About 5-10% of all children will go through a period of time where they stutter. Approximately 3 thirds of all children who stutter recover by adulthood, either by themselves or with the help of speech therapy. Still, stuttering is a prevalent problem in the world, with approximately 70 million people, or 1% of the world population, who struggle with stuttering.
Unfortunately, stuttering can result in a number of challenges for children, and this is especially the case if early childhood stuttering continues into adulthood. In this article, we will focus on the causes of childhood stuttering, and we will explain some of the treatment options available to stuttering children.
What is Stuttering?
Stuttering, sometimes referred to as stammering or dysfluent speech, is a speech disorder characterized by repetition of sounds, syllables, or words; prolongation of sounds; and interruptions in speech known as blocks. An individual who stutters exactly knows what he or she would like to say but has trouble producing a normal flow of speech. These speech disruptions may be accompanied by struggle behaviors, such as rapid eye blinks or tremors of the lips.
Symptoms of stuttering can vary significantly throughout a person’s day. In general, speaking before a group or talking on the telephone may make a person’s stuttering more severe, while singing, reading, or speaking in unison may temporarily reduce stuttering.
Common Difficulties Often Experienced by Children with a Stutter
1. For most children, stuttering occurs over a number of activities at home, school, and in play. For some children, a stutter only occurs in specific situations, such as talking on the telephone or talking in front of groups.
2. A stutter can range from mild to very severe. The impact of stuttering on a child is highly individual such that a mild stutter may cause one child extreme frustration and/or anxiety while a more severe stutter in another child may not affect them at all.
3. The child may avoid situations where the stutter is worse or hide their stuttering by choosing words on which they are less likely to stutter.
4. The child may also rearrange their words and sentences to avoid a stutter. Sometimes they will pretend they have forgotten what to say or remain quiet.
5. Stuttering can have a great effect on a child’s confidence when speaking and may affect their social skills or how they relate to others.
6. School-age children will often report feeling embarrassed when they have to read out aloud or talk in front of the class.
7. Language delay or disorder.
8. Articulation difficulties.
If left untreated, a child with a stutter may face a number of difficulties:
1. They may have trouble learning to talk and speak intelligibly and with clarity.
2. They may struggle with self-esteem and confidence when they realize that their speaking skills do not match that of their peers.
3. Unfortunately, children who stutter are at a higher risk for bullying when others become away from the child’s speaking difficulties.
4. They may experience social isolation, either self-imposed or externally imposed, when it becomes clear that they cannot cope in group situations or busy environments, impacting their ability to form and maintain friendships.
5. They may experience anxiety and stress in a variety of situations, ultimately leading to more difficulty in reaching their academic potential, regardless of their intelligence.
6. They may struggle with various forms of social communication, such as making eye contact, maintaining an appropriate distance when talking to someone, and taking turns in a conversation.
7. They may face problems with vocabulary acquisition whereby the child cannot clearly get their message across to others due to limited word knowledge.
Different Types of Stuttering and Causes
No one speaks all the time perfectly. Many people will experience speech disruptions at some point in their life. However, for most people, these speech disruptions are minor and do not greatly affect a person’s life. For people who stutter, these disruptions, or disfluencies, are more severe and are experienced more consistently.
Researchers currently believe that stuttering is caused by a combination of factors, including genetics, language development, environment, as well as brain structure and function. Working together, these factors can influence the speech of a person who stutters.
1. Stuttering and Language Development
Stuttering most often begins between the ages of two and eight, when children’s language abilities are rapidly expanding. Many children who stutter may know exactly what they want to say, but their motor pathways aren’t quite ready to get the words out.
As children produce longer and more complex sentences, their brain experiences higher demand. This increased demand can affect the motor control necessary to produce speech. When motor pathways can’t keep up with language signals, stuttering can occur.
While the rapid language development occurring in young children makes them more susceptible to disfluencies, all children develop differently. Some children who stutter have additional problems that may contribute to disfluencies, such as speech and language delays, ADHD, and learning disabilities. For developing children, a genetic disposition to stuttering combined with environmental factors may cause their disfluencies to increase over time and persist into adulthood.
2. Brain Activity in People Who Stutter
While no one factor determines stuttering, the predominant theory suggests that a combination of genetics, language development, and the environment can influence the brain activity of people who stutter.
The areas of the brain responsible for language may look and work differently in people who stutter. Findings from brain imaging studies indicate that there is more right hemisphere activity in adults who stutter, with less activity in the left hemisphere areas typically responsible for speech production. Some people who stutter have more difficulty processing auditory information and slower reaction times on sensory-motor tasks. In general, research has shown that the pathways in the brain responsible for language look and function differently when stuttering occurs.
3. Genetic Factors
A family history of stuttering can demonstrate that stuttering runs in families and is influenced by genetic factors. Children who stutter, for example, often have relatives who stutter. Identical twins sharing the exact same genetic makeup have more similar patterns of stuttering than fraternal twins. We also know that stuttering affects males more than females and that females are less likely to continue stuttering as adults.
Researchers haven’t pinpointed a specific gene that’s solely responsible for stuttering. However, it’s possible that if you carry certain genetic material, you may be more likely to stutter at certain years of age.
4. Emotions and the Environment
As children become aware of their disfluencies, negative feelings related to speaking may increase tension and further affect their ability to communicate. Depending on their temperament, some children may experience more emotional arousal and anxiety when speaking than others.
Emotional factors are difficult to measure, and cannot be considered the primary cause of stuttering. However, negative emotions may place an additional cognitive burden on children who stutter during a critical period of language development.
5. Acquired Stuttering
Most people who stutter begin stuttering in childhood, during the developmental period in which they are learning to communicate. In rare cases, stuttering is the result of brain injury or severe psychological trauma. This form of stuttering, known as “acquired” stuttering, differs from developmental stuttering in both its causes and manifestations.
Treatment Options for Childhood Stuttering
1. Indirect Treatment
Mild stuttering may require indirect treatment if it doesn't resolve on its own or improve with parent counseling within about 6 weeks. This type of treatment encourages young children to speak more slowly. It may involve breathing exercises and other techniques that can help create a comfortable and relaxing environment in which the child's speech can improve or stuttering may go away naturally. Your child may have limited involvement with a speech-language pathologist (SLP), who evaluates and monitors progress while observing and interacting with your child.
Treatment will also focus on how you can support your child at home. For example, you may be taught more ways to slow down your own speech and how to provide opportunities for quiet exchanges with your child, where speaking is optional. Some programs focus on continuing to learn creative ways to give your child positive reinforcement during periods of speech fluency. You will also be shown how to track your child's progress and keep detailed records.
2. Direct Treatment
Direct treatment (speech therapy) tends to be used if your child's stuttering lasts (persists), gets worse, or is severe. It involves personal interaction between a speech-language pathologist (speech therapist) and the child who stutters. The main focus is to help keep the stuttering from getting worse. Working with a speech therapist can help your child master certain speech and language skills and feel better about his or her ability to speak.
The therapist teaches your child:
1. How to form words, speak slowly, and relax even while stuttering. Your child can practice these exercises outside of instruction time.
2. How to manage the physical symptoms of stuttering, such as eye-blinking.
3. How to deal with the emotional difficulties that may result from speech problems.
Role-playing and play-based activities are common ways to help your child learn how to apply these strategies. For example, your child may be asked to imagine different situations as he or she speaks and to role-play how others would react. Your child can practice responses and learn to anticipate and manage stressful situations.
Also, a therapist may have your child practice speaking in different settings and with different people. For example, your child may start with speaking alone, then in front of a small family group, and then gradually work up to reading aloud in front of others, speaking on the telephone, and talking in front of a classroom.
The therapist also often works with you and other family members. The therapist teaches the family some techniques for building an accepting and calm environment, which is important for improving your child's speech. This training is an extension of indirect treatment, where a calm environment is provided for speech to resolve naturally with little intervention.
You also may be asked to keep detailed records of your child's progress by using specific techniques in the home setting.
Stuttering usually improves gradually over a year or more with direct treatment. Some children may even lose all trace of speech problems. The success of treatment largely depends on:
1. The cause of the speech problem.
2. A child's strengths.
3. The therapist's abilities.
4. The amount of support from parents and family.
Your child will need to practice his or her new skills after the therapy program has ended. Using the skills day after day will help your child continue to speak as smoothly as possible.
Speech Therapy Resources
There are many organizations that have made it their mission to help children with speech disabilities to find their voice and succeed in life. In California, the California Scottish Rite Foundation’s life-changing speech-language and literacy programs provide opportunities for children to improve their communication skills and self-confidence. Our RiteCare Childhood Language Programs offer best-in-class, individualized services that address the needs of developing children and their families.
Funding from our donors and granting foundations facilitate the resources our Speech-Language Pathologists need to empower children with increased independence, decreased frustrations, and a pathway to academic success, at no cost to the families. Our donors are proud to give, knowing their contributions drastically improve thousands of children’s lives every year.
Moving Past Stuttering
Childhood stuttering is a problem faced by a large portion of children worldwide. In fact, the primary type of stuttering is ‘developmental stuttering’ which occurs in children. When a child stutters, they may face a number of difficulties, both socially, academically, and personally.
children often become self-conscious and find much social interaction, as well as academic activities, challenging. If left untreated, stuttering can develop into a serious problem. This is why it is best to reach out to organizations and practitioners working in speech therapy to ensure that your child beats their stutter and can move forward in life, happy and confident.