Often when I meet someone new at a cocktail party and tell them I’m a speech pathologist, they’ll say ‘Oh like Geoffrey Rush in the King’s Speech!’
Truthfully, providing intervention for clients who stutter is a world away from the Geoffrey’s kooky strategies in the delightful period drama, but similarly, we are able to provide strategies to help people who stutter reduce the severity of their symptoms and improve their communication.
What is stuttering?
Stuttering affects the fluency of speech. It is characterised by disfluencies or disruptions to a speech of several types;
Repetitions – where a syllable, a whole word, or several words are repeated, e.g.
‘w-w-w-when are we going?’
‘when, when, when are we going?
‘when are we, when are we, when are we going?’
Prolongations – where a sound is stretched out and the speaker has difficulty moving to the next sound, e.g.
‘SSSSSSSSusan is late’
Blocks – when someone has a ‘silent’ block in his or her speech, e.g.
‘I’ll b______e there later’
Other elements – Facial grimaces, blinks, twitches or tics can sometimes accompany a stutter.
Stuttering typically appears between the ages of 2.5 and 4 years old. It is more common among boys than girls, and often these little ones don’t even realise they are doing it. Parents sometimes report a near-spontaneous onset of stuttering, where a child goes to bed one night without a stutter and wakes up the next day with a severe stutter seemingly out of the blue. In some cases, it will begin mildly and become more severe over time, and it might disappear only to re-emerge months later. In adulthood, these symptoms tend to be more stable, and these speakers may report a predictable variation of severity in different circumstances.
Stuttering can be mild, severe or restricted to certain settings, for example, someone might only stutter when he or she speaks on the phone, during a work meeting, or to their particularly attractive barista.
Everybody experiences some disruptions in his or her speech from time to time. It is completely normal for someone to repeat a sound, have a block, have a word ‘on the tip of the tongue’ every once in a while. The point where it moves from a regular disfluency to a stutter can be diagnosed by a speech pathologist.
We don’t exactly know what causes stuttering. Some studies suggest stuttering might run in families, and in some instances, it can emerge after a neurological or psychological trauma. In most cases, it just seems to appear in some toddlers without explanation.
Won’t my child just outgrow it?
According to the American Speech Language Hearing Association, about 75% of pre-schoolers who stutter will eventually stop. This may happen within months of onset, or it may happen after several years. It’s unclear why this happens, and there is no way of knowing which pre-schoolers will stop stuttering, and which will continue stuttering into adulthood and throughout their lives. It is clear however that intervention for young children can help improve their speech fluency.
What treatments are available?
There are several treatment options available to people who stutter that are backed up by evidence. A speech pathologist can help you decide the best course of treatment for you or your child.
One treatment commonly used for children involves a high degree of parent involvement. It is a ‘behavioral’ technique called the Lidcombe Program that involves frequent visits to a speech pathologist and dedicated one on one practice time at home. It is advised that families embark on this treatment course when they have that time to dedicate to the practice, as only attending speech therapy without the home practice element is unlikely to yield the same results. Studies have shown that this technique is most successful for children under the age of 7, and shows very promising long-term outcomes.
Treatment for adults is a little different. There are several options which would be suitable for different people, and these attempt to lessen the severity of a stutter when it occurs. Eliminating speech disfluency entirely is not so much the intended goal, rather targeting particular ‘trouble spots’, like speaking on the phone or in public speaking. Developing a technique to speak with a higher degree of fluency during these difficult moments can be really hard work, and using the technique can require conscious effort. For this reason, some people may not use their learned technique all the time, and may still have some disfluencies in certain circumstances.
Be a good communication partner
People who stutter are very aware of it. There are a few things you can do to help someone who stutters.
– Be patient. Just wait for them to finish what they’re saying without looking awkward or embarrassed.
– Don’t tell them to ‘take a breath’ or ‘slow down’. This can sound really patronizing, and the person you’re speaking to won’t appreciate the (unsolicited) advice. They’ve probably heard it all before, and if it worked they wouldn’t be stuttering.
– Don’t try to finish their sentence for them.
– Show that you’re a good listener by using your body language. Listen to what they’re saying, rather than how they’re saying it.
– Talking on the phone is difficult for many people who stutter. Be aware, and don’t interrupt or try to rush them.
– All people who stutter are different, and the type, severity, and triggers for someone’s stutter are different too. Some people might not mind talking about it, and some would much rather if you didn’t ask. Feel the room, and use your common courtesy.