When is a stutter an issue?

I think my child is stuttering. What do I do?

In many instances the answer may be pretty simple.

I was contacted recently by a concerned parent about their child developing a stutter.  This very young boy would repeat the initial sound or initial word in sentences, some sounds/words in the middle, and didn’t seem to care about how he sounded because he was too busy playing.  He seemed to stutter in most any situation and developed it without any apparent precursors.  In continued conversation, I was aware of how upsetting this has been to the family and how they have already taken the first steps into blame and self-doubt – with which children are inherently in-tune.

My response to this family lie in the clues given during our conversation.  Here’s a rundown of what I listen for when getting background information regarding situations like this…keep in mind that each therapist has their own way in which they would approach each situation and my approach changes based upon the information and situations presented as well.

First, I try to determine if the stuttering behaviors or disfluencies are more typical (fluency issues everyone has, just more of them) versus atypical in nature (fluency issues that are more specific to a person who stutters).  This step often requires very detailed and objective examples that give me clues as to what the specific patterns are and what else is going on (e.g. is the child trying to get attention, or are there other behaviors or feelings being expressed).

Second, aside from the other behaviors or feelings that the child expresses at the same time as the disfluencies, who else was in the interactions and how did they act or react before and after the stuttering event.  This is extremely important in helping understand what may trigger the disfluency and what may be reinforcing it after-the-fact.

The discussion on the second step often leads to a discussion on when the stuttering was first observed or what initiating event may have played a role in the beginning of the stuttering.  In some cases stuttering is present as soon as language is present and in other cases it is developed later due to some factor in the child’s environment, something they are no longer receiving such as attention (e.g. when a new sibling is born or when work suddenly takes up all of the parents time), and it can also develop through a real/physical or perceived trauma.  Making this distinction helps to determine what co-occurring issues need to be addressed and helps to better understand levels of severity and the best methods of treatment.

Lastly, I look into severity.  Often times by this point I will have a basic course of action formed and will be looking for more detail to make better and more personalized recommendations to serve the family.  Severity discussions typically include an identification of the level of awareness the child has with his (or her, but most often stuttering occurs in males) speech fluency. If there is no awareness, then developing and understanding home strategies are key.  If there is awareness via frustration behaviors, helplessness, or anger and lashing out, then strategies and solutions identified through evaluation and treatment become essential in developing a plan that the child and family can follow that would be of the most benefit.

In the case of this energetic youngster and his concerned family, I addressed the concerns about their role in their child’s stuttering and assured them that it’s difficult to tell when or why these things develop, but we know of many ways to help.  In this case, the boy was displaying more typical disfluencies, had no awareness at his age, and had a couple of potential instigating events that we could address immediately and determinations of severity would wait to see if the current strategies presented would work or not.

Here is a PDF of tips that I often start with from The Stuttering Foundation website. I also like the National Stuttering Association website (geared more toward school-age students and self-discovery) and ASHA’s posts for more technical details.

If you suspect your child to have a stuttering issue, feel free to utilize the internet resources linked and give me a call or email for more information.