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HomeResources and SupportA-Z resourcesStuttering, speech, voice and language developmen... Stuttering

Stuttering

A child with a cochlear implant, holding a teddy bear

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Stuttering is a speech disorder that affects approximately 5% of young children, and 1% of older children, adolescents and adults. If stuttering is present when the person is of school age, it is likely that the stuttering will remain, though it can still improve and/or fluctuate. People who stutter know what they want to say. While the cause of stuttering is unknown, we know that it is not related to intelligence. Parents and teachers do not cause stuttering. Stuttering may fluctuate over time and in different situations. There is no cure for stuttering, but speech therapy can help reduce it and increase acceptance of it.  

The flowing risk factors could indicate that the child is at risk of persistent stuttering:  

  • Having a family member, such as a parent or sibling, who stutters.  
  • The stuttering began after 3.5 years of age.  
  • The child has been stuttering for more than 6 to 12 months.  
  • The stuttering has increased. 
  • Presence of speech sound errors or advanced language skills.  
  • Gender: males are 3-4 times more likely to stutter than females. 

No one has perfectly fluent speech. There are “normal” disfluencies which are characteristics of fluent speech, and there are stuttering disfluencies.

“Normal” Speech Disfluencies:

  • Interjections / Filler words (“er, uh, umm, like”)
  • Hesitancies / pauses
  • Revision of a sentence
  • Repetition of full words or multiple words

Stuttering-Like Disfluencies:

  • Repetition of sounds (t-t-t-two)
  • Repetition of syllables (so-so-so-soccer)
  • Repetition of one-syllable words (my-my- cat)
  • Blocks: no sound or airflow
  • Prolongation (I ssssssssaw you)

People who stutter can also exhibit secondary behaviours: facial grimaces, noises, and movement of the head, eyes, hands, arms, legs and feet. 

Other factors that can increase stuttering are: tension in the body, fatigue and emotions such as being excited, sad, angry, stressed, etc. 

People who stutter may experience negative emotions and reactions to their stutter. They may feel embarrassed, ashamed, angry and sad. They may avoid words, sentences and situations. Therefore, acceptance of stuttering is important. 

“People aren’t doing anything wrong when they stutter; they are simply trying to talk, just like anyone else would do. If they feel embarrassed about their speech or ashamed of being different, then they are more likely to struggle with speaking or try to avoid talking. This […] increases the impact of the disorder. When people know that it is okay to stutter, then they can communicate more freely and more easily. They can say what they want to say, even if they sometimes say it disfluently. Thus, acceptance of stuttering is the key to successful communication! Parents, teachers, friends, and others can help people who stutter by simply recognizing that what a person says is more important than how a person says it.” - Stuttering Therapy Resources 

Strategies for interacting with children who stutter

  • Model slow speech. Slow down your speech and include frequent pauses to slow down the pace of the conversation. Do not tell the child to slow down, think before they speak or to take their time.
  • Be patient! Allow extra time to answer and give them time to get their message across. Remind them that what they have to say is important. Pay attention to what they are saying, and not the stutter.
  • Give your full attention. Keep eye contact and show them you are listening with your body language (e.g., stopping what you are doing; having a calm, attentive, and relaxed facial expression). If you are not able to listen carefully at that moment, determine with the child a time when you can both focus on the conversation (e.g., when you are done with your task, in 5 minutes, at dinner, during reading time, before bed, before recess, etc.). Make sure to follow up with them at that time about what they wanted to share with you.
  • Reformulate or repeat to validate what was understood, before asking the child to repeat. (“I understood you were talking about what you were doing with Bob. I’m sorry, but I didn’t catch what it was called. Can you say it again please?”).
  • Model and encourage use of gestures/visuals. If you are having a hard time understanding what the child is saying, ask them to show you.
  • Ask simple questions. When the child is having a harder time than usual with their speech, you can support them by asking questions that can be answered with fewer words (e.g., yes/no, what, where, or when questions). You can also comment on what they are saying rather than asking questions.
  • Take turns. When participating in a group conversation (e.g. classroom, dinner), help everyone take their turn talking and listening to each other so that there are fewer interruptions.
  • Encourage and praise the child for their strengths and skills. Stuttering is not related to intelligence. You can expect the same quantity and quality of academic work as for other children their age.
  • Be open about the stutter. If the child is aware of their stuttering, talk about it freely. Acknowledge their feelings, and help them feel accepted (stuttering is part of who they are, it does not define them). Answer their questions openly and honestly. If the child is not affected by their stuttering, there is no need to bring or increase awareness/attention to it.
  • Normalize disfluencies. It is important to discuss with the child that no one’s speech is perfect. Anyone can repeat themselves, say “um”, or have trouble starting a sentence!
  • Encourage self-advocacy: Encourage the child to advocate for their needs. They may want to tell others not to interrupt, to reduce the number of questions, to slow down when speaking, or to include pauses to allow them the chance to respond/speak.
  • Discuss the child’s needs and preferences with them privately. Let them tell you what would be helpful for them. They may request not to read aloud, not to present in front of the entire class, to only be called upon in class when they raise their hand, etc.
  • Encourage the child to speak to you if they are being bullied or made fun of by peers. Visit our Stuttering, Speech and Voice resource page to find more information and supports on bullying.
  • Create a positive and supportive communication environment. Stuttering is not a bad thing!

Avoid:

  • Telling the child to slow down, think before they speak, or take their time.
  • Interrupting a child, finishing their words or sentences, or talking for them.
  • Showing your worry (e.g. facial expression, avoiding eye contact).
  • Asking too many questions.
  • Pretending that you understand what they are saying.
  • Pressuring the child to speak when they do not want to (e.g., saying hello to an unfamiliar person).
  • Discussing their stuttering with others if they do not want you to.

Teasing, bullying and self-advocacy for the child who stutters

People who stutter can be the target of bullying. When trying to help a child who is being bullied, respect their readiness to discuss their situation. It is important that a child who stutters accepts their stuttering as they may be able to better react to bullying situations. Children must feel accepted by the people in their life and that what they have to say is valued.

  • Create a safe space for the child to share their experiences with you. Assure them that what is discussed will remain confidential and will not be shared with others without their permission (e.g., peers or teachers). Share your own experiences with bullying if it has happened to you.  

  • Talk openly about bullying situations. 

  • Consider that questions from others could be genuine curiosity.  

  • Discuss the intention behind the comments. Explain the difference between teasing that is fun (where both speakers are having fun and the goal is not to hurt) and hurtful teasing/bullying (where the goal is to hurt the other's feelings). 

  • Brainstorm ideas of things the child can say or do in different situations. If they are not ready to act, discuss what they could do when they are ready. Try to come up with as many ideas as possible. It may help to role play some of those scenarios. 

  • Help and encourage the child to describe their own experience with stuttering (e.g., in what situation/context is speaking easier or harder and why). When they are able to understand the variables, the child will be better equipped to self-advocate. Discuss conversational likes and dislikes. Role-play to practice asking what they want and need in different communication situations (e.g., speaking first or last in class, not getting interrupted, keeping eye contact).  

  • Encourage education about stuttering. If the child agrees, educate others (e.g., family members, friends, classmates, other adults) on basic facts about stuttering, including that it is not something to be afraid of or made fun of. The child can choose to participate in educating others.  

“I can speak up – Five Finger Strategy” (Langevin, Kully & Ross-Harold, 2007, Stuttering and Related Disorders of Fluency, 3rd Edition, pp.131-149) has been outlined as effective steps to deal with bullying situations

  1. Say the name of the person you are speaking to.
  2. Tell them that you don’t like it.
  3. Describe the behaviour(s) that you want to stop.
  4. Be respectful.
  5. Say what you want (e.g., I want you to stop). 

Other strategies found in literature include: 

  1. Ignoring / avoiding bully situations when possible. 

  2. Making more friends. There is power in numbers when addressing bullying. Asking a friend (or group) to stand up with and for them in bullying situations can be helpful.  

  3. Remaining calm and acting as if it does not affect them. 

  4. Responding with factual answers (e.g., “You are right, I do stutter. You already said that before. So what? That’s just how I speak”). It may take a few of these answers to discourage the bully. 

Please note that each situation may require a different approach. You should also consider your child’s temperament and personality. It is important that children are involved in choosing how the situation will be handled. Note that the verbal response given by the child who stutters to the bully does not have to be said fluently. 

#BestLife for every child and youth

2023-07-26 | P6274

This reference is for educational purposes only. If you have any questions, ask your health-care provider.

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