Monday, August 27, 2012

My child started stuttering. Is this normal?


Stuttering (what we SLPs term "fluency), is a common concern for parents particularly when their children are between the ages of 2-6 years.  Firstly, let me remind parents that it is typical for children between these ages to exhibit periods of dysfluency.  Why does this happen?  Many theorize that often a child's language develops much faster than his/her ability to control oral motor movements and this difference in skills development is then exhibited through dysfluent moments (stutters).  However, these typical dysfluencies differ from a fluency disorder in the frequency and type of dysfluencies exhibited.

Typical Dysfluencies/Stutters:  These type of dysfluencies are typically used for the purpose of delaying a message in order to revise one's statement.  Your child could be using dysfluencies for the purpose of reorganizing the words in a sentence or trying to retrieve the correct vocabulary word for his/her message.  He/she may also use these dysfluencies to correctly organize speech sounds in more complex words. 

The 5 most used, typical dysfluencies are:

1.  Whole word and phrase repetitions:  Ex.  "I, I want some juice."  or "When is, when is dad going to be home?"

2.  Sentence Revision:  Ex. "Him has,  The boy has my toy."

3.  Part-Word Repetitions:  these repetitions differ from a fluency disorder in that they are easy repetitions (no tension present) and are not frequently used.  Ex.  "M, Mo, Mom told me I could have a cookie."

4.  Interjections (verbalized):  we all use interjections as a means to delay our message for the purpose of planning and organizing our proceeding thoughts.  Interjects are most often verbalized by the use of "um, ah, like, right", etc.  Ex.  "I um, want to have ice cream for um, dinner."  "I wen to the store, right, and mom got me a toy."

5.  Interjections (nonverbal):  nonverbal interjections are really pauses within an utterance, again for the purpose of planning and executing the next part of one's thought.  Sometimes these pauses are for the purpose of retrieving the correct word from your child's expressive vocabulary.  Ex.  "Mom, (pause) you told me I could get a toy (pause) when we go to the store."

What should you do if your child is exhibiting these dysfluencies?
NOTHING!  You now understand the purpose for typical dysfluencies and how they are strategies your child uses to improve his/her expressive language.  Therefore, the only thing you need to do is BE ATTENTIVE (make eye contact while your child is talking to you) and PATIENT.  Let your child take as long as he/she needs, to express his/her thoughts.  Then remember to PRAISE your child for "taking the time to find the right words to tell me".

Your child really does have so much to say, so give him/her the opportunity to do so!

When should I become concerned about my child's stuttering?
If the frequency of your child's dysfluencies appears to be increasing over time and the intensity (the tension) with which those dysfluencies are being exhibited increases, you may want to contact a speech-language pathologist for further evaluation.  If your child is exhibiting "bumpy" speech (i.e. multiple sound (e.g. "P, p, p, please can I have that?") or word repetitions frequently (e.g. "You, you, you, you want to go play outside?")), sound prolongations (i.e. if your child is saying a sound continuously (e.g. "I say a caaaaaaat today.") for a few seconds before they can finish the word),  or "hard/sticky" speech (i.e. when your child is speaking and his/her mouth is open but NO VOICE is coming out, as if his/her speech is "stuck" in the back of their throat), you should follow-up with a speech-language pathologist immediately as this indicates laryngeal tension during a dysfluent moment which is not considered typical development.

* This information was complied by my clinical experience and educational opportunities over the years, as well as information from The Stuttering Foundation, and Amy Speech and Language Therapy, Inc.*

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