Stuttering

Stuttering is a speech disorder characterised by problems with fluency and the flow of speech. Children who stutter tend to repeat or prolong words, syllables and consonant or vowel sounds. They may struggle to get words out and experience interruptions in speech (known as blocks). Children who stutter often know what they want to say, but cannot execute a normal flow of speech.

Consequently, stuttering may stir up feelings of anxiety whenever a child wishes to speak. This can adversely affect their interpersonal relationships and quality of life.

Stuttering usually starts between 2 and 6 years of age. Many children go through normal periods of disfluency lasting less than 6 months. Stuttering lasting longer than this may need treatment.

Typical disfluencies happen to many of us as well, and this doesn’t characterise stuttering.

This may encompass:

• Adding a sound or word, also known as an interjection. E.g, “I um need to go home."
• The repetition of whole words in a sentence . E.g “Well well, where shall we go today?"
• Repeating phrases. E.g. "He is–he is coming soon."
• Revising words in a sentence. E.g. "I had – I lost my bottle."
• Not finishing a thought. E.g. "His name is . . . I can't remember."

In general, signs and symptoms of stuttering are:

• Difficulty starting a word, phrase or sentence
• Prolonging of a word or sounds within a word
• Repetition of a sound, syllable or word
• Blocks or stops. This may be brief silences for certain syllables or words, or pauses within a word (broken word)
• Addition of extra words such as "um" if difficulty moving to the next word is anticipated
• Anxiety about talking
• Limited ability to effectively communicate

Stuttering may also be accompanied by physical symptoms, like lip and jaw tremors, rapid eye blinks, head jerks, the clenching of fists, facial tics and tightness of the face.

Stuttering-related symptoms do vary in severity, dependent on a child’s environment and mood. For example, symptoms may exacerbate when a child is tired, excited or experiencing stress. Speaking in front of a group or talking on the phone may be particularly stressful, triggering their stuttering.

In contrast, they can usually speak fluently when talking to themselves, or singing and speaking in unison with others. Some children may even have days or weeks where they maintain fluent speech.

If you suspect your child is struggling with stuttering, get help as early as possible, especially if:

• Their stuttering has lasted for 6 to 12 months or more
• They begin to stutter late (after the age of 3.5)
• They start to stutter more than usual
• They tense up or struggle when talking

• They avoid talking in general 
• There is a family history of stuttering

Our speech therapist will assess:

• The types of disfluencies (typical and stutter-like)
• The number of disfluencies that are the stuttering type
• How your child reacts when they stutter. For example, whether they get upset, anxious
• How your child tries to "fix" their speech – do they start over or stop talking?

Our speech therapist will also find out if the stuttering affects other areas of functioning of your child’s life. For example, the way they play with others, how they perform in the school’s oral tests and their social and communication skills.

Sometimes, standardised language tests may be administered to gain a more comprehensive view of your child’s difficulties. Then, our speech therapist will devise an intervention plan and work with your child and yourself to overcome their stuttering.

Speech therapy typically focuses on controlling speech patterns by encouraging your child to monitor their rate of speech, breath support and laryngeal tension. They would also be encouraged to gradually progress from single-syllable responses to longer words and more complex sentences. Therapy may address the anxiety that comes up in various speaking situations as well.

Once your child is assessed and diagnosed, speech therapy can help them make positive changes in their speech and communication skills, boosting their self-esteem and confidence. 

Much evidence shows that early intervention is more effective than waiting it out. If treated young, children who stutter have a higher recovery rate, significantly less disfluent speech  The earlier that stuttering is identified and treated, the less likely a child will acquire negative emotional reactions to stuttering and experience the ensuing adverse effects. 

Whilst many young children who stutter do eventually recover, many still continue into their schooling years. As such, parents should seek to have their child assessed as early as possible, rather than waiting to see if they outgrow the condition.