Stuttering in Elementary School-Aged Children: Facts and Treatment Methods
One question I often receive from parents who have a school-aged child who stutters is, Will my child always stutter? The short answer, though not what many want to hear, is that there is simply no way to know.
In today's blog post, I will share facts about stuttering. Once you are equipped with facts about stuttering and understand some of the possible treatment methods used in speech-language therapy, I hope that you will leave with a greater understanding of why "Will my child always stutter?" may not be the question we should be asking at all.
Stuttering is a speech fluency disorder that may be characterized by any of the following:
1. prolongations: ssssssssssort of lllllllllike this
2. repetitions: so-so-so-sort of li-li-ke that
3. blocks: where no sound comes out, generally mid-word
Prolongations. repetitions of sounds or syllables, and blocks, are all considered stuttered disfluencies and interrupt the typical flow of speech. Children who stutter also may demonstrate what are called concomitant or secondary behaviors, such as facial grimacing, visible tension, or other accompanying body movements.
What causes stuttering? Although there is not one single cause, various factors such as genetics (family history of stuttering) and neurophysiological differences (meaning the brain tends to work differently during speech), are believed to contribute to stuttering (ASHA, 2019).
According to the Stuttering Foundation of America (2019), 3 million people in the United States stutter, with males being four more times more likely than females to experience stuttering.
Now for the hard facts: There is no cure for stuttering. An older child (beyond preschool-aged) who stutters is likely to experience ebbs and flows in their speech fluency, meaning stuttering may come and go throughout childhood and into adulthood.
Although there is no magic elixir to "cure" stuttering, speech-language therapy can be highly effective and helpful for individuals who stutter and are ready to seek treatment.
Stuttering is a complex communication disorder, where often times the stuttered disfluencies (prolongations, repetitions, blocks), are only one piece of the puzzle. A level of counseling should always be integrated into stuttering therapy.
A skilled speech-language pathologist should work with you and your child to provide education about stuttering. The education process may include teaching your child about basic anatomy and physiology so they are able to understand and identify what parts of their body become tense during stuttering moments. Tension is generally a key component in stuttering, so it is important that your child learns how to identify where the tension is, in order to then modify, relax, and continue speaking.
Therapy should also involve talking openly about your child's emotions around stuttering. What does stuttering feel like? Is it frustrating or embarrassing? Does your child feel aware of their stuttering? How do other people react when they stutter? Does your child avoid certain speaking situations (e.g. talking on the phone, ordering food at restaurants, or raising their hand in class?).
Desensitization techniques may be used to help your child feel more confident speaking in their more feared speaking situations. This may include encouraging a child to openly stutter in feared situations (e.g. on the playground or during a presentation). Additionally, other treatment methods used may include stuttering modification and fluency shaping techniques.
Stuttering modification techniques are strategies used to help your child with their moments of stuttering. Since children who stutter often experience varying amounts of disfluencies from day to day, it is important to provide them with ways to help overcome those difficult moments either while or after stuttering occurs.
Fluency shaping techniques are strategies used to help your child achieve more fluent speech and thereby reduce their moments of stuttering. These techniques are often used prior to or during speaking such as using an "easy onset" or gliding into a word.
It is important to note that progress in therapy should not be measured by how little a child stutters. The goal of stuttering therapy isn't to "cure" the child and make their speech 100% fluent. This type of goal would imply that stuttering is wrong or something to be ashamed of, thereby increasing negative feelings associated with stuttering. Instead, therapy goals should address a child's awareness and utilization of their newly learned strategies (e.g. desensitization, stuttering modification, or fluency shaping techniques).
Stuttering often leaves speakers with a feeling of complete loss of control. Speech-language therapy can provide your child with the knowledge needed to help them say, "I am in control of my speech". Furthermore, this sense of control should extend beyond the walls of a clinic. Our job as SLPs is to help both parents and children feel knowledgeable about stuttering, so that if and when it occurs, individuals can reach into their tool box and keep moving forward!
If we can help re-shape the thinking and attitudes surrounding stuttering, by showing children it is not something to be feared, we can help equip children with newfound confidence and tools that they can use throughout their life to overcome difficult speaking situations.
Thank you for reading and as always if you have concerns about your child's speech or language skills, contact a speech-language pathologist in your area!
Lindsey O'Neill MA, CCC-SLP is a pediatric speech-language pathologist and owner of the private practice, Cultivating Communication LLC, located in Mason, Ohio.