Stuttering in children

My child is stuttering… what should I do?

Stuttering is a fluency disorder which can present in several ways in young children.

Your child may have started:

• repeating words, sounds, or syllables;
• pausing or holding sounds for longer than usual;
• using a lot of empty phrases such as ‘umm’ and ‘ahhh’; or
• making new eye or head movements while talking.

We all have these patterns in our speech from time to time. However, if they are regular and not easily able to be controlled, your child may be stuttering.

Stuttering in children can range from mild to severe. Your child may have difficulty getting their message across, and it can quickly become frustrating and upsetting for both you and your child. Studies have shown that children as young as three can be excluded from social groups due to stuttering. As parents, we want to do everything we can to enhance our child’s confidence and communication skills at this critical age.

Thankfully, there are several treatment options available to significantly reduce the impact of stuttering. In fact, here in Australia, we are world leaders in the treatment of stuttering for children and we are home to programs that have been extensively researched and utilised with great success.

What causes stuttering?

The short answer is – despite this question having been researched over many decades – no one is exactly sure. What we do know is that stuttering is multifactorial. That is, stuttering is influenced by cognitive, linguistic, affective (emotional), environmental and motor movement factors during what we call a complex stuttering moment. We suspect that a complex stuttering moment is caused by a sort of ‘glitch’ in the brain when the person who stutters goes to speak.

In some instances, stuttering runs in families, however this is not always the case. We do know that children usually begin to stutter between the ages of two and six, and that stuttering is more common in boys than girls. Many children who stutter do so only for a short time (up to six months). However, for those who do not recover naturally during childhood, stuttering is usually a lifelong condition. Stuttering in adults is episodic and typically requires care and management at different times in a person’s life. Read more about stuttering in adults here. Unfortunately, it is not possible for a Speech Pathologist to predict if a child will or will not recover from their stutter naturally.

Should I be concerned?

Many parents are not overly concerned when their young child starts stuttering, believing their child will ‘grow out of it’. In many cases, they are right. However, there are some signs that indicate it may be time to see a Speech Pathologist. These include:

• If your child has been stuttering for longer than six months. Statistically, this means that your child has less likelihood of recovering naturally and may require therapy to reduce their stuttering.
• If your child is over three and a half years of age. Stuttering treatment is most beneficial when it is completed prior to the age of six. Younger children are better able to re-wire their speech habits than older children or adolescents.
• If there is a family history of stuttering that did not recover naturally. This may indicate a genetic predisposition to stuttering and intervention may be required.
• If there are any signs your child is stressed. This may include them appearing upset or frustrated, talking less than they once did, refusing or avoiding social situations such as daycare, or playing alone when others are around. Early stuttering treatment may help avoid the development of anxiety.

Is there a cure for my child’s stutter?

With consistent therapy and support, many children can reduce their stutter so that it is barely – or not at all – detectable while they are speaking.

We are careful not to call this a ‘cure’ for stuttering because there is always a chance that symptoms may return during times of stress or later in life. However, by reducing the severity of your child’s stutter, we can drastically improve their ability to speak freely and confidently and even improve their quality of life.

What does therapy involve?

Therapy for stuttering involves attending regular Speech Pathology sessions with your child and working through a structured program under the supervision of your therapist. There are a couple of options for treating a stutter in a child:

• Lidcombe Program – the Lidcombe Program is the gold-standard evidence-based program for treating stuttering in the early years. The Lidcombe Program is a family-centered approach in which parents respond to a child’s speech in a positive way that encourages stutter-free speech. The program involves twice-weekly, weekly, or fortnightly sessions with a Speech Pathologist in which parents are trained in the required techniques, followed by short daily practice sessions in the home. Although there is no fixed timeframe for completion of the Lidcombe Program, it usually takes around 12 sessions of intensive therapy in the early stages followed by 12 months of maintenance and upkeep.
• Westmead Program – The Westmead Program is another evidence-based program for treating stuttering in children. This program uses a method called syllable-timed-speech or ‘robot talking’. This program requires weekly therapy sessions initially, reducing to fortnightly after a period. This program requires home practice of 5-10 minutes, 4-6 times a day.

Once they have finished their assessment, your Speech Pathologist will be able to recommend the most appropriate treatment approach for your child and talk to you about the plan for therapy. Your Speech Pathologist may also use other techniques, in addition to the programs listed above, to assist in reducing your child’s stutter. Stuttering therapy should always be a collaborative process and it is important that you, as the parent, feel that you are playing an active role in your child’s therapy at every step of the way.

What about school-aged children?

Although this age group can be a little trickier to treat, and natural recovery has become unlikely, successful outcomes are still possible. During these years, therapy is very individualized and dependent on many factors such as the child’s age, personality type and personal circumstances. Read more about stuttering in adolescents here.

If you would like more information about stuttering or would like to book an initial consultation with a Speech Pathologist from our team, please contact us on 1300 086 280 or at [email protected].

References

Carey, B., Onslow, M. & O’Brian, S (2021) Natural recovery from stuttering for a clinical cohort of pre-school children who received no treatment, International Journal of Speech-Language Pathology, (23)1, 48-56, DOI: 10.1080/17549507.2020.1746399

Koushik, S., Hewat, S., Onslow, M., Shenker, R., Jones, M., O’Brian, S., Packman, A., Menzies, R., Harrison, L., & Wilson, L. (2019). Three Lidcombe Program clinic visit options: A phase II trial. Journal of Communication Disorders, 82, Article 105919. https://doi.org/10.1016/j.jcomdis.2019.105919

Lewis, C., Packman, A., Onslow, M., Simpson, J.M. & Jones, M. (2008). A phase II trial of telehealth delivery of the Lidcombe Program of early stuttering intervention

Trajkovski, N., Andrews, C., Onslow, M., O’Brian, S., Packman, A., Menzies, R. (2011). A phase II trial of the Westmead Program: Syllable-timed speech treatment for pre-school children who stutter. International Journal of Speech-Language Pathology, 13(6): 500-509.