I often receive calls or emails from parents who are concerned about stuttering in their young child’s speech. Sometimes, the child has just started stuttering; other times, the child has been stuttering for a while but the parents have reached the point where they are concerned enough to take action.
What should we tell them? We want to set their minds at ease wherever possible—there’s no reason for parents to harbor unnecessary fears. At the same time, we don’t want to under-respond and thereby miss out on the opportunity to get an early jump on treatment.
Here’s an example of what I recently told a parent, who reported that her 3-year-old child had recently started to exhibit severe stuttering behaviors, including facial grimacing and observable physical throughout his body:
“Thank you for sharing your concerns with me. I'm sorry for the difficulty that your son has been experiencing. It can be very hard to watch when our children are struggling with their speech. Sometimes, it is a helpless feeling, when we see them try to push words out, and we're not sure what to do.
First, try to remember this: The severity of the stuttering does NOT indicate whether or not he is going to continue stuttering. Once upon a time, we thought that it did—we would become very concerned if we saw a child stuttering severely, thinking that this would mean that he was going to keep on stuttering. Now, we know that the severity doesn't predict the likelihood of continuing—and, we know that the majority of young children who stutter actually recover from stuttering. Some children can stutter very severely and still make a complete recovery. So, as you're watching him now, don't worry yet about the future. Give your son’s young age, we still have a lot of time before we have to worry about this becoming a long-term experience. That doesn’t mean we should ignore it. It simply means that we don’t have to worry too much over the severity of the behavior we’re observing right in this moment."
"Second, when I see a child pushing hard, I try to think of it not as a sign of the stuttering itself but rather as a sign of the child's reactivity to the stuttering. Some kids just get worked up when they find that they are having difficulty talking. If he is a more reactive child in general (that is, if he gets upset easily when other things happen, like if toy breaks or he drops something), then it's likely that he'll also react strongly when he has trouble saying words. It's just the reactivity, not the stuttering, that we're seeing when he's pushing so hard."
"Third, if it is indeed the reactivity that's causing the stuttering to appear so severe, then we can help to reduce that severity by helping him learn to react to feeling stuck with less fear. Not surprisingly, it's uncomfortable for children to feel stuck—to have a system that works fine sometimes but then all-of-a-sudden it does not work so well. Letting him know that this is okay can help to reduce the fear that he might be feeling. The more we can help kids learn that it is okay to have some difficulty learning to talk, the less likely they are to tense and struggle and experience strong fears of talking."
"In general, I try to view stuttering just like I do other difficulties a child may have when learning to perform a new task: when they are learning to color, they color outside the lines; when they are learning to walk or run, they fall down; when they are learning to drink from a big cup, they spill. Stuttering can be viewed just like that: when they are learning to talk, they sometimes get stuck Viewing stuttering in this way helps to take away some of the fear."
(NOTE: More suggestions along these lines can be found in our free "Practical Tip" for speech-language pathologists that is specifically about how parents can support their children in developing healthy, appropriate attitudes toward stuttering.)
Fourth, I always encourage parents to seek out an evaluation by a speech-language pathologist who has expertise and experience in working with children who stutter and their families. Unfortunately, a lot of clinicians simply don’t feel comfortable with their skills for working with children who stutter. Specialists in stuttering therapy can be hard to find, but it is worth searching to find someone who understands this condition and the effect that it can have on parents and children alike.
Thus, I tell parents, "even if you have already received an evaluation, there is never any harm in getting a second opinion. You should never hesitate to reach out to other clinicians until you feel comfortable with the information you receive. Parents know their child best, and so your thoughts and feelings about the therapy should play a significant role in determining the course of action."
"Fifth, the determination of whether or not he needs therapy right now should be based not just on how much he is stuttering. Instead, we make therapy recommendations based on other factors, such as whether there is a family history of stuttering, how long the child has been stuttering, the nature of his speech and language skills, his temperament, his reactions to stuttering, etc. Again, the amount of stuttering doesn't really tell us much for making this decision. So, don't worry if someone says, 'Oh, he stutters so much!' As specialists, we'll consider more than that."
"Finally, I know it's hard, but try not to worry too much yet. When a child is just 3 years old, we have a lot of time before we have to worry about stuttering becoming chronic, and there is *a lot* that parents and others can do to help him to develop more fluent speech and good communication skills. Working with a skilled clinician, you can learn how to help your child communicate effectively and easily."
"Of course, I can't predict the future, but I can say that we know a lot about how to help young children who stutter (and their families) get through these difficult times.”
Note that I don't say all of these things all at once—that would be too much! I provide the information as the parent is ready for it. My goal in sharing this information with parents is to help to reduce their fears while giving them realistic information about what they might need to be aware of.
Certainly, there’s much more to say, and over time, I provide parents with even more information about how to help their young children who stutter. Starting with these basics, however, can help to reduce their fears, so that they can make appropriate decisions about whether their child needs an evaluation.
You can find much more information about what we tell parents of young children who stutter in our booklet, Early Childhood Stuttering: Information and Support for Parents.