Blog

All About Stuttering

07 Nov

Do you have questions about stuttering? You are not alone! In this article, we will answer the following questions: 

  1. Is my child’s stuttering normal or could they benefit from speech therapy? 
  2. What causes stuttering? 
  3. What does speech therapy for stuttering look like? 
  4. What are some helpful responses to my child’s stuttering? 

        People who stutter have interruptions to their flow of speech or disfluencies occurring at a higher rate than people who do not stutter. The flow of our speech is characterized by (1) Continuity, the smoothness of speech; (2) Rate, how fast or slow speech is produced; (3) Rhythm, how the rhythmic patterns of speech are presented depending on intonation, stress pattern, and duration of sounds; and, (4) Effort, the mental and physical effort of speaking.  

        Developmental stuttering is typical in young children between 2-5 years old. These disfluencies impact continuity and do not change in rate, rhythm, and are not produced with effort. Some examples include adding ’um’, ‘like’ or ‘well’, revising a phrase to say it a different way, easy repetitions of a sound, word, or phrase observed without tension or effort. These disfluencies tend to come and go overtime as a child continues to develop.  

        In contrast, stuttering or fluency disorders impact continuity and involve differences in rate, rhythm, and effort, such as rushed or tense speech. If you are unsure whether your child is experiencing developmental stuttering or has characteristics of a stuttering disorder, a speech-language pathologist (SLP) can consult and assess your child’s speech to determine the best next steps. 

        What causes stuttering? 

        The cause of stuttering remains unclear. However, The Canadian Stuttering Association and the Stuttering Foundation of America share factors that contribute to stuttering. 

        • Genetic factors (i.e., having a family member who stutters; this influence is not impacted by severity. For example, if a parent stutters severely, it does not mean a child has a higher risk to develop stuttering). 
        • Child development (i.e., having a developmental delay or speech and language difficulties). 
        • Family dynamics and environment (i.e., high expectations and fast lifestyles) are not proven to cause stuttering, though they may contribute to increased stuttering. 
        • Acquired stuttering can occur after brain injury or trauma. 
        • Neurophysiology (i.e., people who stutter process speech and language differently than people who do not stutter). 
        • Research is investigating the influence of personality, temperament, behaviour, and other personal characteristics on stuttering. 

        Stuttering disorders 

        An SLP can support your child by assessing and providing strategies to support the three main components to stuttering disorders.  

        • Core behaviours are disfluencies which cannot be controlled, including: 
        • Repetitions: repeating a sound, syllable, or word (e.g., I-I-I-I want to go, the b-b-ball is red) 
        • Prolongations: holding a sound for an extended time (e.g., I waaaaaant to go) 
        • Blocks: when sound or aid is stopped at the vocal chords or articulators (e.g., I……..want to go) 
        • Secondary behaviours are learned reactions in response to core behaviours, including:  
        • Escape behaviours: when a speaker is stuck on a word and tries to get out of this position, by blinking, stomping, head turning, etc. 
        • Avoidance behaviours: when a speaker anticipates becoming stuck on a word and tries to prevent it.  
        • Negative feelings can be felt by speakers with fluency disorders, including guilt, shame, fear, embarrassment, and hostility. These feelings can affect a speaker’s attitudes about speaking, themselves and others.  

        Myths about stuttering 

        Before we continue, let’s address three common myths or misunderstandings about stuttering.  

        1. Does nervousness or anxiety cause stuttering? No, nervousness does not cause stuttering. Stress can play a part in making stuttering worse, as some activities (depending on the individual) such as giving a speech or talking on the phone can increase stuttering. In contrast, some activities such as singing and choral reading or speaking can decrease stuttering. 
        2. Can stuttering be learned or caught by hearing someone else stutter? No, stuttering is caused by a range of factors which remain unclear by researchers. However, it cannot be caught or learned by someone else.  
        3. Should speakers who stutter be encouraged to take deep breaths or think about what they want to say? No, these strategies can make the speaker more self-conscious and increase the stuttering. We will talk about helpful strategies in the sections below. 

        Speech therapy for stuttering 

        Just like every area of communication, the main goals of speech therapy for stuttering vary according to the individual. Often, the goals include:  

        • Increasing awareness of the systems of speech: Respiration (Breathing), Phonation (Voicing/turning on your voice), and Articulation (using your mouth, tongue, and lips to make sounds) 
        • Teaching specific strategies for core and avoidance behaviours 
        • Developing healthy and positive attitudes and feelings about speaking, and;  
        • Providing caregivers with strategies to use at home. 

        An SLP would work with your child to determine which strategies may be the most appropriate, and provide teaching and feedback to help your child practice the strategies on their own. An SLP may also discuss helpful responses to stuttering including: 

        • Modelling slow and clear speech 
        • Being patient and listening calmly and patiently 
        • Pause before talking and between ideas 
        • Making talking easier for your child by decreasing pressured situations (e.g., avoid asking too many questions or asking another question before the first is answered; provide time for your child to answer; provide comments to help facilitate conversation; decrease grammar and speech corrections).   

         
        For more information, check out the sources below!