What To Do When Your Child Stutters

There are different types of speech disorders in children. One of the most common ones is stammering, also known as stuttering. A form of dysfluency, stammering refers to an interruption in the flow of speech.

It usually shows up in children between the ages of two and six, since that is the stage when their language skills develop. These children are likely to face difficulties uttering certain syllables, words or phrases; or they may make no sounds, or they may prolong the sounds.

As per statistics available with the National Institute on Deafness and Other Communication Disorders (NIDCD), USA, approximately 5 to 10 per cent of all children stutter during some period in their life, lasting from a few weeks to several years. Approximately 75 per cent of them recover. For the remaining 25 per cent who continue to stutter, the condition can turn into a lifelong communication disorder if not addressed appropriately.

Speech disruptions may also be accompanied with struggle behaviours, such as rapid eye blinks, tremors of the lip or clenched fists. Stuttering can make it difficult for children to communicate with other people, thereby affecting a person's quality of life and interpersonal relationships.

Stuttering vs cluttering

Stuttering should not be confused with cluttering. While both are fluency disorders, cluttering occurs due to disorganised speech and talking too fast. This results in excessive breaks in normal talks. On the other hand, children who stutter know what to say. Their speech is organised in their heads but they are unable to say it fluently.

What causes stuttering?

Stuttering can be caused by several factors, with genetics playing a pivotal role. Experts believe that 60 per cent of those who stutter have a close family member with a similar disorder.

Other causes include:

• Developmental delays in a child
  
• Difference in the way the brain processes the language
  
• Increased activity levels
• Rapid rate of speech
  
• Brain injury that occurs after a stroke, head trauma or other reasons; hence, the brain has difficulty coordinating the different areas that are involved in speech and language, resulting in stuttering
  

Diagnosis of stuttering

According to NIDCD, stuttering should be diagnosed by a speech-language pathologist, who is trained to test and treat individuals with voice, speech and language disorders.

The specialist 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 behaviours, an evaluation of the child's speech and language abilities, and the impact of stuttering on his life.

More importantly, the pathologist would try to determine if the child is likely to continue his stuttering behaviour or outgrow it.

If left untreated, what happens?

If the problem is not addressed early, speech problems in the child may worsen and turn into a lifelong problem. Stuttering may also result in the child having problems socialising and making new friends. The child may interact with parents and family members but might hesitate to talk to others including relatives and friends. She may be reluctant because she was mocked at earlier, or is unable to express herself, or is afraid of acceptance. The sooner the child is treated for stuttering the better.

Speech therapy for stuttering

It is important to remember that there is no permanent cure for stuttering. But, don't lose heart! Speech therapy helps many children eliminate stuttering completely, while other methods help children master skills that would make them stammer less.

How speech therapy works

Speech therapy usually involves helping the child to speak fluently even as she self-monitors. At first, the child is asked to pronounce single words in a slow, relaxed manner. The number of words uttered daily is increased gradually till the child starts forming full sentences.

This gradual process may take anywhere from a few weeks to six months, or even more. Doctors will also focus on helping the child decrease secondary behaviours like twitching, blinking, clamping jaws to name a few.

If the speech problem is not addressed early, it may turn into a lifelong problem

Choosing a speech-language pathologist

It is important for parents to find the right speech-language pathologist for their child, whose goals are similar to those of parents. Together, they must draw up a schedule for the therapy and stick to it.

Therapy Time

The frequency of therapy time required differs from child to child. The decision regarding therapy time should be made after a thorough evaluation and a discussion with the therapist.

How can parents help the child?

You need to be encouraging and provide positive assurance to your child, and be patient with him during this phase as he is likely to face emotional turmoil. You should avoid adding to his stress, as this will only make it more difficult for your child to stay motivated and recover.

Here's what NIDCD suggests parents should do:

• 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.
  
• Listen attentively when your child speaks and wait for him to say the intended word. Don't try to complete your child's sentences. Also, help him learn that a person can communicate successfully even when he is stuttering.
  
• Talk openly and honestly to your child about stuttering, if she brings up the subject. Let your child know that it is perfectly okay for some disruptions to occur.
  
• Pay attention and focus on the content of your child's message, rather than responding to how it is said. Do not interrupt your child.
  
• Speak in a slightly slow and relaxed manner. This can help reduce any pressure your child might be experiencing to speak fast.
  
• Follow the step-by-step guide recommended by your speech-language pathologist and re-evaluate in case your child doesn't show progress.
  

Dr Ruby Sunny is a consultant speech-language pathologist in a leading hospital in Bengaluru.

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