Q: My 3-year old son has recently started to stutter. Another parent told me not to worry; her son stuttered as well, but it eventually went away. However, there are a number of men on my husband’s side of the family who stutter. How concerned should I be?
A: Many parents get very concerned when they notice developments such as stuttering in a child. Even though we are told that some famous people such as Sir Winston Churchill, Marilyn Monroe, Carly Simon and James Earl Jones stuttered, it does not make it easier for us to relax.
A recent report on the Dow Jones Newswire claimed that stutterers find it harder to gain employment because they face discrimination. One lawyer who stutters told a story of how many employers would not even return his calls. He also said this blunt question was thrown at him: "How can I put you in front of a judge?”
As a result of discrimination, even in a current climate of tolerance, some stutterers do not pursue a career in fields where verbal communication skills are a primary focus. Organizations such as the Stuttering Foundation of America as well as other prominent stutterers correctly state, "This discrimination is too bad, because people who stutter can still be great at any job".
According to the Stuttering Foundation of America, the essential defect is hypothesized to be a lack of “sensorimotor integration”, which is necessary to regulate fluent speech. Studies published in journals such as Lancet, Nature, and Brain, indicate that there are brain-imaging abnormalities in adults who stutter. Specifically, there is deactivation of the left-hemisphere sensorimotor centers and over activation of the right hemisphere structures during both stuttered and non-stuttered speech.
The cause of stuttering is still not fully understood. It may emerge from a combination of one’s physical makeup and environmental factors. Geneticists have found that a susceptibility to stuttering may be inherited, though for the majority of children who stutter, there is no family history. Stuttering is more common in identical twins as opposed to fraternal twins, and it is three to four times more likely to occur in boys. There is no clear evidence of brain damage.
In addition to being male, other risk factors that can predict a chronic problem are:
- Stutterers among family members
- Delays in articulation
- Slower speech and language development.
However, none of these risk factors alone appear to predict the continuation or duration of stuttering. Rather, it is the cumulative nature of all these factors which differentiate the child who stutters for a season versus the youngster where stuttering comes and stays.
The onset of stuttering occurs typically during a period of intense speech and language development. As the child progresses from 2-word utterances to the use of more complex sentences, stuttering or disfluency of speech becomes more noticeable. There may be brief hesitations, repetitions and sound prolongations. These first signs of stuttering may gradually diminish, and then disappear in most children.
About 5% of all children go through a period of stuttering that lasts for six months or more. Three-quarters of those who begin to stutter will recover by late childhood. When stuttering persists for 18 months or longer, then it is more likely that it will become a chronic problem. Children with severe stuttering may have associated behaviors such as eye blinking, eye closing, looking away, physical tension around the mouth and other parts of the face, fear of speaking, and a feeling of being embarrassed at all times.
Early identification of children who stutter is critical for a good outcome; early referral to a qualified speech and language therapist can make a big difference. Some clinicians will recommend a referral to a speech therapist if there is no improvement in stuttering over a period of two to three months.
Some parents of children who stutter sometimes mistakenly think that they have done something to cause the problem. They fell responsible for their child’s stuttering, often thinking they may have caused it when they rushed their child to speak or when they asked too many questions.
On their Website, www.stutteringhelp.org, the Stuttering Foundation of America offer these suggestions for parents of children who stutter:
- Speak with your child in an unhurried way, pausing frequently.
- Use your facial expressions and other body language to convey to your child that when he or she stutters, you are listening to the content of his or her message, and not to how he or she is talking.
- Instead of asking questions, simply comment on what your child has said, thereby letting the child know you heard him or her.
- Set aside a few minutes at a regular time each day, when you can give your undivided attention to your child.
- Help all family members to learn to take turns talking and listening.
- Observe the way you interact with your child.
- Above all, convey that you accept your child as he or she is.
There are many books, videos, DVDs and brochures, which are available for further study. One of my favorite DVDs is Stuttering: For Kids By Kids (available from the Stuttering Foundation). This DVD features the cartoon characters Swish and his friends, who talk about stuttering, dealing with teasing, what helps and how to teach others about stuttering.
Meanwhile, next time we hear the deep, booming voice of James Earl Jones on TV saying "This is CNN", or when we see a photograph of Sir Winston Churchill flashing a victory sign, let us remind ourselves that life is all about overcoming obstacles.
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