Speech-language pathologists frequently work with people who stutter, but one of the most common questions parents ask is how to know if their child needs stuttering therapy. It may surprise parents to know that stuttering treatment is not always recommended even if your child is exhibiting some disfluencies. Before treatment has begun, it is important to analyze if the child may be presenting with developmental stuttering, typical disfluencies, or if it is likely to be persistent stuttering (stuttering that lasts into later childhood or adulthood).
What is developmental stuttering?
Developmental stuttering is stuttering that begins between the ages of 2-5 and lasts anywhere between a few days or weeks to 6-12 months before spontaneously recovering. Between the ages of 2-5, children are developing speech and language skills at a rapid rate, often referred to as a “language explosion,” which drastically increases the complexity of the demands placed on their brain and speech mechanism. This increase in complexity in speech and language is thought to be a factor in why some children begin stuttering at this age. Current research suggests around 80% of children who stutter at this age will recover and no longer exhibit stuttering-like disfluencies past preschool.
What are typical disfluencies?
It is also important to differentiate between typical disfluencies and stuttering-like disfluencies. Typical disfluencies include repeating whole phrases and sentences, interjections (uh, um, etc.), revisions. These disfluencies typically occur with little to no reaction or frustration, no physical behaviors such as tension or body movements along with the disfluencies, and are not typically cause for stuttering therapy. On the other hand, stuttering-like disfluencies are typically repetitions of sounds or single words, blocks (being unable to produce the words you want to – it feels like they are “stuck”) or prolongations (holding out sounds unintentionally), and may come with tension, facial grimaces, unconscious body or head movements, or reduced eye contact). If you believe your child is exhibiting developmental stuttering, you can monitor their speech for any changes and begin to implement some simple strategies to create a fluency-enhancing environment at home or school.
- Reduce your own rate of speech: This is actually more effective than asking your child to slow down as children will unconsciously match your pace without feeling self-conscious
- Reduce the number of questions you ask: try rephrasing to a statement and then pausing to see if the child will spontaneously answer (“Let’s see what we should eat for lunch today” instead of “what do you want for lunch?” or “That was such a fun party. I liked the balloons best” instead of “did you have fun at the party? What did you like best?”
- Minimize interruptions and allow the child to finish what they are saying: Help everyone in the family to take turns during conversation – it may be helpful to have designated times to practice this such as allowing everyone to have a turn to share during dinnertime.
So when do speech language pathologists recommend seeking an evaluation for stuttering?
Some guidelines to follow include:
- Your child’s stuttering has lasted for 6–12 months or more.
- Your child starts to stutter late (after 4 years old).
- Your child starts to stutter more often.
- Your child tenses up or struggles when talking.
- Your child avoids talking or says it is too hard to talk.
- There is a family history of stuttering.
- There are also concerns of speech/language development (limited vocabulary, delayed acquisition of grammar skills, speech sound errors that are not developmentally appropriate, etc.)
At the end of the day, parents know their child best and if you observe anything that is concerning to you, don’t hesitate to schedule an evaluation or discuss any concerns with your SLP!
References:
American Speech-Language-Hearing Association. (n.d.). Fluency disorders. American Speech-Language-Hearing Association.
https://www.asha.org/practice-portal/clinical-topics/fluency-disorders/
U.S. Department of Health and Human Services. (2017, March 6). Stuttering. National Institute of Deafness and Other Communication Disorders.
https://www.nidcd.nih.gov/health/stuttering