As toddlers' language skills rapidly expand, some may experience speech behaviours that are similar to those of people who stutter. Stuttering is a fluency disorder that affects an estimated 3 million Americans. According to the American Speech-Language-Hearing Association (ASHA), approximately 95 percent of children who stutter begin to do so by the age of 4. Maybe you've noticed your child repeating a word at the beginning of a question (for example, "Can-can-can I have one?"), using "um" frequently, making painful faces while speaking, or stumbling over their words when they get excited. If your 3-year-old appears to be having difficulty getting their words out, how concerned should you be, and how can you help them express themself? POPSUGAR spoke to speech/language pathologist Rita Thurman, MS,CCC-BSC-FD, to better understand how to support a child who might be dealing with a stutter.
How Do You Know if Your Child Is Stuttering?
The average person will occasionally experience disfluency, or interruptions in the flow of speech, during high-pressure situations like speaking in front of a crowd. Most people can relate to the feeling of flustered nervousness that can cause you to use use fillers, like "um" and "you know," or have trouble organising your thoughts. This form of disfluency is typically just part of the experience as a child develops their language skills, and usually fades as the child grows up.
Stuttering, however, is different. Based on ASHA's criteria, stuttering is characterized by interruptions in the flow of speech due to sound repetitions ("c-c-c-can I?"), part-word repetitions ("ma-ma-ma-mommy"), prolongations ("sssssssit"), or blocks, where sound is attempted but no sound comes out. Oftentimes, people who stutter also have visual markers, called struggle behaviours, which include making facial grimaces or blinking repeatedly. Struggle behaviours can show that a person is anticipating a stutter and is trying to force the words out. Sound repetitions, part-word repetitions, prolongations, blocks, and struggle behaviours are a unique experience of people who stutter; they are distinct from small bouts of disfluency that many people experience. Regardless of whether your little one is experiencing typical disfluency or the beginnings of a stutter, it's important to be patient and supportive when your child speaks. Keep an eye out for struggle behaviours, monitor for signs of frustration, and contact a speech/language pathologist who can help address your concerns and help your child on a one-on-one basis.
How Do You Know When It's Time to Consult a Professional?
Preschool-aged children can benefit from a speech evaluation at any time, according to Thurman. "Parents and preschool children need support from the first day a child starts to stutter in order to decrease the negative impact of stuttering," said Thurman. If you're concerned about your child's speech for any reason, a speech/language pathologist can help you figure out the next steps in addressing your child's needs.
Working with patients who stutter is within the scope of practice for all speech/language pathologists, and specialisation in stuttering is not required for your therapist to be effective. As with finding any medical provider, it's important to make sure you find someone who is the right fit for your child. Look for speech/language pathologists who have experience working with kids, and whose demeanour puts your child at ease.
How Can You Help Your Child at Home When Stuttering Develops?
There isn't just one right way to help a child who's struggling with a stutter. Some speech/language pathologists will recommend families try indirect therapy, which is where a child's caregivers and family members adjust their behaviour in order to support the child. For example, they might try modelling speaking at a slow pace or reducing time pressures when the child is speaking by patiently waiting for the child to finish their thought, even if they are struggling. Modelling slow speech encourages a child to speak more slowly themselves, which makes it easier for them to organise their thoughts and coordinate the mechanisms of speech such as breath and mouth movements.
The home environment is also important, and Thurman recommended making sure the home is a safe space for communication. As part of indirect therapy, listeners are discouraged from telling the child to "slow down" or "spit it out," as these commands can minimize the child's experience. Being told how to communicate can contribute to anxiety and negative feelings about speaking, so it's important to be aware of your own responses to your child.
Does Stuttering Go Away?
Though stuttering often appears in early childhood, Thurman noted that it can appear at any time in a child's development. Whether a stutter goes away is dependent on the child. The likelihood that your child's stuttering will persist is determined by various risk factors including gender at birth, late talking, being a twin or triplet, and a family history of stuttering.
How Can You Provide Long-Term Support for Kids Who Stutter?
If your child continues to stutter into their elementary school years, there are a multitude of ways to support them. Indirect therapy, as previously described, can be helpful in supporting your child at home. Direct therapy, which focuses on helping your child reduce negative feelings about stuttering, increase self-advocacy, and develop strategies to confidently manage disfluency when it occurs, is another form of intervention that a speech/language pathologist might recommend. Thurman said that children and parents should not be too singleminded in how they address a stutter. The type of therapy, she insisted, "must depend on the child, the family dynamics, and the way stuttering presents."
Decreased stuttering might result in response to therapy, but it's important to remember that perfect fluency is not necessarily the goal. Regardless of a child's communication differences or therapy outcomes, parents and family members are always encouraged to be patient and accepting as their child navigates the challenges of sharing thoughts, needs, and knowledge.