Stuttering

Sometimes the words just get stuck. That’s how Marilyn Langevin defines stuttering. She’s an assistant professor in the Department of Speech Pathology and Audiology, Faculty of Rehabilitation Medicine, at the University of Alberta in Edmonton.

It’s quite normal for preschoolers to have some bumpy speech patterns. They’re at a stage of rapid language development when they’re assimilating new words and figuring out how to string them together in sentences. Stumbles, pauses, fillers such as um, and repeating are part of the process. Experts call this normal disfluency.

What is stuttering?

A few children — between five and eight percent of the preschool population — have more than a few bumps. A true stutter is characterized by frequent disruptions in the normal flow of speech. According to Langevin, stuttering occurs in these three ways:

• Repetition when a sound or a word is repeated, usually three to five times (“I li-li-li-li-like you.”) • Prolongation when a sound is held (“I liiiike that.”) • Silent blocks when the airflow stops (“I w…[silence]…ant it.”)

What causes stuttering?

Scientists have yet to nail down a cause of stuttering. However, Langevin says that there are some myths out there that need to be dispelled.

Stuttering is not the result of bad parenting or related to a nervous or shy temperament (though anxiety can trigger an episode).

Stuttering does tend to run in families, which suggests that genetics plays a role. Brain-imaging studies are yielding more clues to the origins of stuttering, says Langevin, who is acting executive director of the Institute for Stuttering Treatment and Research.

The most up-to-date research is showing that stuttering is a neurophysiological disorder. To produce words, the brain sends messages to the vocal chords, lips, tongue and jaw, which feed information back to the brain. In a person who stutters, there’s a glitch in the system.

How to treat stuttering

More than half of preschoolers who stutter outgrow it. “The problem is there’s no way to predict which children will do so,” says Langevin. “If parents are at all concerned, they should get in touch with a speech therapist because early detection is very important.”

Deciding whether to begin therapy or take a wait-and-see approach depends on the severity of the stutter, how long the child has been doing it, the social impact and the concern of the parents, says Langevin. There can be social consequences for kids who stutter, including teasing and withdrawal from play.

A speech therapist will recommend either direct therapy with the child, or indirect therapy, where the parents are taught ways to help their child reduce stuttering.

The most important thing, says Langevin, is to focus on what a child is saying, rather than how he’s saying it. Here are some other ways to encourage more fluent speech:

Offer to help if he’s really stuck Most of the time it’s best to let a stutterer finish what he’s saying, but don’t let it get to the point of real distress. If he’s really struggling, say, “I see that word is really stuck. Say it with me...”

Model a relaxed approach Stutterers do best when the pace is relaxed. Speak calmly (like Mr. Rogers) and take pauses. If a child is having a really bad episode, ask simple questions that require only one-word answers (“Did you have ice cream at Grandma’s?” and “Was it chocolate?”).

Make time to talk The best gift parents can give a child who stutters is a few minutes of unhurried conversation every day, says Langevin. “The worst thing you can do, if you’re rushing to make dinner or get out the door, is to say, ‘Spit it out.’” Instead, she says, ask him to hold the thought. When you can be relaxed and focused, say, “You were telling me about going to the park with Daddy. What happened while you were there?”

Expect good days and bad days Stuttering can wax and wane at this stage. A sudden increase can result from tiredness, sickness or a growth spurt in language development, as kids add words to their vocabulary or begin to put more complex sentences together.

Getting help

These websites can help if your child is struggling with a stutter:

• speechandhearing.ca The Canadian Association of Speech-Language Pathologists & Audiologists can help you find a speech therapist. • stutteringhelp.org The Stuttering Foundation of America website offers support for parents and kids.