MY CHILD STUTTERS

It is normal for children 1-1/2 to 7 years old to ccasionally repeat words, sounds and phrases, to hesitate or to use filler words. Such disturbances in the flow of speech, or disfluencies, often come and go for a few months and decrease in frequency over time. Children with normal disfluencies seem unaware of them and do not become frustrated when they occur.

Parents must be tolerant of a small amount of disfluency and learn to accept that it's OK, say fluency specialists. No one is fluent 100 percent of the time, especially small children when they are excited.

However, about 1 percent of children ages 2-1/2 and older show more prolonged and frequent repetition of sounds, syllables and words. In these rare instances, parents should talk with their child's pediatrician and consider referral to a speech and language pathologist.

The causes of stuttering are not clear, despite decades of research. According to researchers, stuttering does not result from an emotional trauma, anxiety or abnormal child-rearing practices. Nor is it related to intelligence. What researchers do know is that stuttering tends to run in families and that it occurs more often in boys than girls. In fact, about three to four times as many boys as girls stutter.

Assessing a Child's Speech
To distinguish between normal disfluency and stuttering, observe your child's speech patterns over time. If the following speech characteristics last for more than three months and become more frequent, they may indicate a potential stuttering disorder:

• Hesitation between syllables and words;
  
• Repetition of parts of words, either sounds or syllables, at least three times (c-c-c-can or ca-ca-ca-can);
  
• Prolongation of sounds (mmmmmommy);
  
• Blockage of sounds (the child can't get his voice going, or silent pauses occur before voice is initiated or between sounds);
• Accompanying physical tension and struggling while speaking, such as blinking, closing or shifting the eyes to one side, tensing of mouth; and
• Excessive or pronounced breathing or other indications of anxiety while speaking.

Seeking Help
If you think that your child might have a stuttering problem, there are many resources for successful treatment.

Start by contacting your pediatrician or a speech-language pathologist who specializes in fluency. Some pediatricians take a 'wait-and-see' approach, but if you have serious concerns about your child's speech, persist in asking for a referral.

When a professional assesses a child's speech problems, he or she also assesses developmental language skills, which include vocabulary knowledge, sentence formation, grammar, syntax, etc. A child who has difficulties in language development may appear to stutter as he tries to formulate and verbally organize his thoughts. See keyword Child Development: Developmental Benchmarks for information on normal speech and language development.

Should your child be diagnosed with a stuttering disorder, his fluency specialist will work out a therapy program that involves both you and your child. Therapy is individualized for each case, but often occurs in biweekly sessions running from a few months to a year.

Family Support
In addition to therapy, parents, family members and friends can help a child who stutters by providing a calmer and less frantic lifestyle at home, speaking less hurriedly and pausing for a second or so before responding to the child's questions or comments. Make opportunities for your child to experience 'little successes' in non-speech activities.

Children who stutter have their own 'wish list' of how they would like other children and adults to interact with them. Here's what they'd most like to tell listeners:

• Let me take my time when I speak; don't rush me.'
• 'Don't fill in my words; I know what I want to say.'
• 'Look me in the eye when I'm speaking; don't look away when I stutter.'
• 'Don't tell me to slow down when I begin stuttering.'

This last 'wish' is the result of a common myth about stuttering. When a child begins to stutter, a common reaction is for people to tell him to slow down. This advice is not going to help the child stop stuttering or result in any improvement.

Other tendencies that can hinder a child who stutters include interrupting the child while he is talking, and encouraging (or requiring) him to talk rapidly, precisely and maturely at all times. Avoid frequent correcting, criticizing or trying to change the way he talks or pronounces sounds or words. Making him give little speeches or read aloud to visiting friends, relatives or neighbors can exacerbate disfluency. Above all, do not make concessions or excuse inappropriate behavior because your child stutters.

Even if your child doesn't stutter, chances are that he already knows a classmate, friend or relative who does. It's important to teach your child to be compassionate and to listen to what the person who stutters has to say, not how he is saying it. Emphasize that, although a person's stuttering may be obvious, it's not the most important characteristic about him. Stuttering is something some people do, but it is certainly not who they are.