Stuttering is a developmental problem of childhood that usually begins between ages 2 and 5 and can become more severe over time if untreated.
It tends to run in families; about 60 percent of people who stutter have relatives who do as well. About three times as many boys stutter as do girls. Treatment can be very effective, particularly when provided at young ages.
What do parents need to know about stuttering?
We talked with Diane Parris, a certified speech-language pathologist and clinical associate professor of Speech, Language and Hearing Sciences at Boston University.
1 What causes stuttering? And how many children are affected?
We believe that psychological, developmental and environmental factors contribute to the onset and development of stuttering. Some children are born with a predisposition for stuttering, a timing problem in the fine muscular coordination needed to produce speech smoothly. Demands on the developing brain, such as learning speech and language, other motor skills development or cognitive skills development may influence the ability to be fluent.
In our highly verbal society, pressure to speak well and to keep up with another speaker’s fast speech rate further challenges a young child in producing fluent speech.
Finally, the child’s own personality and tolerance for disruptions in his or her own speech may create difficulty.
All of these variables seem to converge in varying degrees to result in a stuttering problem that doesn’t go away. As much as 20 percent of all children go through a stage of development during which they are disfluent; approximately 5 percent of them go through a period of stuttering that lasts six months or more. Most will recover by late childhood, however, leaving about 1 percent with a long-term problem.
2 What are some common misunderstandings about stuttering?
A common myth is that people who stutter are not as smart as other people, or that they are more nervous, fearful or anxious. These things are simply not true. Nor is it true that stress or anxiety causes stuttering. Stress can aggravate stuttering just as it can affect the verbal skills of a person who doesn’t stutter. Many extraordinary people, including Winston Churchill, John Stossel, James Earl Jones and Carly Simon, stutter.
3 What should a parent say to a child who stutters?
Our thinking has changed over the years concerning whether or not to talk openly about the child’s “bumpy speech.” In the past, it was suggested that bringing awareness to the problem might make it worse. In fact, we‘ve learned that it’s okay to talk to children, using terms that are age-appropriate. When a child is having a particularly tough time, it‘s now recommended that we acknowledge it in a gentle, supportive way. The calmer the parent is when doing this, the calmer the child will likely be as well.
You might say, "That was a little bumpy, wasn’t it? Oh well, sometimes that happens. It’s okay."
We’re finding that children as young as 2 or 3 can be aware of having some difficulty on their own, and it’s helpful to be able to reassure them about it rather than to have stuttering become a taboo subject. It’s not a child’s fault that they stutter; it’s no one’s fault. The attitude to convey is openness and calm acceptance. Give the child undivided attention when listening, respond to the content of what the child says, and don’t fill words in.
4 What else do you recommend to a parent?
If you’re concerned about your child’s speech seek out an evaluation by a speech-language pathologist.
These professionals work in public school settings, hospital outpatient clinics and private practices.
They’re trained to help decide whether the child is experiencing a normal period of disfluency or possibly developing a stuttering problem. Together with the family, speech-language pathologists can decide if a period of fluency therapy would be helpful.
5 What’s new in terms of treatment and therapy?
Our emphasis in diagnosis and treatment for the past 20 years or so has been to assess what contributes to the stuttering itself and to find out how a person feels about their stuttering problem. The work we do in therapy is two-fold as well. We help the individual learn how to move speech muscles in a relaxed manner and find positive ways to think about the problem.
In the last decade, we’ve put more emphasis on understanding which young children are more at risk than others for the development of stuttering, and on early intervention. We’re involving parents and teaching preschoolers strategies such as slowing their speech rate and slowing the pace of taking turns in conversation to allow the child more opportunity to speak in an unhurried environment. We've found that short periods of daily focus on individual time with a child while employing strategies such as this can make a significant impact on the child’s fluency. Here, I think it's important to state that while parents can be instrumental in helping, parents don’t cause stuttering.