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Stuttering, or stammering, is a speech disorder characterised by
interruptions to speech such as hesitating, repeating sounds and
words, or prolonging sounds. Around one per cent of people in all
cultures stutter. In early childhood stuttering is common: 11% of
children stutter at some point.
Stuttering can be mild, moderate or severe, and can vary within the
same individual across speaking situations and from one day to the
next, particularly with children. Stuttering is graded by its degree of
severity. Most researchers and clinicians rate stuttering on a 10-point
severity scale. A score of 1 represents no stuttering, a score of 2
represents extremely mild stuttering and a score of 10 represents
extremely severe stuttering. Stuttering can also be measured using
percentage syllables stuttered whereby a speech pathologist counts all
the stuttered and stutter free syllable a child says.
Stuttering behaviours
Stuttering behaviours vary widely between individuals, and commonly
include: Hesitations, as if the next word is ‘stuck’; Repeating sounds,
syllables or words such as ‘I-I-I think’ or ‘where-where-where is it?’and
Prolonging sounds, such as ‘mmmm-mummy’.
Origins of stuttering
The cause is unknown, but researchers suspect there is a faulty
connection in the area of the brain responsible for speech production.
The fact that stuttering tends to run in families indicates that genetics
is involved somehow in the condition. Studies of stuttering in twins
have also found that both twins are more likely to stutter if they are
identical rather than fraternal.
Recent research found that stuttering children were not more shy or
withdrawn than their non-stuttering peers. That is, personality
differences did not play a role in the onset of stuttering.
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It was once assumed that parents played a role in the onset of a
child’s stuttering. When children start to talk, they naturally hesitate
and stumble over words. It was proposed that over-anxious parents
believed this natural hesitation was stuttering, and pressured their
child to talk properly, which caused the child to start ‘real’ stuttering.
However, there is no evidence to indicate that anything parents do, or
don’t do, causes the onset of stuttering.
Development of stuttering
Stuttering typically begins in children aged two to four years.
Stuttering may develop gradually or suddenly. Stuttering can be highly
variable in some children and stable in others.
Impact of stuttering
Older children and adults who stutter often fail to achieve their
educational or career potential and may experience significant anxiety
in social situations. Children who stutter report being teased by their
peers. Preschool children who stutter seems to do well compared to
their peers, having better receptive and expressive language skills and
non-verbal cognitive performance. Preschool children who stutter
were not more shy or withdrawn and did not show any evidence of
social emotional and behavioural problems.
Natural recovery
Many children are reported to recover from stuttering or to ‘grow out
of it’ without any intervention. Reports suggest this may be as high as
80%. Recovery is said to occur in the majority of children in the first
12 months after onset. However a recent study reported that just 6%
of preschool children recovered during the first year after onset.
Because so few children recovered the study was unable to identify
factors that might predict which children might recover. An ongoing
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challenge for researchers is to identify factors that might separate
those children who recover naturally from those who will persist and
require treatment.
Seek professional help
Treatment is not necessary for many children close to stuttering onset.
We continue to recommend a watch and wait approach. Parents
should however consult a speech pathologist if they are concerned
about their child’s stuttering. A speech pathologist will determine
whether treatment should commence immediately or whether it is
better to monitor the stuttering for a while to see if natural recovery
occurs.
Reports that a child is becoming unwilling to communicate or
frustrated with their speech or where there are high levels of parental
concern, are good reasons to instigate a referral and to commence
treatment.
For other children it may be appropriate to monitor the child's
stuttering for a period after onset.
When stuttering persists it is important to commence and to do so
prior to the child starting primary school. Clinical trials have
demonstrated that stuttering becomes less tractable throughout the
school years.
Treatment for children
The best evidence (from clinical trials) for treating children who stutter
is the Lidcombe Program of Early Stuttering Intervention. This is a
behaviour modification treatment. Parents are trained in the
Lidcombe technique.
http://pediatrics.aappublications.org/content/early/2013/08/20/peds.20
12-3067.abstract?sid=69fb8a5d-b81e-474f-b9d0-08decc31d189