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About one in 20 children will stutter at some point during their early childhood. While many will outgrow the problem, predicting who will recover naturally is difficult, say experts from the Speech Therapy Department at Singapore General Hospital.
Stammering
With time, spontaneous recovery becomes less likely. Early treatment gives the best results.
“Stuttering can and should be treated in pre-school years,” says Ms Gan Hui Hui, speech therapist at SGH. The disorder usually begins soon after the child begins to talk, before the child reaches the age of 5.
Tell-tale signs
No one expects a child to have perfect speech rhythm from the beginning. But some stuttering tell-tale signs shouldn’t be ignored.
- Staccato repetition of sounds or words, e.g. “A-a-a-a-apple” or “p-p-p-play”.
- Sound prolongation, e.g. “The colour whiiiiiite”
- Blockage, where the child gets stuck on a word that won’t come out.
In addition, parents may observe some facial or body movements associated to stutter, such as muscle tension, eye blinking, nostril flaring, rolling up of the eyes or head nodding. Some children may also avoid situations that require talking.
Stuttering, also called stammering, can be a bit tricky to assess in young children because it can be severe on certain days and just disappear on others. Nevertheless, stuttering cannot be considered a normal part of speech development.
“Stuttering is a physical disorder that involves the loss of fine control and coordination of the speech muscles”, says Ms Gan. It is not caused by anxiety, but can be exacerbated under stress. Approximately 1% of the population has a long-standing stuttering problem.
Is stuttering the parents’ fault?
A common myth is that stuttering is due to poor parenting style. That misconception may stem from the fact the disorder has a genetic link: about 60% of people who stutter have a family history of stuttering.
But as proof that parenting skills aren’t a culprit, parents actually play a crucial role in the treatment of stuttering in childhood.
In preschoolers, the Lidcombe Program is the preferred treatment. “It is simple and effective, as well as enjoyable for parents and children,” says Ms Robyn Foo, speech therapist at SGH.
During weekly visits to the speech therapist, the parent learns how to carry out the treatment, using games and toys. Parents’ positive reinforcement of fluent speech plays a big part in the program.
The games and praise are used daily until the stuttering disappears or reaches a very low level. The frequency of visits is then gradually tapered off. The Lidcombe Program has been shown to multiply by seven or eight the odds a child will stop stuttering.
As soon as parents suspect that their child is stuttering, they should consult a speech therapist, if only to put their mind at ease, suggests Ms Foo. If there is a family history of stuttering, or if the child is experiencing a lot of distress, early consultation is all the more indicated.
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