The inability to speak clearly and fluently severely affects the confidence and self-esteem of children diagnosed with stuttering – Rekha D.

October 22 was observed as the International Stuttering Awareness Day (ISAD) to raise public awareness about this speech disorder which afflicts 77 million people — approximately 1 percent of the world’s population. The American Speech and Hearing Association (ASHA) defines stuttering aka stammering as an interruption in the flow of speaking characterised by repetitions (sounds, syllables, words, phrases, for e.g: co-co-co-cookie), sound prolongations (for e.g, cooooooooooookie), blocks (for e.g, I want a …… cookie), interjections, and revisions, which may affect the flow and rhythm of speech.

We all have times when we don’t speak smoothly. We may add “uh” or “you know” to what we say (for eg, “I um need to go home.”). Or, one may articulate a sound or word more than once (for e.g, He is-he is my uncle). These dysfluencies are normal if they occur every once in a while. But if they happen repeatedly, it’s likely that the person

is stuttering. The inability to speak clearly and fluently severely affects the confidence and self-esteem of children and adults diagnosed with stuttering.

Onset

Stuttering is common among young children aged 2-6, as they learn to articulate. Young children may stutter when their speech and language capability is developing as they struggle to translate thoughts into words. But most children outgrow developmental stuttering.

Typically, children above the age of six don’t stutter for more than six months. If stammering lasts longer, medical diagnosis and intervention is required. Stuttering can also occur during adolescence and right into adulthood. There is no specific cause of this speech disorder, but probable causes include family history, imitation of an adult who stammers, brain defect, among other disabilities.

Early intervention by qualified speech-language pathologists is critical to enabling children to overcome stammering. Incoherent and confused communication apart, stuttering also results in young children suffering anxiety, fear, shame and guilt. Moreover a large majority of children and adolescents who stutter tend to become withdrawn and anti-social.

Treatment

With the aid and advice of a speech language pathologist (SLP), stuttering can be corrected at any age (earlier the better) with speech therapy.

Dos and Don’ts for parents

Here are some do’s and don’ts for parents, teachers and caregivers interacting with a child/adult who stutters:

Don’t finish their sentences. As a parent, teacher or even listener, you might be tempted to finish their sentences with the good intention of helping them. But this does more harm than good. Resist the temptation to finish phrases and sentences of children who stammer.

Don’t look distressed or avoid eye contact. When a person is experiencing difficulty finishing her sentence, avoid looking away. You need to continue paying attention and listening to what they say rather than how they say it.

Don’t say ‘relax’ or ‘slow down’. Such advice is patronising, demeaning and damages self-confidence.

Don’t speak deliberately too slow or fast. Talking naturally with children/adults who stutter promotes a good verbal communication model.

Provide opportunities to converse. You need to give the speech impaired opportunities to speak without distractions from family members, classmates or friends.

Be patient. Give them time to talk or answer a question before you ask the second one.

Understand the triggers. Some factors aggravate speaking difficulty e.g, telephonic conversations, time pressure, unfamiliar listeners, fatigue and stress.

Repeat or rephrase. It is helpful when you repeat or rephrase what stammering children have said to show them you have understood.

Stuttering symptoms

Stuttering signs and symptoms include:

 Difficulty starting a word, phrase or sentence
 Prolonging a word or sounds within a word
 Repetition of a sound, syllable or word
 Brief silence for certain syllables or words, or pauses within a word (broken word)
 Addition of extra words such as “um” if difficulty moving to the next word is anticipated
 Excess tension, tightness, or movement of the face or upper body to produce a word
 Visible speech anxiety
 Limited ability to communicate effectively

Speech difficulties of children who stutter may be accompanied by:

 Rapid eye blinks
 Tremors of the lips or jaw
 Facial tics
 Head jerks
 Clenching fists

Stuttering may become worse when an individual is excited, tired or under stress, or feeling self-conscious, hurried or pressured. Situations such as speaking before a group or talking on the phone can be particularly difficult for children who stutter.

However, most people who stammer can speak without stuttering when they talk to themselves and when they sing or speak in unison with others.

(Source: www.mayoclinic.org)

(Rekha D. is a speech language pathologist at the department of physical medicine & rehabilitation, Aster CMI Hospital, Bangalore)