Understanding Childhood Stuttering: Symptoms, Causes, and Treatment, Slides of Public Health

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Identification and

Treatment of

Childhood Stuttering

What Is Stuttering?

An impairment of speech andlanguage production, typicallycharacterized by interruptionsin the forward flow of speech

(“speech disfluencies”)

How Does Stuttering

Develop?

^ Typically begins between ages 3 and 5 ^ As the disorder progresses, children arelikely to develop reactions to stuttering...

^ Tension and struggle in their speechmusculature ^ More advanced types of speech disfluencies ^ Concern or anxiety about their speakingabilities

What Kinds ofConsequences?

^ Affective, Behavioral, EmotionalReactions:Anxiety about speaking, avoidance ofspeaking situations (reading in class, talkingto friends), embarrassment, shame, guilt, lowself-esteem, frustration, fear

After Yaruss (1998)

Click for larger

picture

Okay, so…

What

Does

Cause Stuttering?

Current theories point to a complicatedinteraction between children’s

language

development and their

motoric abilities

for

producing speech, combined with the

multiple influences of the child’s

personality

and the child’s communicativeand social

environment

Isn’t Stuttering “Genetic”?

^ Yes, stuttering tends to runs in families...

^ If one family member stutters, there is anincreased chance that another familymember will also stutter ^ The few twin studies that have beenconducted show only 50% concordance forMZ twins, suggesting that there are alsoenvironmental influences

Don’t Most ChildrenOutgrow Stuttering?

^ Yes.

Most children who exhibit

disfluencies or even stuttering early intheir speech/language development

will

recover without intervention^ ^ Prevalence = 1%^ ^ Incidence of Stuttering = 5%^ ^ Incidence of Increased Disfluencies: 15-25%

A Critical Period for

Recovery from Stuttering

^ If children do not recover by age 6 or 7,they are likely to develop chronicstuttering

^ Older children rarely achieve normalfluency, and the negative consequencesincrease over time ^ Negative social and emotionalconsequences can be minimized withappropriate early intervention

So...Who Is At Risk?

^ Certain risk factors can provide someclues:

^ Number, nature, and types of speechdisfluencies ^ Length of time the child has been stuttering ^ Family history of stuttering ^ Child’s reactions to stuttering ^ Family’s reactions to stuttering (parent’slevel of concern and attempts to help)

Who Should Be Referred

for Evaluation?

^ It is impossible to determine whether adisfluent child is at risk for developing achronic stuttering disorder throughinformal or casual observationdocsity.com

^ Speech-language pathologists (SLPs),licensed and certified by the

American

Speech-Language-Hearing Association (ASHA)  Not all SLPs are comfortable withstuttering, so there has been a movetoward specialization

Who Should Evaluateand Treat Stuttering?

How Is Stuttering Treated?

^ Helping children learn to speak morefluently

^ Changing the

timing

and

tension

of speech

production ^ Helping parents learn to facilitatechildren’s fluency in everyday speakingsituations

^ Parents can change their own speech andmanage children’s speaking situations tohelp them speak fluently