If a child in your care has difficulty speaking and tends to hesitate on or repeat certain syllables, words, or phrases, he may have a speech disfluency or stuttering problem. But sometimes, normal language development can give the appearance of stuttering. The child in your care simply may be going through periods of normal disfluency that most children experience as they learn to speak.
Despite decades of research, there are no clear-cut reasons for stuttering, but much has been learned about the factors that contribute to its development. As a result, tremendous progress has been made in the prevention of stuttering in young children.
For young children, language development can take place at different times and "speeds." Here are some guidelines to use when working with children as they develop their speech patterns that can help you understand and identify the difference between stuttering and normal language development.
The normally disfluent child
Many children go through periods when they occasionally repeat syllables or words once or twice, as in "he-he-hello." This is called normal disfluency also may include hesitancies and the use of fillers such as "uh," "er," or "um."
Disfluencies occur most often between the ages 18 months and five years, and they tend to come and go. They usually are signs that a child is learning to use language in new ways. If disfluencies disappear for several weeks and then return, the child may simply be going through another state of learning.
The child with mild stuttering
A child with mild stuttering repeats sounds more than twice, as in "th-th-th-thank you." Tension and struggle may be evident in the facial muscles, especially around the mouth. In this child, disfluencies may come and go but now are present more often than absent. The pitch of the voice may rise with repetitions, and occasionally the child will experience a "block"--no airflow or voice for several seconds. Try to model slow and relaxed speech when talking with the child. Do not speak so slowly that it sounds abnormal, but speak in an unhurried manner, with many pauses. Some children's programs, such as Mister Rogers' Neighborhood, provide a good example of this style of speech.
Slow and relaxed speech can be most effective when combined with time each day for the child to have your one-on-one undivided attention. Setting aside a few minutes each day to listen to the child talk about whatever is on her mind can help you better understand which speech patterns are in use.
When the child talks to you or asks a question, try to pause a second or so before you answer. This will help make talking seem less hurried and more relaxed to the child. Try not to act upset or annoyed when stuttering increases. The child is doing her best as she copes with learning many new skills all at the same time. Your patient, accepting attitude can help immensely.
Effortless repetitions or the prolonging of sounds are the healthiest forms of stuttering. Anything that helps the child stutter like this instead of stuttering tensely or avoiding words is positive. If the child is frustrated or upset when the stuttering is worse, give reassurance. Some children respond well to hearing, "I know it's hard to talk at timesbut lots of people get stuck on wordsit is okay." Other children are most reassured by a touch or a hug when they seem frustrated
The child with more severe stuttering
If a child stutters on more than 10 percent of his speech, stutters with considerable effort and tension, or avoids stuttering by changing words and using extra sounds to get started, it may be an indication of more severe stuttering. Complete blocking of speech is more common than repeating or prolonging sounds.
Consider contacting a language specialist to come to your childcare program to work with children. A speech-language pathologist who specializes in stuttering and who has a certificate of clinical competence from the American Speech-Language-Hearing Association may help. A qualified clinician can help not only children but also teenagers, young adults, and even older adults make significant progress toward fluency. Contact your local health department or the Stuttering Foundation of America (see Resources) for more information.
The suggestions for caregivers and parents provided above are appropriate whether the child has a mild or more severe problem. Try to remember that slowing and relaxing your own speaking style is far more helpful than telling the child to slow down. Encourage the child to talk to you about her stuttering. Show patience and acceptance as you discuss it. Overcoming stuttering is more a matter of losing fear of stuttering than trying harder to speak.
By the Stuttering Foundation of America
The Stuttering Foundation of America maintains a toll-free hotline on stuttering. Call for free informative brochures and a nationwide resource list of speech-language pathologists who specialize in stuttering. 800-992-9392; www.stutteringhelp.org.
American Speech-Language-Hearing Association can provide information on speech-language pathologists and other resources. 888-331-ASHA; www.asha.org.
The National Stuttering Association has local chapters and provides workshops as well as other information. 800-361-1677; www.nsastutter.org.