Conversations with Children Who Stutter

Children who stutter might enjoy some support with conversation. A teenage student recently said to me, ‘I’m not very good at putting my ideas into words,’ and I’m willing to bet this is partially from lack of practice. Children who stutter, unable to keep pace with fluent speakers, sometimes withdraw from conversations and miss out on developing this form of self expression. Others forge ahead, speech/language systems struggling, like a car in serious need of a tune up. How can parents and others create conversations that encourage children who stutter to say what they want to say, when they want to say it and do so with easier speech?

1.      Take the time.

            In “The Flight from Conversation”, (1) Sherry Turkle reports that some of us are so plugged-in to technology “we’ve become accustomed to a new way of being ‘alone together.’” People are engaging in fewer extended, face-to-face conversations as they e-mail, text, and twitter to readers in other places. As parents and friends of children who stutter, we may need to plan ahead to deliberately engage our children in conversation during those free moments after school, in the car, in shared activities, at a mealtime, and/or before bedtime.

2.      Practice whenever possible.

“Hello, Gramma? It’s me – Michael.” This conversation appears in the comic For Better or For Worse in my Sunday paper. (2) Michael, about 8 years old, is talking on the phone. “Tell her about your hockey tournament,” prompts his mother, who is sitting nearby. “Uh - we won our hockey tournament,” says Michael. “Thank her for the sweater she sent you,” says Mom. “Thanks for the sweater you sent me,” mimics Michael. And so the comic continues, Michael’s mother coaching him through a conversation with his grandmother.  As adults, we can find ways to show our children how to discuss TV shows, movies, books, video games, school projects, social concerns, family issues, extra-curricular activities, and hopes and dreams. Topics of conversation arise naturally when parents share in their children’s activities.

3.      Learn  new skills.

Adults develop skills for talking with  supervisors, customers,  co-workers, parents, spouses, and friends. They read self-help books to learn the knowledge, jargon, and conversational expectations appropriate for managing conflict, purchasing a car, increasing sales, and nurturing relationships, among other things. How to Talk So Kids Will Listen and Listen So Kids Will Talk is  a time-tested book about talking with children. And, there is a sequel for talking with teenagers. These books are easy reads that  illustrate “new methods of communication…that parents could teach themselves…with hundreds of examples of helpful dialogue…[and] cartoons that …show the skills in action. “(3)  The Stuttering Foundation offers a few tips specifically for talking with children who stutter. (4)

4.      It’s ok to stutter – easier when possible.

Stuttering that a) occurs less frequently and  b) involves less oral-motor tension than your child typically experiences is considered “easy stuttering.” Easy stuttering might take the form of repeating whole words instead of parts of words, as in “game-game-game” instead of ga-ga-game”, or, repeating a sound fewer times, as in “g-game” instead of “g-g-g-ame. “  Blocks and prolongations that are briefer and accompanied by less oral-motor and facial tension may be ‘easy stuttering’ for your child. You might notice easier stuttering once a week, then  twice a week , then every day.  Maybe you’ll notice ways to help your child stutter more easily.

5.      Ask about factors that affect stuttering.

Stuttering can interact with other conditions such as ADHD (6), language demands (7, 8, 9) and thoughts and feelings (10).  Conversations with a speech language pathologist can help you manage situations to support easier speech. ( 5)  A speech hierarchy is a list of speaking tasks that control conditions to make fluency easier for your child. Ask about where your child’s speech homework falls on such a hierarchy so that you can discuss the SLP's long term therapy plan.

6.      Five minutes may need to become ten.

a.      “I have this game at home” may take 2 seconds to say fluently.

b.      “I-I-I-I have th…..is g-g-g-game at home” may take 5 seconds.

c.       “(pause) III (slow/gentle beginning sound) have /(pause) thhhiis (slow/gentle sound) g {freeze} game at home” may take 10-15 seconds.

            A compassionate and patient listener will allow plenty of extra time for a child to reduce oral-motor tension through the use of fluency enhancing techniques such as pausing, slow/gentle beginning sounds, reduced speaking rate, freezing, and cancellation. It is the rare listener indeed who understands that conscious speech-language-motor planning is a time consuming and laborious process at first. When listeners prefer fast and fluent speech, children may avoid words on which they expect to stutter, holding back on all they wish to express. “I used to do that all the time,” a child recently said to me. Now, he talks more and stutters more, which actually gives us more opportunities for conversation and change.

The value of conversation became apparent as I met my students at local retail stores to work on the carryover.  While experimenting with different ways to give feedback about speech goals, I stumbled upon the obvious. The most valuable feature of these lessons is not the feedback about speech. It is the hour-long, sustained conversation. Validating a child’s thoughts and feelings via attentive, sensitive, respectful, and prolonged conversation is the foundation for carry over work. In Turkle’s article,  she writes,  “ A 16-year old boy who relies on texting for almost everything says almost wistfully, ‘Someday, someday, but certainly not now, I’d like to learn how to have a conversation.’”  I think we can start  that lesson today.

(1)     S. Turkle (2012) The Flight From Conversation. New York Times, April 21.

(2)     Boston Sunday Globe, April 22, 2012.

(3)     A. Faber and E. Mazlish (1980) How to Talk So Kids Will Listen & Listen So Kids Will Talk, NY, NY: Avon Books.  p. viii.  See also A. Faber and E. Mazlish (2005) How to Talk So Teens Will Listen & Listen So Teens Will Talk, NY, NY: Harper Collins.

(4)     7 Tips for Talking with Your Child. Stuttering Foundation, http://www.stutteringhelp.org/Default.aspx?tabid=632

(5)     M. J. Cooley Hidecker, R. S. Jones, D. R. Imig (2009). Unsing Family Paradigms to Improve Evidence-Based Practice. American Journal of Speech Language Pathology, 18, 212-221.

(6)     J. Donaher (2011) ADHD and Children Who Stutter.  Stuttering Foundation, http://secure.stutteringhelp.org/Merchant5/merchant.mvc?Screen=PROD&Store_Code=SFA&Product_Code=6700&Category_Code=V

(7)     K. Ntourou, E. G. Conture, M. W. Lipsey (2011). Language Abilities of Children Who Stutter : a Meta-Analytical Review. American Journal of Speech-Language Pathology, 20, 163-179.

(8)     Trautman, L. S., E. C. Healey, J. A. Norris (2001) the effects of Contextualization on Fluency in Three Groups of Children. Journal of Speech and Hearing Research, 44, 564-576.

(9)     C. T. Byrd, K. J. Logan, R. B. Gillam (2012) Speech disfluency in School-Age Children’s Conversational and Narrative Discourse. Language, speech, Hearing Services in Schools, 43, 153-163

(10) L. Scott (2010) Imprementing Cognitive Behavior Therapy with Children. Stuttering Foundatin, http://secure.stutteringhelp.org/Merchant5/merchant.mvc?Screen=PROD&Store_Code=SFA&Product_Code=6500&Category_Code=V

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