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Fluency & Voice

When to be Concerned About Fluency
Stuttering is a communication impairment characterized by excessive, involuntary disruptions in the rate, rhythm and forward flow of speech. As most young children (two to five years old) are developing their speech and language skills, they experience such normal disfluencies as repetitions of whole words and phrases, false starts and revisions in their sentences, and frequent interjections of uh’s and um’s.

Adults sometimes needlessly react to these normal disfluencies with alarm and concern that their child is beginning to stutter. Of much more concern are the following types of disfluencies, which can be considered danger signs that a stuttering pattern is developing:

Frequent syllable or sound repetitions ("bi-bi-bi-bicycle" or "t-t-t-t-time")
Substitution of a weak vowel (called the schwa vowel) for the true vowel in a repeated syllable ("buh-buh-buh-bicycle")
Prolongation of sounds ("mmmmmmmmama")
Tremors in the small muscles around the mouth, eyes or jaw as the child tries to say a word on which he seems to be stuck
Visible signs of struggle and tension when a child blocks on a word (e.g., squeezing the eyes shut, rapidly blinking, distorting the position of the mouth, tongue or jaw)
A rise in pitch or loudness level on sounds being prolonged or repeated
Observable fear or avoidance of speaking (may include specific words, situations or people)

Facts About Childhood Stuttering

Stuttering is more common among boys than girls by a ratio of about three to one.

The average stuttering child begins stuttering without any obvious cause.

Most children begin to stutter in the preschool years and virtually none, unless they suffer brain damage, begin after puberty.

Stuttering is a condition which, at some time, will affect 5% of children, although it persists in only 1%.

60% of children who have stuttered for less than one year will likely recover without direct therapy.

The longer a child has been stuttering, the less likely he is to stop.

Stuttering is particularly common in relatives of stutterers, especially in sons of stuttering mothers.
(Compiled from Nature and Treatment of Stuttering: New Directions, edited by Richard Curlee and William Perkins, Little, Brown & Co., 1984.)

How to Help a Stuttering Child
It is very important to know how to help and react when talking to a stuttering child. Adults often wonder, "Should I help him say the word he is stuttering on?" "Should I ignore the stuttering?" To help answer these and other questions, here are some do’s and don’ts in interacting with a stuttering child:

Do:

Allow the child time to get his thoughts expressed, regardless of his repetitions and revisions.
Look at the child when he is talking to you and demonstrate your interest in what he is saying, not how he is saying it.
Keep the child interested in talking by making speech fun and rewarding (use songs, rhymes, games involving speech, etc.).
Model a calm, slow manner of talking and try to convey a reassuring, unhurried manner when talking with the child.
Minimize stress and anxiety provoking situations at home and at school.
Become aware of any patterns or circumstances that seem related to a child’s stuttering and modify them if possible.
Convey understanding, acceptance and reassurance if a child expresses concern about his stuttering.
Seek professional help or advice whenever you are concerned about a stuttering child.

Don’t:

Finish a sentence or word for him because you know what he is trying to say.
Give the impression that you are alarmed or disappointed because of his stuttering.
Force a child to speak or recite before strangers or visitors.
Point out to the child that he is stuttering, tell him to "stop stuttering" or ask him to "say it again without stuttering."
Give suggestions that require the child to do something before he speaks, such as "Stop and think about what you want to say before you say it," or "Take a deep breath and try it again."
Suggest that the child substitute an "easy" word for a word he is having trouble saying.
Let stuttering become an excuse to avoid responsibilities.
Allow anyone to tease or mock a child about his stuttering. (Information taken from The Hearing-Speech & Deafness Center website: www.hsdc.org)

WHAT ARE VOICE PROBLEMS IN CHILDREN?

Pediatric voice problems involve pathologic laryngeal conditions, including inflammation of the vocal folds, chronic laryngitis, vocal nodules, vocal polyps and contact ulcers, all of which can be identified by the child’s Ear, Nose and Throat doctor. These conditions, usually caused by vocal abuse, are normally reversible Family with the elimination of laryngeal overuse and tension, along with a program of vocal hygiene.

HOW DO VOICE PROBLEMS DEVELOP?

Shouting is the primary way in which children abuse their voices. Typically, children yell from room to room in the house and scream to each other on the playground. At times, they make funny noises or imitations of character voices. Children who are excessive talkers may experience inadequate breath supply and support, causing them to push down harder on the vocal folds to complete lengthy utterances. All of these behaviors — shouting, screaming, yelling, excessive talking — are used by children to get the attention of playmates, siblings, parents and teachers. However, these behaviors can result in serious vocal abuse problems.

HOW DOES SPEECH THERAPY HELP?

A prerequisite to successful vocal rehabilitation is the development, through listening, of an awareness of abusive vocal patterns. The child must be able to identify and develop a perceptual awareness of vocal behaviors that cause abuse to the larynx. Once these specific abusive behaviors are recognized, parents, teachers, siblings and friends can assist the child in identifying situations that promote poor vocal habits and

offer regular feedback to the child. (Information taken from the website http://www.cslot.com/children/child_voice_disorders.htm)