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How Can I Help My Child Who Stutters?

Screen Shot 2019-12-10 at 2.45.59 PM.pngHow Can I Help My Child Who Stutters?

Kristin Park, MS CCC-SLP

Many toddlers and preschoolers go through a brief period of stuttering when developing early speaking skills. In some cases, however, this normal period will turn into atypical stuttering, or speech disfluency. How can a parent tell if their child is developing typical speech? When is it time to consider intervention? Is there anything parents can do to help at home? This blog aims to define stuttering and explore options for concerned parents. References are listed at the end of the blog.

What is typical speech fluency development?

Between the ages of 18 months and 7 years, many children pass through stages of speech disfluency associated with their attempts to learn how to talk. Children with normal disfluencies between 18 months and 3 years will exhibit repetitions of sounds, syllables, and words, especially at the beginning of sentences. These usually occur in about 1 out of every 10 sentences.

After 3 years of age, children with normal disfluencies are less likely to repeat sounds or syllables but will instead repeat whole words (I-I-I can’t) and phrases (I want…I want…I want to go). They will also commonly use fillers such as “uh” or “um” and sometimes switch topics in the middle of a sentence, revising and leaving sentences unfinished.

Normal children may be disfluent at any time but are likely to increase their disfluencies when they are tired, excited, upset, or being rushed to speak. They also may be more disfluent when they ask questions or when someone asks them questions. Their disfluencies may increase in frequency for several days or weeks and then be hardly noticeable for weeks or months, only to return again. Typically, children with normal disfluencies appear to be unaware of them, showing no signs of surprise or frustration.

When is it time to consider intervention?

It can sometimes be difficult for parents to discern normal speech development from more atypical fluency patterns. It is important to keep the child’s pediatrician informed of any concerns and changes in their speech/language development. The pediatrician may refer the child for a speech and language evaluation, conducted by a Speech-Language Pathologist (SLP). Some factors to consider when deciding to contact an SLP include:

● If the toddler/preschooler has stuttered for 6 months or more

● If stuttering patterns began after the child turned 3.5 years old

● If the child has a coexisting speech or language disorder

● If the child struggles when talking - signs include lip tension, excessive blinking, or

covering their mouth when speaking

Parents often show a wider range of reactions to normal disfluencies than their children do. Most parents will not notice their child’s disfluencies or will treat them as normal. Some parents, however, may be extremely sensitive to speech development and will become highly concerned about normal disfluencies. Overly concerned parents often benefit from referral to an SLP for an evaluation, tips for home intervention, and continued reassurance.

How can parents help foster fluency at home?

When it comes to stuttering, there are several strategies that allow parents to support their child in facilitating confident verbal expression. Some tips to use at home include:

Increase the length of pauses between speaking turns. Children might feel pressure to get their words out before somebody else begins talking. Slightly longer pauses can decrease this perceived time pressure and may help reduce the demands on the child.

Reduce your own rate of speech. It’s common to hear parents and other adults tell children who stutter to “slow down.” While well-meant, this statement could make children feel even more frustrated because stuttering just isn’t that simple! However, it can help to model an unhurried manner of speaking.

Reduce the number of questions you ask in succession. When reading to or playing with a child, it’s easy to slip into the role of “teacher” and inadvertently pepper them with questions to test their knowledge. Instead, try using a more even balance of comments and questions. This reduces the demand for rapid, accurate responses from the child. Try making statements beginning with “I think” or “I wonder” as a prompt. Make comments that might prompt the child to share details spontaneously. For example, instead of asking, “What did you eat for snack?” one can say, “I had an apple for my snack.”

Follow the child’s lead in play. Following the child’s lead helps reduce the amount of verbal instructions and questioning during play. Allow the child to direct play and support them by using good eye contact and providing encouragement and praise to help boost confidence.

Decrease length and complexity of language. Children often imitate the grammar and vocabulary used by their parents. Reducing the complexity of the parent’s language—grammar, vocabulary, sentence length—when communicating with a child creates a less-demanding speaking environment.

Knowing what's "normal" and what's not in speech and language development can help parents figure out if there's a cause for concern or if their child is right on schedule. Recognizing and treating speech and language delays early on is the best approach. With proper therapy and time, children will be better able to communicate with their parents and the rest of the world.

 

Sources

“Differential Diagnosis.” Stuttering Foundation: A Nonprofit Organization Helping Those Who

Stutter, https://www.stutteringhelp.org/differential-diagnosis.

“Delayed Speech or Language Development (for Parents).” Edited by Kelly L. Komisaruk,

KidsHealth, The Nemours Foundation, June 2017,

https://kidshealth.org/en/parents/not-talk.html.

Whelan, Alexander. “5 Tips to Share With Parents of Preschoolers Who Stutter.” Leader Live -

Happening Now in the Speech-Language-Hearing World, 14 June 2019,

https://blog.asha.org/2019/05/15/5-tips-to-share-with-parents-of-preschoolers-who-stutter/.