Sophia Elbaz MS., CCC-SLP, TSSLD
Stuttering is a disorder of the communication process, affecting 5-10% of preschool children and 1% of school age children. It is characterized by dysfluencies in speech including repetitions and prolongations on whole words or certain sounds or syllables of words. For example, a child might say “What are you d-d-d-d-doing?” This is a part word repetition because the first sound of the word” doing” was repeated. A prolongation is when one gets stuck on a sound or syllable, such as “Llllllet go of me.” In addition, there may be silent pauses while conveying language called “stops”. This can happen in between words or in the middle of a word. For example, “I don’t (pause) want to go to school today.”, or “That was ex (pause) cellent.” Fillers in speech such as “um”, “like” and “you know” are also dysfluencies that may occur excessively in a child’s speech. Some or all of these dysfluencies occur periodically in most children, however when dysfluencies are more frequent and are accompanied by secondary characteristics such as, facial or neck tension, loss of eye contact or hand or head movements, a stuttering assessment by a speech language pathologist may be warranted.
Stuttering in preschool children aged 2-5 is a common developmental stage that can resolve on its own. Many times, it occurs when a child is experiencing a language spurt and the language demands are not in sync with the motor aspect of speech. However, when a child of this age is stuttering for longer than six months, has secondary characteristics accompanying the stuttering, avoidance of speech and/or a family history of stuttering, stuttering intervention is recommended by a speech language pathologist to prevent longer lasting stuttering patterns. At this age, parental involvement in the therapeutic process is a necessary component in efficiently managing the stuttering.
Stuttering intervention in school age children focuses on stuttering modification which promotes awareness and acceptance of the stuttering. Fluency techniques are provided as needed to help shape and produce a more fluent speech pattern. At this age, motivation is a crucial factor in the success of treatment.
There are multifactorial features and various theories as to the cause of stuttering. Some theories focus on neurological factors such as dysfunction of the cortical and subcortical areas of the motor control system. Abnormalities of inter-hemispheric relations and the neural mechanisms of speech-motor control may contribute to the speech dysfunction. Complex linguistic demands also may affect the preschool and school aged child. If a child is having difficulty processing language, the language produced may result in distorted speech containing dysfluencies. Genetics also play a role, as studies show people who stutter are three times more likely to have a first-degree relative who stutters. Environmental and psychological factors are also possible contributors; however, it should be noted that although anxiety can exacerbate stuttering, that in itself is not a root cause.
From preschool aged children and beyond, education for the parents of children who stutter is very important to foster healthy self-esteem in these individuals as they grow and learn how to navigate the world around them. The ultimate goal one could aspire to in therapy is for the child to realize that stuttering does not define the person, the person does.
Sophia Elbaz, MS., CCC-SLP, TSSLD is a speech language pathologist working privately with children specializing in stuttering intervention. She is Lidcombe Program trained and has experience working with families of children who stutter. She also provides therapy to increase language and articulation skills.
