Stuttering in Children: A Brief Guide for Parents

At the age of three to four, children begin stuttering as they develop their speech and language skills. That is just normal during the speech development stage, which causes toddlers to constantly repeat, hesitate, and mispronounce words, sounds, and syllables. This temporary stage is called normal disfluency or pseudo-stuttering that occurs as children learn how to speak properly. Parents have no reason to worry because kids will eventually outgrow this stage after several months.

Causes

Until now, the exact cause of speech disfluency in children is still the subject of numerous studies. However, there are factors that may possibly trigger speech disorders in children such as genetics and the malfunction of the mechanisms responsible for speech production in the brain, nerves, and muscles.

Symptoms

Stammering in children becomes a cause for alarm when they fail to show signs of improvement after six months since the onset of stammering. The following are the symptoms every parent should watch out:

• Frequent repetition of a certain syllable (e.g. “Mom, I want some cho-cho-cho chocolates.”)

• Tendency to pronounce particular sounds in a lengthy way (e.g. “Ccccccan I wwwwatch TV?”)

• Substitution of vowels when repeating certain syllables. (e.g. “I will wuh-wuh-wuhsh my feet.”)

• Change of tone and pitch when the child gets stuck with a word

• Avoidance of speaking for fear of getting embarrassed

How to Help Children Overcome their Condition
As a parent, you have to make life a bit easier for your child and lessen the struggles he or she has to endure while going through the speech disfluency stage. The following are useful tips to help your child cope with the speech problem:

• Refrain from asking your child too many questions. Toddlers will find it easier to speak more clearly when they are allowed to express themselves instead of answering questions often.

• Do not react negatively or scold your child whenever he or she stutters. Making your child feel that you dislike stammering will only make him or her more self conscious. Just listen and show a neutral reaction or simply smile. Also, avoid the urge to complete or correct the sentence for your child. Let him or her express the message without any interruption.

• After your child has completed the sentence, say it again in a slow manner to let him or her know that you understood the message.

• Speak to your child in a moderate pace. This will train your child to speak calmly instead of hurrying to say things. In addition, pay attention to what your child has to say. If you look like you’re in a hurry, your child will tend to speak faster to keep up with you.

• Encourage—but don’t force—your child to talk. That way, the child learns to be confident when speaking. Whenever your child says a complete and correct sentence, praise him or her.

Your child needs your care, understanding, and support to be able to cope with stuttering. Give your child the assurance that you won’t punish him or her for every mistake. That way, it will be easier for the child to outgrow the speech problem.

An Integrative Approach in Treating Stuttering

Generating Fluent Speech

There are several speech therapies aimed at controlling or eliminating stuttering. These therapies vary from what kind of program fits the characteristic of the patient.

One of these therapies is called generating fluent speech. A comprehensive speech processing approach that aims to guide people who stutter to develop a speech processing similar with normal fluent speakers. Developed by Barbara Dahm, it is a therapeutic program for stuttering developed at Communication Therapy Institute in Israel. This has been developed from her several years of experience with people who stutter.

Established in 1987, Communication Therapy Institute is a private clinic specializing in the treatment of stuttering. Barbara Dahm, M.Ed is a speech pathologist who founded and currently heads CTI Communication Therapy Institute.

This program is based on the premised that stutterers use processes for the production speech different from the normal fluent speakers. Thus, the program includes steps in which stutterers relearn the speech production process. Exercises include learning to vibrate their vocal folds in an effortless manner, thus training them to monitor words and speech sounds.

The program’s exercises aid the stutterers to focus their attention away from the activity. This results to simplified language development process and as such becomes subconscious. Stutterers also learn an uncontrolled speech muscles and makes articulation an automatic process at a rapid rate. It also aimed at making the patients fully understand their speech production system so that they can self-correct their errors. After this program, patients are expected to be confident speakers whatever situations they may face.

The exercises are not intended to teach fluency but train the stutterers to detach from the result of the activity of speaking. Eventually, repetitive and religiously done activities will result to a proficient act of speaking. The goals of learning conscious effort, artificial monitoring speech, and subconscious controls will make stutterers speak effortlessly.

The therapy program is divided into two stages. Children from age 10 and adults will undergo approximately 90 hours of intensive therapy for stage 1. Stage 2 will consist of six months self-help therapy. However, during these times, clinicians will be available depending on the patient’s needs.

Children below age 10 have a different set of stages. Stage 1 comprises a regular scheduled individual therapy sessions until the patient is able to produce speech easily and correctly in conversation and oral reading. Stage 2 consists of shorter and less frequent therapy sessions with self-help and family assisted home therapy.

Results have shown that people learn the process within the three-week period of the first stage. Some patients also testified that through this program, they were able to understand their difficulty in speaking. The program aided them for making self-improvements in their ability to speak fluently.

The research study showed that Generating Fluent Speech is an effective therapeutic program. The results showed that patients developed a stronger sense of self-confidence and relaxing body mechanisms when speaking.

Recently, the findings of latest researches indicated that Generating Fluent Speech is most utilized therapeutic approach in treating several stuttering cases.

Easy to Follow Tips to Get Rid of Stuttering

Before you hide yourself from the world because you are finding it hard to connect with other people, you must look at the case and help yourself overcome the problem. This is the usual dilemma of adults who have stuttering problems. They fear that others might laugh at them and won’t mind what they are saying, so they choose to back out and lessen their exposure with lots of people. If you can relate with the situation, you must bear in mind that nothing can be achieved if you won’t do anything about it or if you will run away from it all. You must first try to help yourself and seek a professional’s help if the case is already becoming a heavy burden.

You can start with these simple routines and exercises if you think that the condition is still manageable. Make sure that you act on the problem as soon as you recognize that there really is a problem before it gets out of hand.

1. As the saying goes, practice makes perfect. If you are already having problems in conveying your thoughts to other people, it won’t help if you will simply stop talking to them. You need to challenge yourself that you can surpass this and no matter how you fumble at first, you should continue telling people what you want to say.

2. Get out of your comfort zone every once in a while. It is expected that with this condition, you will try to limit your circle to friends, relatives and family members who will not laugh at the manner you speak. But to be able to evolve and succeed in life, you need to learn how to socialize and represent yourself even to people whom you do not know.

3. You have to be comfortable in verbalizing your thoughts to other people. While you are at this stage, you must not feel very pressured to speak in a fluent manner. It doesn’t matter at this point if you are fluent or not. What matters more is how you feel why you are speaking with others. As you try to find your voice and as you begin getting rid of initial nervousness, you will eventually learn to speak in more fluent terms.

4. Another good way to build up your confidence while speaking with other people is by looking them in the eyes. You will feel the connection by maintaining eye contact, and this is also a good exercise to complete your thoughts and ideas.

5. You are already under pressure as it is while you are trying to help yourself get rid of the condition. You must not add any more stress contributors by expecting that you will overcome the problem after some days or even a week or so. This will take time, lots of practice and hard work. You must be determined to finish the task and achieve your goal in the long run.

You must never let stuttering overshadow who you really are. You must find ways to beat it by doing the recommended tricks to help you get past this stage.

A Stuttering Modification Process

It is an intensive interval therapy program for people who stutter. First conducted in 1987 Germany, this therapy program was named after Van Riper from whom it took several of its basic underlying principles of treatment.

It is called the Van Riper Program as Intensive Interval Therapy. It is called interval because of its block schedule system—a five-day duration of segments with six to eight weeks between the segments. It is called intensive because of its long period of session during segments—about eight hours a day.

The basic principles of this program involve the preference and utilization of stuttering modification approach over a fluency shaping approach. It also considers motivation and relapse as major difficulties in many adult stuttering therapies. In addition, it believes that therapist plays a lesser role in most adult stuttering therapies.

The Van Riper Program is done in a group—about 12 patients with two therapists. This is often conducted in a church-run boarding house. In Germany, the therapists include Andreas Starke, together with Angelika Engert and Bernd Koppenhagen.

There are five weeks overall in the process. The first week focuses on identification. The two major goals in this initial week are improving the understanding of each patient’s stuttering and making patients understand the basic concepts of speech production. This segment involves a video recording of each patient and recorded ten-minute conversational speech and five-minute reading. This is followed by lectures on speech production and analysis of the video recordings.

The second week focuses on desensitization. The major goal of this segment is to desensitize patients to the expectation and experience of stuttering. This phase include exercises in maintaining eye contact, analyzing reactions to stuttering, and regaining control in stuttering event. In this phase, patients are expected to make modifications in their reactions to stuttering such as avoiding, interjections, and postponing.

The next week uses the cancellation procedure from Van Riper’s technique with introduction and practice processes. This stage teaches patients with slow motion speech with attention given to precise prolongation of natural speed production and the use of pauses. Records have shown that frequency of stuttering have substantial reduction in most patients.

Aside from introduction and practice, the fourth week now employs the pull-outs devised by Van Riper. This is simpler than the process in the previous stage. Patients are trained to gain control of the stuttering event, thus completing the word through slow movement. Most patients rarely have difficulty achieving this process. Often than not, they find such process pleasurable.

In addition, the fourth week involves less outdoor activities and telephone sessions. However, for ensuring their fluency, a 15 to 20 minute public speech is done as an exercise.

Lastly, the final week involves no exercise anymore. It is more of reviewing the sequence of therapy and instructs the patients to work their way backwards. In addition, the therapists further explain the sources of relapse and discuss specific characteristics of a life of a person who stutter.

In a recent survey, this stuttering modification process has been successful so far in many patients.

Relaxation Technique in Treating Stuttering

The F. M. Alexander Technique

Along with varied therapies and programs designed to treat stuttering, one method is based on the premise of developing and controlling self-awareness, movement, balance, support and coordination. This is called the F.M. Alexander Technique.

The F.M. Alexander Technique is a psychological approach used in treating stuttering. Worth noting is that it is not a treatment specific to stuttering or to any disorder. It is a method of improving ease and freedom of movement. It teaches to use the appropriate amount of effort exerted in certain activities. However, the F.M. Alexander Technique is not or limited to a series of exercises; it is a reeducation of the mind and body.

It was named after its developer F. Matthias Alexander, who initially developed it as a technique for vocal training for singers and actors in the late nineteenth century. While developing this system and with varied experiments, F.M Alexander realized the importance of naturally functioning respiratory mechanism in a well-functioning physical body.

He introduced a technique, which he called the reeducation of breathing mechanism. Hence, many medical doctors eventually recognized such innovative perspective during those times. F. M. Alexander also discovered that breathing and vocalization are essential component of how body functions well. Take for example the habitual breathing and vocal patterns. Both are crucial aspects of habitual patterns of general bodily coordination. Coordination includes posture, breathing, movement, and tension patterns.

As such, he eventually developed a method that teaches patients to change consciously their maladaptive habits of coordination. F. M. Alexander found out that habits are generally psychophysical in nature, be that physical or mental habits. This is because he realized that the mind and body function are integrated entity rather than working individually.

In addition, he observed that one’s perspective towards his activities determines how he coordinates himself to those activities. At the same time, long-practiced habits of too much tension and inefficient coordination affect vocal training. The method of breathing reeducation and then a comprehensive technique of psychophysical reeducation help solve the difficulties.

Thus, the F. M. Alexander Technique aids stutterers to develop more awareness and control in their activities. This came from the premise that the difficulties people experience in many levels such as learning, control of performance, and physical functioning are caused by unconscious habits. As such, these unconscious habits interfere with the natural poise and the capacity to learn. Therefore, the technique teaches a person to eliminate such interference in the innate coordination of the body creating greater self-confidence and presence of mind.

Therefore, finding out about vocal technique and breathing problems, many of his students developed therapeutic mechanisms in solving various problems including stuttering. They followed his premise on breathing mechanisms and respiratory technique.

However, one should keep in mind that the F. M. Alexander Technique does not treat a passive patient. Positive results will yield from conscious eliminating of harmful habits that cause physical and emotional stress. Both American educational philosopher John Dewey and Nobel-prize-winning scientist Nikolaas Tinbergen recognized such technique as an effective aid in improving physical and psychological well-being. Thus, it is now used as a combination therapy in treating stuttering.

Key Factors to Know in Stuttering Therapy

Photo Courtesy : speechtherapyandtesting.com

There are myriad of ways to treat stuttering. One should not let stuttering get in the way of their speaking and conversing with other people, especially when one needs to demonstrate emotions.

A very popular treatment in stuttering is the speech therapy. This requires consulting a speech-language pathologist. However, finding the right speech-language pathologist for you is very important for they vary in expertise. Some may work perfectly with young children, while others specialize in problems associated with brain damage.

There are key factors to keep in mind in entering a therapy process. Pathologists and clinicians will not solve your disorder. They will be just key instruments in aiding you to eradicate stuttering. First, you should remember that all stuttering therapies are self-help process. Second, such therapy is long term and full-time process for stuttering affects not only your speech but also attitudes and behaviours. Thus, the third key point is about a therapy that alters speech, attitude and behaviour. Last, be sure to be clear about the process.

Speech therapies are sometimes available at local health clinics or university speech clinics. But do remember that mostly clinicians and pathologists here are graduate students in training. The graduate students also change each semester, so your relationship with your clinician is also changing.

Choosing a clinician and pathologist is another important factor in your therapy process. Vital aspects of time, financial resources, and plans are to be considered here. As a guide in selecting your clinician, here are some key points to look at. This advice is from Hugo Gregory of North-western University, a known speech-language pathologist.

One is the perspective of clinician on how to treat and use a program for his patients. Does he believe in one general type of program or a varied program that fit a particular characteristic of a stutterer?

Second is the content of the program. Does it focus on altering speech or does it include change in thoughts and feelings, or a combination of both?

Third is the process of the program. Does it include mechanisms for modification of stuttering or does it emphasize on learning skills for a stutter-free speech? This is also related to the fourth one. Does the program combine procedures for modifying stuttering with teaching of skills for building fluency?

Fifth is the practical aspect of the program. Does the program ensure a practice of learning from the clinic to real-life situations?

Sixth is the effort of the clinician to understand and link the frustration of the stutterer and his life experiences to be able to map how his patient will succeed in therapy and life in general.

Seventh is the span of time the therapy process will take. Is it short term or it has follow-up program to assist the stutterer in the process of change?

Lastly, has the clinician provided several opportunities for his patients to express their experiences before the therapy, during and after the therapy?

Generally, people who plan for a stuttering therapy should remember that good clinicians are honest, positive in their attitudes, open-minded, informative, and detail disciplined.