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David Baxter PhD

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Stuttering or Learning to Speak?
By Crystal Patriarche

Trouble talking is normal for kids learning to speak, but if your child is having more severe problems, he may be stuttering.

For parents of toddlers learning to speak, it can be difficult to tell the difference between normal difficulties with speech and stuttering. If your child has trouble talking and hesitates on or repeats certain syllables, words or phrases, he may have a stuttering problem.

However, he may simply be going through periods of normal "disfluency" that most children experience as they learn to speak, according to Dr. Barry Guitar from the University of Vermont and Dr. Edward Conture from Vanderbilt University.

Stuttering is a complex disorder that affects three million Americans, and according to The Stuttering Foundation, a non-profit organization working toward the prevention and improved treatment of stuttering, there is a general lack of knowledge when it comes to stuttering.

What Is Normal?
The occasional repetition of syllables or words once or twice (li-li-like this), the use of hesitancies and the use of fillers such as "uh," "er" and "um" are signs that a child is learning to use his language skills in new ways, according to Dr. Guitar and Dr. Conture.

These "disfluencies" occur most often between ages 1 and 5 years, and they tend to come and go. If they disappear for several weeks, then return, the child may just be going through another stage of learning.

"When my daughter was about 2 years old, we took her to a daycare for a couple days, and she started stuttering at exactly that point," says JoBeth Cox from Indiana, mother of Peytan, now 4. "My mom swears it's because we tried to make her go to daycare, but even when we took her out and put her back with my mom, she continued to stutter."

It was really obvious during about a two-month period, and everyone would notice, she says. "Some family expressed concern about whether or not she was upset about something or stressed, and it was causing her to do it. But after the doctor said it was normal, everyone just tried not to make a big deal when she did it," says Cox.

Cox went to her pediatrician with concerns but was told most children go through some stage when they are learning to talk when they have difficulties. As predicted, Peytan stopped stuttering by age 3.

Mild or More Severe Stuttering
But not all children will stop on their own. A child with milder stuttering repeats sounds more than twice (li-li-li-li-like this), while tension and struggle may be evident in the facial muscles, especially around the mouth, according to Dr. Guitar and Dr. Conture.

Other signs to look for, say Dr. Guitar and Dr. Conture, are the pitch of the voice. It may rise with each repetition, and sometimes the child will experience a "block" – no airflow or voice for several seconds. If the stuttering is present more often than absent, your child may have mild or more severe stuttering – more severe if the stuttering makes up more than 10 percent of his speech, according to The Stuttering Foundation.

If the child stutters "with considerable effort and tension, avoids stuttering by changing words and using extra sounds to get started, he will profit from having therapy with a specialist in stuttering," say Dr. Guitar and Dr. Conture.

What Should You Do?
When a child is trying to tell you something and begins stuttering, your first reaction might be to tell them to slow down and relax. In fact, this is what most people would do, according to a new survey by The Stuttering Foundation. Leading experts, however, say that reaction can aggravate the problem.

In the national survey of 1,000 adults, The Stuttering Foundation found that nearly 90 percent of the adults would say "slow down and relax" to a child who begins to stutter. But experts say that such simplistic advice will not help stop stuttering and may actually frustrate a child who stutters.

Try to remember that slowing and relaxing your own speaking style is much more helpful than telling the child to slow down, say Dr. Guitar and Dr. Conture.

"The survey results indicate that it is more important than ever for us to focus our efforts on educating parents of young children about stuttering," says Jane Fraser, president of The Stuttering Foundation. "With early detection and intervention, stuttering in young children can almost always be overcome. It is crucial that parents become informed."

According to the survey, 33 percent of those surveyed said they would correct a child who is stuttering or that they would finish the child's sentences. "Parents should realize that the way they react to stuttering plays an important role in the child's speech development," says Lisa Scott Trautman, Ph.D., assistant professor of speech-language pathology at Florida State University. "If a child senses frustration and impatience when he speaks, his concerns about talking will increase."

According to experts, parents should allow the child to complete his thoughts without interruptions or corrections and they say that patient, attentive listening is critical.

"If it was really bad, I would tell her to look at me in my eyes so we could focus on each other," says Cox. "That usually helped. I tried not to correct her or have a reaction because she was aware she was doing it, and it bothered her. She would get really frustrated and even embarrassed."

"The most important thing to me was to make sure other children were not making fun of her and that we didn't make a big deal out of it. Her cousins would ask why she was doing it, or they would laugh at her," says Cox. "Even though she was only 2, it would upset her tremendously when people laughed at her or noticed it."

When stuttering lasts longer than six months or if it seems fairly severe or worsens, you should seek evaluation by a speech therapist. According to The Stuttering Foundation, the success rate is high when children begin therapy between the ages of 2 and 5 years old.

How to Help Your Stuttering Child
The Stuttering Foundation and experts offer these seven tips for helping children who stutter:
o Speak with your child in slow, relaxed speech and pause frequently. Your own unhurried speech will be much more effective than criticism or saying "slow down." Think Mr. Rogers from children's television.
o Don't ask your child so many questions. Children speak more freely when expressing their own ideas rather than answering questions. Let your child know you heard him by commenting on what they said but not asking questions.
o Use body language like facial expressions. Let your child know you are listening to the content of what she's saying and not to how she's talking.
o Give your undivided attention to your child. Set aside some time, and let your child choose what he would like to do. When talking during this special time, use relaxed speech and pauses. This can build confidence for children and lets them know you enjoy their company.
o Take turns talking and listening. Children, especially those who stutter, find it easier to talk with few interruptions and the listeners' attention. Teach the family to take turns talking and listening.
o Observe your interaction with your child. Increase the times when your child knows you are listening to her and let her know that she has plenty of time to talk. Decrease criticisms, talking too fast, interruptions and questions.
o Accept your child as he is. The most powerful thing you can do is support him, whether he stutters or not.

Want to see more?
Take Your Toddler on a Talking Adventure!
Early Intervention Key in Language Development
Talking Toddlers Telling Tales: Speech Milestones and Tips for Parents
The Straight Truth About Stuttering Quiz
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