Stammering can also occur as a reaction to this interruption in speech. In most cases, it is the reaction to stammering that most significantly impacts on the person.
The latest Growing Up in Ireland study estimates that less than 1% of the population is considered to stammer. That is, less than one in one hundred people stammer.
My-my-my-my or D-d-d-d-d-daddy or puh-puh-puh-pony
Mmmmmmmmammmy or Saaaaaarah or wwwwwwwwwind
D-------avid or JJJJJJJJuice
If a child goes through a period of stammering, sometimes it can seem quite severe at the onset but this is not a sole predictor for whether a child will continue stammering or not.
‘Stammering’ tends to be the term used by clinicians and researchers in the UK and Ireland and ‘stuttering’ tends to be the term used in the USA and Europe.
It is considered that stammering is usually due to a combination of different factors as opposed to one single factor.
These factors include:
Inheritance is only one of many factors involved in the start and persistence of stammering. A family history of persistent stammering is associated with the increased likelihood that a child may continue to stutter in some form.
There are also reported cases of stammering where there is no family history, which helps us understand that many factors play a part in the start of stammering.
Early intervention (i.e. seeking and receiving treatment as close to the time stammering begins) is the most effective for children who stammer in order to help prevent or ease the processes outlined above taking place.
A comprehensive speech and language assessment of any siblings will help determine their own risk profile so that preventative therapy may be put in place to support their fluency e.g. language development, emotional reactions, supportive interaction skills, such as turn-taking.
The longer a person has been stammering the more their thoughts, feelings, attitudes, decisions and choices in life are linked with their stammering.
A Speech and Language Therapist can make positive impacts on stammering from childhood through to adulthood. Addressing the factors that contribute to a stammer persisting can take time but has been found to be effective. There can be a time in the person’s life which is more suited to the work that is involved in undertaking therapy and that is perfectly okay.
It can happen younger or older than this. This age range is a period of rapid development and change for children in terms of their emotional development, speech and language development, motor development and cognitive development. Any changes taking place in their lives such as a new brother or sister, moving house, starting school may also be relevant.
Research indicates that girls are more likely to recover from a period of stammering and at a younger age than boys.
Although an important factor, gender is not a sole marker for stammering. A full assessment with a Speech and Language Therapist would best identify the child that is more likely to persist in stammering.
Research indicates that is more likely on average 94-97% of the time. Stammering presents and develops in a unique way for each individual but some types of stammering are outlined above. See What types of stammers are there?
If you see any sign of struggle in speaking and / or reaction to speaking it is important to make a referral to a Speech and Language Therapy clinic. A comprehensive assessment of all factors relating to stammering can then be investigated.
Most likely there is a combination of different factors contributing to one child’s stuttering. A Speech and Language assessment would be required to further explain the risk and diagnosis more accurately.
Genetics may also play a role here with regard to resilience to stuttering. Dr. Shelly Jo Kraft of Wayne State University in the USA is the Principal Investigator of the largest proposed genetic study of stuttering to-date which investigates the genetics underlying stuttering. This study aims to identify the genes and transmission models responsible. Irish people who stutter are already participating in this study.
Regular monitoring with a Speech and Language Therapist will best inform you. Persistence of stuttering within a family may also play a part in determining potential outcomes.
In the short-term, for some children, their reaction to moments of stuttering may influence the development and continuance of stammering. Being mindful of your own reactions to their moments of stammering is important. It can be helpful to consider what you say, your tone of voice and facial expressions. Sometimes it is only when we pause to take time to reflect that we realise how tense our voices have become or how we our nervous glances at our partner can be viewed by others. Children are very good at picking up on these signals.
Be as neutral and calm as possible in your conversations with your child. Come down to their eye-level and wait to let them finish their sentences. This will show your child that there is nothing alarming about how they are talking and plenty of time to say what they want to say. As much as possible, focus on WHAT your child is saying (instead of HOW they are saying it). Children’s pronunciation and grammar are still developing.
Keep a diary of times you’ve noticed increased stammering (e.g. a late bed time, sick, birthday party etc.) and when you’ve noticed decreased stammering (e.g. one to one situations, or when they are not being interrupted). This information will help you understand any patterns if the stammering increases again. These observations will also greatly benefit the Speech and Language Therapist’s assessment and initial management strategies.
If you already have a diagnosis for your child, it would be important for your child to have an opportunity to mix and interact with other children who stammer, in a fun capacity. Often times, children will think that they are the only person who stammers in their school or in their family. Mixing with other children who stammer in their own individual way is the most effective way of easing this isolation. The Irish Stammering Association runs drama camps each summer and online support groups for children who stammer so keep an eye out on the website for further details.
The website of the Irish Association of Speech and Language Therapists also offers information on the referral process in Ireland and also has a list of private speech and language therapists in Ireland.
There are a number of Speech and Language Therapists who work in private practice. You can access these details on www.isti.ie
Changes that are recommended by a Speech and Language Therapist are discussed with parents. These changes are most associated with improvement and / or recovery. They are not changes which imply that any reactions or behaviours were the cause of the stammering.
Strategies for parents to use as a family:
Each child has their own factors which combine to cause stammering. These can be linked with stuttering more, or stuttering less, depending on the circumstances.
A Speech and Language Therapist can help you explore these factors to help understand the reasons behind the fluctuations in speech patterns, and how best to manage them.
Consulting with a Speech and Language Therapist can support a teacher when they are working with your child at school. If your child and/or your child’s friends and/or their teacher are reacting to your child’s stuttering then it is important to talk to their teacher. This information will be very important and may support the advice and support a speech and language therapist offers in collaboration with the parents.
Any information that helps the teacher understand more about stammering, its causes, how best to react, the factors involved for your child etc. will be helpful to all concerned. The Speech and Language Therapist may also be able to arrange a consultation with the teacher.
If you decide together that it would be beneficial, then a set of concrete helpful suggestions may be an idea.
The SLT working with your child may be able to prioritise certain scenarios such as managing their stutter at school, thereby facilitating the development of their own coping skills.
For example; a helpful strategy could be that their teachers accept that a variety of responses to a roll call would ease the pressure in this scenario e.g. putting up a hand, saying ‘here’, ‘present’ or their name to indicate their presence. This variety should be extended to the whole class so that your child does not stand out for this reason. By allowing a range of responses your child then has a choice in how to respond that best suits their needs at that time. This choice will help your child feel more in control.
Each school tends to have its own policy for managing bullying so it would be important to link in with either the Teacher or the Principal to discuss the situation and negotiate strategies.
If one parent is concerned then we already know that an assessment would be helpful. By both parents meeting with a Speech and Language Therapist and doing a full assessment of your child, a risk profile can be compiled and an informed decision made about whether your child is at risk for continued stammering.
Some people favour a ‘watch and see approach’ as opposed to a ‘wait and see approach’. This is considered best practice for any child presenting with stuttering. A ‘watch and see’ approach involves assessment and regular monitoring with a speech and language therapist. This process will help develop supported proactive reactions and management of your child’s stammer. It is important that both parents work together in supporting each-other with changes suggested and with thoughts and feelings that may arise for each partner along the way.