Stuttering

• Repetition
of phrases, words, syllables or intial sounds of words. Generally, the longer the repeated unit, the less serious the problem. Speech experts are more likely to be concerned about a child who persistently repeats only the first sounds of words than about one who repeats a word or phrase at the start of a sentence.

• Interjection
of unnecessary words and phrases such as "um" and "like" when the desired word is not at hand.

• Pauses
in speech that do not correspond to the context—for example, stopping in the middle of a simple statement.

• Prolongation
of sounds, such as drawing out the initial sound of a word. This type of stuttering is usually accompanied by signs of frustration and anxiety.

WHAT CAUSES STUTTERING?
A number of factors can contribute to the development of stuttering. One is confusion about the rules of syntax that help give language its meaning but have no logic for a child who is just starting to put his thoughts into words. Such confusion may lead children to trip over words and phrases or say them in the wrong order. Another is the preschoolers' rapid development of ideas—a development that may outpace word knowledge and vocal coordination. Conversely, children whose vocabularies are expanding rapidly may stumble because they have so many new words from which to choose.

What turns this normal tongue-tied phase into an ongoing problem is the addition of self-consciousness. The harder the child tries, the more difficult speech becomes. The child may start avoiding difficult words or simply clam up in certain situations. Continued problems serve to increase anxiety, which, in circular fashion, worsens stuttering. By the time the child reaches school, the problem may be entrenched.

WHEN SHOULD I SUSPECT THAT MY CHILD IS DEVELOPING A STUTTER?
According to the Speech Foundation of America, the following behaviors may indicate a developing problem. These behaviors are particularly worrisome in children over the age of four:

• Frequent sound or syllable repetitions.

• Syllable repetition in which an "uh" vowel replaces the correct vowel in the word, such as "wuh-wuh-why?"

• Frequent prolongations of sounds.

• Trembling of muscles around the mouth or jaw during speech.

• Changes in voice pitch or loudness during prolongation of sounds.

• Tension and struggle during certain words or sounds.

• A look of fear on child's face while saying a word.

• Avoidance of or delay in saying certain troublesome words.

IS PROFESSIONAL ATTENTION NECESSARY?
The answer depends on the age of the child and the degree of the problem. If you have concerns, talk to your pediatrician. Your doctor can refer the child to a speech pathologist for testing and, if necessary, therapy. Speech therapy is most effective if it is begun in the preschool years, preferably before age five.

HELPING A CHILD WHO STUTTERS

• Be patient. Give the child all the time he needs to make a statement. Maintain eye contact and keep your expression neutral. Do not jump in and supply the words the child is groping for.

• Speak slowly and carefully yourself.

• Do not let siblings and other children interrupt the child.

• Acknowledge the problem in a way that does not convey shame or worry

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.