Stuttering In Childhood
Stuttering or stammering is a complicated multidimensional communication problem. The overt or visible side of which is marked by hesitant speech which has abnormal interruptions like repetitions, prolongations, pauses and blocks. These disruptions in fluency are sometimes accompanied by secondary features like eye blinking, head jerking, facial grimaces or heavy breathing. Some people who stutter show a great deal of muscular tension and forcing while they try to speak. The covert side of the problem revolves around what the person actually feels. Shame, embarrassment, frustration and avoidance are just a few feelings that a person with stuttering experiences. While talking the PWS ( People who stutter) may substitute words, talk indirectly around a topic, or reply with incorrect information to avoid certain struggle words. The problem of stuttering can impact the person’s life severely.
Stuttering is a disruption of the flow of speech. Any stoppage in the flow of speech is stuttering. Children and adults can have stuttering. It may become severe over time if not treated. 95% of stuttering develops during childhood. If left untreated, it may become severe.
Normal Non-Fluency and Stuttering
This article is about normal non-fluency and stuttering. Let’s first try to understand our speech. Firstly, our speech develops as we grow. Secondly, typical kids learn to say words by 1 year of age. Further, speech-language development continues as one grows. Language refers to the linguistic aspects of communication. Similarly, speech refers to the qualitative aspects of communication.
Human Speech System
So, let’s talk about the aspects of speech.
Human speech consists of the below;
- Suprasegmental aspects
Disruption in any of this can cause a speech disorder. Hence, we will only talk about Fluency in this blog. Therefore, fluency of speech is the continuity and effortless flow of speech. Further, a fluency disorder is a disruption in this flow. This can be a normal non-fluency or stuttering disorder. So, read on for more on normal non-fluency and stuttering.
What is normal non-fluency?
Normal Non-Fluency is seen in young kids. Further, between 2-3 years of age. By 2 years of age, the intensive language learning stage begins. So, during this time, fluency disruptions are seen. Further, this is because kids are learning to talk. That is to put words together. So, often they fumble.
Red Flags of Stuttering
The following are the signs/ red flags that you should watch for:
- Frequent repetitions of sounds, syllables, words (For example I I I I want water)
- Prolongation of sounds (For example Caaaaaan.. I have bread?)
- Blocks (Inaudible or fixation of the jaw)
- Usage of fillers (For example I ummm need ummm paper ummm pencil)
- Awareness of speech disorder in the child or adult
- Avoids speaking
- Physical tension (For example jaw jerks, hand and leg movements, eye blinking, fidgeting)
- Escape behavior in talking situations
- Disruptions once or twice in every phrase that is spoken.
- Emotional outbursts due to inability to talk.
If your child has any of these signs, consult today. Stuttering will not resolve by itself. Further, it may increase in severity. Early in the treatment, the better it is.
No single cause has been identified for stuttering. But researchers believe that the coordination of brain nerves and speech muscles is a concern in children and people who stutter.
- Stuttering is known to run in families.
- Children who stutter are three times more likely to have a close family member who also stutters, or did.
- More boys than girls have stuttering.
What does a Speech Therapist do?
A Speech Language Therapist is trained to assess an individual holistically and understand the skill level. This can lead to a diagnosis and thereafter writing a plan of intervention. Speech therapists will communicate and counsel family members of the client as well as the client about assessment results, and the course of action to be taken.
Speech therapists can work in a variety of environments which may include:
- Schools and day care centres (special and mainstream schools, day care centres)
- At home (providing home-based intervention)
- Hospitals (providing bedside evaluations and working along with physicians and nurses)
- Specialist centres (wherein they may provide speech-language therapy or work as a team with other paraprofessionals)
The common dysfluencies noted in children with stammering are
- Repetitions – syllable, sound, word or phrase repetitions (Eg : “li-li-li-like that”)
- Prolongations – holding onto a sound for an extended period of time (Eg : “llllike that”)
- Blocks – when no sound is produced, then a “burst” of tension is released when the speaker is able to vocalize (Eg : “——like that”)
- Interjections – adding extra words (Eg : “um, uh, like”)
- Revisions – speech is revised during the utterance (Eg : “I have to go…I need to go to the shop”)
Since stammering can greatly interfere with the child’s family, school and social interactions, it is important to focus on ways and methods that will improve the child’s fluency.
Read full blog on Tips For Children Who Stammer
Stuttering Recovery and Relapse
So, we will talk about Stuttering Recovery and Relapse. Stuttering is a common speech disorder. Further, early treatment is best. In other words, this avoids quality-of-life issues later. Also, psychological issues with stuttering are common. In other words, such as mental pressure, anxiety is seen in kids and adults. Also, prevention is better than cure.
Further, many kids recover on their own. But, it is not possible to know which group of kids will recover or who will not. Further, the best way is to monitor kids. Also, only pre-school kids may show natural recovery. Therefore, check for natural recovery 1 year before starting therapy.
For young kids, direct or indirect therapy option is there. Direct therapy helps the child to change the way he speaks. Whereas the indirect one will focus on ways to speak easily. These will include slowing down and others.
Parents are a crucial part of a child’s therapy.
For older kids and adults, treatment is a little different. SLP’s help them to feel less tense. Help to speak freely at school, at school, and in social settings.
Games to practice Fluent Speech
Children who stutter are often very clear in their mind and know what they want, but may find it difficult while expressing it out loud. Be it any technique or modifications your speech therapist advises, in the end, the child has to practice speaking with lesser dysfluencies. Here are few games that I recommend to all parents, to help their child practice smooth and fluent speech.
- Roleplay Activities
- Turn-Taking – A skill
- Hot and Cold
- The “Bus” Game
- Marco Polo
When stutterers want to improve on speech fluency, often the younger individuals seek for apps to help with speech fluency
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