I am a speech therapist. My son Caleb is 4 years old. He has week-long periods of very disfluent speech every few months. Am I panicking? No, but I keep it in the back of my mind. As the parent of a preschooler, can you relate to this? Does your child have times when they speak in never ending sentences? The kind of sentences that keep going and going and going and then the next week, it seems they are stuttering every other sentence? Rest assured this can be very typical for a child this age. Children between the ages of 2 and 6 often go through periods of disfluent speech.
What is Stuttering?
J. Scott Yarrus, a Board-Recognized Specialist and Mentor in Fluency Disorders and Associate Professor of Communication Science & Disorders at the University of Pittsburgh, characterizes stuttering as sound or syllable repetitions, prolongations, and blocks. He highlights that not all within-word disfluencies are stuttering, and not all stuttering involves within-word disfluencies. He notes that, “stuttering behaviors may also be accompanied by tension or struggle, but not always. Stuttering is often accompanied by a speaker’s feeling that he cannot continue speaking even though he knows exactly what he wants to say.”
To clarify for non-speech geeks:
- A Sound or Syllable Repetition might be “m-m-m-mom” or “ ba-ba-ba-back”.
- A Prolongation might sound like a single sound being drawn out within the word such as “ taaaable” and
- A Block is when the person has difficulty initiating a targeted word.
Caleb’s disfluencies consist mostly of sound and syllable repetitions. “ I I I I I want, I want, I want a drink”
Understanding Risk Factors and Stuttering
So what do we do with this information? Dr. Yarrus offers the analogy of an Easter basket. You start with an empty basket and fill it with eggs. An egg goes in for each risk factor identified. The more eggs in the basket, the more likely the stuttering may be a continuing trend.
Currently researchers believe stuttering arises due to multiple risk factors, risk factors that occur both within the child’s genes and the child’s environment. *This makes a family history of stuttering an important egg to look for.
So what are these risk factors? Yarrus lists them as:
- Family history of stuttering
- Preponderance of “stuttered” types of disfluencies (We are all dysfluent at times!)
- Time since onset > 6 months
- Child is aware of or concerned about disfluencies
- Child is highly reactive to mistakes or disfluencies
- Parental reactions are negative or fearful
- Child has concomitant speech/language disorders
- Others? Research is ongoing…
Risk factors have been identified and your basket is empty or full. Where do we go from here?
In my case, with inconsistent periods of disfluency, no family history and very limited awareness and frustration on Caleb’s part, I’m going to keep it in my mind and be gently encouraging during these times. I actually ignore it most of the time. If you find your basket fuller and have concerns, further assessment is strongly advised. It’s always better to be proactive instead of reactive!
Yarrus tells us “that studies show as many as 75-80% of preschool children who stutter will recover and the majority of these children will recover within the first 6 to 12 months. Recovery is still observed up to 2, 3, and even 4 years post-onset.” Recovery can happen both with and without treatment.
If your child does not end up in this 75-80%, treatment is strongly recommended to prevent frustration, the development of increased tension, negative psychological effects and to improve their overall communicative effectiveness. For further information visit: http://www.asha.org or http://www.stutteringcenter.org
This post was written by Joy Rice. She is a Speech Therapist at the S. June Smith Center, in Lancaster, PA. Joy has M.S. in Speech Language Pathology and a Certificate of Clinical Competence. Joy works with children in the Preschool program.
This post was written based on an in-service, “Practical Treatment Strategies for Children Who Stutter: Ages 2-6” presented by Dr. J. Scott Yaruss on 10/1/12.