Stuttering / Dysfluency in Children

Did you know there is no such thing as fluent speech?

Stuttering - Dysfluency in ChildrenLearning to talk is not always easy. Between the age of 2 and 6 years, when your child is rapidly developing speech and language skills, breaks in the rhythm of speech are expected and are not usually a cause for concern.

The exact cause of stuttering is unknown. Speech production is an extremely complex physical-neurological-psychological process. A very slight physical variation in the activity of the brain can interfere with the rapid coordinated movements of the vocal cords, tongue and lips, creating what we call stuttering. Stress can certainly make stuttering worse. Stuttering sometimes runs in families. Early identification and intervention are important steps in helping the child to develop fluent speech.

When should I be concerned?

If you recognize any of the following characteristics in your child, he/she may be at risk for dysfluency:

  • Using many part-word or whole word repetitions (‘ba-ba-ba-ball’; ‘my-my-my’)
  • Prolonging sounds (‘mmmmmmy’)
  • Avoiding speaking situations or saying, “I can’t say it”
  • Speaking with tightness or tension of the face and neck muscles
  • Speaking with unexpected rises in the pitch or loudness of the voice

How can a speech-language pathologist help?

Speech-language pathologists assess a child’s speech fluency through a variety of speech tasks (e.g., telling stories, describing pictures). Through these activities they can observe the types of dysfluencies the child experiences and can introduce a variety of strategies to help the child speak more fluently.

Is there anything I can try myself?

While you are obviously not the cause of your child’s stuttering, there are changes that you can make in the way you talk to your child, in your daily schedule, and in your environment that will help encourage smooth speech:

  • LOOK at your child when they are talking to you.
  • PAUSE for at least 1 second before answering or responding to your child.
  • Talk more SLOWLY and CLEARLY (e.g., put more pauses between words).
  • Use SHORT and SIMPLE sentences.
  • COMMENT on what your child is saying. TALK and have FUN.
  • FOLLOW your child’s lead.

Have you heard of “cluttering”?

Cluttering is a syndrome characterized by a speech delivery rate which is abnormally fast, irregular or both. In addition, the person’s speech is affected by 1) a failure to maintain normally expected sound, syllable, phrase, and pausing patterns and/or 2) greater than expected incidents of dysfluency, the majority of which are unlike those typical of people who stutter (The ASHA Leader, November 18, 2003).

Cluttering is a fluency disorder that is often confused with stuttering. Although the two disorders frequently co-occur, cluttering is actually very different from stuttering:

Cluttering Stuttering
Dysfluencies characterized by unfinished words, interjections and revisions

Dysfluencies characterized by sound, syllable or word repetitions, sound prolongations and blocks

Low awareness of dysfluencies

High awareness of dysfluencies

Few secondary behaviours Many secondary behaviours (e.g., eye blinking, nostril flaring)
Disorganized speech with some grammatical errors

Well organized speech, but fear and anxiety limit output

Reading and writing difficulties Strength in language arts

Cluttering is usually assessed by a Speech Language Pathologist in conjunction with other professionals such as classroom teachers or psychologists. Treatment can be very effective and usually includes slowing the rate of speech, increasing awareness, improving speech sound precision, improving organization of speech and reducing excessive dysfluencies.