Is it too soon to put my child in therapy? Will attending speech therapy cause my child to become self-conscious about their stuttering? What happens if therapy doesn't work? My pediatrician said not to worry, but the teachers keep bringing it up. I think it's a big deal, but my spouse doesn't. I read online that I shouldn't bring attention to it, but my mother says I should remind him to slow down every time he stutters.
I don't know what to think!
Early childhood stuttering is enormously complicated. There are no clean-cut answers, other than "it depends on the child." Here are a few of the most common questions we encounter from parents, and our take on the answers.
To wait or not to wait on therapy, that is the question
This is THE question when it comes to therapy for preschoolers who stutter. There is no single, simple metric for making this decision. Pediatricians often suggest waiting until a certain age, but this is unfortunately grossly oversimplified and not appropriate in many cases.
What makes this question so complicated is that many preschoolers show signs of disfluencies, and many of those children will spontaneously recover without any intervention whatsoever. How do we know which children need therapy, and which ones will likely figure it out on their own?
We don’t have a crystal ball to determine which children will and will not persist, but we can identify risk factors. We look for clues that the child may be more likely to continue stuttering past the age of natural recovery (e.g., family history of stuttering, male gender, another speech/language disorder in addition to stuttering). These indicators are not guarantees that a child will or won't recover, and there is not a direct causation between these risk factors and chronicity. So, yes, a wait and see approach may be appropriate for some of the children who begin stuttering during their preschool years. For others, though, early intervention will be critical.
How long a child has been stuttering for is a major risk factor for persistence. The longer a child stutters, the more likely the child will be to continue stuttering further into the school-age years. This is another reason that the common "wait until s/he is five or six years old" is very risky advice. If a child begins stuttering at two or three, but continues to stutter until they are five or six and receives no treatment, their risk of developing a lifelong stutter has significantly increased.
This is why there is no such thing as starting treatment too early. If a child is struggling, even if it has only been for a few weeks or months, we want to provide help for the child where they are in their communication today. If your child falls off a bike, you don't ignore their pain because it's "too soon" to comfort them, because you know the pain will dissipate later. Supporting a child with communication struggles in the here and now does not cement communication difficulties— it relieves them! The reverse is also true: neglecting to acknowledge, address, and help a struggling child greatly increases the odds of continued challenges down the road.
Of course, speech therapy is daunting. We get it. You may have heard that you should just “wait and see,” but you still feel like you want to do something. We get that, too. Or, you may feel that it's really not that big of a deal, yet others are urging you to take action. Yes, we get it, that's normal too! That’s why at speech IRL we have our parent coaching approach. This serves as an "in between" option: not quite a full dive into weekly speech therapy, but consistent communication with a specialist, where the focus is learning about stuttering and the best strategies for your individual child.
What happens if my child continues to stutter?
The honest truth: therapy doesn't always make stuttering go away.
Since the majority of stuttering cases are due to patterns of neurological development, some children who begin to stutter in the preschool years will persist and continue to stutter during their lifetime. There is no cure for stuttering, but speech therapy can help support children in their abilities, teach them to become confident communicators, and provide education and counseling to their families. All children who stutter have the same chance to grow and thrive as others. Stuttering presents extra challenges and an added need for problem-solving skills, but it does not need to be a curse.
Is it OK to use the "s-word" around preschoolers who stutter?
Many parents are nervous about talking about stuttering with their child. "Will I make it worse? What happens if it scares them? Maybe if I ignore it, the problem will go away." It is not uncommon for parents to be reluctant to bring a child to speech therapy for fear of making the child aware of their stutter, or that acknowledging the stutter exists will make it worse.
We're here to tell you that it's OK to talk about stuttering. In fact, it's one of the best things you can do to support a preschooler who is struggling with their speech.
Look at stuttering through the eyes of your child. Your child is experiencing a loss of control of control over their speech. This can be overwhelming, frustrating, and even frightening. Now imagine everyone around your child refusing to talk about it. The adults never bring it up, never offer help when it happens, and never discuss it, even when the child stutters constantly and is obviously distressed. The child knows they are having a hard time: does nobody care? Or is what is happening to them so shameful that the adults don't even want to acknowledge it? This approach is not helpful, and can even be more harmful in the end--not talking about something can make it bigger and more frightening than it actually is.
Call him Voldemort, Harry. Always use the proper name for things. Fear of a name increases fear of the thing itself.
- Albus Dumbledore
Think of other activities your child is learning at this time, like coloring, riding a bike, or spelling. When a child makes a mistake, what do we do? We provide gentle corrections and provide advice for next time (especially when they're showing frustration over their errors), and then praise them for the awesome job their doing. Most importantly, we treat it as a normal stage of learning how to do things.
When we treat stuttering like the above activities, we can normalize an activity that can seem frightening and frustrating to a young child. We also take advantage of opportunities to practice flexibility and problem-solving in the moment of stuttering, as well as to provide language to describe the emotions that may come up during stuttering.
Finally, talking about stuttering can create a healthy attitude toward communication in general. It’s OK to make mistakes and learn from them. We don’t have to hide or feel ashamed when mistakes happen, which is an important life lesson to learn.
Stuttering is confusing. Stuttering during the ever-changing preschool years is especially so. Our philosophy is to make the most of the knowledge, tools, and experience we have, while also making room for the unknown. We never know exactly where kids will end up, but we can do our best to help them walk a steady, supported path. As speech therapists, that means helping parents find a steady, supported path as well.
The mantra that stuttering specialists live by is "keep talking". This goes for parents as well. Worried? Scared? Confused? Skeptical? You're not alone. Talk about it. Ask questions, share information you've learned. We're here to listen, and to help.
Questions about your child? Get directly in touch with our preschool stuttering specialist by e-mailing natalie@speechIRL.com.