Language Development & Stuttering

Developmental stuttering begins during a time of dramatic language learning. In this blog, I will share an article about vocabulary development and stuttering. (1) Many, maybe most, of my students seemed to have above average language skills. My students also often present with mild articulation errors, a history of articulation therapy, or were late talkers. My caseload over the years has featured children who were eager to grow linguistically while their speech motor systems appeared unable to keep up. It’s been hypothesized that “advanced language during early development may set the stage for fluency breakdown because language behavior is not synchronous with other aspect of development.” (p.62)

I offer parents the superficial hypothesis that some children may stutter because of a ‘mismatch’ between their language abilities and their speech-motor skills. Speech requires precise and extremely efficient coordination between several systems. “ …sentence production occurs incrementally, and as children begin to use more complex sentence structures, disruptions occur as a result of some ‘glitch’ in the formulation of the sentence.” (p.58) So, 3-year olds who have the language skills of 6 year olds may experience disfluency because ‘their mouths can’t keep up with their ideas,’ as the popular laymen’s explanation goes.

Nancy Hall’s article takes this hypothesis a step further by investigating vocabulary development specifically. Perhaps the ‘glitch’ is a child’s ability to get at the words he needs to express all those ideas in his head. Research has consistently found that children who stutter (CWS) “typically stutter on function words more often than on content words” (p.61) and that this corresponds with clause boundaries. Function words include articles (e.g., a, the) and conjunctions (e.g., and, but) and these tend to occur the onset of sentence parts. For the sentence, “I went / to the store / and bought / a new shirt”, we teach children to use easy onset and pausing at the slash marks because research tells us these are locations where stuttering most likely occurs. The words “to, and, a” are all function words.
However, this pattern changes over time. Children older than 6 begin stuttering more frequently on content words.

I like this puzzle: is stuttering a “delaying strategy” (p.61) while the child maps the syntax (grammar) of sentences OR retrieves the vocabulary he needs to express his thoughts? Children ages 2-6 learn the syntax of their native languages. They learn when to use “I” instead of “me”, work out noun-verb agreement, verb tenses, prepositional phrases, and what linguists call the “deep structure’ of language. Around age 6 years, the child begins school and its vocabulary development that becomes more intense as state curriculum frameworks emphasize English Language Arts in a formal way. Around 4th grade, lexical skills again leap ahead as children move from‘learning to read’ into ‘reading to learn.’ Multisyllable words require children appreciate derivational morphology to decode and comprehend more and more challenging academic material.

So, how do children learn vocabulary? Children learn some new words very quickly, after hearing them only a few times. The technical term for this is “fast mapping.” Other words are learned via “slow mapping”, in which children compare new words with those already in their vocabularies.

Consider the subtle differences between “succeed”, “achieve”, and “accomplish.” Children learn large categories of words (foods, feelings, objects) as well as syntactically different words (verbs, adjectives, multisyllabic word derivations). Researchers who study child language development have found several ways in which children make mistakes with words. This leads them to suppose ways in which insufficient lexical development might contribute to fluency breakdowns that serve a purpose. “The breakdowns…serve linguistic functions while the child attempted to revise of repair linguistic errors, or to buy formulation time while not relinquishing her conversational turn.” “These disruptions may result in the retrieval of a closely related but incorrect lexical item, or the presence of a place-holding disfluency, such as “um”, while a child attempts to retrieve a particular word. (p.58)
“It is the combination of a vulnerable speech production system and sensitivity to breakdown in CWS that sets the stage for overreactivity to glitches and subsequent tension in their attempts to repair the glitches.” (p.59)

This article does NOT suggest that CWS necessarily have a language delay or disorder. However, assessment and treatment need to take into account a child’s language development, perhaps ‘strengths and weaknesses’. “In particular, establishing the lexical/semantic level at which a child can maintain fluency or manage stuttering is important.” (p.65) And, there may be children for whom “…the clinician may need to include direct work on language competencies as well as the stuttering behaviors.” (p.65) This article supports language-based intervention for some children who stutter.

(1) Hall, Nancy E. (2004) Lexical Development and Retrieval in Treating Children Who Stutter, Language Speech, and Hearing Services in Schools Vol 35, pp 57-69.

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.