Stuttering: A Parent's Guide

What is Stuttering?

Stuttering is a speech disorder where the normal flow of speech is disrupted. Characteristics of stuttering can include prolongations of sounds (mmmmmy dog), repetitions of sounds or syllables (m-m-m-m-my), or blocks, in which moments of silence can occur while trying to produce a sound or word.

People who stutter often experience increased muscle tension, such as in their lips, jaw, or throat. At times, moments of stuttering can be accompanied by physical movements including eye blinking, finger tapping, head jerking, or fist clenching; these are called “secondary characteristics.” Stuttering is sometimes referred to as stammering (especially in Britain) or disfluent speech.

Types of Stuttering

There are two primary types of stuttering: developmental and neurogenic.

Developmental Stuttering

Developmental stuttering is the most common form of stuttering. It affects young children during the time in which they’re developing their speech and language skills. Many children experience temporary periods of stuttering. When the stuttering continues, it might be called developmental stuttering or the more formal diagnosis of “childhood-onset fluency disorder.”

Neurogenic Stuttering

Less common, neurogenic stuttering occurs as the result of injury to the brain or spinal cord following an event such as a stroke, tumor, degenerative disease, or traumatic brain injury. The speech patterns of people with developmental stuttering and those with neurogenic stuttering are similar, although some differences exist.

There is a third category called psychogenic stuttering. This type is rare and can occur in adults who have experienced emotional trauma.

Who Stutters?

Stuttering in children usually develops between ages 2-6. For the vast majority (approximately 75%) of children who experience stuttering during this time, it will disappear on its own without intervention. For the remaining group, it will likely persist in some degree throughout their lifetime.

What Causes Stuttering?

The exact cause of stuttering is unknown, although research points to various possible causes. One cause is genetic: children who stutter often have family members who also stutter. A second potential cause is related to neurology: research has shown there may be some differences in the brains of those who stutter versus those who do not. A third contributing factor involves personality: evidence shows some trends in the personalities of those who stutter compared to non-stuttering peers (tendencies towards perfectionism, e.g.).

It’s not possible to always predict which children will persist with their stuttering and which will not. However, there are a few risk factors. First, boys are 2-3 times more likely to persist in stuttering than girls. Second, those who begin stuttering at age 3.5 or later are more likely to continue than those who started at a younger age.

Stuttering Doesn’t Always Sound the Same

If you’re a friend or family member of someone who stutters, you may notice that their speech sounds different from one day to another. Stuttering is unique in that it can vary depending on the situation. For example, stuttering can increase during stressful speaking situations, such as a presentation or an interview. Other situations are known to facilitate smooth speech, such as reciting something memorized (Pledge of Allegiance, e.g.), talking to pets, speaking/reading in unison with others, and singing.

When Should I Get Help for My Child’s Stuttering?

As mentioned above, it is normal for many children to experience periods of stuttering at some point in early childhood. When deciding whether to seek professional help, there are a few factors to consider :

• Duration: the stuttering has persisted more than six months
• Onset: the stuttering began at age 3.5 or later
• Severity: the stuttering seems to be increasing in severity
• Family History: other family members with persistent stuttering
• Reactions: your child is reacting negatively to their speech or is avoiding speaking
• Physical tension: your child has noticeable physical tension during moments of stuttering (clenched fists, closed eyes, e.g.)

What is Speech Therapy?

Speech therapy is for individuals with a range of communication disorders, including stuttering. A speech-language pathologist (SLP), commonly referred to as a “speech therapist,” conducts speech therapy with individuals of all ages, from infants to senior adults. SLPs can work in schools, hospitals, skilled nursing facilities, outpatient clinics, and private practices. Learn more from our article “What is a Speech-Language Pathologist?”.

How is Stuttering Assessed?

If your child’s stuttering meets some of the criteria listed above, it might be time to seek professional help. When you first meet with an SLP, they will get the child’s case history in order to learn more about her development, her speech, and your concerns. They will then conduct an assessment, in which they’ll note details about your child’s disfluencies during different tasks, depending on the child’s age (this could include rote speech, reading, and telling stories). These notes will include the number of syllables stuttered, how long the moment of stuttering lasts on average, what type of disfluencies are present (repetitions, prolongations, blocks), whether secondary characteristics are present (eye blinking,  e.g.), and what types of reactions the child has to her stutter.

How Can Therapy Help My Child’s Speech?

Treatment approaches for stuttering will vary depending on the individual’s age. For preschool children, much of treatment will focus on parent education. Parents will be asked to evaluate the kind of environment their child is in and perhaps make some changes such as decreases in: the rate of their own speech, interruptions while their child is speaking, sequential question-asking, and negative reactions to disfluent speech. They will be encouraged to give their child plenty of time to finish his thoughts and to focus on turn-taking in conversation among all family members.

As children get older, therapy becomes more directly focused on their speech, as well any negative feelings they might have about their stutter. There are two main approaches to direct stuttering therapy: stuttering modification and fluency shaping.

Stuttering modification helps people who stutter do so more quickly and easily. Many of these strategies seek to desensitize individuals to their stuttering and reduce avoidance behaviors. For school-aged children, this could include activities like doing an informational presentation to their classmates about stuttering. This could also include voluntary stuttering, a strategy used to reduce fear of stuttering and increase feelings of control, or “self-advertisement,” in which a person who stutters tells their listener at the start of a conversation that they’re a person who stutters. Self-advertisement (or, self-disclosure) helps reduce anxiety for the speaker and increase the listener’s understanding if unexpected speech patterns occur. Fluency shaping focuses more on strategies to eliminate or minimize stuttering. These include “easy onset” (beginning speech in a very gentle way) and “light contact” (reducing tension between lips, tongue, etc. when producing sounds).

The goal of all good therapy for stuttering should be to help the person to feel confident in their speech and to communicate as effectively as possible, whether stuttering is present or not.

What Else Can Be Helpful for People Who Stutter?

In addition to therapy, many people who stutter benefit from involvement in online or local support groups. These groups are a great place to share experiences, learn from others’ journeys, and to receive encouragement from individuals who understand what it’s like to stutter. There are also many resources online for people who stutter and their families, including The Stuttering Foundation and The Stuttering Association for the Young (SAY). 

Ready to Take the Next Step?

If you or your child stutters, and you’d like to get some help, let us know. At Speech Leader, we’d love to consult with you and help determine if online speech therapy would be helpful.