Stuttering & Fluency Disorders

Can County Speech Help Me?

Services for Adults & Children

What should I know as a parent
about stuttering?

Information about Fluency and Dysfluency

How does a Speech-Language Pathologist decide if your child is beginning to stutter?
  

Warning Signs

Multiple Repetitions

Schwa Vowel

Prolongations

Tremors

Rise in Pitch & Loudness

Struggle & Tension

Moment of Fear

Avoidance
 

Adolescent & Adult Services

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County Speech Therapy Approach

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Warning Signs

Stuttering is more than just disruptions in the smooth flow of words, which we refer to as disfluencies.  It is also reactions to difficulty speaking.  There are a few key warning signs to look for when trying to decide whether your child might be stuttering.  When you consider these warning signs, try to avoid becoming too conscious of them.  See them in relation to your child’s total speech, most of which is probably quite fluent.
 
Also, keep in mind that many of these behaviors come and go.  They occur at times in children who are never thought of as stutterers.
           

Multiple Repetitions

All of us, particularly children learning to talk, repeat words and phrases.  It is not uncommon for a 3 year old to repeat one word several times.

“Is-is-is it time to go yet?”

Sometimes, “starter” words or sounds such as a prolonged or repeated “er” or “um” are used.

            “Um, um, um, can I have one of the cookies?”

Also, parts of words, usually the first syllable, may be repeated.     

“Can I have my ba-ba-ba-baby?”

If your child begins to frequently use these repetitions with many words and in many situations, he or she may be having more difficulty than normal with his speech.  The use of these repetitions may be a passing phase.  It is, however, one of the first signs a clinician looks for when deciding whether your child may be stuttering.

Schwa Vowel

The schwa (or weak) vowel is used in many everyday words.  It is the “uh” sound heard in unstressed syllables such as “around,” “concerned,” “suggest,” “wanted,” and “the boy.”
The child who is beginning to stutter often uses the schwa in a way that distorts the word.  If he says “go-go-go-goat,” we don’t’ worry.  But if he says

“guh-guh-guh-goat,”

we identify this as a warning sign, particularly if he repeats the schwa sound very quickly. In words that begin with a vowel, such as “over,” he may say

            “uh-uh-uh-over,”

instead of repeating the initial sound “o.”  You may have difficulty in distinguishing these differences, but the therapist is trained to do so.

Prolongations

Sometimes, instead of repeating initial sounds, your child may prolong the first sound of a word, ,so that “Mommy” becomes

            “Mmmmmmmmmmmmmmommy.”

These first three signs—repeating sounds, repeating the schwa, and prolonging sounds—may occur occasionally in nearly all children.  If they begin to occur too frequently in too many speaking situations and begin to affect your child’s ability to communicate, you should be concerned.

Tremors

Occasionally you may notice that the small muscles around your child’s mouth and jaw tremble or vibrate when she seems to get stuck on words.  The degree of tremor may be mild or intense.  These tremors are associated with difficulties in moving forward with speech when her mouth is held in one position with no sound coming out.  The therapist will want to know how often you have noticed these tremors and if they appear to be lasting longer now than before.

Rise in Pitch and Loudness

As your child tries to get a word out, his pitch and loudness may rise before he finishes the word.  It may slide upwards or suddenly jump to a higher level.  In both cases, he is trying to get the stuck word unstuck, but again this is a sign that the needs help.

Struggle and Tension

Your child may struggle to get words out or have an unusual amount of tension in his lips, tongue, throat or chest when she tries to say certain words.  At other times she may have only a small amount of unnecessary tension on the very same words.  The degree of struggle may vary from being hardly noticeable to very obvious in certain speaking situations, and may disappear entirely for long periods of time.  In any event, struggle and tension indicate your child is having greater difficulty with speaking.

Moment of Fear

You may see a fleeting moment of fear or frustration in your child’s face as he approaches a word.  If so, he has probably experienced enough difficulty getting stuck to make him react emotionally to the anticipation of trouble.  He may go beyond momentary fear and begin to cry because he can’t say a word.  If you can help your child while the fear is still a brief passing experience, there is a good chance of preventing a vivid or lasting fear of speaking from developing.

Avoidance

Struggling to speak and being afraid to talk may lead your child to avoid talking.  She may postpone trying to say a word until she is sure she can say it fluently.  She may refuse to talk at times, substituting or inserting words or that are not really part of the sentence.  She will continue to have normal delays in speaking as she tries to choose words or formulate sentences but the delays may take longer.  If she does not speak even when it is clear that she knows what she wants to say, she is probably avoiding because of her growing frustration with talking.

Avoidance should be seen as a serious and urgent signal for professional intervention.  Avoidance tells us that your child is self-aware, is “monitoring” her speech and “trying” to be fluent.  Sadly, this mind-set will likely lead to greater difficulty and more advanced stage of a fluency disorder.

You may observe these last five behaviors—tremors, rise in pitch and loudness, struggle and tension, moment of fear, and avoidance—in your child.  They occur when he or she begins to react to interruptions in speech, and usually mean that your child is trying to do something about the interruptions.  Again, if you observe these behaviors, you should be concerned and consult a Speech Pathologist.