In most cases, dysfluencies first occur in young children between the ages of two and five years, as they learn and refine their speech. At this age, the dysfluencies may be considered “developmental” or a normal part of the “speech-learning” process. The young child may repeat words or phrases once or twice as he attempts to gather his thoughts for self expression (e.g., “Mommy, mommy, mommy.” “Guess what, guess, guess what?”) These repetitions are usually effortless and easy. Frequent insertions of “filler” sounds may also be heard as the child searches for the right words to use (e.g., “I saw…um…uh…it was um…like a big…uh… balloon!”) Often, children will outgrow such “normal nonfluencies” with little to no intervention. However, some dysfluencies present more of a concern, as they may worsen or become a more persistent problem. In particular, a speech-language pathologist should be contacted if a child, adolescent, or adult exhibits one or more of the following:
- A worsening of the dysfluencies in terms of frequency (i.e., it is happening more often), duration (e.g., the dysfluencies have gone from lasting a half-second to several seconds, and/or the number of repetitions have increased), or severity (i.e., the dysfluencies have proceeded from phrase or whole-word repetitions to part-word repetitions, such as “ba-ba-baby”, or prolongations, such as “Wh–>y?”)
- Observable struggle when attempting to get the word out, as evidenced by signs such as a tightening of the muscles around the face and neck or the word seeming to “get stuck” in the throat or mouth
- Any avoidance of particular “feared” words and/or speaking in general
Stuttering often affects an individual’s self-esteem as a communicator, causing him to shy away from situations and opportunities.
The nature of stuttering therapy is dependent upon many factors, including the age of the individual, the severity of the problem, and the person’s motivation to improve his speech. For young children, parents are provided with suggestions for the appropriate handling of the child’s dysfluent moments and for helping the child become a more fluent speaker. During therapy sessions, specific techniques will be employed while engaging the child in fun, language-based activities.
As an older child becomes more understanding and aware of his difficulties, he can be instructed in ways to achieve greater fluency and will learn how to prevent and work through moments of stuttering. Likewise, an adolescent or adult will learn to analyze factors affecting his fluency and will practice achieving fluent speech in a variety of communicative situations.
Playing Memory or Go Fish with your child can be a great way to practice fluent speech. It is important for your child to feel successful and experience fluency. These cards games can be adapted depending on the child. For example, you may start at a level where the child only speaks with one word responses (naming cards turned over in a memory game). If the child is fluent with this task, have him say a phrase (e.g., “I found a dog.” “I found a flower.”) As the child maintains fluent speech, encourage an expanded response into sentence form (e.g., “I found a dog and flower, and that is not a match.”)
Mr. Potato Head
This fun-loving spud can be a great tool for fluency practice. Have the child request each part. Start with one word responses (e.g., “hat”) and gradually move into sentence level responses if fluency can be maintained (e.g., “I want the yellow hat.”)
Using commercial board games can be a motivating way to practice fluent speech. Games such as “Guess Who” and “Battleship” can be functional for older children, whereas “Candyland” may be used for preschool aged children. These games can be used to achieve a varying complexity of responses. For instance, “Battleship” is a great game to use initially, because the speech demand is low since only numbers and letters are needed as responses. “Guess Who” requires sentence level speech (“Does your person have blonde hair?”) and should be used with children who can be successful at this level.