Stuttering is a motor speech disorder, characterised by various interruptions to the smooth flow of speech.

Stuttering usually starts when children are two or three years old and almost always before five years of age. It may start suddenly or it may develop gradually over days or weeks. Occasionally, parents report that their children’s stuttering began overnight. It is common for stuttering to fluctuate from day-to-day or from one conversation to the next for no obvious reason.

Parents often report that their children stutter more when they are tired, or very excited, or have a long story to tell. Children can have long periods where the stuttering seems to disappear, only to return days, weeks or months later.

Most preschool age children are not aware that they stutter, while others are aware and may even be frustrated by their efforts to talk.

School age children who stutter often report feelings of embarrassment when answering questions or reading aloud in class.

Types of stuttering

Children who stutter may repeat whole words, sounds or syllables, or they may momentarily ‘block’ so that they cannot speak, or they may prolong sounds. Sometimes they may show signs of frustration when they try to talk. To summarise, the most common types of stutters are:

• Repetitions of –
• sounds e.g. “c-c-c-c-c-car”,
• words e.g. “can-can-can-can I go”,
• phrases e.g. “Mummy can I … Mummy can I … Mummy can I go?”.
• Prolongations, or stretching of words or sounds such as “sssschool” or “luuuunch box”.
• Blocks, or silences when the child has difficulty getting a word out. Sometimes children may seem unable to make a sound, even though they are attempting to force words out.
• Secondary behaviours, such as unusual facial movements, eye blinks, and head, body or hand movements while the child is talking.

Who stutters?

Stuttering more commonly occurs among boys than girls.

There is research that indicates stuttering tends to run in families. About one half to two thirds of people who stutter report having a family member who stuttered. Genetics play a part, but how this happens is unclear at present.

What causes stuttering?

Though the cause of stuttering is not yet fully understood, we do know the following facts:

• The cause of stuttering is physiological. It is not caused by psychological factors. Nor is it caused by anxiety or stress, although many adults who stutter report feeling anxious or stressed as a result of stuttering.

• Stuttering is not learned from others and cannot be copied from siblings or parents.

Will stuttering stop without treatment?

Many children recover naturally, without treatment from speech pathologists.

Current research indicates that more girls than boys recover naturally. And, of course, the longer a child stutters, the less likely s/he is to recover without treatment.

However, it is not possible to predict for an individual child whether or not natural recovery will occur.

Stuttering treatment

The Lidcombe Program is the only scientifically researched treatment for stuttering in preschool-age children.

The Program was developed in the late 1980s by speech pathologists from the Stuttering Unit, Bankstown Community Health Service
(www.swsahs.nsw.gov.au/stuttering) and researchers from the University of Sydney (www.fhs.usyd.edu.au/asrc).

The Lidcombe Program is considered best practice by Australian speech pathologists and is now used extensively in other countries.

The Program is conducted jointly by speech pathologists and parents.

During weekly clinic visits speech pathologists train parents to measure their child’s stuttering and conduct treatment with them at home.

Speech pathologists and parents consult each week about the child’s progress since the last clinic visit and plan changes to treatment for the week ahead. In this way treatment is individualised to each parent/child so that it is effective and also fun for each child.

If you feel your child may be stuttering contact your local speech pathologist for an appointment.

The speech pathologist will provide a comprehensive speech assessment to diagnose stuttering and give you information about stuttering and your child.

Most importantly, the speech pathologist will be able to weigh up all the factors for your child and determine the best time to begin treatment.

Websites for Stuttering

• Speech Pathology Australia
  http://www.speechpathologyaustralia.org.au
• Stuttering Unit Bankstown Health Service
  https://www.swslhd.nsw.gov.au/bankstown/Stuttering/default.htm
• Australian Speak Easy Association
  http://www.speakeasy.org.au
• Canadian Stuttering Association
  http://www.stutter.ca/
• National Stuttering Association
  http://www.nsastutter.org/
• Stuttering Foundation of America
  http://www.stuttersfa.org/
• American Speech-Language-Hearing Association
  http://www.asha.org/

Franco & his mother Grace

Franco is four-and-a-half years old and attends a local preschool. His parents decided to hold him back and he will now go to school next year.

“He has a combination of stuttering and grammar problems,” said his mother Grace. “It isn’t to do with the fact that we speak two languages, it is something to do with his speech.

“We took him back to preschool for an extra year to help deal with his problems.”
Franco was a late talker and started talking between two-and-a-half and three years of age.

“He was only saying mum and dad and they say that can be quite normal for a boy,” said Grace.

“I’d been thinking about getting help for him for about the last six months, but it wasn’t until he had a week of severe blocks about six weeks ago that it was the straw that broke the camel’s back.

“I can’t imagine how frustrating it was for him, but it was extremely frustrating hearing it. I was in the car listening to him trying to get a sentence out and I was so frustrated that we had to find out what was going on.”

Franco’s stuttering includes all three types – repetitions, prolongations and blocks or silences where he is unable to get a word out.
“I was made aware that repetitions are not as severe as prolongations and blocks.
Grace remembers being more alarmed when she found out how simple the program was to treat stuttering.

“It’s the simplicity of the program that alarmed me – how are we going to shift this with minor changes? I really had to concentrate on giving him that positive praise and it felt almost false. But it quickly becomes genuine.

“Once we started listening carefully to his speech and the sort of stuttering that was occurring, which is part of the program, we were able to narrow things down so that we could treat him.

“He attends a holistic preschool that is very aware of his problems and we had him assessed by the special needs teacher.

“We come to Learning Links to help with the stuttering and our preschool is working with his speech pathologist at Learning Links to develop activities to improve his grammar.”
Franco has been coming to Learning Links for about five weeks and there is already an improvement in his speech.

“It’s very good that I’m already seeing behavioural changes. He’s becoming more aware of himself and more mellow.

“The program involves the parent or parents attending the session. You need to know what to look out for, how to praise and the type of language to use. You try and make it really positive.

“We are guided by our speech therapist and the therapist observes me conduct therapy with Franco and she’ll correct me and help. We chart his severity on a grid and the idea is that the severity rating drops as the stuttering decreases.

“Franco loves coming to Learning Links. The program has also bonded us because we spend time together every day – just the two of us. It’s hard when you have more than one child because you can’t give them the attention.

“Once the intensive program is over, you come in on a fortnightly then a monthly basis just for a check up. It would be absolutely fantastic if we can help Franco in such a short time.”

by Angela Nikolas, Speech Pathologist