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October 4th, 2010
08:50 AM ET
What can I do to help my stuttering daughter?Every weekday, a CNNHealth expert doctor answers a viewer question. On Monday, it's Dr. Jennifer Shu, a pediatrician. Question asked by Karina of Doraville, Georgia: My 4-year-old daughter has been stuttering at the beginning of her sentences for the past month. It doesn't seem to bother her and she has a good vocabulary and talks in full sentences. I stuttered too when I was her age but it went away. What can I do to help her? Expert answer: Thanks for your question. Stuttering is most common between the ages of 2 and 5 years old, when a child's speech is quickly developing. It affects about 5 percent of kids but becomes less common with time, affecting less than 1 percent of adults. This disruption in one's speech (also called a disfluency) can cause a repetition of a part of a word at the beginning of a sentence or at the middle of one, or there may be no sound at all for several seconds before a word comes out. Stuttering can run in families and can occur in children with or without other speech problems. Most of the time, the stuttering will go away on its own within about six months. In the meantime it's best to wait and let the child finish her sentence rather than to advise her to take a deep breath, slow down or to relax. Be patient, maintain good eye contact and show your child that what she's saying is important to you so she'll continue to feel comfortable talking. If your child's stuttering seems to be severe (happening with every sentence, for example), frustrates her or doesn't go away after a few months, you may want to ask your pediatrician to recommend a speech-language pathologist for an evaluation and treatment. Therapies may include teaching a child to speak in shorter sentences, control her breathing during speech, and slow down her speech. Once the stammering improves, she will then be encouraged to lengthen her sentences and speak at her usual pace. Finally, it's very important for anyone who stutters after a brain injury or major stress to receive treatment, because this type of stuttering is less likely to improve without intervention. Good luck!
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love. Recent Comments
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May I suggest trying what Demosthenese did. He overcame a severe speech impediment to become history's greatest orator by putting pebbles in his mouth...gradually increasing their number...while attempting to speak. Clean them off first!
maybe if you want to choke her? did you read the age?
This has to be the dumbest thing I've ever read.
Demosthenes was considered the greatest orator of his day and one of the greatest of all time, so there might be some validity to his method. He strode along the seashore, mouth full of pebbles, trying to outshout the surf. Perhaps an alternate therapy would be best for a toddler.
To me, the lesson is that those who are using therapy of some kind to correct a physical defect must be fanatical about their therapy. I have observed a few friends struggling with injuries and strokes. Those who became fanatical about it recovered a lot more than those who did not. My brother had an injured arm and his therapist gave him a rubber ball to grip. That kid squeezed that ball 18 hours a day. He carried it everywhere and you never saw him without it. In the end, he recovered much more use of that arm than was expected.
my cousin is 13, and he still stuuders, it's very bad he doesn't know how to stop. When we were 7 we thought he would stop but now he is older and it still hasn't went away. any help or ideas?
korreon, ask your cousin to try this experiment. Tell him to run as fast as he can, then when he stops, tell him to start talking right away and see if he stutters those sentences. If he doesn't stutter then, he will have success with controlling his breathing. This was how I discovered how to control my stuttering when I was 8. I realized that I never studdered when I was nearly out of breath and breathing hard, forcing more air past my voicebox, which had the effect of calming the muscles and allowing me to speak. Today you would not know I ever stuttered, unless you talked to me on the phone, then you might think I'd just run indoors and grabbed the phone. Not true of course, but something many people have asked me when speaking to me by phone. I just say yes to keep from having to give a long explaination about my former speech problems.
Korreon, a teenager will likely not outgrow stuttering, and speech therapy is really the best (and possibly the only) way to go. Your cousin or cousin's parents should check with his school's councilor's or administration. Very likely some speech therapy is available thru the school system. If not, private speech therapists are out there. I would look for one that specializes in stuttering as opposed to one that works solely with stroke or brain injury victims. I would also recommend HCRI, the Hollins Communications Research Institute, which offers an excellent short term residential program (see http://www.stuttering.org). As a graduate of HCRI, I can tell you that the program really does help - for me it was really life changing. Also keep in mind that speech therapy - including programs like HCRI - may be covered by health insurance.
I agree with PJ. I'm actually surprised that your cousin's teachers haven't made a recommendation to your school's or school district's speech language pathologist. I do believe that it is fedrally mandated that every school needs to provide the services of an SLP. If your school isn't providing those services or has not done a proper screening of their students, call them out. And call out the teachers who haven't made the recommendation. Problems like that can be helped, if not completely corrected with proper therapy.
I saw your post. I am a speech pathologist who overcame a severe stuttering disorder. I think your son needs intensive therapy but of course needs to be evaluated first. Don't give up. I had lost hope when I was a teen. I have seen teens make tremendous progress. My website might have some articles which will inspire you. http://www.allislandspeech.com
4 year olds are not stutterers their minds work faster than they can talk and stammer. Listen till they finish then repeat what they said in question. Ie child thereafter is a dog outside. There is a dog outside? This reinforces the way it is spoken without making child feel they're not speaking correctly. Stuttereing can become a nervous habit from too much criticism of they way they are speaking. Stay calm and patient. Some children take longer than others to master language.
I stuttered all through my child hood until i was about 14 years old. I stayed with my aunt during that summer. she would stop me mid sentence and have me to say the sentence again slowly. T's and P's were my biggest issues. after that summer i went back home stutter free. and am still that way today. Thank you Aunt Barbara....
I had speach pathologist and others that tried everything, nothing worked. Putting stones in your mouth will do nothing for you. except maybe break some teeth.
I have a stuttering problem that had started as long as I can remember. After years of therpy, it took a short period of time with a great Speach therapist who also was a stutterer herself. If you notice you can sing and not stutter. It's all in controlling your breathing. Teach the student to breathe through the words like singing. With pratice you can beat this. Let me say that it is one of the most embarassing things I have had to go through in my life. I am 52 now I am a counselor so I speak everyday all day on the phone and face to face. There is a light at the end of this tunnel. I now do public speaking also. Never stop the person who is stuttering. When they are finished have them try to breathe the word.
I agree with P Hickman–there's no reason to think this girl has a true stuttering problem. Most likely, her mind is just working faster than she can form the words. Our older daughter did this all through ages 3.5 to maybe 4.5. She's very high-energy and verbally talented, and one part just couldn't keep up with the other.
As with so many things in early childhood, wait a while and it will pass. No need to worry, scrutinize, and make her feel like there's something wrong with her.
This post is mostly if the stutter is chronic, but having had a bad stutter for decades, with several unsuccessful therapies, I decided to check out http://www.stuttering.org , which is the website for the Hollins Communication Research Institute based out of Roanoke, VA, they have been fluency therapy programs since 1972. At the time I attended, the program was 12-days straight, which was onsite, and they basically teach you how to vocalize from scratch, since the main causes of stuttering is caused by vocal chord distortions, and because of this, each speech class requires different voicing techniques.
While some individuals who stutter, may find that they outgrow it, which is great, but if your situation is chronic and are finding other techniques or programs failing you, or if your personal and/or work life are suffering, I can not recommend this place enough... and although it is 12 intense days, I would do it again in a heart beat, because the difference is night and day
I have to highly recommend the HCRI program as well. While I had some improvement in high school after working with a school speech therapist, it was nothing compared to the results I received after going thru the Hollins program. I went from being almost impossible to follow in normal everyday speech to conducting training classes and seminars with very minor effort for my employer. Transformative.
My daughter stuttered when she was age 3 or so. I brought her to a speech pathologist. One of the best pieces of advice he gave me was to slow down my own pace of speaking. Kids are trying to model the speech that they hear, but they don't have the physical development or fluency to match an adult's speed. Also, a hectic lifestyle (like rushing to get out the door in the morning) can add to the pressure a kid feels to "hurry up" and speak. This pressure can cause or contribute to disfluency. Slow down the pace of both your lifestyle and your own speaking, with somewhat exaggerated pauses between groupings of words, and see if this helps. It did for us. Good luck!
I would take her to see a speech pathologist now. Since it began at 4, it is less likely to go away by itself than if it was to began at 2, for instance. The good news is that girls are more likely to recover than boys. Also, the term "stammering" is not used in the US.
Something not mentioned is food allergies. Some people's reactions include how the brain processes and emotional reactions as well as the common ones like bumps or histamine. My 4 yr old son's allergy to corn and rice presents itself as an increase in whining, aggression/temper tantrums, coughing, and oddly stuttering and mispronounciation. If we break down and let him have a taco (no cheese-he's allergic to dairy) or a gluten free rice waffle (no hfcs or regular syrup) for the next 2-3 days he stutters and slurs his words. We have to ask him to repeat himself frequently. Had him in speech therapy and the teacher had never heard of this. When my son has a clean diet he is articulate, the quantity of word useage increases and he is very calm and easy going. (why do we give him any corn or rice at all? bc he's allergic to dairy, wheat, eggs, food dyes, millet, oats, rye, hfcs, guar gum, juices that come in a carton vs a plastic jug...the list goes on. It's just to give him something different from his usual plain meat, fruit and couple veggies. Thank God he's not allergic to organic ketchup!)
I have to say the expert here gave really decent advice: Wait and make sure it is not a phase and if it gets worse or doesn't improve, seek professional help.
And, as a stutter myself, I have to second the comments of several of you: Be patient and pay attention – don't correct or tell the stutterer to slow down or breath; be conscious of your own speech which the child is simply trying to copy and try articulating carefully and slowing it down; and, finally, slow down the lifestyle which may be pressuring or hurrying the stutterer.
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As an SLP, I have to say the advice her is pretty good. Most SLPs would not due direct therapy with a child this young unless the stuttering is severe or there are secondary behaviors (head turns, blinks, extraneous body movements). The parent should also try slowing there own rate of speech. This will cause the child to slow her rate. Decreasing demands on the language system may also be a good idea during times of high dysfluency. For example if the child's speech tends to be worse first thing in the morning or when they are tired, instead of engaging in activities that require speech do other things (play outside, art activities, etc). I also second the person who said that the term stammering is not used in the US.
You have a great rescource at the University of Georgia in Athens GA in the Speech and Hearing depatment. I would contact the clinic and discuss this with the professor who specializes in stuttering.
RH
For the people who are recommending home remedies or what "worked for them", I know you're trying to help, but please don't. A child's communications abillity is too important to rely on pebbles, or running, or software, or whatever. Follow the doctor's (or your doctor's) advice and/or see a professional (a speech-language pathologist).
As a speech language pathologist with a special interest in stuttering, my advice is to have her assessed. The people who talk about pebbles, or who say "a 4 year old cannot stutter, her mind is working faster..." are not well informed. There is often a waiting list for service, so get her on it asap. If she is one of the lucky ones who recover without help, you have lost nothing by being on the waiting list for the next few months.
Most SLPs who are knowledgeable about stuttering WOULD do direct treatment with preschool children. This is the age when therapy works best. The Hollins institute mentioned in a couple of posts is for teenagers and adults.
Slowing down your own speech has little effect on her speech. Many studies show this.
Do everything you can to get her assessed in the next 6 to 12 months and therapy - if the stutter persists - starting before she turns 6. This gives her the best chance of excellent results.
For more info: go to The Stuttering Home Page. There is an interesting on-line conference going on now - open to all.
Peter – thank you for a helpful post! I tried to post places on the internet where people can get good information about stuttering, including the Stuttering Foundation, National Stuttering Association, FRIENDs, British Stammering Association, the Stuttering Home Page and the online conference that you mentioned - my post was first "moderated" and then apparently not allowed to be part of the comments since it does not show up which is disappointing. People can use the search engines to find any of those resources and well as "StutterTalk" - I hope they do.
I was a severe stutterer until my mid to late twenties and still occasionally stutter but very rarely. Sometimes I'll stutter for no apparent reason at all, other times if I'm really tired or stressed out or if I've been drinking which seems to make fluency worse. I went to many therapists as a kid and the only therapy that helped me was when I was in my twenties I went to a program at UCLA that was developed by Joseph and Vivian Sheehan. They taught us to "slide" on our words, to actually "stutter on purpose" which was the hardest thing I'd ever done. You spend a lifetime trying NOT to stutter, coming up with all kinds of ridiculous "tricks" that helped you get a word out once or twice and these "tricks" become part of the problem and the way you stutter. Sliding on a word (SSSSSSSSSSlide, not s-s-s-s-lide) not only makes you slow down but since you are stuttering on purpose you stutter in a more relaxed way. Just by doing this and more or less admitting "to the world voluntarily" that I stuttered I became more fluent. This helped but what really helped me to overcome stuttering was by finally not caring what everyone thought. It's really that simple. You have to get your head in the right place and once you do that you can overcome stuttering. This is very hard for a teenager. Most 2 to 4 year olds aren't aware of how they sound to others so it doesn't necessarily become a problem. I didn't start stuttering until I was 7 or 8 years old and I was very aware at that age that I wasn't speaking "normally". Kids made fun of me and I was mortified. This just intensified my fear of stuttering and made it worse.
I was a stutterer and a clutterer for many years with a lot of therapy and psychiatry ( in those days it was thought that stuttering was a psychological problem) nothing much helped. When I was in my late teens I experimented with reading with a metronome and either that helped or I just grew out of it. I have no idea. I know that nothing was as frustrating as having people tell me to slow down and relax. It was so frustrating that typing these words after all these years tightens me up.
My daughter started to stutter at the age of 4 ( a little unusual since stutterers are mostly male). I tried and tried politely to get my wife and her relatives to stop telling her to slow down and relax. They didn't take me seriously until all the frustration bottled up from when I was a child exploded in a major table pounding tantrum. After that they took me seriously and left her alone. Maybe that helped, maybe she just grew out of it. Who knows
Exactly! That makes it worse! My dad often tells me to slow down, and it frustrates me!
So many comments on stuttering, so much misinformation! Here's a reality check from the National Stuttering Association.
Most stuttering is physiological and often genetic. About 5% of kids stutter at some point but about 80% outgrow it. If someone else in the family stutters, waiting and hoping the child will outgrow stuttering is NOT a good idea.
The best bet is to have a stuttering child evaluated by a speech-language pathologist who specializes in stuttering, preferably when the child is of pre-school age. Early intervention improves the odds that the child will outgrow stuttering, and gives the child a head start on coping with stuttering if he or she continues to stutter. There is no downside risk to speech therapy and no advantage in waiting: The younger the child, the better the chances of success.
Do not trust your pediatrician to be aware of this. Our surveys show that nearly one-third of parents get bad advice on childhood stuttering from pediatricians and other professionals. This is such a widespread problem that we have posted information for physicians on our web site, http://www.WeStutter.org.
You also should be aware that because stuttering is a low-incidence disorder, most speech-language pathologists have had little training and experience in working with stuttering. So it's important to find an experienced clinicians. Board recognized specialists in fluency disorders are listed at http://www.stutteringspecialists.org
My daughter is 4 years old, and I just recently made her an appointment to get an evaluation through her preschool. At first, I thought that maybe it was just a phase that she is going through, but it seems to be getting worse. She has very long pauses at the beginning of her sentences and repeat words throughout her sentences. I am hoping that she can either outgrow this or an early intervention can help her overcome it. My worse fear is that she will be a target of ridicule at school. This will break my heart.
Don't make her nervous about bullies. Don't go "remember, don't listen to what they say about your speech" that will make her even more worried (or just scare her, if she wasn't) times have changed and some will be mean, but she's four, and don't believe first graders. Or kindergartners care a bout speech.
Didn't the person say it doesn't seem to bother their daughter? I wouldn't be worried about it until she starts elementary school, when clear speech is most important. Also, apparently the help was for someone with a child who is nervous about their speech. Don't act all worried when it happens and the child won't become self conscious. It's as simple as that.
I was a stutterer since I can recall. It made my childhood miserable. Unless you're a stutterer (or were a stutterer), you will never know the anguish and pain that a stuttering child has to go through on daily basis. The simplest tasks to many seem like endless barricades for children who stutter. I recall when I went to the store to buy deli meats for my mom she had to write it down for me on a piece of paper for me to give to the lady at the counter in the store. I could not say "Pound of sliced turkey breast please". I recall my parents took me to therapists, but nothing and no one helped. Then....one year, it all went away when I was a teenager – poof, GONE. I am now a successful engineer who delivers presentations and speaks to large groups quite frequently. I even delivered my college valedictorian speech in front of thousands of people – without a hitch. Once in a while I stutter when I have to say my name (it starts with a vowel) but only in situations that are tense. That was my biggest problem, those darn vowels and Ps!!! My son is now 4 and he's had a stuttering problem since he was 2 years old. It was evident at 2, then it went away, now it's back with a vengeance. We are taking him to a therapist next month. I am hoping therapists nowadays have new techniques versus those in the 80s when I was a kid growing up. It KILLS ME to hear my son struggle like he does. He cannot seem to get past the first word of every sentence. It brings back such painful memories for me. I wouldn't wish this upon my worst enemy (and I don't have enemies). If your child stutters, PLEASE take them to get evaluated ASAP. Otherwise, the problem may not simply go away on its own. This is a serious matter and NOT the matter of "slowing down". NOTHING was aggravating to us stutterers more than "slow down". UGH!! I used to think to myself "If all I had to do was 'slow down' don't you think I would have beaten this thing by like.....6 or 7 years old???" Unless you yourself are a stutterer, you do not understand the damage this can do to a child's self worth, confidence and academic excellence.
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