Stuttering is a highly variable communication disorder that affects many young children. Many children exhibit early signs of stuttering or disfluencies during their preschool years. While it is not uncommon for children to ‘outgrow’ their stutter, it is impossible to determine whether stuttering is going to resolve itself or become a life-long ongoing problem.  As a result, early assessment, diagnosis, and management are essential to work towards ensuing the best possible long-term communication outcomes.

There are multiple theories and popular beliefs surrounding the cause of stuttering. Research findings suggest stuttering appears to have a genetic basis, however, the main cause of stuttering continues to remain a mystery.

Stuttering is a disorder in the rhythm, coordination & timing of speech such that the person knows exactly what they want to say, but at the time is unable to move forward in their speech due to involuntary repetition, prolongation, or blocking of sounds and words.

Stuttering behaviours 

Repetitions

  • Individual sounds – E.g. I-I-I-like
  • Part words – E.g. Li-li-like
  • Whole words – E.g. Like-Like

Prolongations

  • Stretching out of a sound/syllable –
    E.g. snow > “ssssss-now”

Blocking

  • When the individual attempts to speak but no sound comes out
  • A forced and audible release of air will often be observed, however there are times when blocking can be silent
  • Blocking is often associated with signs of struggle and muscle tension

Emotional reactions that may accompany stuttering

Individuals who stutter may experience social anxiety caused by the fear of an inability to speak. This may result in a physically ill feeling, such as butterflies in the stomach and sweaty palms. 

Avoidance of certain situations associated with the pressure to speak may also accompany stuttering. Examples of this include a fear of speaking on the phone, or ordering in a restaurant. 

Stuttering can also have an impact upon a child’s ability to communicate in a variety of key settings, including the classroom or other social settings involving communication. This can result in reduced self-esteem as well as self-confidence. 

Risk factors

The following are some factors that increase the risks of stuttering becoming a persistent disorder as opposed to a ‘phase’ the child may grow out of: 

  1. Family history
Individuals with a known family history of stuttering are typically at an increased risk of persistent stuttering
  1. Gender
There is a higher prevalence of stuttering in boys in comparison to girls
  1. Age at onset
There is an increased risk of persistent stuttering with a later onset age (i.e. beyond 3.5 years of age)
  1. Stuttering frequency and severity
There is an increased risk of persistent stuttering if stuttering frequency and severity do not decrease after approximately 12 months.
  1. Duration since onset
The longer a child stutters beyond one year post onset, the higher the risk of persistent stuttering.
  1. Duration of stuttering moments
Children with a longer duration of stuttering moments (e.g. more than 3 unit repetitions – ‘li-li-li-like’) tend to be at an increased risk of persistent stuttering
  1. Ongoing prolongations and blocks
Children are more likely to persist with stuttering if there is no reduction in prolongations and blocks

The nature of stuttering is highly variable and individualised, and stuttering behaviours can range from mild to severe. Hence different children will have different needs from their parents, teachers, therapists, as well as other communication partners.

The following are some recommendations that may assist with responding to and interacting with children who stutter:

  • Minimising interruptions of your child’s speech and giving them time to finish their sentence. This reduces any time pressure and demands upon them to complete their sentence and may also help minimise any negative impacts on their feelings and attitudes towards their stuttering.
  • Encourage good turn-taking within the home environment. Try setting the conversational pace by modelling a slower, relaxed speaking style to which your child will likely follow naturally.
  • Exhibit a positive and accepting attitude regarding different communication styles and abilities. Being mindful of your subconscious reactions towards your child’s stuttering moments (e.g. facial expressions, body language) can prevent negative perceptions towards their fluency difficulties.
  • Avoid completing your child’s sentences or attempting to talk for him or her. Instead, convey that your child has your attention and that you are listening to the content of their message, not how it is said.
  • Setting 10-15 minutes aside each day to spend some one-on-one time with your child. Ensure that the interaction is child-directed. The primary focus of this activity is listening to what your child has to say by providing him or her with your undivided attention.
  • Ensure questions are balanced with praise and positive comments. Reducing demanding questions, criticisms and corrections, and making more positive and accepting comments can assist with building confidence, and reducing distress in social situations.  This also facilitates the establishment and maintenance of social and interpersonal relationships.
  • While it is not recommended to frequently comment on your child’s stuttering, maintaining an open, positive and supportive dialogue with regards to stuttering can facilitate understanding of the fact that stuttering is nothing to be ashamed of, and can instead be perceived like any other difficulties individuals may have when attempting to master a more complex skill, such as riding a bicycle.

These recommendations can assist with building a solid foundation for good decision-making regarding your child’s communication skills, thus maximising opportunities for enhancing his or her overall fluency and communication abilities.