of these children, the disfluencies have disappeared by age 5 and these children are never labeled as stutterers.

So should we just “wait and see” hoping our child will outgrow it? We are strong believers in prevention. So if you have concerns, we would like to talk to you and guide you through this process.

What if stuttering persists? For those children who experience true stuttering rather than normal nonfluency, speech therapy is necessary.

Can stuttering be cured? Unfortunately, no. We do everything we can, though, to prevent stuttering from occurring and to keep mild stuttering from becoming more severe. We can help someone who stutters manage their problem by teaching them a variety of coping strategies—physical, in the moment of their stuttering block and emotional—to deal with the reactions they and others have about their stuttering.

Is it psychological? Although there is no evidence that stuttering is caused by an emotional upset, an emotional component can very quickly develop as young children struggle to make themselves understood. Children’s sense of themselves and their self-esteem can quickly be negatively impacted if they see themselves as different from others.

Why does it come and go? Although we try to look for patterns (e.g., times of day, people, events) there often aren’t any. Still, stuttering can come and go for no apparent reason. Although stuttering, especially at the early stages is quite inconsistent, there are some predictable times and situations—when children are tired, excited, rushed, or competing (especially for their parents’ attention).

What can we do at home?

make sure you listen to your child
focus on what he says, not how
look at the routines in your home (e.g., bed/nap, meals)
look at your overall pacing—the speed of your speech, your schedule—is there a lot of rushing to get places, get things done?
try to comment more and question less (e.g., “Oh, I wonder what he’s doing” instead of “What is he doing?” or “That’s a red block instead of “What color is that block?”)

Get everyone involved—we have lots of written information and DVDs for parents, teachers, and peers.

What shouldn’t we do? Don’t panic! There is help available. There are some things to avoid: Don’t correct your child, finish her sentences when she gets stuck, or offer advice (e.g., “take a deep breath” “think before you talk” “slow down”). While all this makes sense and is well intended, people who stutter tell us this “help” typically has the opposite effect.

What do you do? In our approach to treating stuttering we work closely with all family members. For although we know families do not cause stuttering, we are convinced that they can be a big part of the solution. We coach parents to make sometimes quite small changes in routines or interaction patterns with often dramatic results. For instance parents have adjusted their morning routines to give themselves more time, keep the TV off, and significantly reduce the stress of rushing to get out of the house. We help families identify times and situations when their child is more likely to be fluent rather than focusing on the times when he is stuttering. We help families understand different personality styles and reactions to perceived pressure. We advise parents to be open in talking about their child’s difficulties. Rather than ignoring a struggle, we suggest saying, “Oh that was a little tricky for you; I noticed you got stuck on that word. It’s OK; we all have trouble getting words out sometimes.” This tends to normalize rather than stigmatize a child who then comes to realize that none of us ever has fluent speech 100% of the time.

At the same time, we work directly with the child to increase the amount of fluency in a variety of situations. We also teach children specific “fluency enhancing strategies” that help when they get “stuck” on a word, sound, or phrase.

Where can I get help? See the links on our Resources page for the most reliable information.

Call us for a telephone consultation (at no cost). We can offer advice, direct you to resources, and schedule an appointment to meet with you and your child, if necessary.

From: Briggs and Associates Newsletter—Fall, 2010