Stammering: Tips for Children and Adults

The way we speak and communicate is part of our personality, and even our identity. When it comes to speaking, there are people who have fluent and appropriate speech, with very occasional mistakes, and people who tend to make mistakes more frequently, or to repeat some syllable or word of their speech. We can all go from being more to less fluent depending on the moment, whether we are focused or have a prepared speech, presenting good fluency; or that we are tired or nervous, and we are more clumsy when it comes to speaking. Even so, there are people who tend to have poor fluency in speech on a chronic basis, presenting constant repetitions of syllables at the beginning of a sentence, taglines, or even gestures associated with when they get stuck in a word.

Stuttering, also called dysphemia, is a speech disorder. The speech of people who stutter is characterized by repetitions or prolongations of sounds, syllables, or words. Their speech can also present interruptions in the flow of speech, called blockages, have associated expressions or movements (spasms) and muscle tension in face and neck.

Stuttering often appears in children as part of language development, in the same way that it tends to disappear. It is more common in boys than girls, and approximately 25% of children will stutter when they start to speak. Still, only 1% of people who stutter in childhood continue to do so into adulthood.

Dysphemia can affect communicative, social, and, later, work levels. Therefore, it is important that these children, in whom stuttering persists, are evaluated by a speech therapist and that they obtain an early intervention, which will completely eliminate, or at least reduce, the stuttering speech pattern as much as possible. The treatment will be less effective if started in adolescence or adulthood.

Today the cause of stuttering is not yet known, although it is considered more accurate to determine the factors related to its onset and its chronification. The most recent research and learning data in clinical practice conclude that there is great variability between stuttering individuals, and that the most important thing for treatment is to know the variables present in each individual in particular, which could be responsible for the initiation of stuttering disfluencies and the permanence of a stuttering speech pattern.

There are different types of stuttering depending on the cause for which they appear. The most common are:

• Developmental: It appears when the child is learning to speak, and disappears by itself. It occurs between 2 and 5 years.
• Established or chronic: It is suffered by children who have acquired a stuttering speech pattern; and adolescents or adults with dysphemia since childhood.

And less common:

• Neurogenic: Secondary to a brain injury.
• Psychogenic: Caused by severe trauma or high stress situations.

Do not be alarmed if your child starts to stutter! As we have just seen in the different types of dysphemia, it can be a developmental dysphemia and disappear in a few months. Even so, if the stuttering remains, the treatment will be more effective if it is done in early childhood, and it will be important to consult a speech therapist when:

• Stuttering persists 3-6 months after its appearance.
• There is muscle tension in the face and neck or movements associated with stuttering.
• The child has anxiety or avoids verbal situations.
• There is a family member who suffered or suffers from dysphemia, or another communication disorder.

Some ways in which we can help our child to feel secure in communicating and not to pay attention to his or her stuttering are:

• Speak slowly and clearly, it is important that your child understands and processes language properly.
• Try to make a quiet and calm atmosphere at home.
• Pay attention to what your child says, not how he/she says it. This will require stopping and paying attention. Don't be impatient or irritable when your child communicates with you.
• Do not offer options such as "Slow down!" or "Can you say it more clearly?" Ideally, wait for the child to finish her/his sentence.
• Minimize questions and interruptions while your child is speaking.
• Never scold or laugh at them if they stutter or make a mistake when speaking.
• Try to create time each day to talk alone with your child.

If adults have a stablished stuttering speech pattern, it is more difficult for them to eliminate or modify that pattern. Still, speech therapy is effective in learning how to reduce stuttering and can greatly help people who suffer from it. There are adults who have already received speech therapy as a child, or in different stages of their life, improving their fluency, but that in stressful stages they may return to a pattern with more stuttering. In these cases it will also be good to receive some speech therapy sessions again.

Other tips that adults can practice at home include:

• Practice speaking slowly. Before practicing it in conversation, it could be good to practice speaking slowly at home, when you are relaxed and alone for starters. You can read a book aloud, paying attention to starting sentences smoothly and keeping a calm pace.
• Avoid words that trigger stuttering. Make a list of the words that usually cause repetitions or blocks when speaking and look for synonyms that can replace those words.
• Try mindfulness. Mindfulness is characterized by being intentionally and impartially attentive to what we do or think, without judging or rejecting the experience. Its practice can help with self-acceptance, reduce avoidance strategies, such as talking less, and improve emotional control. Studies have shown that adding this type of meditation to a stuttering treatment program can be beneficial for some people.

How to behave when talking to an adult who stutters? It is important to know that there are no differences in intelligence or psychological adjustments between people who stutter and people who don’t. On the other hand, people who stutter don’t have to be more inclined to be anxious or shy, and the differences in personality between some people and others will not have to do with whether they stutter or not. With this said, as adults, we must know how to behave when we speak with an adult who stutters, and take into account the same points as if we spoke with a child who stutters, such as paying attention to what is said, and not how it is said; in addition to taking into account that people who stutter may have less control over their speech when they are on the phone, with more interruptions or blocks, so it could appear that they have hung up, when in fact they are taking a small involuntary pause.