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Stuttering

How speech pathology treats stuttering

Most people will be aware of stuttering thanks to films such as The King’s Speech. Or through Australian media personalities like Megan Washington and Harrison Craig. However, the majority of us are unaware of how stuttering works and how we should respond when someone stutters.

What is stuttering?

Stuttering is a speech disorder that impacts the flow and smoothness of speech. Stumbling or stuttering over words occasionally is normal for most people. However, concerns arise when stuttering behaviours become frequent. Therefore, affecting how well others can understand them in turn affecting their confidence.

It is important to clarify that people do not stutter because they are anxious or nervous. However, anxiety can make stuttering worse. Scientific researchers are yet to pinpoint a specific cause of stuttering. But, it is generally accepted to be of neurological origin[1].

How stuttering starts

  • Stuttering typically emerges during the preschool years between 2 to 5 years of age, either all of a sudden (e.g. overnight) or gradually[2].
  • 8.5% of children develop stuttering by the age of 3[2].
  • Approximately 5% of children are likely to recover naturally from stuttering[3]. That is to say, the remaining children will continue to have a stutter unless they receive professional help from speech pathology.
  • Significantly, Speech pathologists cannot predict which children will naturally recover.

What does a stutter look like?

Stuttering behaviours are generally divided into 3 categories:

  1. Repetitions: repetitions of sounds (e.g. bbb beach), repetitions of syllables (e.g. ha ha ha happy) or repetitions of words (e.g. but but but but what about)
  2. Blocks: when you cannot get your words out (e.g. c…..an)
  3. Prolongations: when the beginnings of words are elongated (e.g. ssssssstop)

Stuttering can cause or include other behaviours, which may include facial grimaces, tics, frowns etc.

“Pre-schoolers who undergo speech therapy have a 7.7 times greater chance of not stuttering compared to those who wait.”

The impacts of stuttering

Children with stuttering can experience negative reactions from their peers. This may include, being interrupted, teased or ignored. Preschool children who have speech therapy have a 7.7 times greater chance of not stuttering when compared to those who wait and see [4].
 
Stuttering becomes more difficult to treat from the school years into adulthood. Early treatment is typically recommended. Research shows stuttering behaviours can have a lifelong impact on education and career success. Most importantly, ongoing stuttering is linked with reduced mental health outcomes.
 
We recommended a team care arrangement for people who stutter and have mental health concerns (e.g. Social Anxiety Disorder). Evidence shows without team care stuttering behaviours are more likely to return.

When to seek help for children

It is important to seek help from a speech pathologist as soon as you notice your child is stuttering. While some children don’t appear aware of their stutter, others may demonstrate frustration or embarrassment about their ‘bumps’. For this reason, early speech pathology support is vital for this group of children. 

When to seek help for adolescents and adults

Speech pathology has a number of different strategies and supports for teenagers and adults who stutter. Please reach out to us:

  • Firstly, if stuttering is preventing you from socialising with others or forming friendships.
  • Secondly, if your stuttering is impacting your performance at work, especially if your job involves a lot of talking (e.g. teacher, builder, shop assistant).
  • Further, if you feel self-conscious or anxious about your stuttering speech pathology can provide strategies to support you.
  • Most importantly, if stuttering is impacting your mental health and wellbeing, we are here to help.

What the assessment will look like

Depending on the age of a person being assessed, assessments typically take between 1 to 2 hours. Assessment will include:
 
A discussion with you :

This allows us to understand your concerns and observations of your child’s stutter. During this time we will also gather any other relevant background information.

Both formal and informal assessment tasks:

For the purpose of determining the type and severity of the stuttering behaviours in play, in conversation and in recording from home.

Language review:

Reviewing your child’s everyday language skills. This includes what/how they understand language and how they put their ideas into words. Because this allows us to rule out any underlying language difficulties.

Additional referrals:

Finally, your speech pathologist may refer you/your child to a clinical psychologist. In order to support any mental health concerns that may exacerbate the stuttering behaviours.

What therapy will look like

For preschoolers, we deliver the Lidcombe Program. This is a parent training program and has two stages. The focus of the program is above all else ensuring a positive experience for both parent and child.
Currently, there is a lack of research evidence for school-age stuttering treatments. Therefore, we use the Lidcombe Program for school-aged children if deemed appropriate. Alternatively, we use a program called Syllable Timed Speech.
Finally, for adolescents and adults, we deliver the Camperdown Program. This is a speech restructuring program with four corresponding stages.
“Stuttering behaviours are divided into 3 categories: Repetitions, Blocks and Prolongations”

Our FREE Discovery Session is ideal for anyone with any questions relating to speech, stuttering, language, literacy, social skills, swallowing, and voice.

This is an opportunity for us to give some information on how to monitor your concern and give you advice on how to start self-managing any issues immediately.

Discovery Sessions can help you understand if an assessment or therapy is needed, how Speech Therapy would work, and if appropriate, help you book in.

References

“Searching for the cause of stuttering. – NCBI.”
https://www.ncbi.nlm.nih.gov/pubmed/12241868
. Accessed 11 Jan. 2019.

“Predicting stuttering onset by the age of 3 years: a prospective … – NCBI.”
https://www.ncbi.nlm.nih.gov/pubmed/19117892. Accessed 11 Jan. 2019.

“Predicting stuttering onset by the age of 3 years: a prospective … – NCBI.”
https://www.ncbi.nlm.nih.gov/pubmed/19117892. Accessed 11 Jan. 2019.

“Early childhood stuttering I: persistency and recovery rates. – NCBI – NIH.”
https://www.ncbi.nlm.nih.gov/pubmed/10515508. Accessed 11 Jan. 2019.

“Management of childhood stuttering – Semantic Scholar.”
https://pdfs.semanticscholar.org/81a1/6954676aea74968832d72b404b04b1ced815.pdf. Accessed 11 Jan. 2019

Packman A, Onslow M. Searching for the cause of stuttering.
Lancet 2002; 360: 655–656.

Reilly S, Onslow M, Packman A et al. Predicting stuttering onset by the age of 3 years: a prospective, community cohort study.
Pediatrics 2009; 123: 270–277

Yairi E, Ambrose NG. Early childhood stuttering I: persistency and recovery rates.
J. Speech Lang. Hear. Res. 1999; 42: 1097–1112

Onslow M, Jones M, Menzies R, O’Brian S, Packman A. Stuttering. In: Sturmey P , Hersen M , eds. Handbook of Evidence‐Based Practice in Clinical Psychology.
Hoboken, NJ: Wiley, 2012; 185–207.