About the presenter: Nan Bernstein Ratner, Ed.D., is Associate Professor and Chairman, Department of Hearing and Speech Sciences, University of Maryland at College Park. She holds degrees in Child Development, Speech-Language Pathology and Applied Psycholinguistics. Dr. Ratner is the editor of six volumes, and the author of more than 30 articles and 20 chapters addressing stuttering and language acquisition in children. With Jean Berko Gleason, she is the author of the text Psycholinguistics. Dr. Ratner currently serves as Co-editor of Seminars in Speech and Language, Associate Editor of the Journal of Fluency Disorders and The American Journal of Speech-Language Pathology, and is associate coordinator of the Steering Committee for ASHA's Special Interest Division #4 (Fluency and Fluency Disorders). She is a frequent presenter at state speech and hearing association meetings and is a fellow of the American Speech Language and Hearing Association.

The Relationship Between Language And Fluency In Children And Role Of Parents In Managing Stuttering

by Nan Ratner
from Maryland, USA

Our laboratory has historically been interested in the relationship between language and fluency in children, as well as the role of parental behavior in the management of stuttering. Some of our published work in these areas can be found online at the following URL: http://www.bsos.umd.edu/hesp/reRatner.html

Our lab has most recently completed a 3-year study of children observed near the onset of stuttering symptoms. We have collected data on 15 children with an average age of 34 months, and an average elapsed time since onset of 3 months. We have been interested in the following questions:

  1. What are the language abilities of children at the time that stuttering starts?
  2. What language variables predict whether a child will be fluent or disfluent during conversation?
  3. Why do stuttering children react with struggle to their speech output, when other children with speech and language problems seem rather oblivious to their errors?
We have also been interested in how well parents of stuttering children understand their current levels of speech and language capacity.

To date, we have found the following:

  1. When compared to children of the same age, gender and social-economic background, stuttering children perform SLIGHTLY but consistently more poorly on all of the measures of language development that we used: vocabulary production and understanding, sentence construction and comprehension, and utterance length. Because these measures are not very sensitive (they are really meant to diagnose major language disorders in children), we interpret this to mean that some young stuttering children may have subclinical language weakness that could affect their ability to fluently produce speech.
  2. Stuttering starts while children are still learning language rules. Overwhelmingly, stuttering was most likely to occur in utterances containing developmental errors (e.g., sentences that had missing or wrong verb endings, missing articles, etc.) These errors are expected for children at this age and are normal, but the fact that stuttering was most likely to occur on such sentences for ALL the children we studied re-emphasizes our need to investigate the possible role of language formulation in stuttering onset.
  3. We used an experimental task (Delayed Auditory Feedback) with the children. Many adults who stutter have experienced DAF, but it is not used very much with children. This is because very small children normally do not respond in any particular way to DAF. However, young stuttering children in our study were statistically more likely to change their speech under DAF, suggesting a precociously developed self-monitoring system. (The comparison children didnŐt react, as we expected from the research literature on this topic). We interpret these data to suggest that struggle may arise in stuttering children when they have trouble formulating a sentence properly, are disfluent, and then react poorly to hearing their mistake.

Parents of stuttering and nonstuttering children also completed a number of questionnaires for us. We found that parents of stuttering children were BETTER at predicting how their children would perform on the language testing than parents of children who do not stutter. Also, work being completed in our labs by Stephanie Miles suggests that parents of stuttering children adjust the complexity of language input to them extremely well. Although there has been speculation that some parents inadvertently stress the capacity of stuttering children by using complex language, we found no support for this in our sample. Therefore, we would not advise parents to simplify speech input to stuttering children as a method of reducing the frequency of disfluency.

August 20, 1999