A Guide To Stuttering

Transcription

1 Chicago Speech Therapy Presents: A Guide To Stuttering For Parents An illus trated guide t o unders t anding your child s speech f luency AVAILABLE ON:

2 Copyright 2017 by Karen George, MS, CCC-SLP All rights reserved. No part of this guide may be reproduced in any form (electronic, mechanical, photocopying, recording or otherwise) without expressed written permission from the publisher and author. Additional copies of this guide may be ordered directly through Amazon.com. For bulk purchases, contact us through our website at: First Edition Karen George, Ali Petit, Title: Chicago Speech Therapy Presents: A Guide To Stuttering For Parents An illustrated guide to understanding your child s speech fluency Special thanks to the countless people who have contributed to this work including designers, researchers, fact-checkers, the publisher, production managers, illustrators, proofreaders, sources, indexers, and editors. A special thanks to the entire Chicago Speech Therapy team who supported this work. Printed in the United States of America. Pediatric Publishing 2017 Pediatric Publishing

3 What Is Stuttering? Stuttering is characterized by the American Speech and Hearing Association as, disruptions of the production of speech sounds, also called disfluencies. A child may have a stutter if they have difficulty speaking or demonstrates hesitation or repitition of syllables, words, or phrases. Or, a child could simply be going through a normal phase in development as their language repertoire expands and they learn to talk. 1

4 Normal Disfluencies Vs. Disfluencies Characteristics Of A Stutter Looking at different types of disfluencies helps us determine if a child may be stuttering or if they are going through a new stage of learning. Normal Disf luencies vs. a St ut ter Normal Disfluencies These are bumps or repetitions in speech that: 1) Occur occasionally 2) Are not considered atypical 3) Are not concerning to the child Stuttering Disfluencies characteristic of a stutter are: 1) More intense 2) Occur more frequently 3) Often accompanied by frustration 2

5 Normal Disfluencies Vs. Disfluencies Characteristic Of A Stutter Normal Disfluencies Inserting interjections, such as um, like, or uh Revising whole words and phrases ( I want-i need that ) Repeating whole words and phrases ( mommy-mommy-mommy let s go or I want-i want that ) Repeating syllables once or twice ( li-like ) Hesitating when thinking about what to say Disfluencies disappear for several weeks at a time Disfluencies Characteristic of a Stutter Repetition of parts of words ( ca-ca-ca-cat ) Prolongation of the initial sound in a word ( ssssss-snake ) Blocks where the child is unable to produce sounds and words at all ( l ---- like ) Normal disfluencies are used to postpone or avoid stuttering ( I, um, you know, uh, I want to um, g-g-g-go with you ) Secondary characteristics such as increased physical tension when speaking, eye blinking, or head movement Disfluencies are present more often than absent 3

6 What Factors Can Contribute To Stuttering? There is no single cause of stuttering; however, many factors can contribute to making a child more likely to present with disfluencies in their speech. STUTTERING Communicative Stressors Interpersonal Stressors Childhood Factors Communicative stressors, interpersonal stressors, as well as factors within the child can potentially be associated with stuttering. Factors that contribute to childhood stuttering can be thought of in the context of a bucket of water. When many of these factors are present, a child s bucket fills up and can tip over, increasing the likelihood that stuttering will occur. 4

7 What Factors Can Contribute To Stuttering? Communicative Stressors Hey! I m talking! I want to talk, too! Hey! It s my turn! Negative reactions to stuttering Fast-paced, demanding questioning Frequent interruptions Competition for talking time Rapid rate of conversation 5

8 What Factors Can Contribute To Stuttering? Interpersonal Stressors Interpersonal Stressors Unrealistic demands Major life changes Family or sibling conflicts Traumatic events Fast-paced or unpredictable behavior 6

9 What Factors Can Contribute To Stuttering? Childhood Factors Genetic predisposition to stutter Language or motor mismatch such as advanced language skills and average or below-average motor skills (or vice versa) Highly reactive temperament (e.g. cries easily or highly fearful) Regulation (difficulty stopping crying, changing activities, etc.) Other speech-language disorders 7

10 What Can We Do To Help? There are many ways for parents and other adults to modify their communication to encourage smooth speech. In fact, much of therapy for young children who stutter involves parents implementing strategies to enhance their child s speech fluency. The following communication modifications can help to create an environment where time pressure is reduced and fluency can be facilitated. Turn to page 16 for more ways you can help your child at home. 8

11 What Can We Do To Help? 1. Use easy talking Easy talking means speaking at a slowed rate, speaking in phrases, and pausing between words and phrases. Think about Mr. Rogers or President Barack Obama. These two men have speech styles that let our children know that speech can be relaxed. 9

12 What Can We Do To Help? 2. Pause before answering your child What do you think is going to happen?... I think they will win the game! Children who are struggling to keep their speech moving forward often place a great deal of urgency on responding. They need to learn that pausing is acceptable, so parents and grown-ups need to lead by example. 10

13 What Can We Do To Help? 3. Modify questions Questions place a great deal of demand on a child s linguistic system and set the stage for accentuating time pressure during speech. When it is necessary to ask questions of a child who is experiencing disfluencies, modify or soften them by adding a tag at the beginning of the question such as Maybe... I wonder... It looks like... Do you think... I think... I guess... I bet... These modifiers really serve as a filled pause letting the child know that a question is coming, but that there is not a sense of time urgency in answering them. 11

14 What Can We Do To Help? 4. Repeat and rephrase your child s speech attempts (fluent and disfluent) using easy talking It s a s-s-s-snake! Right... that s... a... snake! Using easy talking helps your child know that you are listening and gives them the opportunity to hear you model easy talking. 12

15 What Can We Do To Help? 5. Avoid interrupting your child s speech Your words matter! Protect talking time! If a child fears interruption then time pressure or urgency to get speech out increases. This sets a child up for enormous struggle. Let everyone in your family know that interruptions are not permitted and be sure to reinforce your family members for being patient and listening while other people are talking. 13

16 What Are The Next Steps For My Child? Contact Chicago Speech Therapy for more information regarding fluency: (312)

17 Strategies for Parents The following page contains strategies to help you learn how you can improve your child s fluency at home 16

18 Strategies to Build Smooth Speech Set aside time to play in which your child has your undivided attention Slow & s teady Sentences! Choose activities that do not put stress on your child to communicate at a high level. Avoid activities that require intense focus on the task, as this may detract from their focus on communication. Examples are Play Doh, puzzles, or finger painting. As you play, speak in slower, shorter sentences. Old McDonald... Read books together, modeling easy, relaxed speech. Rather than asking your child questions about the book, comment on and label what you see. They might decide to chime in spontaneously! Had a f arm! Sing songs or nursery rhymes together. Singing is a natural way to practice easy, relaxed speech in a fun way! 17

19 References Cox, Ted. Once Daring, MTV Now a Bland Corporate Commodity. Daily Herald [Arlington Heights, IL] 1 Aug. 2006: 1. Infotrac Custom Newspapers. Web. 27 Aug Curtin, Michael F. Media and the Degradation of Language: The Tides of Vulgarity Can be Countered. Vital Speeches of the Day (Aug. 2006): Print. Edmundson, Mark. One the Uses of a Liberal Education: I. As Lite Entertainment for Bored College Students. Harper s Sept. 1997: Print. Halimi, Serge. Myopic and Cheapskate Journalism: U.S. Press Obsessed with Local Issues. Le Monde Diplomatique English Edition. Le Monde Diplomatique, Aug.-Sept Web Stuttering Center Of Western Pennsylvania. Factors Potentially Associated with Childhood Stuttering. Pennsylvania: Stuttering Center of Western Pennsylvania, Web. 8 Dec Thomas, Frank. Dark Age. Commodify Your Dissent. Ed. Frank Thomas and Matt Weiland. New York: W.W. Norton, Print. Washburn, Katharine, and John F. Thornton, eds. Dumbing Down: Essays on the Strip Mining of American Culture. New York: W.W. Norton, Print. 19

20 About Chicago Speech Therapy Chicago Speech Therapy, LLC is a premier provider of in-home pediatric speech therapy services in Chicago and the surrounding suburbs. Chicago Speech Therapy also publishes an informative newsletter that shares cuttingedge speech therapy information and is distributed to more than 1,463 pediatricians and 997 preschools. Chicago Speech Therapy has become Chicago s premier speech practice by adopting a unique approach (in-home therapy), employing innovative and effective therapy techniques, and recruiting top speech-language pathologists from across the US. About Karen George, MS, CCC-SLP Karen George is a Chicago speech-language pathologist and founder of Chicago Speech Therapy. She is the author of several books such as A Parent s Guide to Speech and Language Milestones, A Parent s Guide to Articulation, A Parent s Guide to Speech Delay, A Parent s Guide to Stuttering Therapy, A Parent s Guide to Speech Sounds Development, and A Parent s Guide to Pediatric Feeding Therapy. Karen is often asked to speak and has addressed audiences at top children s hospitals and prestigious graduate speech programs. Chicago Speech Therapy is highly referred by many Chicago-area pediatricians and elite schools. Karen received both her Bachelor s and Master s degrees in speech-language pathology from Marquette University. In 2015, she was named Young Alumnus of the Year for her work at Chicago Speech Therapy. In addition to Chicago Speech Therapy, Karen is the founder of Chicago ABA Therapy, Chicago Occupational Therapy, and CST Academy, a therapeutic preschool-style program. She also started Chicago Speech Therapists Connect, a networking group for Chicago speech therapists, which has grown to more than 500 members. About Ali Pet t i t, MS, CCC-SLP Ali Pettit is a pediatric speech-language pathologist and lead instructor at CST Academy, Chicago Speech Therapy s therapeutic preschool-style program. As a Michigan native, Ali received both her Bachelor s and Master s degrees from Central Michigan University in speech-language pathology. In order to help children achieve their goals, Ali believes in the importance of educating parents to help empower and support their children. Ali has extensive experience working with fluency concerns, autism spectrum disorder (ASD), communication disorders, and other developmental delays. Ali loves having the opportunity to see young children grow, change, and succeed in speech therapy. To contact Chicago Speech Therapy, please go to: or call us at (312) Karen George, MS, CCC-SLP Pediatric Speech-Language Pathologist $24.95 USA $27.95 Canada