Stuttering - Children & Teens

Several studies have shown that stuttering does not typically occur when singing, talking or playing alone. In fact, stuttering is a combination of physical and physiological factors. It is not always easy to identify the reasons for not stuttering in certain situations. However, one most common reason behind this phenomenon is that when talking alone or playing, you are more relaxed, you don’t think about how people will judge you, and most importantly, you are not interacting with anybody. Stuttering is a fluency disorder that shows while having social interactions. 

On the other hand, when it comes to the singing debate, there are a few hypotheses. First, singing occurs in the right side of the brain, while language uses the left. So while singing, you’re no longer using your left brain. Second, in order to sing, you use your vocal cords and mouth differently. This could have a part in why people don't stutter when singing. Third, singing is a different form of communication than speaking. It is a one-way communication, and eliminates the possibility of some challenges such as being interrupted or involved in an unpredictable conversation. 

These explanations might or might not be the reason why we don't stutter in some situations as listed above. The reason could be the combination of the three, or it could even be something else. There is still a lot of research to be done in this field.  

If you notice that your child is beginning to stutter, it is important to seek professional help. You should get in contact with a speech and language pathologist (SLP) experienced in assessing and treating fluency disorders. The SLP will ask you a few questions over the phone to get an overview of your child’s condition. Accordingly, he/she will schedule an appointment to assess your child’s stuttering, and advise whether to treat your child straight away, or whether to wait and check your child regularly. 

Stuttering visible signs could differ from one child to another. It is common to see that your child is having difficulty in starting a word. Below are some other common early signs of stuttering:

Stuttering is exclusively diagnosed by a speech and language pathologist who is trained to assess speech fluency skills and stuttering-related behaviors. In other words, the clinician will make an in-depth analysis of a variety of speech samples produced by the child (e.g. spontaneous speech, narrative, retell) collected in the clinical setting as well as in the home environment in order to determine the severity of the overt manifestations, and document changes in speech fluency over time. In addition, the clinician will tap into the cognitive, affective and behavioral dimensions to detect if the disorder is negatively impacting the quality of life of the child.

At this point in time, there is no evidence to suggest that speaking two languages in the home since birth causes stuttering. The idea that being exposed to two languages causes difficulties in children has been a long-standing myth. However, many studies conducted in the last couple of years have dispelled this myth. In fact, childhood may be, for children who stutter,  the best time to input a second language. 

Research has shown that stuttering has biological causes such as a genetic predisposition to speech disfluency, so emotional or psychological problems are not the root causes of stuttering, hence it is not a mental health diagnosis. However, emotional factors often accompany stuttering. For instance, anxiety can make stuttering worse, and this could create a vicious feedback loop in which the child fears stuttering, triggering him to stutter even more.  

Stuttering affects people of all ages. It is observed most often in children between the ages of 2 and 6 years as they are developing their language skills. Approximately 5% of all children go through a period of stuttering that lasts six months or even more. However, 75% of them will recover by late childhood, leaving about 1% with a long-term persistent condition. 

There are no instant miracle cures for stuttering. Yet, many treatment approaches provided by speech language therapists have proven successful in helping children who stutter to reduce the frequency of disfluencies in their speech, and most importantly develop a positive attitude towards themselves as speakers. 

Therapy is however not an overnight process and its length can vary from a few sessions to a year's follow-up or even more sometimes, depending on the child’s specific case. 

A speech language therapist specialised in the field can help not only preschool children, but also school-aged children and adults make significant progress in their overall communication skills. 

Stuttering may make it difficult to communicate with others, which could affect your child’s quality of life and interpersonal relationships. 

In other words, your child may experience negative social interactions at some point in time, which might place him at risk of developing low self-esteem. 

Positive parental support combined with the skillset of an experienced speech language therapist can help your child to improve his self-confidence as a speaker, and learn how to assert himself in society.  

Stuttering is not a cognitive or language disorder, and typically it should not affect your child’s school performance or learning process. However, stuttering could negatively affect your child’s confidence and self-esteem. From an academic perspective, this could prevent him from asking questions in class to clarify misunderstood notions. It could also prevent him from answering questions, or simply participating in class. In the longer term, this could affect your child’s academic performance if no measures are taken to help him overcome his difficulties. 

Early intervention can reduce the chances that your child will keep stuttering, so it is highly recommended to get an SLT assessment and start the treatment as soon as you have doubts. 

Different speech language therapy treatment approaches are available to help your child. The key and common element in all the treatment approaches is to include you, your child, maybe some other frequently seen family members and your child’s teacher. 

Collaboration is necessary to build an appropriate treatment plan. 

The specific treatment will depend on how much your child stutters, how he is reacting to his stuttering, how stuttering is affecting his daily life, what type of reactions he is being exposed to in his environment, and his age. 

Typical treatment might involve the use of indirect strategies, which will include specific adjustments/ changes to be done to your child’s environment to make it easier for him to communicate. The treatment can also include direct strategies aiming to help your child improve how he feels about talking and learning to become more confident in his speaking skills no matter how much stuttering he may still have.   

You are an important part of your child’s treatment and can have an incredibly positive impact on your child’s therapy process. Working together with a speech language therapist who is knowledgeable about stuttering will help your child learn to talk effectively, and most importantly, with confidence. 

Your active involvement in your child’s therapy session is highly recommended and needed. The involvement could be through your presence during therapy sessions or the constant follow up with your child’s therapist to learn tips on how to best support him/her outside of the sessions. 

In general, it is important to provide your child with a calm environment when communicating with him, by reducing time pressure and other stressors. It is recommended to set time aside to talk to your child, praise him whenever convenient and encourage him to talk. In addition, speaking slowly yourself with some frequent pauses will give him time to say what he wants when needed. 

When your child is talking, it is essential to refrain from comments such as “take it easy”, “relax”, “think”, “repeat it”, “slow down”, “breath well”. Instead, maintain eye contact with him and try to control your emotions and your general attitude (e.g. do not show embarrassment). Moreover, do not interrupt him, rather wait patiently until he is finished talking.