This leaflet was written for us by a panel of speech professionals. Please note that 'Stammer' and 'Stutter' have the same meaning.
Learning to talk is exciting, it enables children to communicate with family, friends and the world at large and provides a way of bridging the gap between self and others. Problems with speaking can be extremely upsetting for parents and frustrating for the child. There are, however, plenty of opportunities for mistakes to occur since conversations involve listening, understanding, creative thinking, controlled movement and co-ordination of muscles. In addition, children live very much in the present, which sometimes leads to feelings so intense that turning thoughts and experiences into words can be difficult. It is not surprising that some children stumble and get stuck when learning to talk.
This page aims to give some information about stammering in children and some ideas about what can be done to make speaking easier and more enjoyable. Whenever possible a speech and language therapist (also speech pathologist or speech clinician) should be contacted so that parents may be supported and the development of stammering prevented.
What is normal dysfluency in young children?
Pausing, repeating words or sounds ("can, can, can I", or "mu mu mu mummy"), stopping and starting again are the sorts of dysfluencies that occur when children are learning to talk. Many have episodes of obvious dysfluency during the years of very rapid language development (2-5 years) and at other times during childhood when there are extra pressures to speak well. A child who is slow in using sentences or in speaking clearly may be particularly sensitive to communication pressure.
What is stammering (or stuttering)?
When normal dysfluencies occur so often that they interfere with talking or cause distress to either the speaker or the listener, then stammering may develop. If relaxed repetitions or stretched out sounds become very tense and the child struggles to finish a word then he or she may be stammering. However, there are many children who experience these problems with talking who don't develop a stammer. It is impossible to tell for sure which children will pass through a stage of stammering and which will not, so it is always best to do whatever we can to make speaking easier for the child.
Why do some children have problems with speaking fluently?
A child is likely to feel confident and happy when there is a balance between the demands that are made, the child's ability to meet these and the amount of support that is given. Here are some examples of the demands, abilities and supports that can affect speaking:
- Demands can arise from what people actually do or say as well as what the child thinks they want.
- People may demand: good, clear speech; answers to lots of questions; information; grown-up behaviour; quick replies.
- The child may want to: do things well; please parents and other adults; be liked by other children; talk frequently about needs, wants, hurts and pleasures.
- The situation may be: noisy, busy, frightening, exciting, tiring, competitive, there may be interruptions and lots of talking.
Communication abilities. To speak in fluent sentences children need to: know lots of words; know how to put words together (grammar); think quickly of the 'right word' or correct sentence to say what they really mean; listen and understand what others say; learn which sounds we use in our language and how they are put together to form words.
They must also develop motor or mechanical skills so that they can copy the sounds that others use in order to be understood; co-ordinate all the muscles used for breathing and speaking; control the muscles to move quickly and smoothly from one sound to the next.
These abilities are affected by how the child feels as well as by the demands placed upon him. When the child feels: happy, confident, listened to, sure of the content etc., then it's easier to speak well. When the child feels: upset, tired, unwell, over-excited, unimportant etc., then speaking can be difficult
Support. It can be difficult to offer support to others when we are anxious ourselves. However, trying to take the child's view changes our focus and makes helping possible. Then we can do those things that make the child feel loved and wanted as well as all the little things that help in particular situations, for example:
- Listening attentively
- Responding kindly and uncritically.
- Offering physical support when needed
- Helping the child to feel safe.
- Being encouraging.
- Helping others understand our child.
Speaking is easier when Abilities and Support balance Demands.
Is stammering inherited?
As far as we know, it is not so much the stammer that is inherited but rather particular patterns of language development and particular strengths and weakness in different areas of language skill. This means that some children need more support and fewer demands in order to develop their speaking skills in their own good time.
Once a child has developed basic language and articulation skills, it is easier to deal with more complicated ideas and communication pressures.
How does a stammer develop?
- Too many demands, which the child is not mature enough to meet, can increase dysfluency which can develop into stammering, especially if the child is very sensitive to failure. There are also things that a child may think and do that can make the problem worse, for example:
- A belief or feeling that speaking dysfluently is shameful or wrong.
- Concentration on the detailed mechanics of speaking may lead to self-consciousness and more mistakes.
- Trying harder to speak fluently may turn relaxed repetitions into tense stoppages as the child tries to force the word out.
- In trying to understand stammering certain words, people or situations may be blamed. Avoidance of these to reduce stammering may lead to constant scanning ahead and changing of words and so to less and less confidence in speaking abilities.
- The experience of a loss of control while speaking can be humiliating. As a society we think badly of people who are unable to control their body and its functions.
A feeling that they are seriously different from others may make children feel isolated and lonely.
What sort of speaking situations can lead to more dysfluency?
- Speaking to adults who talk very quickly.
- Speaking while having to look high up to see the listener's face.
- Speaking when you think you will be interrupted.
- Speaking to someone who is not really listening.
- Speaking when you fear the consequences of what you say.
- Speaking when you do not want to or when you have nothing to say.
- Speaking when very tired, upset, or feeling unwell.
- Speaking in a rush when you have a lot to say or a complex idea to express.
What can we do to make speaking easier for a child?
- Look at the child and get your face on the same physical level
- Speak in language that can be understood easily
- Talk about the present and things that can be seen
- Reduce the number of questions that you ask, allow your child to choose when to tell you things
- Give your child time, slow your own speech, show that you are listening and interested
- If your child is very dysfluent then reduce demands. Maybe return to some of the favourite books, rhymes, games and activities to help your child feel the security of the familiar.
How can we take the focus off speech?
Find time to do things with your child that do not require much talking and where the activity or looking or listening is more important than speaking. Spontaneous, easy talking may occur naturally as a result of the shared experience.
Is there anything parents should avoid doing?
Try not to get stuck with responses that you know are not helping. You can experiment with ways of helping especially if you can discuss them first with a speech and language therapist. Try to put yourself in your child's shoes, look at speaking situations from his or her point of view and think about what may help. Avoid encouraging tricks, that is, things that we do not normally do in relaxed conversations but which improve fluency for a short while, for example: taking a deep breath, shutting our eyes or speaking with an accent. Other, more usual ways of increasing fluency can be tried. If something helps then continue, if not then stop and think again. For example, you may find that slowing your own rate of speech helps whereas telling your child to slow down just increases frustration. Do not correct mispronunciations or grammatical mistakes. Just say the correct version for your child to hear.
Do not blame yourself, you have not caused the stammer. Try to think optimistically about all the things that you can do to help your child speak more fluently. To say "don't worry" is unfair since it is probably impossible not to worry. However, if you can remain attentive and calm when your child gets stuck while talking, then your positive attitude may help him or her to feel confident.
Are there other things to do?
Discuss with your partner the things that each of you find influences how comfortable you feel when talking. Children often respond to similar pressures. List the factors that have a negative and positive effect on your child.
Try to put into words your child's upset and difficult feelings, this will help him or her to feel understood and supported. Do some of the things that you and your child enjoy and where speaking is not especially important.
Be encouraging. Stammering can undermine children's confidence so that they fail to notice their achievements and everything becomes overshadowed by failures with speaking.
Reduce the pressures on all members of the family including yourselves. Do not worry about 'good manners', just give a good example and your child will learn. Do anything that makes talking and listening enjoyable. If your child seems aware of stammering then talk gently to him about it. Some adults who stammer felt during childhood that there was a 'conspiracy of silence' which made them feel ashamed of their stammering. Uncritical and open discussion can help.
Try to be consistent in your handling of all your children. Being clear about family rules helps everyone to feel secure. Consistency with bedtimes, eating, discipline, etc., can reduce battles and also help to avoid excessive tiredness and irritability. Do seek the help of a speech and language therapist at your local health centre. In most districts you can make direct contact, there is no need to go to a doctor or health visitor first. It does not matter how young your child is, most therapists like to see a family as soon as they are worried rather than wait until the stammering is developed and so harder to deal with. Therapists are careful not to increase a child's awareness of stammering so they often work mainly with the parents, though an older child may be more directly involved in therapy.
Finally, do discuss this information with your partner, and with anyone else who has regular contact with your child. Remember also that you are not alone in your concern over your child's speech, there are many other parents who at some stage have also been worried.