What is stuttering?
Stuttering or Childhood-Onset Fluency Disorder is characterized by interruptions or stoppages in the smooth flow of speech. These interruptions may consist of:
Repetition of sounds, syllables, words, or phrases, for example, r-r-r-rain
Prolongations of sounds, for example, m-a-a-a-a-ango
Blocks, tension-filled stoppages of speech and airflow that feels like the word is "stuck".
Although stuttering is presumed to be mainly a speech issue, the disorder actually involves more than just repetitions, prolongations, and blocks. People who stutter (PWS) may go through various negative emotional reactions to the fact that they have difficulty speaking. These emotions could be feelings of
embarrassment,
anxiety,
fear and
shame.
This may lead to struggle while speaking or may find solace in avoiding talking altogether.
A feeling of loss of control, or inability to get the word out, is often present among people who stutter.
Stuttering can occur gradually or all of a sudden. It often starts between the age of 2-5 years. 5% of Preschoolers go through a period of stuttering.
Secondary behaviors observed with stuttering are physical movements that occur during a stutter to help get the word out. These may include eye blinking, jaw jerking, and head or other involuntary movements. These behaviors are usually mechanisms used to minimize the increasing severity of stuttering. They can add to the patient's embarrassment and fear of speaking.
Risk Factors
These factors can determine whether an evaluation or consultation is needed from a Speech Therapist or not, in terms of stuttering.
Family Background:
50% of children who stutter have family members who also stutter or have stuttered in the past. There is definitely a genetic component to this. The risk that your child is actually stuttering instead of just having normal disfluencies increases if that family member is still stuttering.
Age at onset:
Children who begin stuttering before they turn 3.5 years old have a better chance of outgrowing stuttering.
Time since onset:
About 80% of children who begin stuttering will stop within 12 to 24 months without any kind of intervention. However, If your child has been stuttering for longer than 6 months, and the severity is increasing, he/she may be less likely to outgrow it on their own.
Coexisting speech and language disorder:
It will definitely decrease the chance of overcoming stuttering on their own. A child who is susceptible to making more frequent speech errors such as substituting one sound for another or leaving sounds out of words will be at a greater risk.
Causes of Stuttering
There is a genetic factor for stuttering. Stuttering is often hereditary and is more likely to occur if there is a family history involving stuttering.
The origins of a stutter are related to the way a child’s brain develops neural pathways for speech and language. During the preschool years, there is something called the “language explosion,” that occurs due to Rapid Development. This is when stuttering can start to occur. A child’s vocabulary may increase at a rapid rate, during this time period, and the brain’s neural networks involving speech - those that process emotion, cognition and language— will have difficulty in coordinating.
Stuttering can also be associated with other issues such as difficulties with articulation and speech sound production, or even ADHD.
How does it affect the child?
Whether it is the speaker's social-emotional aspect or their well-being, Stuttering can have some major effect on the child. The impact may also vary from child to child, it may cause one child extreme frustration or anxiety while a more severe stutter in another child may not affect them at all. However, it plays a major role in the personality development of a child as it may affect a child’s self-esteem along with a lack of confidence. As a parent, it may be tempting to avoid or ignore a stammer due to fear of making it worse but if something is hard and not noticeable, it can be frightening for a child too! No two people will stutter exactly the same way or the same amount in all situations. This is one of the frustrating aspects of the condition. Speakers are not able to predict when they will stutter or when they will talk fluently. This variability can also be confusing for parents, teachers, and peers. As they might wonder why a person is fluent in one situation but disfluent in another. As speakers and listeners learn to accept this variability, stuttering becomes easier to deal with.
Why is it important to treat it?
Yes. It is best to treat fluency disorders as early as possible. Stuttering can be noticeable to some children and not noticeable to others. There is no universal cure for stuttering. However, treatment can help. Treatment is most effective when it focuses on not just fluent speech but also the other aspects that come with it. Since stuttering is not just the act of stuttering but is quite deep-rooted, the treatment for stuttering should be made sure to address more than just the noticeable speech disfluencies. Approaching the disorder, as a whole, is the key to helping people reduce the whole impact of stuttering on their lives.
It is also important to treat it because when children are still stuttering later in childhood, they can experience numerous negative reactions from peers, teachers, or even unknowledgeable adults. But in those situations, the child may also adapt to behaviors to escape stuttering, such as holding back from saying what they really want to say, avoiding speaking situations at school, and avoiding words they want to use.
Young children may overcome stuttering entirely. Meanwhile, older children, adolescents, and adults might continue to stutter in some way throughout their lives, but with appropriate treatment and support, they can definitely become effective communicators who are not held back by their stuttering in any way. If left untreated since childhood, adults who stutter may end up avoiding jobs or personal commitments that have speaking demands. This can have a negative impact in their life for the long haul.
What do we do in speech therapy?
Speech Therapy can help improve any speech disorder including stuttering. The treatment focuses on all aspects of Stuttering. The aim is to decrease disfluencies and increase your overall speaking confidence.
At Sounderic, we follow a holistic approach to stuttering treatment. It begins with assessing the severity of stuttering and the stuttering pattern according to age. From there, the parents/caregivers are counselled regarding the same. Following which, the child will learn some basic techniques to gain more control over their stutter and to manage it. Once the child is comfortable and quite familiar with the techniques taught, role-playing and real-life simulation are a major component of therapy at Sounderic, which will allow the child to practice using those strategies and techniques in real-life situations. These exercises also aim at reducing fear, anxiety, and avoidance so that they can speak confidently and instill more confidence. Thoughts, feelings, and overall life impact are also some components that will be focused on, throughout therapy. We incorporate principles of strategies such as Avoidance Reduction Therapy or Acceptance and Commitment Therapy. There is a wide range of physical and psychological tools from a variety of approaches that we incorporate. Our work with each individual client is to figure out what will work for them, specifically. In general, there are two goals we focus on:
(1) to stimulate a healthy attitude about speaking, and
(2) to reduce the severity and frequency of the stutter. Specific treatments are individualized based on the patient’s age
How can parents help?
Parents play an extremely important role in a child’s intervention for Stuttering. Treatment for stuttering can be as successful as Parents’ actions at home, regarding the same. It is vital for parents and caregivers to demonstrate acceptance and also minimize reactions to the disfluencies like stuttering. Children can very easily pick up on our thoughts and emotions. If parents feel anxious or worried about the stutter, that can definitely create a vicious cycle where the child may begin stuttering more because they feel increased pressure. Treatment often involves teaching parents about ways to support their child’s production of fluent speech.
Parents may be encouraged to:
1. Model an easy, relaxed way of talking. Speaking in a slightly slowed and relaxed manner can help reduce time pressures the child may be experiencing.
2. Maintain openness and honesty in all that you do. If a child mentions their stutter, it’s absolutely alright to acknowledge that you noticed it too. Let the child know that it is okay for some disruptions to occur. There should be honesty if this subject is brought up.
3. Get face to face- it demonstrates they have your attention. Make comfortable eye contact and smile.
4. Listen attentively, and in general, focus on the content of whatever the child is saying
5. 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. 6. Make the right noises and comments: ‘Mmmm’, ‘I’m listening’, ‘come sit with me’, ‘I can't wait to listen to this, it sounds great!’. These comments are a clear signal that you are willing to wait and listen to them. 7. Use touch: hold their hand, rub their back or arm. This connection is reassuring in action.
8. Lean in close: it's a signal to them that what they are saying is important to you.
Things to Avoid:
1. Try not to ask them to stop and breathe. This is frustrating for children and can also lead to unnatural breathing patterns
2. Try not to react negatively. Make sure your face, words and actions are calm and anxiety-free.
3. Don’t let them take over just because they stammer. Enforce it as a normal conversation, where there are regular turns to talk. It is also recommended that a child must be evaluated every 3 months to determine if the stuttering is increasing or decreasing.
4. Avoid finishing a child’s thoughts, even when they stutter. Help the child learn that a person can communicate successfully even when stuttering occurs.
We want to: Reassure, Acknowledge, Praise We can do that by: Keeping usual eye contact, Nodding, Smiling, using Gentle words and Kind feedback.
These points will help you navigate properly in terms of dealing with your child’s stuttering.
Bullying
It is common for children who stutter to be bullied by their peers, and also adults who stutter commonly report discrimination in the workplace. These reactions make it more difficult for people with a stutter to practice fluent speech.
Bullying can be very challenging for children who stutter. In fact, many children go to school with the fear of being picked on. It is more common than we can imagine. Bullies often use stuttering as a weakness and exploit it by making comments, isolating people, or by trying to hurt them. Other people may also react negatively, mimicking the bully’s attitude.
It is integral to help the child overcome any negative reaction to his stuttering so that it will be easier for him to respond to bullies, which can reduce the likelihood of any further bullying.
This is significant in therapy where we help the child overcome his negative reactions to his stuttering.
Step 1 is to assist the kids in understanding what they are experiencing.
Step 2 is to help them reduce their concerns about stuttering.
Step 3 is to help them desensitize those moments of stuttering.
Conclusion
Quality of life is affected by speech disfluencies and negative reactions. Therefore we often say, “Stuttering is more than just stuttering,” because the fluency disorder can affect almost all factors of a person’s life. Stuttering is complicated. As often as we might have heard it, It is not a psychological problem, even if it does cause emotional distress; it is not caused by parents, even if they play a very important role in the child’s stuttering experience; and it is not just a physical problem even if it may I still secondary behaviors such as jaw jerking and tightening of body. Stuttering does run in families and can be associated with neurological differences. Knowing these facts can help people who stutter and also spread awareness in their families. After all, it’s okay to stutter!
Regardless of their stutter, their main aim is to talk. If they are embarrassed by their dis-fluent speech, then they are more likely to struggle with speaking and will try to avoid talking. This might make the problem worse. Thus, acceptance of stuttering is the key to successful communication!
It is important to reiterate the fact that parents, teachers, friends and others can help by simply recognizing that what a person says is more important than how a person says it!