Information for Parents of Young School-aged Children Who Stutter
Stuttering has traditionally been associated with many myths and misconceptions. Here are answers to some of the more commonly asked questions.
What is dysfluency and when does it become stuttering?
It is quite normal for a very young child who is in the process of acquiring language to be more or less dysfluent at times during the growth period. Most of this dysfluency takes the form of initial sound repetitions and repetitions of words. This stumbling over words can be attributed quite literally to the fact that "the mouth can't keep up with the mind." Children make rapid leaps forward in their language development, then pause in favor of some other development, such as a fine motor skills. It is during the rapid leaps in language acquisition that we most often see worrisome dysfluency.
By the time a child has reached the age of five or six, this normal dysfluency associated with language development should have disappeared. If it does not, we often see that the dysfluency changes its form. The part-word and whole repetitions become silent struggle or tense prolongations of sounds. Children may start to gasp or break words with little puffs of air. They may also develop secondary features, such as eye blinking, head jerking or other facial grimacing or body movements.
It's important to remember that stuttering can take many forms. Just because a child is not stuttering in some stereotypical way, does not mean that he or she is not experiencing fear and anxiety as the result of these blocks.
While some children gradually develop the kinds of stuttering behaviors we have just described, others seem to speak with a great deal of struggle from the very onset of speech. When that is the case, and most particularly, if the child himself expresses concern or irritation about his difficulty speaking, intervention should not be delayed. The earlier intervention takes place, the better.
Is it likely my child will outgrow this?
It is said that 80% of all youngsters who demonstrate dysfluency at one time or another before the age of 6 are likely to "outgrow" this speech behavior. However, through research, we now know that it is possible to estimate fairly accurately which children are likely to "outgrow" it and which children will need therapeutic intervention if we are to prevent them from becoming chronic stutterers.
If the child has been stuttering for a period of longer than one year, the likelihood that the stuttering will disappear without intervention drops to about 40%. By the time the child has been stuttering for 5 years, the chance of "outgrowing" it is reduced to 18%. Therefore, the longer the child has stuttered, the greater the likelihood that the stuttering will be chronic.
Is stuttering hereditary?
Research strongly suggests that genetics may play an important role in the development of stuttering. Neither imitation nor the passing on of attitudes about speech has been shown to be an acceptable explanation for the high rate of stuttering in familes. Up to 80% of all stutterers report a familial history of stuttering. Nearly four times as many males as females stutter, but this is also true for language disorders and learning disabilities. Although males appear to be more susceptible biologically to stuttering, women who stutter have a 36% likelihood of having family members who stutter, men who stutter have an 18% likelihood.
However, there are many cases in which it is impossible to identify a hereditary component.
What causes stuttering?
Whatever you have heard to the contrary, parents do not cause stuttering in their children. Stuttering is a neuromuscular disorder, not an emotional disorder. Of course, in time, the effects of stuttering may lead to anxiety and a poor self-concept. That's why it is so important to have early identification and intervention.
Research has shown that stutterers demonstrate some differences in central nervous system characteristics. Most people process language in the left half of the brain, whereas stutterers would appear to distribute language processing over both sides of the brain. Stutterers tend to perform no less accurately, but slower on fine motor coordination activities.
The vocal cords of adults who stutter appear to function somewhat differently too, with stutterers demonstrating delays in getting the voice started. Even the fluent speech of stutterers shows more tiny pauses in speech flow than is found in the speech of non-stutterers. Some research suggests differences in auditory function as well.
Most recently, researchers have identified actual areas of lesion in the brains of adults who stutter. Research with stuttering adults also has shown that their respiratory patterns are different from those of non-stutterers. The combination of this respiratory and laryngeal disturbance causes disruption of the speech mechanism as the stutterer tries to begin voicing. Each pause in speech can result in a repetition of this difficulty. The stutterer struggles against these blockages in the speech flow, resulting in what we see as stuttering.
How does the computer-aided program treat this problem?
By presenting visual biofeedback from both the respiratory and voicing systems, the stutterer gains control over the physiological behaviors which cannot be seen by the clinician. The computer program teaches the patient to coordinate the breathing with the onset of speech, to breathe without breath holding, and to maintain the speech flow throughout the phrase. It's rather like "physical therapy for the vocal cords." These aspects of coordination are practiced so thoroughly that they maintain themselves long after the program is over, and become a part of the child's everyday speech.
What is the treatment program my child would be entering?
The computer program which will be used to treat your child was based on a highly successful program for adults. That program has been in use since 1983 and is now in use all over the Untied States and in other countries.
The same underlying characteristics which we described above for adult stutterers exist in the neuromuscular systems of children who stutter, although usually to a lesser degree. Children who stutter have been successfully treated using the same basic goals or targets used with adults. The problem in the past has been one of communication. It is difficult to explain these concepts to a young child. The advantage of visual biofeedback is obvious. It is no longer necessary to have long explanations, since the child can "see" what the target is on the computer screen.
The parameters of the targets or goals necessary to produce fluent, normal sounding speech in children had to be specially developed to take into account the greater flexibility of the children's neurological systems.
One of the goals of this program was to make therapy more efficient (fewer hours of therapy required to achieve long-term fluency). A comparison with other forms of therapy suggests that this computer-aided therapy not only produces excellent results, but does so very efficiently.
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