When talking with friends and family, do you ever notice adding “uh”, “umm” or “you know” to your speech? If so, these are considered disfluencies. Disfluencies are moments when our speech is not smooth and fluent. It is important to note that this is often normal as we attempt to convey our thoughts and opinions to others.
While it is normal to experience occasional disfluencies in our speech, people who stutter may have a frequent number of disfluencies and/or different types that make their speech choppy and difficult to follow.
What is Stuttering?
Stuttering is often referred to a disorder of fluency and rhythm characterized by repetitions, blocking, prolongations, and increased tension and negative feelings. Often with stuttering, older individuals are aware of their speech disfluencies and may attempt to avoid speaking and hide their stutter.
Stuttering varies by day to day as well. There are certain situations that may make and individual more likely to stutter such as when they are overly excited or stressed. Most students I’ve worked with previously report increased stuttering when presenting in front of a class or when socializing with new people. It is important to note that this is very common since these situations are novel and can be stress-inducing. With stuttering, there will be good and bad days however implementation of strategies can help you.
Types of Stuttering
- Repetition of sounds, words and phrases: “I want want ice cream”
- Prolongation of sounds: “Zzzzzebras are mmy favorite”
- Blocking: “I (pause) want to play with my friend”
- Revisions: “I play… I run at the playground”
- Interjections: “He um is meeting me at the library”
- Incomplete Sentences/Phrases: “I went to… last fall…. in October… we went to Disneyland”
In addition to speech disfluencies, children may also develop secondary behaviors in attempt to
“rid” of the stutter or make their speech more smooth. Examples include but are not limited to an eye twitch or head nod.
Causes of Stuttering
While there is no exact cause of stuttering, the following are factors that influence stuttering.
- Family History: Evidence suggests that one is more likely to stutter if there is a family member who stutters. “Sons of mothers who stutter run a greater risk of stuttering than sons of fathers who stutter; daughters generally have a lower risk, but daughters of mothers who stutter have a higher risk than daughters of fathers who stutter.” (McGibbons & Hedge, 237)
- Gender: According to research, stuttering is more common in males than females with as a high of a 5:1 ratio.
- Co-Occurring Conditions: The prevalence of stuttering is higher with individuals of co-existing developmental disabilities and brain injuries (e.g. epilepsy) and lower for deaf and hard of hearing individuals.
Stuttering in Toddlers
Stuttering often emerges from ages 2 to 5 years old and is often referred to as developmental stuttering. Developmental stuttering is characterized by repetitions, interjections, and revisions of speech due to the child’s difficulty to motorically keep up with the message they hope to convey. In other words, children are learning language and speech at such a fast rate that there is a lag in the connection between speech and language, thus creating disfluencies.
Developmental stuttering often resolves on its own as the children gets older. However, 1 in 4 children have persistent stuttering. The stutter is more likely to linger if the individual has stuttered for 6 months or longer and exhibits more severe types of stuttering such as blocking and prolongations.
If your child exhibits more severe types of stuttering habits, has negative feelings and perceptions about their speech, or has had stuttering for 6+ months, it is recommended that seek help from a speech-language pathologist.
Stuttering Modification Strategies
Fluency modification strategies aim to produce fluent speech with decreased occurrence of stuttering. Here are examples of fluency modification strategies.
- Pull Outs: When implementing a pull-out, try to slow down your speech mid-stutter and utilize light contact of your speech articulators (e.g. lips, teeth, tongue, etc.) to pull out of the stutter.
- Cancellation: When implementing a cancellation, pause after a stuttered word and repeat in a more relaxed form.
Stuttering Fluency-Shaping Strategies
Instead of modifying your speech to prevent stuttering, fluency shaping strategies aim to establish normal fluency with the appropriate airflow of speech. In other words, you may still exhibit stuttering since these strategies do not eliminate the stutter.
- Easy Onsets: Easy onsets focus on using a relaxed and gentle production of speech after the exhalation.
- Light Contact: Light contact focuses on the gentle touch of your articulators to help you ease into the word for more fluent speech. For example, you would gently press your lips to create an easy and relaxed “p” sound in “pig” versus a hard “p”.
- Breathing Management: With fluency, managing your breath pattern is extremely important as your airflow helps you voice and communicate with others. It is important to be aware of your breath pattern with diaphragmatic breathing and to practice maintenance of an even airflow.
- Slow speech: Often with individuals who stutter, they will often speak in a fast rate causing them to experience an increased occurrence of disfluencies. Slow speech practices changing your rate to increase smoothness of speech.
When to Seek Professional Help for Your Stutter
As stated above, it is very common for children between ages 2 to 5 to exhibit developmental stuttering. It is also difficult to gauge whether they will “outgrow” their stutter or if it will persist and require further treatment.
Schedule a free consultation if you have any questions, however the following points are a great way to determine if your child may benefit from speech and language services.
- If your child’s stutter persists for over 6 months
- If your child demonstrates any other speech and /or language concerns
- If your child exhibits atypical disfluency patterns such as prolongations or blocking
- If your child’s stutter is impacting their perception of speech and affecting social relationships and how they communicate at school
- If your child is experiencing a high level of anxiety or fear when speaking is required
- If your child demonstrates secondary behaviors with their disfluencies such as facial grimacing, head nods, or eye twitches
Strategies to Help Your Child's Stutter
Here are strategies to help your child manage stuttering.
- Do not interrupt. Naturally when conversing with others, it is common for individuals to try to “fill” in the gaps especially when there are moments of disfluency. Try to avoid filling in their speech as this can affect their perception of their speech and cause negative feelings.
- Talk about stuttering openly. As a speech-language pathologist, I think it is important to debunk any myths or negative perceptions surrounding stuttering and to increase awareness. Not only will stalking about the stutter help your child better understand their speech, but will also debunk any perceptions.
- Provide a Model. When speaking to your child, try to model slow speech to help promote smoother speech.
- Educate family and friends. To minimize negative perceptions, educate family and friends so they can better understand what your child is going through. Often, teachers and family are unaware of how they are talking and will unintentionally create more demands. One child I worked with had grandparents that repeatedly told him to “speak better” and “talk right”. Although the grandparents attempted to help in the way they knew how, it created negative perceptions and the child eventually stopped talking.
- Praise your child. When your child demonstrates smooth speech, praise your child. You can say, “I love your stretchy speech” or “I like how you said that”. We want to acknowledge strategies utilized to help increase the use.
- Create an open and relaxing environment. Try to decrease the demands for smoother speech. In other words, create a relaxing enivronment that decreases any potential stress or tension your child might feel. High intensity situations often result in an increased frequency of stuttering.