Stammering/dysfluency

Dysfluency and Stammering in Children

What is normal dysfluency in young children?

Pausing, repeating words or sounds ("can, can, can I", or "mu mu mu mummy"), stopping and starting again are the sorts of dysfluencies that occur when children are learning to talk. Many have episodes of obvious dysfluency during the years of very rapid language development (two to five years) and at other times during childhood when there are extra pressures to speak well. A child who is slow in using sentences or in speaking clearly may be particularly sensitive to communication pressure.

What is stammering (or stuttering)?

When normal dysfluencies occur so often that they interfere with talking or cause distress to either the speaker or the listener, then stammering may develop. If relaxed repetitions or stretched out sounds become very tense and the child struggles to finish a word then he or she may be stammering. However, there are many children who experience these problems with talking who don't develop a stammer. It is impossible to tell for sure which children will pass through a stage of stammering and which will not, so it is always best to do whatever we can to make speaking easier for the child.

Why - Risk factors for early referral

The following factors have been shown to be characteristic of those children at greater risk of developing a persistent stammer.

If you observe a child who has dysfluent speech, or if a parent reports hearing this, and one or more of the following factors are present: please refer to Speech and Language Therapy:

• There is parental concern
• The child is showing signs of frustration or is upset
• There is a family history of stammering or speech and language difficulties
• The child has had any other difficulties with speech and language
• The child’s general behaviour is causing concern
• the child is in a dual language situation and is stammering in his first language

Early referral is desirable because:

• The Speech and Language Therapist needs to evaluate the risk of persistent stammering. If the child seems low risk they will monitor progress, if high risk they will intervene.
• Provides support for parents and carers.
• Intervention close to onset takes less therapy time and can prevent later psychological difficulties.
• Empowers parents and other key workers.

Referral can be made when there is concern about the child's speech, which may be close to, or within weeks of onset.

Please Note: 

•  Do not wait to see if the child ‘grows out’ of it.                      
•  Stammering is episodic and may not be evident during the child’s appointment
•  Stammering therapy is more effective before the age of five years

How to refer

Referral can be made by the parent or carer directly or via the Health Visitor, GP or nursery or school. To make a referral, please fill out the referral form on our website as fully as possible and send it to our department.  Please do not directly address the referral to any specific therapist as this will cause a delay in the referral being dealt with.

Where:

Pre-school children will be assessed at the local community speech and language clinic and further follow up by a Specialist SLT is available for more complex or longer term stammering conditions at Gaol Street Specialist Clinic in Hereford.

Older children and teenagers will be seen at the Specialist clinic at Gaol Street in Hereford, where some after school / college appointments may be available.

Advice and training may also be offered in nursery or school to staff.

To contact our service

For further information or advice, please contact the Speech and Language Therapy team on 01432 363975.

Useful information and resources 

• The British Stammering Association www.stammering.org
• Expert Parent website - information to guide parents as their young person progresses through the education system to the end of statutory schooling at 16 years of age
• Education Officer - you can contact her if you have queries related to education.
• You may also want to ensure the school is aware of:
  www.stammeringineducation.net
  
  The BSA information and training resource for teachers and school staff, showing best practice for teachers and school staff when working with pupils who stammer, plus tips and techniques for English oral work. It includes video and audio clips of children who stammer, teachers and therapists, as well as classroom situations.
  
  
• The Michael Palin Centre for Stammering Children: www.stammeringcentre.org