General principles of working with the child who stammers

Asking the child what he would like you to do

Some children as young as three have shown that they know that their speaking can be hard but, if they are not appearing to be anxious or struggling at all it is best just to listen and respond as normal.

However, the child’s behavior should always be monitored for signs of distress, frustration or worry. If he seems tense and shows signs of distress as he struggles to speak just react calmly to the difficulty as you might with any other with a comment that acknowledges his efforts and yet does not appear to him to show you are worried about his speech. 'That was a bit hard for you, you did really well there', acknowledges and compliments him at the same time. With young children a smile and a kindly physical gesture, such as a pat on the shoulder may add to the reassurance.

Slowing down your own speech when you talk to him will make it easier for him to follow what you are saying and help him feel less rushed. This can be more helpful than telling a child to slow down, start again or take a deep breath.

Talking with the child about his speech

Children vary in how the stammer is affecting them so it is a fine judgement as to when it might be helpful to speak with the child about his speech and how he may be helped. We can never say for certain just when a young child will start to become worried about his speech; it varies so much with the individual. Some children can reach primary school and still be relaxed about their stammer, some may in the preschool be worried after an incident of stammering and need support and go on to forget about it, while another child may start to develop anxiety that particularly affects them when too many demands are being made.

When he wants to talk about his speech

The key worker should have a positive relationship with the child and be able to judge when he wants to talk about his speech. If the child leads on that, and mentions it, then clearly a gentle conversation should take place where he is encouraged to explain what worries him and given help in working out what might improve particular situations. For instance he may be worried about a comment made by another child. The child should be given as much time as he needs to formulate his thinking and staff should show empathy with his concerns by the language and facial expression used. Parents and the therapist should be told about any chats with the child about his speech so that they can monitor his attitude to it as well.

As a practitioner, when you chat with the child about his speech, you should never try to persuade the child out of feeling a certain emotion, even if he is reading a situation in a completely different way to you and you feel he is over-reacting. If the child is upset, you will increase rather than reduce his feelings of stress by not taking their upset seriously. Attempting to jolly children out of their mood will result in them internalising their stresses, which will take a toll on their bodies and brains. The BSA knows from parents that it is often difficult for people who do not stammer to appreciate the emotional pain that stammering can cause an individual, and even some young children can experience this and need to feel that they are being supported and understood.

When the child does not mention his worries about his speech

When he seems to be getting upset in speaking situations and yet has not mentioned any worry to staff,  it is worth having a word with the parents and the therapist and to see whether they think that the child is ready to talk about his speech and is able to contribute some ideas as to what he thinks will help.  Some children are ready even at a young age to talk about what might help them. They can have very sensible ideas, for instance, about their dislike of not being allowed to finish by other children and would benefit from a regular chat about this with the key worker. Once this routine is established and the parents are following it up at home a more complete picture of the child’s feelings and attitudes can be built up for sharing with the other staff and the therapist.