Helping Children Talk Fluently: suggestions for parents
Stephen B. Hood, Ph.D.
Speech and Hearing Clinic
The University of South Alabama
Mobile, AL 36688
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
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 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
FACTORS THAT MAKE THE PROBLEM WORSE -- AND THINGS TO DO ABOUT
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
Positive Influences: Things to Increase
- 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 seem to be single questions 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."
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?"
- 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."
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
The modelling 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
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
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 co-exist
with significant amounts of disfluency and stuttering, they may serve to make
the problem worse.
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
- 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:
- 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.
- 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 find 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.
- 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 Stuttering Foundation of America,
Box 11749, Memphis, TN 38111 (1-800-992-9392) or the National Stuttering Project,
2151 Irving St.-- Suite 208, San Francisco, CA 94122-1609 (1-800-364-1677) for
printed materials and audio tapes.
Stephen B. Hood, Ph.D.
Professor and Chairperson
USA Speech and Hearing Clinic
University of South Alabama
Mobile, AL 36688