A question that comes from my personal experience with my daughter. Today’s post is on Stuttering or stammering as famously said. In the recent months, I have received numerous calls from parents of young children, who are worried about their child’s speech.
I have to admit that being a speech language therapist, I wasn’t an expert in stuttering, especially for children as young as 2 years old. When my daughter went through a phase, I had to take on two roles of a mother and an SLT. And it wasn’t easy at all.
Today, when parents talk to me I can relate to them more so than ever. I’ve been there and wondered, Is it something we did? Did I speak too fast? Then it’s a downward spiral from there.
However, having the right information and being proactive can help you and your child. I am not going to go through numerous theories of stuttering. I want you to understand the basics of stuttering Vs Normal Non fluencies or disfluencies, so that you calm your nerves when an episode happens with your child.
What are typical/normal disfluencies?
Disfluencies are breaks or disruptions that occur during the flow of speech. It is common for young children to have disfluencies in their speech. Almost 5% of all children between the ages to 2 years – 7 years go through periods of disfluency and fluency. Types of disfluencies include:
- Whole phrase repetitions (where is…..where is my toy?)
- Single whole word repetitions (where….where is my toy?)
- Interjections (where is…..um..ah my toy?)
- Revisions (what…..where is my toy?)
- Hesitations (long pauses while thinking)
- Children are not usually aware of their disfluencies. Even if they stumble in their speech, they continue to speak.
Based on research, Fenson et-al. (2007) reported that average expressive (speaking) vocabulary at 18 months is about 110 words. Dale, Bates, Reznick and Morisset (1989) have shown that, by 20 months, it becomes 168 words. By 24 months, Fenson et.al. found the vocabulary size to be 312 words!
That’s more than double from 18 months. There is huge vocabulary burst happening during this time. Children are increasing their vocabulary repertoire and learning to make longer and complex sentences which requires good motor coordination or movements. It’s almost like your brain is wiring and firing so fast, that your mouth can’t catch up. So you see, its natural that these disfluencies may show up.
What is Stuttering and Stutter- like disfluencies?
Stuttering is a disorder that appears as an interruption in the smooth forward flow of speech. Current data suggests that 75% to 80% children who stutter at some point of time during their development recover. However, if disfluencies don’t get better with time i.e reduce with time, or persists for more than 6 months, then a consultation with speech language therapist is ideal.
Types of Stutter-Like disfluencies:
- Repetition of sounds (sh..sh..shoe)
- Repetition of syllables (ba..ba..ball)
- Prolongations or stretching of sounds (Wh…….re is the toy?)
- Blocks – a stop in speech accompanied by tension in the mouth. Sometimes, their mouth might stay open or close for a while.
As children grow older, they become more conscious and tend to avoid speaking situations. They start showing obvious signs of frustration.
The causes of stuttering are largely unknown. Despite that, it has shown a strong link to genetic predisposition. Having someone from either the maternal or paternal side with stuttering. Also, males are three to four times more affected.
What’s my story? What did I do?
Almost a year ago, I was getting ready to resume work after spending an entire two months with my daughter (Azah). Other simultaneous events happening in our lives were a change of nanny and Azah starting nursery. It was overwhelming for us as adults, so imagine her.
I am all about preparation. So, I did what I usually do. I’ve been prepping Azah about our nanny leaving. Taking Azah to nursery premises and interacting with her teachers. She was taking it all in and I could see that.
One day, she came up to me, she said “Mam…mam..maaaaa” then an abrupt stop. I noticed and just let it be. What followed in the upcoming days were a lot of repetitions, hesitations and my anxiety all over the place. Nothing prepares you for this.
I wanted to know, if I was being paranoid or not. Clearly, I was! My mom told me that, I stuttered for a few weeks, when I was Azah’s age. Still, my concerns were evident, when I spoke to Azah and she could sense it. Children are master energy detectors. I had to find a solution. Funny right? I knew what I had to do, but first I needed to curb my anxiety.
I called up my colleagues and spoke to them, for a second opinion, to make sure I am not overlooking the facts. Not being biased since it’s my daughter.
My husband said that, “Well, she is in the best place to be, if she ever develops stuttering. You can and will do everything to support and help her”. That’s exactly what I wanted to hear.
I checked mine and my husbands family history to see if there was a genetic component. There was none to be specific.
Following are the steps I followed and recommend to parents;
- Take a deep breath. Accept whatever is happening, by embracing the moment. Do not overthink about the future. What will happen to my child etc.
- Make a deliberate attempt to speak slowly in a relaxed state and advise family members also to do so.
- At the beginning, do not bring attention to your child’s speech nor try to correct him/her.
- Listen attentively and maintain eye contact when you speak to your child.
- The number one mistake we make, is when our child is struggling to speak, our facial expression changes. We make a face (anxious) and that’s a fact. With practice, maintain a calm and relaxed expression.
- Do not finish your child’s sentences. Give them time to finish their sentences.
- Schedule a reading/family time– We started by practicing small deep breaths with my daughter. Find a time during the day, when your child is happy and free of any distractions. Sit with your child and read a story in a slow and relaxed manner.
- Sing their favorite songs slowly. Azah loved to sing “twinkle twinkle star” nursery rhyme. We sang together slowly in an unhurried manner.
I became mindful of my interactions with my daughter. Her disfluencies persisted for 4 months. I could gradually see it reducing and as I become more relaxed, so did Azah.
In a few months, I helped two to three families in the same way. Nonetheless, some children had to come for therapy, because they had disfluencies for more than a year and they started having significant communication difficulties at school/home.
Early intervention is the best way forward for any speech and language difficulty. Therefore, I urge parents to observe your child, be mindful of situations that create anxiety, have peaceful and tranquil interactions and when in doubt, consult a speech language therapist.
Until next time…
- Language disorders by Dr Rhea Paul.