Stuttering is a communication disorder in which the rhythm or fluency of the flow of speech is broken down and where there is a disruption in speech. When it takes effort to speak, it may cause unusual facial and body movements. This disorder affects rate, pitch, loudness, inflectional patterns, articulation, facial expression as well as postural adjustments and fluency.
Stuttering is characterised by:
Repetitions of a word or sound, such as ‘p-p-p-party’,
Prolongations, such as ‘lllllllllaugh’
Abnormal stoppages, where there is no sound.
Causes of stuttering?
Stuttering often occurs when influential factors are combined, each of these factors have different causes in different people. The causes of what makes stuttering continue and what makes it get worse differ from each other. The following are influential factors:
- Family history (Genetics): about 60% of those who stutter also have or had a family member who stuttered.
- Age at onset: If the child begins stuttering before 3 years old, there is a greater chance that they will out grow the stuttering.
- Time since onset: If the child has been stuttering for longer than 6 months, the chance that he/she will outgrow it is less likely.
- Gender: girls are more likely to improve on fluency of speech than boys. In early childhood there are differences between girls’ and boys’ speech and language abilities and so others react towards them differently.
- Child development: if the child has other speech or language disorders or delays, they are more likely to stutter.
- Neurophysiology: research has shown that people who stutter use a different area in their brain when they process speech and language.
- Family dynamics: When a family leads a fast–paced lifestyle, as well as when the parents have high expectations of the child, this may lead to stuttering.
The development of stuttering:
- Normal disfluency
Normal Disfluencies occur usually between 2 and 5 years of age, they are usually signs that the child is learning new ways to use language and is not classed as a stutter. Normal disfluencies may attract adult attention, but the child is generally unaware of it. It is characterized by repetitions, revisions, prolongations and pauses. The child may, repeat syllables or words once or twice (‘h-h-happy’), use revisions (‘The boy had… the boy went…’), and may often have hesitancies and use fillers (‘uh’, ‘er’, ‘um’).
- Borderline stuttering
Those who have borderline stuttering may present with more than 10 disfluencies per 100 words. They differ slightly from normal disfluencies, as they use more repetitions and broken words. Children with borderline stuttering are usually unaware of their stuttering, but sometimes may show frustration.
- Beginning stuttering
Beginning stutterers have tense and hurried speech. They may use abruptly ended repetitions, irregular repetitions and there may be stoppages evident. They may start using escape devices (such as blinking or increase in pitch and loudness) and starters. At this stage the child is sensitive to stress, resulting in frustration and triggering tension responses. When the child becomes dysfluent, he feels threatened and is under stress, causing him to stutter with tension.
- Intermediate stuttering
The person who has intermediate stuttering will have an increased amount of tension due to frustration, fear and helplessness, this will cause blocks, repetitions and prolongations, and this is a viscous cycle. The child will be fearful, causing the child to develop more avoidance behaviours, which are difficult to undo. The child will start to feel shameful and embarrassed as his/her speech is different to his friends.
- Advanced stuttering
The advanced stutterer will have habitual patterns, causing treatment to be more difficult. Advanced stuttering is often characterized by long blocks, with substantial tension and visible tremors. There may be an increased amount of word avoidances, situational avoidances and escape behaviours. The child/adult will feel increased frustration, leading to coping behaviours and a highly constrained lifestyle.
How can parents help their child?
- When speaking to your child, speak in an unhurried way, pausing frequently. This is more effective than telling your child to ‘slow down’.
- Decrease the amount of questions you ask your child, letting him/her express his/her own ideas.
- Show your child that you are listening to the content of the message and not how he/she is talking. This can be done by showing it in your facial expressions and body language.
- Each day give your child your undivided attention, letting him/her lead the activity and giving him/her the opportunity to talk about what they like. Let this be an opportunity to build the confidence of your child!
- Teach all members in the family, to take turns talking and listening, and not interrupting, this helps hold the child’s attention.
- Watch how you interact with your child, trying to increase positive messages and decrease criticisms, fast speech and interruptions.
- Support your child, by showing him that you accept him/her as he is, by reduce the amount of pressure put on the child to speak correctly and try not to correct the child or finish their sentence.