Stuttering is a confusing and often misunderstood developmental speech and language disorder. Before discussing stuttering, it is important to understand the concepts of speech fluency and disfluency. Fluency is generally described as the forward flow of speech. For most speakers, fluent speech is easy and effortless. Fluent speech is free of any interruptions, blockages, or fragmentations. Disfluency is defined as a breakdown or blockage in the forward flow of speech, or fluency. For all speakers, some occurrence of disfluency is normal. For example, people may insert short sounds or words, referred to as “interjections,” when speaking; examples of such are “um,” “like,” or “uh.” Also, speakers might repeat phrases, revise words or phrases, or sometimes repeat whole words for the purpose of clarification. For young children, disfluency is a part of the normal development of speech and language, especially during the preschool years (between the ages of two and five years).
There is no standard definition of stuttering, but most attempt to define stuttering as the blockages, discoordination, or fragmentations of the forward flow of speech (fluency). These stoppages, referred to as disfluencies, are often excessive and characterized by specific types of disfluency. These types of disfluencies include repetitions of sounds and syllables, prolongation of sounds, and blockages of airflow. Individuals who stutter are often aware of their stuttering and feel a loss of control when they are disfluent. Both children and adults stutterers expend an excessive amount of physical and mental energy when speaking. Older children and adults who stutter show myriad negative reactive behaviors, feelings, and attitudes. These behaviors, referred to as “secondary behaviors,” make the disorder more severe and difficult.
Many children, especially those aged between two and five, have difficulties in speaking smoothly. Many of them repeat the first word many times before they form a whole sentence.
Roughly three million Americans stutter. Stuttering affects people of all ages. It occurs most often in children between the ages of 2 and 5 as they are developing their language skills. Approximately 5 percent of all children will stutter for some period in their life, lasting from a few weeks to several years. Boys are twice as likely to stutter as girls; as they get older, however, the number of boys who continue to stutter is three to four times larger than the number of girls. Most children outgrow stuttering. About 1 percent or less of adults stutter.
Others even have a hard time completing a word. Others inject lots of “ands”, “uhs”, or “ums” while forming sentences. Some stop and start new sentences.
These are not considered stuttering. Basically, stuttering starts when a young child begins to show more obvious difficulties.
For instance, rather than repeating an entire word, many young children begin to repeat fragments of words. This occurs every few words. In some cases, even more often.
Stuttering further develops in the stage when a child becomes very self-conscious about the way he speaks.
He twitches his face in disappointment; he tries to move his mouth, but he cannot say a word.
A stuttering child may exclaim out words and sentences in a hurry. He may blurt it out in an uncommonly loud voice. Because they are ashamed, many stuttering children avoid talking as much as possible.
“Children with speech difficulties need to feel loved. You can help your child by making him comfortable with himself. It will surely help balance the inevitable loss of self-esteem and the self-consciousness caused by stuttering.”Busting Myths on Stuttering
Myth # 1: Children who stutter are unintelligent.
Truth: There is completely no relation between stuttering and intelligence. In fact, many stuttering children are extremely intelligent. Some deliver very well in the classroom, while others have average intelligence. Others, however, perform quite poorly, when compared to average students.
Myth # 2: Stress or bad parenting causes stuttering.
Truth: No one really knows the causes of stuttering, though genetic factors appear to be involved. Stress usually stimulates stuttering for those who have a high tendency to stutter. This claim, however, lacks supporting evidence. Many doting and caring parents have raised children who stutter. Therefore, bad parenting is an unlikely cause of stuttering.
Myth # 3: Tell a child to “speak clearly”, “slow down,”, etc. will help stop stuttering.
Truth: On the contrary, telling your child these will only make him more self-conscious, which worsens the problem. There are more helpful responses than these. All you have to do is to listen to your child patiently. Model clear and slow speech yourself, and make out what he is trying to say.
Myth # 4: All children outgrow stuttering.
Truth: Although many children outgrow stuttering, it does not improve on its own all the time. If stuttering continues over six months or if there are other symptoms that manifest in your child, then you should seek professional help. Sooner, not later.
Myth # 5: Children can have a control over their stuttering. They only need to try.
Truth: The truth is, the more a child tries to control the muscles involved in speech, the more difficult and laborious speaking becomes. This will only worsen the problem.
Myth # 6: Ignoring stuttering completely is the best remedy.
Truth: While parents should not focus too much on their child’s stuttering, it certainly does not help if they pretend the problem does not exist at all. Stuttering children know the problem very well, and pretending that there is no problem suggests that the parents are uncomfortable in handling stuttering.
Myth # 7: Stuttering can be caused by listening to others stutter.
Truth: There is no basis for this claim at all. Stuttering is not caused by merely listening to others stutter, but by genetic and some other factors.
What causes stuttering?
Although the precise mechanisms are not understood, there are two types of stuttering that are more common. (A third type of stuttering, called psychogenic stuttering, can be caused by emotional trauma or problems with thought or reasoning. At one time, all stuttering was believed to be psychogenic, but today we know that psychogenic stuttering is rare.)Developmental stuttering
Developmental stuttering occurs in young children while they are still learning speech and language skills. It is the most common form of stuttering. Some scientists and clinicians believe that developmental stuttering occurs when children’s speech and language abilities are unable to meet the child’s verbal demands. Developmental stuttering also runs in families. In 2010, for the first time, NIDCD researchers isolated three genes that cause stuttering. More information on the genetics of stuttering can be found in the research section of this fact sheet.
How is stuttering diagnosed?
Stuttering is usually diagnosed by a speech-language pathologist (SLP), a health professional who is trained to test and treat individuals with voice, speech, and language disorders. The speech-language pathologist will consider a variety of factors, including the child’s case history (such as when the stuttering was first noticed and under what circumstances), an analysis of the child’s stuttering behaviors, and an evaluation of the child’s speech and language abilities and the impact of stuttering on his or her life.How is stuttering treated?
Although there is currently no cure for stuttering, there are a variety of treatments available. The nature of the treatment will differ, based upon a person’s age, communication goals, and other factors. If you or your child stutters, it is important to work with a speech-language pathologist to determine the best treatment options.
For very young children, early treatment may prevent developmental stuttering from becoming a lifelong problem. Certain strategies can help children learn to improve their speech fluency while developing positive attitudes toward communication. Health professionals generally recommend that a child be evaluated if he or she has stuttered for three to six months, exhibits struggle behaviors associated with stuttering, or has a family history of stuttering or related communication disorders. Some researchers recommend that a child be evaluated every three months to determine if the stuttering is increasing or decreasing. Treatment often involves teaching parents about ways to support their child’s production of fluent speech. Parents may be encouraged to:
- Provide a relaxed home environment that allows many opportunities for the child to speak. This includes setting aside time to talk to one another, especially when the child is excited and has a lot to say.
- Refrain from reacting negatively when the child stutters. Instead, parents should react to the stuttering as they would any other difficulty the child may experience in life. This may involve gentle corrections of the child’s stuttering and praise for the child’s fluent speech.
- Be less demanding on the child to speak in a certain way or to perform verbally for people, particularly if the child experiences difficulty during periods of high pressure.
- Speak in a slightly slowed and relaxed manner. This can help reduce time pressures the child may be experiencing.
- Listen attentively when the child speaks and wait for him or her to say the intended word. Don’t try to complete the child’s sentences. Also, help the child learn that a person can communicate successfully even when stuttering occurs.
- Talk openly and honestly to the child about stuttering if he or she brings up the subject. Let the child know that it is okay for some disruptions to occur.
Many of the current therapies for teens and adults who stutter focus on learning ways to minimize stuttering when they speak, such as by speaking more slowly, regulating their breathing, or gradually progressing from single-syllable responses to longer words and more complex sentences. Most of these therapies also help address the anxiety a person who stutters may feel in certain speaking situations.