SUGGESTIONS TO HELP CHILDREN TALK EASILY
Stephen B. Hood, Ph.D.
Speech and Hearing Center
The University of South Alabama
As parents, we tend to worry about whether our child will be normally formed at birth. Thereafter, we worry about whether something might "show up later." In the case of stuttering, there is nothing that can be determined at birth. The signs of a potential stuttering problem usually appear between the ages of three and five years, when the developmental nonfluencies which can lead to a full blown stuttering problem become apparent. What should we watch for? What are the danger signs? What can we do about them?
WHAT
DO WE WATCH FOR?
Many children pass through
stages of developmental nonfluency. These stages tend to come and go in episodes or cycles that
may last for several weeks or even a month. There are some episodes where the child is remarkably fluent
and verbal, only to be followed by periods where the child is excessively
hesitant in talking.
Normally nonfluent children tend to be disfluent on approximately 5%
of the words they speak. In other
words, they experience breaks in their fluency on roughly 50 words per 1,000
words spoken. Disfluencies are
more frequent at times of excitement, linguistic uncertainty occurring when
formulating sentences that are overly long and complex -- or when trying to
think of the name of a particular word--, times of high communication demand,
and other forms of communication stress.
These disfluencies are easy and effortless, and there are no signs of
tension or struggle: the child is generally unaware of these disfluencies. For the most part, these disfluencies
will involve the easy, effortless and rhythmic repetition of whole word and
phrases, the simple interjection of "ums and ahs" and other simple
forms of fluency failure. The
number of units of repetition will generally be just one or two: like-like
this, or like-like-like this.
Children at Risk for
Stuttering show disfluencies well in
excess of 5%, and these disfluencies are more fragmented; in other words, they
will more likely involve the repetition of single sounds and syllables, sound
prolongations, and stoppages in speech flow. The number of units of repetition will generally be more
than just two units: like-like-like-like-like this, or li-li-li-li-like this.
Danger Signs: What
are they? Signs of increased
fragmentation are a concern. For
example, the child used to repeat phrases or whole words, and who later repeats
syllables or sounds; or the child who used to repeat words and syllables and
now prolongs sounds of becomes inaudible, is at higher risk for a stuttering
problem. Increases in effort,
tension and struggle are also important danger signs; for example, disfluencies
which are accompanied by increases in loudness and/or pitch. In addition, children who
mispronounce the first syllable
during a repetition are at higher risk:
for example, repetition of the correct syllable base-base-baseball is
less serious than repetition of an incorrect syllable such as buh-buh-baseball.
With respect to emotional
characteristics, disfluencies in normally nonfluent children, even when they
are more nonfluent than usual, cause little or no concern or awareness to the
child. Most children will be
totally unaware of these breaks and bobbles in fluency. It is a danger sign when the child
shows marked awareness, especially when this awareness lasts for any
considerable time period.
FACTORS THAT
MAKE THE PROBLEM WORSE -- AND THINGS TO DO ABOUT THEM
Regardless of the exact cause of
the problem, there are a number of factors that tend to make the problem worse,
and increase the likelihood of the problem developing into one of increased
severity. Clinically, we try on
the one hand to reduce the occurrence of these negative influences, and work to
help the child cope with them when they do occur. Listed below are some examples of factors that generally
tend to increase disfluencies and stuttering in young children and, for that
matter, in all of us:
Negative
Influences: Things to reduce.
Being Interrupted
Most adults
have difficulty talking to "verbal bandits" who constantly interrupt
us when we are talking. These
people, who steal the show and monopolize the floor, tend to cause us to become
angry or frustrated because we are not being allowed to finish what we are
saying.
For young
children, who are just learning to use vocabulary and grammar in social
situations, this is even more of a problem. It is difficult to verbally compete with an adult or sibling
who interrupts and verbally monopolizes the conversation. Interruptions must be minimized to the
extent possible. It is important
to emphasize "turn taking."
Just as traffic intersections have signal lights that tell us when to go
and when to stop, the same concept is true in speaking, where we need to
differentiate between the speaker who goes, and the listener who waits for
his/her turn.
Pausing is an
important component of turn taking.
We need to allow some time in between turns. We need to allow the speaker to finish, before establishing
our own turn.
Being Contradicted
There are lots
of ways to contradict, some of which are relatively positive and some of which
are relatively negative. Examples
of more positive contradictions are such things as "Well, I'm not so sure
about that,˛ or "Not really, because it seems to be . . . " Examples of negative contradictions as
statements such as "No, you're wrong again . . . " or, "Can't
you ever understand what I am telling you" -- and "Now listen, I am
telling you this for your own good."
To contradict
and disagree may be very appropriate and necessary, but possibly there are ways
to do this in a more positive manner.
Try to maintain a vocal pattern that is soothing, pleasant, melodic and
positive while disagreeing and giving an alternative answer. Try also to make "contradictory
comments" in ways that are received in the most positive manner possible.
Being Rushed or Hurried
Being rushed or
hurried can be a problem both in speaking, and in general. We live in a hurried society where
things are always due ten minutes ago.
We miss deadlines, hurry from place to place, arrive barely on time or just
a few minutes late, or run so late we miss things all together.
Likewise in
speaking, when we are running late, we tend to be hurried in general, and this
takes a toll on talking too rapidly to make up for lost time. Wouldn't it be nice if we had a more
leisurely paced existence? Yes,
but easier said than done.
Here's an
example of what some people have found the following ideas to be helpful: Set the family alarm clocks a few
minutes earlier to get things off to a slower pace in the morning: examples -- allow time to walk to
breakfast and eat slowly rather than rush to the table and gobble down the
morning meal, then walk to the bathroom for hygiene rather than rush to brush
teeth, then be able to drive at a leisurely pace to preschool/school rather
than feel the need to hurry through the yellow light, etc. This is more helpful than rush-rush-hurry-hurry: "Get a move on Billy, you're late
again, so hurry up so we're not late again."
Being Asked Multiple questions
In general,
parents often tend to ask too many questions of their children. Too often these questions are asked in
rapid succession. We sometimes ask
what seems to be single questions– but with multiple parts. For example: "So, Billy, tell me about how school went today, and
how did you do in your show and tell activity? And by the way, do you have anything to do to be ready for
school and home work for tomorrow?˛
Verbal Demands and Verbal
Displays can be negative.
We tend to take
great pride in what our children can do, both behaviorally and
communicatively. But we need to be
careful. Try to avoid the verbal
displays: for example, "O-K
Jane, show grandmother how well you can count to ten,˛ or, "O-K Billy,
show Aunt Mildred how well you can read this book." Being required to give "little
speeches" (i.e., verbal 'show and tell'), reading difficult materials to
impress adult listeners, being asked to recite things that have been memorized,
or requests to explain difficult and abstract concepts are sources of stress
that need to be reduced as much as possible.
We need to
reduce verbal demands. Demanding
too much talking, asking too many questions, requiring verbal justification,
and exposing children to verbal interrogation can be communicatively and
interpersonally stressful.
Calling undue
negative attention to times of increased disfluency is to be avoided because
this tends to make the child even more aware of the problem.
We also need to
reduce time-pressures to "hurry up" -- both in speaking and in
general life style.
It often helps
if we change questions to Comments.
Sometimes it is better to make comments rather than ask questions. By making comments, we invite the child
to follow up with comments of his/her own rather than making it sound like we
are "demanding a response."
Rather than
directly asking "What is his name" you might comment, "Gee, I
wish I knew his name."
Rather than
directly asking "What color is the car" you might say, "I wonder
if this is the red car."
Rather than
directly asking "What do you see in this picture" try commenting,
"Wow, this picture has lots of things to see."
Try to limit the scope of your
questions. Rather than ask
"How was your day at school?" Try a more general comment such as
"Was there anything going on at school you want to tell me about?" Or a more limiting question such as
"Do you want to tell me just one thing that happened today at
school?"
Positive
Influences: Things to Increase
It helps to keep the environment
and atmosphere as calm and non-hurried as possible. Try to plan ahead so that your "walk, not run.˛ This is easier said than done, but a little
goes a long way.
To the extent possible, speak
slowly, speak with increased melody and inflection, and allow greater pause
time between speaking . . . and
speaking again. Young children
have problems when others speak too rapidly. By allowing pause time to occur we reduce the pressure to
hurry, and this in turn allows time to organize our thoughts and formulate our
language.
Advice to the child to
"slow down and take your time" really isn't helpful. The child simply will not slow down
when those around him are going 90 miles per hour. Slowing down must be a joint effort on the part of all. This is further enhanced when there is
a degree of additional melody and inflection attached to the message. For those who would like a role model,
it is suggested that you watch the Mr. Rogers program on television.
Allow the child to finish his
thoughts before interjecting your own.
It's often easy to anticipate what the child is saying and to begin your
answer before the child has finished.
It's more positive to allow the child to finish, then pause, and then
respond. This is all part of the
concept of turn taking.
The modeling of talking skills
is important. In your own speech,
strive for a slower rate and with increased melody and inflection. Children tend to copy the adult models
to which they are exposed, so be a good model. Telling the child to "slow down and take your
time" will be of little or no value if the rest of the people are talking rapidly,
interrupting, contradicting and verbally competing with each other.
Reducing verbal competition can
be helpful. When children must
compete with siblings, parents and other persons for recognition, this can be
difficult. The above-mentioned
ideas for verbal turn-taking, sharing the talking time and slowing down the
overall pace of the communication can often prove helpful.
It helps to minimize
distractions, and other things that compete for the child's attention. For example, it is often difficult to
carry on a conversation when the child's attention has been captured by a
television, radio or stereo.
Personality
Traits and Family Dynamics Can Be Important
A number of personality traits
and issues pertaining to family dynamics are important. As with any list, parents need to
carefully consider the extent to which any one, or several of these factors,
might be serving as a source of actual or potential stress. Realize also that there are areas of
considerable overlap among these factors.
These factors, in and of themselves, are not necessarily the
"single cause of stuttering˛: however, when they coexist with significant
amounts of disfluency and stuttering, they may serve to make the problem worse.
Hypersensitivity
Children who are excessively
nonfluent and who are "beginning to stutter" are often overly
sensitive. They tend to react
emotionally and negatively when things don't go their way, when they make a
mistake, when they are scolded or criticized, or when they feel that they do
not live up to the expectations of other significant people in their
environment. They often try overly
hard to please others, and their feelings are easily hurt.
Low
Tolerance for Frustration
When things don't go well, most
of us become frustrated. This is
normal and to be expected. For
some people, the frustration tolerance level is so low that every little set
back becomes a major crisis. While
on the one hand it is good to reduce the frustrations that the child
experiences, efforts must also be made to increase the child's ability to
tolerate and cope with these frustrations. Certainly this is a fine line to draw. Although some parents find this a
difficult request to accept and follow, the bottom line is that children do
need to learn to handle frustration:
examples -- the child must learn to become a gracious winner and
loser at board games such as Candy Land, Shoots and Ladders and Monopoly. Always letting the child win only
postpones the day of reckoning.
Tolerance for the fact that we do not always get our own way helps us
develop an increased tolerance for handling frustration.
Tendencies
toward Perfectionism
Making mistakes is a normal part
of learning. We simply do not do
things perfectly all the time, and we do make mistakes in the process of
learning. Thus, while it is
important that we instill in out children the famous Scout Oath "To Do My
Best" we need to keep this in a proper perspective. Yes, we want to do out best, but we
also want to be realistic concerning the mistakes we make in the process. (Even though our basic math skills are
adequate, who among us has a perfectly balanced check book every month?) Children need to learn that making
mistakes is a part of the learning process, and this is why pencils have
erasers! Indeed, we do fall down
learning to walk, and we do fall of the bicycle learning to ride. We belly-flop learning to dive, and we
stall the car learning to drive stick-shift. AND -- we have bobbles in our fluency while learning to
talk.
Compulsiveness
and Impatience
Things don't always happen
immediately and we need to learn this.
Sometimes we have to learn to wait. Children who are impatient need to learn this. Children who are compulsive with
respect to acting on immediate instinct must learn that some things happen, but
happen later. Indeed, we need to
learn to "Look before we leap."
The attitude of "I want it and I want it now" must be replaced
with the attitude "I would really like it, but I realize it might take a
little while."
Unrealistic
Self-Expectations
Sometimes, we expect too much of
ourselves, and this is especially true if we are highly sensitive and
perfectionistic. Sometimes, if we
are perfectionists, we expect things to be perfect. As we mature, we need to be aware of our weaknesses as well
as our strengths, and need to become realistic in terms of our
expectations. Not all of us will
become Olympic Champions, Phi Beta Kappa Members, or President of the
Class. As parents, we need to be
realistic in helping our children determine what is a realistic level of
expectation. This is especially
true in family environments where a young child is constantly compared and
contrasted with adults, or older siblings, who are able to do things
"better" simply because they are "older and bigger."
Low
Self Concept and Self Esteem.
It is important that we feel
good about ourselves. When we are
constantly put down or made to feel inferior, or when we are (unfairly)
compared to others, this hurts our morale and damages our ego strength. Emotional support from significant
"hero figures" is important to all of us, and this is especially true
for children.
Some
Closing Thoughts
Any list of suggestions has
strengths, as well as weaknesses.
Not all suggestions apply equally to all children. Further, there is always the problem
that people will feel that these suggestions must be followed at the 100% level
to be effective, and this is of course unrealistic. But coming closer can help. As a supplement to what is listed above, here are some
examples:
1. Strive
to be firm, fair and consistent.
Children need limits that are reasonable and fair and consistent, and
learn best when they are reasonably enforced. It's generally better to have fewer limits that are
consistently enforced than more limits that are enforced on a hit and miss
basis.
2. Keep
things as simple as reasonably possible.
For example, while it may be beneficial to make things available to a
child and encourage participation, there is a fine line between encouraging and
pushing. Awareness of this can
make a difference. When in doubt, DON'T
BE A PUSHY PARENT. Young children
do not need to talk like, or read like, or behave like miniature adults.
3. Show
interest and comment, but reduce where possible the questions you ask. Verbal show and tell can be taken too
far. Ask fewer questions of the
child, especially those that are irrelevant. And, where possible, refrain from asking the same
question(s) again and again.
There are several sources of
information that may be helpful in providing additional information. Interested readers can contact The
National Stuttering Association and the Stuttering Foundation of America for
printed materials, audio tapes and video tapes.
Stuttering Foundation of
America,
Box 11749, Memphis, TN 38111
Phone:
1/800-992-9392
National Stuttering Association:
119 W.
40th Street, 14th
Floor
New
York, NY 10018
www.nsastutter.org
Phone: 1/800-937-8888
FRIENDS: The National Association of Young People Who Stutter
c/o 145 Hayrick Lane
Commack, NY 11725
Phone: 1/800-866-8335
Stuttering Home Page: