Stuttering
What is stuttering?Stuttering, sometimes referred to as stammering or diffluent
speech, is a speech disorder. This is different than normal repetition of
words that children may do when learning to speak. Normal developmental
stuttering may occur when the child is between the ages of 18 months and 5
years. This may include repeating words or phrases, poor pronunciation of
words, leaving out words or sounds, and speaking some words that are hard
to recognize.
True stuttering may occur in a child that has some normal developmental
speech problems who is then pressured to speak better. This child then
becomes aware of his/her speech and struggles to speak better, which
actually makes the speech worse.
While every child is different and will learn to speak at different
times, the following are some of the speech styles that are part of true
stuttering:
- repeating words, sounds, or syllables
- talking slowly or with a lot of pauses
- the rate of speech is not even
- an increase in the stuttering when the child is tired, excited, or
under stress
- a child that is afraid to talk
Normal developmental stuttering and speech difficulties happen in about
90 percent of children. True stuttering happens in only about 1 percent of
children. True stuttering occurs more often in boys than in girls.
Normal developmental speech problems usually improve over about two to
three months. Some mispronunciation of words may be present with a child
over several years. True stuttering often worsens in adulthood if it is
not properly treated.
What causes stuttering?The exact mechanical causes of stuttering are not completely
understood, but it is thought to be a hereditary condition.
What are the different types of stuttering?There are several types of stuttering, including the following:
- developmental stuttering
This is the most common type of stuttering which occurs in children. As
their speech and language processes are developing, they may not be able
to meet verbal demands.
- neurogenic stuttering
Neurogenic stuttering is also a common disorder that occurs from signal
problems between the brain and nerves and muscles.
- psychogenic stuttering
Psychogenic stuttering is believed to originate in the area
of the brain that directs thought and reasoning. This type of stuttering
may occur in people with a mental illness, or those who have experienced
excessive mental stress or anguish. Although stuttering may cause
emotional problems, it is not believed to be the result of emotional
problems.
How is stuttering diagnosed?In addition to a complete medical history and physical
examination, diagnosis of stuttering may also include:
- detailed history of the development of the disorder
- evaluation of speech and language abilities by a speech-language
pathologist
Managing normal developmental speech problems:It is important to remember that every child develops speech at
different times. If your child is having speech problems, have your
child's physician involved in the evaluation of the child. The following
are some suggestions to help with normal speech difficulties your child
might have, and help to prevent the child from developing true stuttering
difficulties:
- Encourage your child to talk to you about fun and easy topics in a
non-stressful place.
- Try to make talking fun or make it a game.
- Do not interrupt your child while he/she is speaking, even if the
child is making mistakes or having trouble.
- Do not ask your child to repeat something you do not understand.
Attempt to guess what the child is saying and continue on with the
conversation.
- Do not have your child practice certain sounds or words. This will
make the child uncomfortable about his/her speech.
- Do not try to slow your child's speaking. Try to talk with your
child in a calm, quiet place and be a model of speaking slowly. Asking
your child to slow down will only frustrate your child.
- Ask other adults not to correct your child's speech and do not talk
about your child's speech problems in front of him/her.
- Listen attentively to your child.
- Wait for the child to say the words without saying them for him/her.
- Talk openly about the stuttering if the child brings up the subject.
- Avoid asking the child to speak for others.
Treatment for stuttering:Specific treatment for stuttering will be determined by your
child's physician based on:
- your child's age, overall health, and medical history
- extent of the condition
- your child's tolerance for specific medications, procedures, or
therapies
- expectations for the course of the condition
- your opinion or preference
The goal of treatment is to focus on relearning how to speak, or to
unlearn incorrect ways of speaking. Although there is no cure for
stuttering, early intervention may keep stuttering from becoming a
life-long problem. Speech and language evaluation is suggested for
children who exhibit stuttering or struggle with speech for more than six
months. Medications and electronic devices to treat stuttering are
sometimes used.
When do speech difficulties become a concern? Your child's physician will make this determination with you
and your child. The following are some of the warning signs that child
might have true stuttering or other speech problems and not just normal
developmental difficulties:
- your child stutters after the age of 5
- your child is fearful of talking or does not talk
- there is a family history of stuttering
- your child is not saying words by 18 months
- other people cannot understand any words that your child is saying
and your child is over 2 years old
- if your child is older than 3 years old and about half of what the
child says is not understood by others
- repetition of words or phrases continues after six months and after
trying the above recommendations
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