Stuttering overview

Causes, Signs and Symptoms, Diagnosis, Treatment and Prognosis of Stuttering Disorder

Stuttering is a fluency disorder which is sometimes referred to as stammering or disfluent speech. In short, stuttering is any interruption in the flow of speech. It’s quite common for children between ages 2 and 5. In fact, about 5% of children will develop stuttering during their childhood. It’s part of the process of learning how to speak. For most children, these issues get better on their own, however for some kids, less than 1%, stuttering will continue and perhaps get worse after age five. It is twice as common in boys than girls and 3 to 4 times more likely to persist into adulthood for boys. Stuttering should be treated because it can affect a child’s academics and social interactions. It often causes emotional problems such as anxiety, fear or avoidance which can limit the potential of a child.

Causes of Stuttering

Researchers are still studying the causes of stuttering, but here are some potential causes.

  • Developmental Stuttering happens when a child stutters because their language and speech skills cannot keep pace with what they want to say. Most kids grow out of this before age 5.
  • Brain injuries. Brain trauma or defects can cause stuttering. This is called neurogenic stuttering.
  • There is some research that suggests that genetic abnormalities in the speech and language part of the brain can be a cause and can be inherited.
  • Emotional trauma can cause psychogenic stuttering

Signs and Symptoms of Stuttering

Here is what you need to listen for if you suspect that your child has an issue with stuttering.

  • Stuttering may start with repetition of consonants often /k, g/ and /t/.
  • Difficulty with starting to say a word or phrase.
  • Sound, syllable or word repetition.
  • Sound prolongations
  • Interjecting extra sounds or words like “um”
  • Circumlocutions – talking around a word – replacing a word that is problematic with an easier word to produce.
  • Rapid eye blinking, jerking of head or foot stomping can accompany stuttering.
  • Tremors of lips or jaw.
  • Frustrations with speech

All of these symptoms can intensify under the following conditions; excitement, fatigue, stress or when a person feels self-conscious or hurried. Interestingly, some people who stutter, do not stutter when they read aloud, talk in unison or sing. Researchers do not know why yet.

Stuttering Diagnosis

The child needs to be evaluated by a speech language pathologist and the parent needs to be interviewed to get a complete history of the situation.  During the evaluation the speech language pathologist will obtain a language sample and observe the child speaking. When evaluating a child, the SLP is looking at frequency of dysfluencies, the types of dysfluencies exhibited  (whole word vs. part word, multiple part-word repetitions, prolongations and/or blocks), other secondary characteristics (avoidance, pitch changes, tension, use of starters) as well as feelings and attitudes toward their speech. When you visit the speech language pathologist be prepared to answer the following questions:

  • When did the stuttering start?
  • Is there a family history of stuttering?
  • Under what conditions does the stuttering get worse?

Is there any involuntary movement of eyes, feet or head accompanying the stuttering?

Stuttering Treatment

There is currently no cure for stuttering, but there are treatments available to reduce the disfluency. The treatment selected will differ based on the age of the child and other factors. For very young children, early treatment may prevent developmental stuttering from persisting into adulthood. It is a best practice to teach the parents methods to support fluency because a relaxed home environment that affords the child many opportunities to speak without negative reactions is so important. The therapist works with the parents to identify factors that may be contributing to the stuttering such as a child’s personality (perfectionist, sensitive, intense, other speech/language issues), interpersonal issues (conflicts in the home, overscheduled), communication influences (negative responses to speaking attempts, high expectations (asking many questions), competition from other siblings, rapid rate of conversation.  Once the stressors have been identified then the therapist and family collaborate to reduce these possible-aggravating factors. Older children can benefit from learning fluency shaping and modification techniques such as reducing the speaking rate, inserting natural pauses, using a gentle onset of voicing and light contact of the articulators.

Stuttering Prognosis

Most children who stutter return to normal speech within 2 to 4 years. Stuttering that begins after a child is 5 years old is more likely to persist into adulthood, but good treatment can limit the issue.

I wanted to write and express my appreciation and satisfaction with the speech services that Kidmunicate, specifically Eileen Scott MS CCC-SLP, has provided to Luke over the last eight months.

As you may recall, when I first came to you in May, I was grasping at straws. Luke had been to a number of speech therapists, both private and through school, without much success. As of May 2014, Luke had been struggling with fluency for over 3 years. I was beyond frustrated and felt like I was failing at finding him the help that he needed despite my best efforts.

Early on, I worked closely with our school, private speech therapists, and even psychologists. It was evident to me that his issue, stuttering, needed to be addressed by someone who had much more expertise in this field. His disfluency was also affecting his confidence in school and it pained me to see this.  I then turned to CHOP for an evaluation and I was so excited that we finally got a resource that could help however there was one big challenge…they only had the expertise in their Philadelphia office, which was going to be extremely hard to get to on a weekly basis.

Soon after, a friend recommended Kidmunicate. After calling and talking to Pam and Deb, I could immediately tell that Kidmunicate was different. They asked me tons of questions to understand Luke’s challenges and based on his situation, they paired us with one of their experts in fluency, Eileen.

When I brought Luke for his first visit with Eileen, he was very nervous and didn’t have much confidence that she could help. After the first visit, I met with Eileen and knew that she had a solid plan in place to improve Luke’s speech. She was able to clearly outline the areas that she wanted to focus on and she had specific goals that she wanted to reach each week. We saw progress almost immediately. She introduced new tools and strategies that I had never heard of from any other therapists, and it was crystal clear that she had a much deeper level of expertise than anyone I’d seen before.

Within a few months, my husband and I saw a drastic improvement. Luke started to gain more confidence in the classroom and with his friends. At this point, we’ve been able to cut back therapy to every other week because Luke understands has the tools and strategies to use when he has difficulty speaking moments.

I can’t say enough positive things. Kidmunicate has been wonderful to us! (Maureen P – Mom)

Helpful Resources

Link 1: The Stuttering (and cluttering) Foundation
Link 2: The difference between cluttering and stuttering cartoon.

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