Stuttering is a speech pattern that contains an abnormally high frequency or duration of disruptions in the forward flow of speech affecting its continuity, rhythm, rate, and effortfulness. A disruption in speech is called a disfluency. We all have disfluencies in our speech, such as “uh”, “um”, pausing, or rewording, but it is only considered stuttering when we are disfluent more than ten percent of the time.
The Essentials of Stuttering
Fluency is the effortless flow of speech. There are four parts to fluency: continuity, rate, rhythm, and effort. Stuttering affects all four parts. Continuity is the smoothness of speech. It is decreased by how often and where pauses happen in speech and by how many extra sounds are added. Rate …show more content…
is how fast or slow speech is, and is measured by words or syllables spoken per minute. The rate of information and sound flow is too slow for people who stutter. That is why it can be harder to listen to them. Rhythm is the pattern of speech and it depends on intonation, stress pattern, timing, and duration. People who stutter have disruptions that are louder, longer, and slightly higher pitched. This is what makes disfluencies more noticeable. Lastly, effort is how much mental or physical work it takes to talk. Normal speech is not effortful. It takes people who stutter more effort to talk. It takes mental effort to think ahead of time about what words won’t make you stutter and it takes physical effort to stop or escape from a stutter.
Stuttering affects many children as they learn to speak. This is called developmental stuttering. Young children may stutter when their speech and language abilities aren’t developed enough to keep up with what they want to say. Most children outgrow developmental stuttering, often within four years. About three quarters or more of very young children who stutter are prone to recover without any form of treatment.
Stuttering usually begins at a time when the child is integrating speech and language skills within a changing physical and neurological makeup during a dynamic expansion of communication demands, personal interactions, and situational experiences. Some children begin stuttering as soon as they begin combining words, but this is not very common. Most do not start until approximately one year later, around the age of two or three. About ninety percent of children who stutter begin to do so before the age of six. Stuttering can begin either suddenly, intermediately, or gradually. The progression of stuttering severity is often episodic, containing oscillations that range from no stuttering to mild to severe across time.
Influences: Factors that may Contribute to the Development of Stuttering
Family dynamics can have an influence. Some examples of these factors include parental attitudes and expectations, the child’s speech and language environment, and stressful life events. This does not mean that the parents are doing anything wrong. Often these things are not harmful to a child that doesn’t stutter, but can aggravate stuttering in a child that has a tendency to stutter.
Other’s reactions to stuttering are a big problem. Often people don’t know how to react. They are awkwardly caught off guard, or they can’t wait for the person who stutters to finish what they are saying. There are good reasons to believe that those who stutter have expectancies of social harm. Research suggests that those who stutter differ from control subjects in their expectation of negative social evaluation. While these peer reactions do have an impact on stuttering, it is unknown whether social anxiety mediates stuttering or is a simple by-product of stuttering.
Developmental factors are believed to be a contributing factor. During the preschool years, a child’s physical, cognitive, social/emotional, and speech/language skills are developing at a very rapid rate. This rapid development can lead to stuttering in children who are predisposed to it. This is why stuttering often begins during the preschool years.
For a long period, information on the genetic aspect of stuttering was primarily based on data concerning the percept of people who stutter having relatives with histories of stuttering. This figure has varied in the past from 20% to 74%. The most recent research shows that approximately 60% of children who stutter have a family member who does also, or who used to stutter as a child. Although it is apparent that stuttering runs in families, this fact, in-and-by itself, is insufficient to conclude genetic underlining (Yairi).
Professionals know that there is a disruption of speech fluency associated with stuttering that is reflected by actual differences in the structure and function of the brain.
It is not known, however, if these neurological differences are the cause of the result of stuttering (or both). Research done shows physical differences in several brain areas associated with speech and language skills. Such results may indicate that theses physical differences create competing commands that may interfere with fluent speech. However, and alternate view is that these neurological differences may develop in stutterers during early childhood due to the child’s attempts to voluntarily control or monitor disfluencies (Ramig & …show more content…
Dodge).
Theories About Stuttering
First is the diagnosogenic theory. This says that stuttering happens when a child becomes overly sensitive to typical disfluencies, which every child has, because of someone’s reactions. As a result, he tries hard to avoid being disfluent or “messing up” again. According to this theory, stuttering is in the listener’s ear, not the child’s mouth.
The communicative failure and anticipatory struggle theory says that stuttering happens because of early experiences, such as the reactions of listeners and the environment, which made the child thing that speech is hard, and they trigger the child to stutter. For example, if the child has a hard time talking, he may become tense, and break up his speech. Then the core stuttering behaviors soon become a part of the speech pattern that the child learns to dread. This theory says that stuttering is learned, and both internal and external influences play a part.
The capacities and demands theory says that children who stutter are not able to handle the normal speech, language, and situational demands so fluency is lost and the child stutters. Motor skills, language skills, emotional maturity, and cognitive development are all needed to talk smoothly. If a child has to compete with others for a turn to talk, the child feels he has to talk fast so that you will listen to everything he has to say. This is an example of a motor demand. An example of a language demand is if a child has a high vocabulary or is trying to use big words while he talks. An emotional demand would be trying to talk while excited or upset. An example of a cognitive demand is if the child is talking with a lot of anxiety that he is going to stutter and be ashamed is he does.
Last is the two-factor learning theory.
This theory operates on classical conditioning. The speaker learns to associate speaking with a negative emotional response. According to this theory, stuttering is an automatic reaction to a learned stimulus. Somehow and easy, normal disfluency becomes paired with an event that makes the child become tense. From then on, a disfluency is tense (a stutter) even without the event. Some examples of what might trigger this are the child’s location during a stutter, sounds that occurred during a stutter, people or gender of persons listening to the stutter, talking on the phone during a stutter, and words or sounds said during a stutter. These things can all accidentally happen during a stutter, which gives these things the power to make a person stutter tensely when they happen again. Then, when the person who stutters does something on purpose to get out of the stutter, such as jerking their head or blinking their eyes, and the stutter stops, that behavior is now conditioned to stop a stutter in the person’s head. For example a child might think, “The phone rang while I was trying to talk to my friend this morning and I stuttered. The next time the phone rings while I am talking, I will stutter”
(Ducworth).
The best way to understand stuttering is to talk all the theories and views of stuttering and combine them together into one perspective. What causes stuttering can be considered a complex interaction of five factors (CALMS): Cognitive, Affective, Linguistic, Motor, and Social. Genetic and physical factors are necessary, but they may not be sufficient to cause stuttering. The CALMS factors are needed as well (Mayo Clinic Staff).
Difficulties for Children who Stutter
Many people have functional lives and successful careers despite stuttering. Some famous people who stutter are Marilyn Monroe, Julia Roberts, Bruce Willis, and Tiger Woods. So, if that’s not enough proof that you can stutter and still be successful, then I don’t know what else is. There is no cure for stuttering, but speech therapy can help children learn techniques to help control their speech. Stuttering can, however, have a huge impact on a person’s self-esteem and confidence.
Children who stutter often have anxiety, or nervousness, about talking, guilt, shame, fear, embarrassment, frustration, and negative attitudes towards speaking. These feelings can range from very mild and hardly impacting a person’s life to very severe and preventing the person who stutters from functioning socially at all. The negative feelings and attitudes can prevent a person who stutters from doing everyday things such as ordering food at a restaurant, speaking on the phone, or even speaking at all.
These negative attitudes and feelings can stem from feeling out of control, concern and anxiety of parents, and teasing and rejection from other children, which can make stuttering worse and more often, cause avoidance behaviors, and make a person not willing to risk change. It can also make it harder for improvements made in therapy to stick. Treating negative feelings and attitudes that accompany a stuttering disorder is a very important focus in therapy. These negative feelings can either make stuttering therapy harder because it requires the person to face and overcome them, or they can make it more successful because they empower and motivate the person to overcome stuttering. The bottom line is that they need to be treated and handled carefully.
Time pressure is also one of the worst things from people who stutter and it is getting worse. Today’s world is very fast-paced and people are always trying to do things as quickly as possible. This time pressure is very common in our communication. When we talk to others and they don’t answer fast enough, we get impatient. We will start talking again or we assume the other person didn’t understand us. People who stutter feel this pressure to respond, plus they are stressed because they know that if they pause, the might have trouble getting started again.
Advice for Teachers
Stuttering is unique among the various disabilities because its severity may actually be aggravated and negative effects may increase as a result of participation in school. Because confirmed stuttering is developmental in nature, school experience may be a key ingredient in the development of severe stuttering. It is the child’s first, significant participation within organized social activity, in which the genetic predisposition to stutter is combined with environmental stressors.
There are many warning signs to watch out for. First are multiple part-word repetitions. This refers to repeating the first or last sounds of a word, more than one or two times, faster than normal, or with irregular tempo. Second are prolongations. Prolongation refers to stretching out a sound at the beginning of or particularly within a word, such as “rrrrrrrr---abit” or “raaaaaa---bit.” It is important to distinguish easy stretches from prolongations associated with tension of struggle. Third is use of the reduced “schwa” vowel. Instead of saying “re-re-re-read” the child says “ruh-ruh-ruh-read.” This behavior indicates that the speech difficulty has become uncoupled from language and communication and is being felt as a performance struggle. It also indicates that the child has lost a measure of awareness due to the severity of the blocking experience. Fourth is blocking. Blocking refers to stopping or getting stuck before or during the production of a sound or word. Blocks may be anticipated as the person approaches a word, or blocking may be used to close down the system so as to draw less attention to the stuttering movement. Fifth is struggle and tension. Increased muscular tension of the articulators accompanies stuttering that has developed to the point where intervention is indicated. To overcome this tension, the child recruits additional surrounding muscles and muscle groups in an attempt to overcome the feeling of blockage. Struggle and tension may be seen in the nose, jaw, neck, cheeks, lips, forehead, and upper chest. Sixth is pitch, rate, and loudness increase. These phenomena often occur on prolongation of sounds, when the child is struggling to break out of a block and proceed to the next sound. The child may anticipate or feel that he is going to have difficulty on the sound and uses the pitch or loudness rise as a way to force his way through the block. Seventh is disturbed of irregular breathing. Upon anticipating stuttering, the child may hold his breath, take several breaths, or display other types of erratic or irregular breathing patterns, such as trying to rapidly say lots of words per breath group. Eighth is movement of other body parts. When experiencing one or more of the other warning signs, the child may jerk his head forward or back, move his arm, leg, or hand, or attempt other unusual behavior as he expects to stutter or actually experiences the moment of stuttering. Tenth is avoidance of talking. Stuttering is usually hard for teachers to notice because kids who stutter tend to avoid talking as much as possible.
All preschool children are busily learning to talk. As such, they make speech mistakes. Some children have more than others, and this is normal. There might be certain children who have many disfluencies-most commonly repeating words and prolongation of sounds. These are quite noticeable to listeners. If you are concerned that there may be a problem of stuttering developing with one of these children, don’t pay any special attention to the child at this point. Rather, talk to a speech pathologist for suggestions. Also, talk to the parents about their opinion of the problem so that you know whether this is typical speech behavior for him. In most instances, if parents, teachers, and others listen to and answer the child in a patient, calm, and unemotional way, the child’s speech returns to normal as his language abilities and his adjustments to school improve. If the child continues to have disfluencies, however, you may want to ask a speech pathologist to observe him.
There are children in elementary school who not only repeat and prolong sounds markedly, but also struggle and become tense and frustrated in their efforts to talk. They need help. Without it, their stuttering problem will probably adversely affect their classroom performance. As suggested with the preschool child, consult with a speech pathologist as well as with the parents and discuss your observations with them. If you, the parents, and the speech pathologist agree that this child’s disfluencies are different from other children in your classroom, you may decide as a team to evaluate the child for stuttering.
Usually it is advisable for you to talk with the child privately. Explain to him that when talking—just like when learning other skills—we sometimes make mistakes. We bobble sounds or repeat or get tangled up on words. With practice we improve. Explain that you are his teacher and that his stuttering is okay with you. By talking to the child in this way, you help him learn that you are aware of his stuttering and that you accept it—and him.
As you are asking questions in the classroom, you can do certain things to make it easier for a child who stutters. Initially, until he adjusts to the class, ask him questions that can be answered with relatively few words. If every child is going to be asked a question, call on the child who stutters fairly early. Tension and worry can build up the longer he has to wait his turn. Assure the whole class that they will have as much time as they need to answer questions, and that you are interested in having them take time and think through their answers, not just answer quickly.
Many children who stutter are able to handle oral reading tasks in the classroom satisfactorily, particularly if they are encouraged to practice at home. There will be some, however, who will stutter severely while reading aloud in class. Most children who stutter are fluent when reading in unison with someone else. Rather than not calling on the child who stutters, let him have his turn with of the other children. Let the whole class read in pairs sometimes so that the child who stutters doesn’t feel special. Gradually he may become more confident and be able to manage reading out loud on his own.
Teasing can be very painful for the student who stutters, and it should be eliminated as far as possible. If the child has obviously been upset by teasing, talk with him or her one-on-one. Help the child to understand why others tease, and brainstorm ideas for how to respond. If there are any certain children picking on him, talk to them alone and explain that teasing is unacceptable. Try to enlist their help. Most want the approval of the teachers. If the problem persists, you may want to consult a guidance counselor or social worker if one is available in your building. They often have good suggestions for managing teasing (Yaruss & Coleman).
Mayo Clinic Staff. (2009). Stuttering causes. Mayo Clinic. Retrieved from http://www.mayoclinic.com/health/stuttering/DS01027/DSECTION=causes.
Yaruss, J. S., & Coleman, C. (2004). Stuttering at a glance: Information for teachers. The Stuttering Center of Western Pennyslvania. Retrieved from http://www.mnsu.edu/comdis/isad8/papers/coleman8/teacherinfo.pdf.
Yairi, E. (2011). Genetics of stuttering: New developments. The Stuttering Foundation. Retrieved from http://www.stutteringhelp.org/default.aspx?tabindex=492&tabid=502.
Ducworth, D. (2004). Causes and treatment of stuttering in young children. Super Duper Handy Handouts, 65. Retrieved from http://www.superduperinc.com/handouts/pdf/65causeTreatment.pdf
Ramig, P. R., & Dodge, D. (2010). The child and adolescent stuttering treatment and activity resource guide, Second edition.