Childhood-onset Fluency Disorder (Stuttering)
Childhood-onset fluency disorder, or stuttering, is common in early development, often affecting speech fluency. The child knows what they want to say but find it hard to say it at that specific moment.
Stuttering is natural of a child’s development, but sometimes the child does not outgrow the stuttering. When such dysfluencies persist, it could lead to limitations in communication, academics, and social functioning.
Signs of Stuttering
The key warning sign of stuttering is a disruption in the normal fluency and rhythm of speech, persisting beyond 6 months. This is often inappropriate for the child’s age and language skills, and occurs over an extended period of time. The child could display anxiety about speaking or has difficulties with situations that require speaking such as social participation and academic setting.
Symptoms of stuttering include:
Ψ Repetitions of sounds or
words (e.g., ma-ma-ma-mummy, I-I-I-I want car)
Ψ Prolonging the sound of consonants as well as vowels (e.g., mmmmummy)
Ψ Audible or silent blocking, such as pauses in speech
Ψ Replacement of certain words to avoid them
Ψ Words pronounced with physical tension
Stuttering may also be accompanied by certain motor movements, such as fist tightening, head jerking, tics, tremors of the lips/jaw, and eye blinking. Stuttering can also be a symptom of other disorders, like Tourette’s syndrome.
Risk factors
Childhood-onset fluency disorder typically occurs at ages 2 to 7.
It is observed that children who face an increased likelihood of stuttering have family members who stutter, experience symptoms of stuttering that last longer than 6 months, have high self-expectations or experience stress within the family. It can also be a result of other speech-motor or sensory deficits or neurological conditions (e.g., trauma or stroke).
The importance of early diagnosis
Early diagnosis and treatment will minimize difficulties that subsequently develop in other areas of functioning and well-being. If left untreated, stuttering could lead to communication problems, bullying, avoidance of social situations, emotional problems, and anxiety and depression in adulthood.
Treatment will support the child in their dysfluency. It could entail avoiding certain words, increasing confidence for public speaking, and building the ability to communicate oneself.
Management of Stuttering
A speech therapist would first conduct an assessment, then develop a multimodal-treatment plan to build adaptive communication skills and improve speech fluency.
Speech Therapy
Speech therapy aims to improve the fluency in speech by implementing shaping techniques through direct and indirect techniques. Direct techniques get the child to adjust the rate of speech by giving feedback on speech in a non-judgmental way. Indirect techniques aim to encourage the child to speak by creating a comfortable environment; when the child feels that it is safe to speak, they are more likely to.
Cognitive Behavioural Therapy (CBT)
CBT helps children cope with stressful situations in helpful ways; it strengthens their ability to cope, hence reducing the likelihood of stuttering. It identifies and challenges unhelpful thoughts and beliefs held by the child in distress, and replaces the automatic negative thoughts with adaptive coping strategies. Besides, CBT could include behavioural experiments that test the child’s maladaptive thoughts to get the child to work on their avoidant behaviours associated with stuttering.
Speech difficulties can result in emotional and social difficulties in children. CBT can equip the child with appropriate and adaptive strategies to overcome and manage their stuttering and anxiety related to their speech difficulties. These include relaxation techniques and problem-solving skills.
What should you do if you suspect your child has a stutter
It’s important not to punish or scold your child for stuttering as this will only create stress for them which exacerbates their speech difficulties. Listen attentively and patiently to what they are speaking without attempting to finish or correct their sentences.
Reach out to a speech therapist ((https://www.annabellekids.com/elysia-soh) who has worked with individuals with childhood-onset fluency disorder for an assessment and management of their speech difficulties!