Many "normally fluent" children are more nonfluent when engaged in formulating complex language forms. Many children who stutter will evidence more frequent and more severe stuttering when engaged in complex linguistic formulation. Children also are apt to experience difficulties when they have word finding difficulties. I am not sure if there are cause-effect relationships, but these do appear correlated.
For kids who have memory and sequencing problems, we often work on these in therapy. Examples:
- Picture sequencing cards. Commercially available. The child is to put a sequence of 3, 4, 5 pictures together, in the correct order, to tell a story. Example: first the boy is walking to the lake--- then the boy is fishing---and last the boy catches a fish..................
- Remembering sequential activities. Clinician asks the child, "Tell me three things you did this morning, after you woke up." Child says, "I went to the bathroom, I brushed my teeth, and I washed my hands and face."
- You can do activities which involve both motor sequencing
(pointing) plus verbalization. To do this, put four items on the table in front of the child. Say "Listen carefully, and then point to each of the things I say to you. Listen carefully so that you can point to them in exactly the same order. Ready? Here we go." "Point to the car, then the horse, and then the wagon." After the child points to the three items, you then ask the child to tell you the names of the objects he pointed to..........
- Another type of memory/sequencing recall would be something like this. Suppose parent and child had been driving around, running errands. Later, the parent might ask the child, "Can you remember three of the places we went to this morning when we were out riding in the car doing errands." And then work it out so that the child says something such as "We went to the food store, and we went to the bank, and we got gas for the car."
These activities are fairly directive, in terms of helping with language formulation. The emphasis/focus is NOT on the stuttering. We do these in an environment that is relaxed and not hurried. We allow plenty of pause-time between speaking and listening, for turn-taking, which has the effect of reducing interrupting each other. We model "turtle talk" which incorporates these pauses along with a slightly slow speaking rate, and with slightly exaggerated melody/inflection.