CHILDREN WHO STAMMER

Many children are just going through a stage of development when they stammer. Stammering is a form of disfluency - an interruption in the flow of speech. Children between the ages of 2 and 5 commonly repeat whole words and phrases and may interject fillers such as "uh" and "um" into their speech. This is called "normal disfluency."

When you consider that children of this age are still learning how to speak, developing coordination of the muscles used for talking, learning new words, putting words together into sentences, and discovering how to ask questions and influence outcomes with their words, it's easy to see why they acquire disfluencies.

What causes stammering?

Stammering can be worrisome to parents who fear that somehow "bad" parenting is the root of the problem. Parental behavior does not cause stammering. In reality, the causes of stammering are not precisely known - it is a very complicated and involved condition.

About three times as many boys as girls stammer. However, more is known about the environmental factors. Stress, for example, can affect stammering.

Early signs

The first signs of stammering may appear after the second birthday or when a child is beginning to put words together to form sentences. To parents this may be upsetting, but it is a normal stage in speech development. Showing patience with your child and adopting a cautious, accepting, and informed attitude are best during the preschool years. A child may be disfluent for a few weeks or several months, with symptoms disappearing and perhaps appearing again. Most children who begin stammering before the age of 5 will lose the disfluency.

The school years

When children enter elementary school, they sharpen their communication skills. Usually, disfluency drops to very low levels. If stammering continues in the school-age child, he is old enough to be aware of the problem and may be embarrassed by it. Classmates and friends may draw attention to it. Even children with chronic, severe stammering can be helped with learning strategies that can enhance communication.

When to seek help

Your child may benefit from professional intervention, especially if:

• you are concerned or anxious about his speech
• repetitions of whole words and phrases become excessive
• sound and syllable repetitions begin to happen more frequently
• your child appears to be struggling with speech
• the disfluencies start to be effortful or strained
• you notice increased facial tension or tightness in the speech muscles
• you notice vocal tension resulting in rising pitch or loudness
• your child chooses to avoid situations where he would have to talk

If your child's speech is characterized by some of these warning signs, you should consult a speech and language pathologist at your child's school or at a hospital. Most schools will offer testing and appropriate therapy if you have been concerned about the disfluency for 6 months or more.

What parents can do

There are several steps you can take to provide a nurturing environment for your child:

• Don't require him to speak precisely or correctly at all times. Allow talking to be fun and enjoyable.
• Use family mealtime as a conversation time. Avoid distractions such as radio or television.
• Avoid corrections or criticisms such as "slow down," "take your time," or "take a deep breath." These comments, however well-intentioned, will only make your child think he is doing something wrong.
• Avoid having him speak or read aloud when he doesn't feel comfortable or when the disfluencies increase.
• Don't tell your child to start over.
• Don't tell your child to think before he talks.
• Provide a calm atmosphere in the home. Try to slow down the pace of family life.
• Speak slowly and clearly when talking to your child or others in his presence.
• Maintain natural eye contact with your child. Try not to look away or show signs of being upset.
• Let him speak for himself, and allow him to finish his thoughts and sentences. Pause before responding to your child's questions or comments.
• Encourage activities that do not require a lot of talking when your child is more disfluent.
• Talk slowly to your child. This takes practice! Modeling a slow rate of speech will help with his fluency.