Stuttering affects the ease and fluency of speech. When there are unusual disruptions in speech, such as long pauses or breaks in speech, repetition of words or phrases, blocks when no sound will come out, or sounds are stretched out too long, they are termed dysfluencies.
School children who stutter experience poorer educational adjustment than normal speakers. For the two to three percent of adults who stutter, employers believe stuttering decreases employability and interferes with promotion opportunities.However, stuttering is protected by the American Disabilities Act (ADA). Employers can not discriminate against people who stutter at any time, including during hiring or when considering promotions.
Dysfluencies
The frequency, duration, type and severity of stuttering can vary greatly from person to person and in different speaking situations.
Challenges may occur when speaking on the phone, having a conversation, ordering food in a restaurant, or talking in front of a group of people. As a result, stutterers may limit their participation in many activities. A hallmark of stuttering is the inconsistencies of when it occurs. A person might only stutter in certain situations, with specific people or during times of increased anxiety, such as at the beginning of the school year, or when introducing themselves, or to superiors. Sometimes a stutterer may have long periods of fluency, followed by a return to their prior patterns.
Stuttering may occur during different stages of life.
Developmental Stuttering occurs between the ages of two and five. The average age of onset is three years and 95% of children start before the age of four. Up to 90% of children who have developmental stuttering will recover. These children are usually unaware or unconcerned about their speech. They do not avoid words or speaking situations, have no related anxiety, and do not have any unusual secondary behaviors such as tics, facial distortions or any visible tension. For these children, the best advice is to refrain from having any reaction to the disfluencies and avoid causing the child to become aware of their speech.
Children who are two years and older and are aware of and troubled by their speech should begin therapy as early as possible to prevent it from getting worse. These children or teens are usually bothered by their stuttering , even though they may hide it, and are usually relieved to talk about it and get help. They are sometimes the victims of bullying and need awareness and strategies to deal with their emotions and also protect themselves from vicious teasing.
When stuttering lasts beyond childhood, it is called Persistent Stuttering. Acquired stuttering is very rare and may be the result of severe viruses, infections, or neurological events including stroke or traumatic brain injury.
What should I do?
If your child is 2-7 years old and is not aware or concerned about speech, is not frustrated or avoiding talking, it is best to take a wait and watch approach.
It is time to call the therapist if even a young child becomes frustrated, upset, avoids certain sounds or talking in any situation, has developed any tics, gestures, or grimaces, has been bullied or self-esteem has been impacted. Similarly, stuttering that persists beyond the age of five through adulthood may need to be assessed.
Evaluation
The speech pathologist will assess different speaking situations including conversation, monologue, reading aloud and possibly telephone conversations. Fluency events, such as sound, word or phrase repetitions, sound prolongations and blocks will be counted and compared to peers. If a person is dysfluent more than 3 times per minute, exhibits prolonged stuttering, has visible tension, produces severe blocks or sound prolongations or avoids specific sounds or situations, they may be diagnosed with a stuttering disorder. Respiratory patterns, changes in vocal quality, tension and secondary behaviors are also analyzed. It is also important to rule out the presence of any other motor, speech or language problem which may be at the root of the stuttering behavior.
Therapy
Therapy is appropriate for any age unless developmental stuttering is suspected. It has been proven that speech therapy significantly reduces the frequency in stuttering. Children have been shown to experience a 61% decrease in dysfluencies, and studies have reported that adults improved by 60 to 80%.
Things to avoid:
Do not tell the person to slow down or take a breath
Do not interrupt
Do not talk for them or finish their sentences
Do not avoid talking with them
Do not avoid people who stutter
Things do:
Maintain eye contact
Wait for the person to finish speaking
Act as though you have unlimited time for them to finish their thoughts.
Speak slowly yourself, which often helps them to slow down
