IS THIS NORMAL?: Help! My Child St-st-stutters.

by Tara Delaney

Question: I just watched the movie “The King’s Speech” and, like in the movie, my four-year-old daughter stutters a lot, especially when someone asks her a question. Is this normal?

Tara Says: Praise to “The King’s Speech” for depicting the struggles associated with stuttering as well as a realistic view about how this disorder can be positively impacted by trained professionals. 

Stuttering is considered a communication disorder in which a person repeats sounds, syllables or words. It is quite common for young children to repeat words, especially when they are stressed, tired, or really trying to get your attention, as in “M-Mommy, M-Mommy, M-Mommy, I want a cookie, cookie! (Come to think of it most children seem to have the word “Mommy” on auto-drive.) Stuttering usually involves the repetition of sounds especially the first sound or first syllable of a word (e.g.,  “M-M-M-Mommy, I s-s-s-s-see the d-d-d-dog”) or in prolonged pauses or consistent interjections “um, uh, you know” disrupting the normal flow of speech.  The medical term for this condition is disfluency. The term stuttering may refer to difficulty with the entire process of communication or the specific disfluency of unintended repetition or pauses. 

It is likely that what you are seeing in your daughter is developmental stuttering. Normal stuttering, which is associated with early childhood language development usually around ages 2-5, often appears sporadically and with decreasing frequency over time. There are several factors at play during these years which trigger developmental stuttering, including commencement of utilizing words and sentences to express more connected thinking.  There is also a demand for increased linguistic competency and proficiency in articulation, all of which requires increased cognitive processing. Alba Barraza, Speech and Language Specialist at Baby Steps Therapy in Rocklin, CA, says, ”Some of the children I work with have more difficulty when they are asked a ‘thinking’ type question that requires simultaneous processing to formulate the answer and get it out. The catch is that these kids are bright and want to be right, so there is some anxiety built up around speech.”

New research shows that developmental stuttering may, in fact, be genetic. So it is important to find out if there is any family history that may explain the speech challenges you are seeing your daughter exhibit. If there is a family history, the pattern of stuttering may give some insight to your daughter’s pattern. If a family member stuttered, determine if  they stuttered for a short period of time or if they continued to stutter, requiring professional intervention to develop strategies.

What parents can do: Take a deep breath. There is no evidence to suggest that stuttering is linked to psychological difficulties. Given that, a stressful or pressured environment can exasperate stuttering type behaviors for children who already struggle with fluent communication.

Continue to note what your daughter is doing or experiencing when she stutters—this may help to uncover a potential trigger. Your daughter’s stutter frequently occurs when she is asked a question, so have you noticed who is asking the question and what type of question it is? For example, does she stutter more when a teacher asks the question and it is a multi-processing question (“What did you do this weekend?”) versus one of rote recall (”What color is the chair?”)? A multi-processing question requires your daughter to organize the information and then speak. This process happens almost simultaneously; a color question or any rote question is a quick recall that doesn’t require formulation of information. Finally, note these important insights:

• If the stuttering increases when she appears to be nervous, anxious or tired, help her avoid those situations or prepare her in advance to help decrease her anxiety.
• Practice reciting information with your daughter. You can do this with nursery rhymes or familiar sayings.  Make this a fun game and not a focus of your child’s difficulty.
• When you or others ask your child a question, slow down your rate of speech and make sure your child is given enough time to answer the question.
• When your daughter is trying to speak, do not finish sentences for her even if you know exactly what she is saying.
• Sometimes, encouraging her to move or walk while talking can help. When I am working with a child that struggles getting the words out or repeating words, I will give her a ball to squeeze or encourage her to clap lightly while answering questions. 
• Don’t correct your daughter when she is stuttering, because that could increase her anxiety and make her reluctant to speak. Instead, you can acknowledge what she said by repeating it. For example, “Yes, you’re right–the moon is round and white.” In this manner, you are praising your daughter for her answer you are also repeating it so she hears her own words without disruption. 

Most children outgrow stuttering or developmental disfluencies. Approximately five percent of all children between the ages of 2 to 5 stutter. By the time children reach adulthood the numbers reduce significantly; less than one percent of adults stutter.  

If your daughter’s stuttering persists for longer than six months, each disruption lasts longer than a few seconds, or if she exhibits noticeable facial tension or secondary tendencies, i.e., slapping her leg, snapping her fingers, etc. while trying to talk, you should consider having your daughter evaluated by a speech and language pathologist, who will try to determine if the stuttering is developmental or related to processing difficulties. Early detection and intervention should be balanced with what is developmentally linked. A rule of thumb to consider: If something is impacting your child socially, it needs attention. 

Finally, stuttering is not an indication of weak cognitive abilities and, even if stuttering persists, therapy and specific strategies can help children or adults work through and learn strategies that will help them be successful, as it worked for King George VI.

Tara Delaney is a nationally known child development expert who specializes in sensory processing, autism spectrum disorders, and social/behavioral issues. She is the author of two books: The Sensory Processing Disorder Answer Book (Sourcebooks) and 101 Games and Activities for Children with Autism, Asperger’s and Sensory Processing Disorders (McGraw-Hill). An active occupational therapist, Tara is also the Founder/Executive Director of Baby Steps Therapy, a nonprofit clinical practice focused on helping every child achieve his or her greatest potential in the classroom and beyond. Visit her web site at www.taradelaney.com.