What is stuttering? Stuttering is more than just stuttering. It arises due to an interaction among several factors that are affected by both the child’s genes and their environment:
- Language Skills for formulating messages (planning)
- Motor Skills for producing rapid and precise speech (producing)
- Temperament for reacting to disruptions in speech (reacting & regulating)
In other words, stuttering is built-in! It is not just a habit or a behavior…it’s a neurological dysfunction of the child’s language and motor systems that varies (consider someone with asthma).
A speakers reactions to their stuttering and the environment in which stuttering takes place affect the severity of the stutter:
- Affective – feelings, attitudes, emotions
- Behavioral – actions (avoidance, tension, struggle)
- Cognitive – thought-processes, self evaluation
- Environment – reactions of listeners and situation
All of these components can affect a speaker’s participation and/or limitations in an activity, i.e., presenting a book report in front of the Speech-Language Pathologist, Teacher, class, or entire school will have different reactions and severity of stuttering.
What causes stuttering? Stuttering is so broad-based we must assess all levels during an evaluation:
- What etiological factors may contribute to stuttering? (Remember stuttering is built-in.)
- What are the observable stuttering behaviors? (eye-blinking, facial grimaces, head/neck tension, hand/foot tapping…)
- What are the child’s reactions? (affective, behavioral, cognitive)
- What are other people’s reactions? (environment)
- What is the overall impact of stuttering on the child’s life? (the impact of stuttering is the key to motivation)
The goal is to learn how to treat stuttering, right? It depends on how we define stuttering. If we define stuttering as only speech behaviors then we run into problems. What is our success rate with getting kids to be totally, normally fluent all the time? If we use a broad-based definition of the entire disorder taking into account the child’s overall communication experience, then we can be much more successful. If stuttering is more than just stuttering, then stuttering treatment is more than just treatment for stuttering…We must treat the Disorder, not just the Behavior!
If we keep trying to force children to be fluent when they can’t, we give them the message that stuttering is bad…and so are they. We may actually increase the shame and guilt that makes stuttering so problematic.
We must help children become effective communicators, NOT non-stutterers:
- Impairment – focus is on changing timing and tension (speaking rate, pausing, pace, light contact, easy start)
- Reactions – reducing negative reactions by helping the child come to terms with and accept stuttering (reduce the shame that is associated with stuttering by making the child the expert)
- Environment – educating those in the child’s environment to curb teasing and increase support and understanding (pseudo-stuttering)
- Impact – minimizing the negative impact of stuttering in the child’s daily life
How do we know when a child is done with therapy? Therapy is over when a child can successfully manage stuttering and communicate effectively (or when he has “learned to be his own clinician”). Stuttering is not a fix-it disorder, it is a manageable speech disorder!
Stuttering Organizations and Resources
Stuttering Foundation of America (SFA) – (800) 992-9392 – Publishes many helpful booklets and videotapes for clinicians, people who stutter, and their families.
National Stuttering Association (NSA) – 1-800-We Stutter (1-800-937-8888) – Publishes helpful booklets for children who stutter and their families. Supports more than 80 local chapters for adults who stutter, as well as, several new local chapters for children and families nationwide. Hosts an annual conference with a 3-day youth program.
Friends: Association for Young People who Stutter – Hosts an annual conference bringing together people who stutter from around the country.
The Stuttering Home Page – Contains a tremendous amount of helpful information about stuttering, including essays about stuttering and links to other stuttering pages.
Article written by Sarah M. Guest, M.S. CCC-SLP.