Tuesday, February 25, 2014

Identify the Signs - Struggles to Say Sounds or Words (3 to 4 years old)

Children at times may have difficulty getting out the words that they want to say. Even as adults we have moments where what we are intending to say does not come out as smoothly as we want it to. But when is this a normal disfluency and when is it considered stuttering and is a problem? This post is going to be a little bit different than my last few posts in that smooth speech does not "develop" in the same way as language does or as we acquire speech sounds. So, I will talk about disfluent speech, give you examples of stuttering and lay out some important risk factors to consider when determining if the stuttering is a concern or a normal, developmental stage and may go away naturally.

Facts about Stuttering

Stuttering may begin at any time in a lifespan but is most likely to occur in the preschool years between the ages of 2 1/2 and 4 years old. It may begin in a variety of ways. It may occur slowly, increasing gradually over a period of time. Or with in days or weeks could become significant. It may occur for a while, then go away, only to reappear again later in a cyclical pattern. It is important to note that about 75% of preschoolers who stutter will eventually have fluent speech. Some regain fluent speech within months and for some it may take years.

There is no known cause of stuttering. Based on recent research, we know that genetics plays a role in this disorder, but not all who are predisposed to stuttering will experience significantly disfluent speech. Some children begin to stutter as they are learning new vocabulary or are experiencing growth in their language development. So, they may have fluent speech at the two-word phrase level but when their language skills are developed and they could be putting together 4-5 word sentences, they may stutter on the longer sentences.

There are quite a different ways that stuttering may sound:

  • repetitions (sound, word or phrase repetitions) - I- I- I-want to go to the movies.
  • prolongations (sounds are stretched longer than typically produced) - Sssssssunday will be fun.
  • interjections (adding in extra words) - I um, uh like um you know, want the fries.
  • blocks (pausing or stopping of the sounds) - I w.........ill drop off the book at the library.
  • revisions (changing what was going to be said) - I need a, I'll get the silverware.
While many preschoolers are unaware of their stuttering, as they experience other children's (and adult's) reactions to their speech they begin to develop an awareness of their difficulties. Frequently there are physical signs in addition to the speech difficulties. These are called secondary characteristics and may include facial tension, body/limb tension, excessive blinking, head turning, lip tremors, facial tics or other unusual movements. These are signs that the stuttering is bothering the child or that the child is aware of the disfluent speech and is trying to "get out" of the stuttering moment.

Risk Factors

Family history of stuttering
Has occurred for more than 6 months
Continues to increase in severity
Strong concern about the stuttering (or frustration on the part of the child)
Child is avoiding talking
Presence of tension or other secondary characteristics (see list above)

If your child has any or all of these risk factors, the chances of the stuttering going away on it's own are much less than if your child has none of those risk factors.

If you are concerned about your child's stuttering, at any age not just preschool age, please contact a certified speech language pathologist. If you are in the central Florida area, feel free to contact me (here). If you are not, or if you would like more resources, check out The American Speech-Language Hearing Association's website for more information (here).

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