Stuttering and Fluency
How do you know if your child has normal nonfluency or stuttering?
Many children between the ages of two and six years may engage in periods of dysfluent speech when they are tired, excited or apprehensive about their lack of talking clearly. This is called Normal nonfluency.
Normal nonfluency is the repetition of sounds, syllables, words or phrases, the prolonging of sounds and pauses, or the use of sounds like “um” or “ah”. A three year old child will often repeat a sound like “s-s-s” or a syllable like “cra-cra-cra-cracker”, or a word “like-like like” this. Repeating, pausing, backing up, holding on to sounds, and general confusion of “thinking and talking” are very typical as children are learning to talk. Children between two and four years have many experiences they want to talk about but don’t have the fast muscular coordination it takes to express themselves smoothly. It is therefore easy to understand why their speech may be dysfluent during these years.
Too often, however, parents call this normal nonfluency “stuttering”. The mismanagement of nonfluency can develop into stuttering. The “do’s” and the “don’ts” that follow are the kind of things that are very important in helping you avoid the problem of stuttering. As one who has seen so much unhappiness because of this problem, I can say that the proverb “An ounce of prevention is worth a pound of cure” fits perfectly.
There are definite ways for you to react to your child’s nonfluency. The following suggestions reduce his chances of becoming a stutterer.
- Pay attention when your child talks to you. Let him know you are listening. Give him your time and attention when he has something urgent to say. Remember that he wants to share his feelings, experiences and ideas with you. Let him know you are interested. Don’t rush him!
- If you are in the middle of a task, like doing dishes, stop for a minute. Bend down so that you and your child are on an eye-to-eye level, and listen. A little touch on the arm or scooping him close to you will let him know you are really listening. When a busy parent comes home to sit down and read the paper or catch a few minutes of television, this may be the very moment your child takes to come running to tell you about his day. Put down the paper, turn away from the television and pay attention to him, this won’t take very long.
- Don't put him on exhibition for relatives and friends by having him recite stories and little rhymes. Don’t coax him to say “hello” or talk when he doesn’t want to. When he feels like talking, he will. If you are concerned about his developing manners, just use them yourself! Be his role model and he will copy you.
- Don't insist that he talk if he's crying, has hurt himself, or is obviously upset. These situations will almost always disrupt his fluency. Calm him down first. Comfort him and stop the heavy sobbing before you ask him what happened.
- Do keep your own speech slow and easy to understand when you are talking or reading to him. Let him hear talking that is easy for him to copy.
- Don't interrupt him when he's talking, or complete his sentences out loud. He will not like your interruptions. All he wants is a good, attentive listener. He shouldn't have to worry whether you'll let him finish.
- Don't make suggestions to him about talking in a better way. Never make comments like "Slow down", "Count to ten", or "Start over". This advice only gives a strong idea that something is wrong with the way he talks. It makes him think that his speech is not good enough to please you.
- Do avoid situations where he will feel that he's failing. Encourage him to play games and to do things he does well. Don't tell him "Grow up", "Stop acting like a baby", or "You can say that better if you want to or try harder." The amount of nonfluency in his speech development will often depend on how he thinks about himself. Build his self-ego with kind, praising comments on all the actions he does well.
- Do empathize with your child's feelings. If he is frustrated and complains "I can't say that word", or "I can't talk right", then let him know, by explaining, that some words give you trouble too. Convince him that you have trouble talking sometimes also and must talk easier.
- If he seems to become startled or upset by saying words nonfluently, you should calmly reuse the words in a natural and typical way. If he says "Billy broke my t-t-t-toy", you might say, "Did he break your toy? Where is it? Let's go see if we can fix that toy".
- There will be days when things are going well and he is much more fluent. Take advantage of these times to let him talk. Suppose he comes in from playing, really wanting to talk and tell you what's been going on, and he starts out without any hesitations or repetitions. Join in by asking him easily to tell you all about it. Don't ask too many questions, though. Just let him go. Suppose however, he starts out with a lot of repetitions and hesitations. Then choose your questions carefully. Ask questions that take short answers. "Were you having fun?" (He can answer "Yes", "No", or "Uh uh"). "Who were you playing with, Mary or Billy?" In this instance, ask a question that will take a short specific answer. Take the pressure off him so he won't have to struggle to tell you what's been going on.
- Do tell other people not to imitate or joke about his nonfluent speech. This includes his brothers, sisters, other relatives, friends, babysitters, and especially grandparents. Be very definite and outspoken about how you want others to react to him when he is nonfluent. They should ignore it.
- Do not discuss his nonfluency when he can overhear you. He should not be made to feel that the way he talks is special or wrong.
- DO REFER YOUR CHILD FOR A COMPLETE FLUENCY EVALUATION
- When your child is dysfluent more than 50% of the time;
- When you or your child are bothered by his dysfluency;
- When the dysfluency is accompanied by any secondary characteristics (such as eye blinks, facial grimaces, abnormal head or jaw movements, jerked body movements);
- When there are frequent "failed communication episodes" with outbursts of crying or covering the mouth.