By: Joan Winfrey-Seoni
Language is how we communicate and we use a variety of forms to express ourselves. This includes speaking, gesturing, reading and writing.
Children learn the rules of language, both written and verbal, by listening to what they hear. In this way, language is learned in stages over the course of time. While every child grows at a different rate, what is important to look for is continuous language growth.
Of those children who develop difficulty with language or speech, some are not exposed to enough language to learn the rules, some find they need only to gesture to get a response, but most suffer without any known physical cause. Speech is a medium of oral communication that employs a language code.
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‘Recent research has indicated that if children are identified early on and subsequently treated, the stuttering behavior may successfully be eradicated.’ Joan Winfrey-Seoni
Certified speech-language pathologist The Medical Center at Princeton |
Many children display speech difficulties that fall into two categories: developmental non-fluent speech and stuttering. It is heartening to know that 75 percent of young children who show early signs of non-fluency later outgrow it.
Developmental non-fluent speech occurs between the ages of 2 and 6. Developmental non-fluency is marked by easy, effortless rhythmic repetition of phrases and whole words as well as short interjections ("um" and "uh").
Also common are part-word repetitions that contain the same vowel sound as the word the child is trying to say. For example, non-fluent speech would be the repetition of the sound "ba
ba" when trying to say "ball." There are fewer unit repetitions (usually just one or two) with this non-fluency stage and normally non-fluent children tend to be disfluent in five to six out of every 100 words they speak.
Children who are at risk for stuttering show a greater number of disfluencies and they are more fragmented. For example, danger signs include a child who routinely repeated phrases or whole words but now repeats syllables or sounds, or a child who used to repeat words and syllables but now prolongs sounds or becomes inaudible.
Other danger signs include an increase in the effort, tension and struggle, such as an increase in the loudness and/or the pitch. Also, the child who mispronounces the first syllable during a repetition is at a higher risk. For example, repetition of an incorrect syllable such as buh-buh-baseball is a more serious indicator than repetition of the correct syllable ba-ba-baseball.
In addition, there are secondary behaviors that may accompany stuttering such as eye blinking and hand or foot movement. If you believe your child may stutter, there is much help available and much that you can do to help your child.
A speech-language pathologist with experience in child development can evaluate your child’s speech-language development, design a speech fluency plan, and carry out the plan in individual or small group sessions.
This professional is typically educated at the master’s or doctoral level, certified by the American Speech-Language-Hearing Association, and licensed in almost all states. Speech-language pathologists can be found serving in schools, hospitals, clinics and in private practice.
There are many schools of thought regarding the causes of stuttering. The disturbance may be at the level of neuromuscular, respiratory, phonatory or articulatory mechanisms. Regardless of the reasons behind why a child may stutter, there are suggestions that many speech-language pathologists recommend to help you and your child deal with the difficulty:
Speak softly and slowly to your child and to others in the presence of your child
Allow your child plenty of time to speak so he does not feel he has to rush to get a word out
Avoid telling your child to slow down or take it easy
Reduce all sources of stress in the home as much as possible
Do not become impatient or embarrassed by your child’s speech
Do not make stuttering a taboo topic
Remind your child you love him for who he is
Do not call attention to your child’s repetitions either by facial expressions, word, or deed
Remember that a child develops his attitude about talking by observing how his parents talk
Give your full attention to your child when he is speaking
Do not ask your child to substitute an easy word for a hard one as this will increase the fear of certain words and phrases
Do not ask your child to start over when he stutters
Maintain an open, caring home environment in which communication happens freely and often.
If you believe your child may need help with his or her language, consult the speech and language professionals. When working with a speech-language pathologist, she will ask for a family and medical history and then will spend time with your child, just listening and talking.
For a younger child, she will look at how he or she answers questions, names single-word pictures and speaks spontaneously. The number of sound prolongations, the number of syllable and word repetitions, and how sentences are revised to avoid a problem word are all taken into account.
For an older child, the speech-language pathologist will look at automatic speech tasks such as counting, reciting, singing or reading. Your child may be asked to describe something in a monologue and will be engaged in a simple conversation.
From listening to your child’s patterns, the speech-language pathologist will discuss specific techniques to help your child gain confidence and speak more fluently. Sessions typically last for 30-60 minutes, once or twice a week, and will continue as long as they are needed.
Noticing early warning signs of speech difficulty is important. Recent research has indicated that if children are identified early on and subsequently treated, the stuttering behavior may successfully be eradicated.
Joan Winfrey-Seoni is a certified speech-language pathologist on staff at The Medical Center at Princeton. Health Matters appears Fridays in the Lifestyle section of The Princeton Packet and is contributed by The Medical Center at Princeton.