Most preschool children encounter challenges with their speech, such as repeating sounds, syllables, words, or phrases. They often use filler words like “uh…” and “um…” and may exhibit
changes in what they say, speaking without a consistent rhythm or continuity. While these patterns are common, certain speech difficulties may deviate from the usual. If a child
demonstrates any of the following patterns persistently for six months or more, it is likely that they are developing a more persisting difficulty:

• Making repeated repetitions of the initial sound or initial syllable of various words.
• Lengthening the first sound of several words.
• Exhibiting tension and effort in pronouncing words.
• Noticeably changing the tone and volume of their voice during speech interruptions.

Stuttering is a challenge that frequently emerges during the preschool years. While many children experience temporary stuttering and eventually overcome it, others persist in their stuttering, and the related difficulties remain unchanged. In some cases, the stuttering pattern in children exhibits a progressive deterioration. Typically, those within this group perceive speaking as a challenging and frustrating ordeal, identifying themselves as children who stutter. To circumvent the stress associated with stuttering, they frequently opt to avoid speaking altogether.

 

What are the goals of stuttering treatment?

Speech therapists often do not directly engage with young children who stutter but instead collaborate with the child’s parents. Many speech therapists believe that a child’s challenges
may worsen when listeners criticize their typical difficulties or pay heightened attention during instances of speech difficulty. In any case, stuttering seems closely linked to the additional
attention resulting from the child’s conversation partners’ reactions to speech difficulties.

However, a child who stutters may display atypical speech flow patterns from a very early age, signaling a potential need for immediate intervention to foster fluency development. In the
initial assessment preceding this intervention, the child’s overall language proficiency must be examined to prioritize treatment goals. In other words, a child with evidence of persistent
speech flow issues may also present other challenges, such as specific language delay/disorder, articulatory and phonological problems, etc. Therefore, a comprehensive communication and
language profile must be documented, and speech therapy intervention should be meticulously structured to maximize benefits without exacerbating stuttering.

For younger children, most approaches aim to establish a foundation for effortless speech. In the case of elementary school-age children, the primary objective of speech therapy is to help
the child perceive speaking as something easy and enjoyable rather than intimidating and challenging.

 

How can parents and speech therapists assist a child who stutters?

Generate models of accurate speech pronunciation.

Have you observed your child speaking rapidly to you? Repetitions at the onset of words may occur more rapidly when your child exerts more effort. Certain words can pose challenges. Your
child might tense the muscles around the mouth or make facial expressions. It may seem like a natural response to advise your child to calm down and not try so hard. However, offering
“helpful hints” may bring more attention to the issue, leading to subsequent frustration for your child. They may not fully grasp the meaning of phrases like “slow down” or “don’t try so
hard.”

In both direct and indirect intervention, parents and the speech therapist employ the speech patterns they want the child to adopt. They speak slowly and comfortably, devoid of tension or
apprehension. In other words, they set a positive example and impart the lesson. The speech therapist’s objective is to encourage the child to begin speaking based on this model. Therefore,
the therapist creates models of deliberate, effortless speech with the aim of enhancing the child’s fluency.

 

Gradually increase the length and content of the sentences.

Developing the ability to construct new sentences, carefully selecting the appropriate words for those sentences, and swiftly manipulating our articulators to articulate words requires a
considerable amount of skill. You might observe that as your child attempts to employ longer and more intricate phrases or sentences, their articulation becomes less precise. The child may
introduce pauses in the flow of their speech as they concentrate on formulating the upcoming words.

Therapeutic programs play a vital role in helping children maintain fluency while expanding the length and complexity of their sentences. These programs systematically break down the entire
process into distinct stages. The child must achieve a specific level of proficiency before advancing to the program’s subsequent phase. Initially, the child might be tasked with uttering
a single word, naming a picture, or replicating the speech therapist’s utterances. As the program progresses, the child is encouraged to articulate longer, more intricate sentences that
demand thoughtful consideration and a heightened level of coordination in articulatory
movements. At each stage of the program, fluency is acknowledged and rewarded.

 

Introducing new ways to articulate words.

Typically, when individuals encounter difficulty with a word, they tend to repeat, elongate, or emphasize the initial sound or syllable. Children can be coached to make specific modifications
to the onset of words, enhancing the smoothness of their speech. When a child can initiate the pronunciation of a word without exerting excessive strain on their articulators, they often find
it easier to produce it. Additionally, some children benefit from learning to consciously insert pauses between their phrases or sentences. Other techniques fostering uninterrupted speech
flow include adopting a rhythmic pattern and gradually elongating the initial sound or syllable of words.

In direct therapy, the focus is on tailoring interventions to each child’s individual speech patterns. Simultaneously, parents and speech therapists can engage in discussions about
adjustments to the family’s communication patterns, reducing challenges in the child’s speech.