I appreciated the opportunity to talk to you about your three year old son_____. This letter will follow up on our conversation and I hope it will be helpful to you and especially _____.
Stuttering, or the appearance of stuttering, is cause for concern in parents and other people. You are wise in receiving professional help because all the well intentioned "help and advice" from other people is often times inappropriate and could be harmful. Do not listen to persons who say: "He thinks faster than he can speak (we all do), slow down (almost impossible to do--try it on yourselves), think about what you want to say (we know what we want to say--this will decrease ____'s spontaneity), take a deep breath (speech doesn't need much air), etc." At this point we do not want to increase his awareness for the repetitions in his speech. It is better that he bounce around on words than to hold back and to become concerned about HOW he talks. We want to encourage spontaneity in _____'s speech, not to inhibit it. The best approach is to be a good listener and respond to his inquiry without showing your concern. Sometimes this is not easy to do because of our worry and concern, but keep trying to listen to WHAT his is saying and NOT HOW he is saying it. Try to decrease you own awareness of his speech pattern and let _____ do his own thing right now. Because he is a bright, verbal child he will have much to ask and say, and even though at times seems to be a motor mouth it is best to not shut him up. This phase will pass too. Since we do not want _____'s awareness of his speech bumps to increase we must tell other people who are in contact with him to do the same things you are doing. You appreciate their concern but you can tell them that you are not that concerned right now, that time is on your side, and professional advice dictates the right way to treat _____. They will understand if they know that you are getting professional help and these are the ideas that are being offered to you and from you to them. The more we can do now the less we will need to do later on. These early repetitions of words and syllables are often normal in many children, especially with those kids who are good talkers. They have so much to say and so little skill in saying it that it will take a little bit of time for the speech to catch up with the mental capacity. This refinement of the speech skill over time is normal and should be appreciated. We don't learn how to ride a bike before we learn how to walk. Patience, patience, patience.
You mentioned some environmental conditions that precipitate _____'s disfluency, such as being hurried and excited. This environmental analysis is important to do because then you can control these negative stimuli either before or during the event. For example, hurrying to eat is a commonplace event with most on-the-go people. So, let's give _____ small portions that he can eat and keep up; or, ask yourselves why it is important to hurry to eat. What is the next event that is so important? Maybe, for a short period of time we can cut-out some of the extra events in our lives. Maybe we all need time to smell the roses. Maybe both parents can cooperate (you probably already do) in sitting a little longer at the dinner table, cleaning up the kitchen, helping _____ get dressed in the morning (do you set out his clothes the night before? Does he help with this? Do you maybe get up 10-1 5 minutes early to have everything else prepared? Do you give _____ positive strokes for any forward movement rather than penalize him for not hurrying up?) etc. What are the environmental conditions that can be changed and how can they be changed to make life a little easier. The stuff you do with and for _____ will also effect your lives. If you can make little, sometimes subtle changes, in your own approaches to daily events you will find you will become more relaxed too and less hurried. Your environmental analysis will help you decide which activities are mandatory, most important, important, less important, not really important.
Remember, a child who is three is experiencing much impact in his little life. This year is 1/3 of his total existence. There is much to see, to hear, to learn, and to experience. Not only that but now there is competition in his life with his sibling. This can cause many conflicts and turmoil, but with inclusion of _____ into the day to day business of managing the baby he will feel a part of the activities that must surround his baby sister.
The "who, why, where, what, when, how, and I" questions, while being pesky and at time irritating, are very important parts of developing language. Answers to these limitless questions aid the developmental process and show the inquisitiveness and intellect of the child. These parts of speech are also DEMAND, PROPOSITIONAL, inquiries. They call for an immediate, satisfying response that generally can be presented and perceived one of two ways: positive or negative. Positive: "yes you can have another cookie," "cows can't fly because they are too heavy and the farmer can't milk a cow who is flying," "we can go to the store as soon as I finish changing the baby." Negative: "no you cannot have another cookie, you've had too many already and you'll spoil your dinner" (three negatives in one response), "how many times do have to answer that question anyway? I told you yesterday the answer to that," "NO--CAN'T--etc." Is it any wonder that these types of developmental language constructs are so difficult for children to say and why it gives rise to uncertainty which you hear in the child's speech by his hesitancy and repetitions of syllables and words? Usually the first words spoken are repeated because of the sometime uncertain response of an adult.
It is important to remember that the changes needed today might not be the ones needed tomorrow, next week, next month, or next year. We should remember about the developmental milestones and how they change with time. Being proactive about bringing about change now will provide you with dividends for the future.
All of this seems like a lot to think about and do, but you will see that much of it involves a positive attitude with a corresponding positive reaction and action. Do some one-on-one activities with _____ too without the baby tagging along. Remember not to hurry these activities--find the time to be alone with _____ to have some spontaneous fun. We are not interested in perfection--could a three-year-old be perfect anyway? Treasure these moments, when _____ is a teenager you'll probably look back on these early years with much fondness. Remember the fraction of 1/3 and appreciate the imperfection that exists now and that is normal. Time is on _____'s side for smoothing out his speech performance, but you are totally right in seeking professional advice now. It is never too soon, but in some cases it becomes too late. We would rather become professionally involved too soon than too late. This shows that you care and you are taking the right steps to get _____ over this early disfluent phase.
I will enclose some other writings of mine that you might find interesting and helpful. Please call me in four to six weeks with a progress report-or sooner if you notice _____ struggling in any way with his speech. If you begin to see associated tension, eye blinks or closures, tightness in his speech where he struggles to get the word out, or he even avoids talking, then you must contact me immediately and we will arrange for a personal visit.