Does Your Child Stutter? Help for Parents by Dr. Heather Grossman, Clinical Director of the American Institute for Stuttering
If you are a parent of a child who stutters, watching your child struggle to speak can be heartbreaking. You may worry how their speech will affect their ability to make friends, participate in school, speak up for themselves, and the list goes on. You probably have so many questions. Is it really stuttering? Will they outgrow it? Should I address it at all?
If you look online, you will find many differing opinions about the best practices for treating childhood stuttering, and about stuttering in general. It can seem overwhelming to navigate. But, excellent guidance and support are available.
Basic information about stuttering
The cause of stuttering is multi-factorial, meaning that a combination of different factors results in stuttering. It is inheritable, and runs in families. Given a genetic predisposition to stuttering, it is then “triggered” by environmental factors and other aspects of the child’s genetics, temperament, and speech-language skills.
Treatment for stuttering differs greatly from therapy for other speech-language difficulties such as those involving articulation or language formulation. At the present time, there are fewer than 160 speech-language pathologists (also known as speech therapists) who have received Board certification as fluency specialists from ASHA (the American Speech-Language-Hearing Association). Most therapists who treat children who stutter are generalists, lacking the necessary experience and training to customize a treatment plan that meets the unique needs of the individual child and family. So it is critical for parents to act as active consumers when choosing a therapist, and to seek guidance from a therapist who specializes in treating children who stutter.
Many parents first ask advice from their family pediatrician about stuttering. Common advice is to “wait and see” or “not worry because they will grow out of it.” It is true that around 75-80% of children will stop stuttering on their own. But, we need to be particularly sensitive to those children who are more likely to continue to stutter and require professional treatment.
Our blogpost about what questions to ask when seeking help for your child who stutters may be useful before you reach out to a speech therapist. https://www.stutteringtreatment.org/blog/3-questions-to-ask-when-looking-for-a-speech-therapist-for-your-child-who-stutters
Is it really stuttering?
Children often have moments of disfluency as a normal part of their speech and language development. Many parents notice an increase in these disfluencies during periods of great language growth, such as that which occurs at around age 3 ½. These may take the form of repeating words (“Mommy can we, can we, can we go?”), repeating parts of words as (“Ma-ma-Mommy, can we go?), or interjecting fillers such as “Uh” or “um.” These would not indicate a stuttering problem. True stuttering occurs in around 8% of children. The disfluencies of these children are more likely to contain higher numbers of sound and syllable repetitions, prolongations of sounds (such as “rrrrrrrrabitt”), speech blocks where no sound is produced, and to show signs of visible struggle/tension while speaking. The child may show accompanying secondary movements such as closing their eyes or moving their hands.
Research tells us that about 75-80% of these children will not continue to stutter into adulthood. While we can not know which children will recover from stuttering without treatment, some factors do suggest a greater chance of persistence. These include gender (boys are 4 times more likely to continue to stutter), positive family history, sensitive/reactive temperament, increasing severity over time, and the presence of other speech/language challenges.
If you are worried about your child’s speech fluency, do seek guidance from a qualified professional. Even if therapy is not recommended, you will be given helpful suggestions about fostering healthy communication skills and have your questions answered. If therapy is recommended, research shows that the most effective therapists will not try to eliminate stuttering (which causes undue stress and tension for young children) but to teach children how to manage their stuttering. Best practices in stuttering therapy for children involve promoting healthy attitudes about speaking, working to ensure that children who stutter fully participate by speaking in school, with friends, etc. and helping them speak without physical tension, fear or avoidance.
Need for treatment and support
Left untreated, children who stutter are often prone to teasing and bullying and come to resort to detrimental avoidance strategies to suppress stuttering. For example, they may start to hit the table because it seems to help them push out their words. Over time, the “trick” stops helping and new crutches emerge. Physical struggles to speak typically increase over time as the child tries to break through blocks with force. They are also likely to begin avoiding words that give them trouble, speaking less in situations where they are worried they will stutter, and may seem to become “shy.” Stuttering can have an extremely negative impact on how children communicate with others.
What to do!
You may feel helpless as you watch your child struggle with stuttering but help is definitely available. Stuttering can feel isolating for both the child and parent. Support is essential for children to know they are NOT alone and that what they have to say is much more important than how fluently they say it. But support is sometimes even more important for parents! A qualified specialist will help you help your child, while navigating the ups and downs that are typical of childhood stuttering. You will be given tools to help your child even before therapy begins and be given an outlet to discuss your personal concerns.
What happens in therapy?
Once you have connected with a therapist you trust, you will gain insight into the often paradoxical nature of stuttering. For example, when individuals put pressure on themselves to be fluent, they often only stutter more, and many children speak more fluently in situations where it is “safe to stutter” such as while working with their speech therapist.
If your child is a pre-schooler, there are strategies you can use everyday that are shown to immediately reduce tension and stuttering. For example, rather than telling the child to “slow down” (which has very high demand), you might slow down your own speech rate, pause more deliberately, and listen without conveying time pressure. These strategies can help immensely. Other suggestions will include maintaining normal eye contact while the child is stuttering, and ensuring healthy conversational turn-taking in the family. It can be difficult to find the right language to talk about stuttering with your child; your therapist will help you establish a healthy dialogue about stuttering.
As children get older, one of the most important things families can do is strive to create a “stutter-friendly” communication environment. Active, patient listening takes practice. Of course you want your child to speak more fluently, but unfortunately many of the traditional physical “tools” that are still used to promote “smooth speech” tend to be short-lived and fail to work in situations when the child most wants to be fluent. Effective treatment focuses on goals including reducing physical struggle when stuttering, maximizing confidence and participation in all speaking environments, and developing effective communication skills. Along the way, we focus on accepting the child unconditionally, and this includes accepting stuttering.
An important part of effective treatment involves teaching the child how to be a confident self-advocate. Others will likely ask about stuttering, or unfortunately even mock it. We want to make sure the child has the knowledge and language to handle any situation that might come up.
Give yourself permission to NOT think you need to “fix” your child’s speech and allow yourself to listen with open ears and an open heart. Those who eventually consider themselves to have overcome stuttering are those who have come to stop worrying about it.
About the American Institute for Stuttering
AIS is a 501(c)(3) non-profit organization that offers speech therapy for children and adults who stutter and support and workshops for parents, guardians, family members, and caretakers. Thanks to generous grants from the New York Community Trust and the Mother Cabrini Health Foundation, we offer free or reduced-cost therapy to families who need financial aid. To date, we have helped over 10,000 people all over the country who stutter. We offer teletherapy throughout the country or in-person treatment in New York, Atlanta, and starting in June of 2022, Los Angeles. Please visit https://www.stutteringtreatment.org to learn more about our services.
About Heather Grossman
Dr. Heather Grossman has worked with people who stutter for over 30 years and was among the first select group of Speech-Language Pathologists to receive certification as a Specialist in Fluency Disorders from ASHA (American Speech-Language Hearing Association). Before receiving her PhD at the University of Louisiana in 2008, she supervised and taught graduate classes at Hofstra University in New York. She has also taught graduate classes in stuttering as well as topics including language development and psycholinguistics at several other institutions including Mercy College, Queens College, and Long Island University in Brooklyn, NY. Dr. Grossman’s research has focused on the phenomenon of voluntary stuttering, and she has more recently been investigating applications of Rational Emotive Behavioral Therapy to stuttering treatment. She has had numerous professional publications and is a frequent presenter at national and international stuttering conferences. She is also an active member of the stuttering self-help community and regularly volunteers her time to support FRIENDS: The National Organization of Young People who Stutter.
