What is stammering?
Stammering (also called stuttering or dysfluency) disrupts the forward flow or fluency of speech with repetition, prolonging or blocking of words and sounds with possible facial tension and extra body movement. The pitch, tone and volume of the voice may be altered. Stammering has no single cause, although there may be a genetic link. There is no single or definite cure and there is no single best strategy for supporting pupils. Current research indicates that the cause of stammering has a physiological basis in the brain structure.
Stammering is found in every culture and language at an incidence of about 1% of the adult population. The probability of a stammer occurring is not linked with ability or personality profiles.
Stammering is usually made worse by stress or anxiety and can come and go, even in the same conversation.
A stammer usually starts between the ages of 2 and 5 years. Most of these children recover, but some children’s stammers persist. The latest research suggests it may affect as many as 1 in 12 children at some stage.
Noticing when a child is stammering
There are lots of different aspects to stammering, and no two people who stammer are the same. Sometimes behaviours which are related to the child’s stammer can be misinterpreted. Some of the things teachers have observed in children who stammer are listed below:
Overt behaviours by the child:
- appearing worried and anxious to rush away
- blocking on a word or a sound, and trying to force it out
- changing words to an ‘easier’ one
- clenching hands, tensing facial muscles, or even making gestures as if they are forcing the words to come out
- coughing
- giving abrupt answers
- getting out of breath
- losing eye contact
- moving head
- prolonging sounds
- pronouncing words differently
- putting hands over or around the mouth
- repeating words and sounds
- seeming tense and anxious
- speaking in a funny voice, such as a baby voice
- speaking more quietly, or sometimes more loudly
- talking when they feel able to speak so that they may interrupt or call out in class and seem to be rude
- using a filler word such as, ‘like’, ‘and’,’ y’know’, ‘sort of’, to act as a run in to the speaking
Covert behaviours
- avoiding talking and getting out of situations where talking is expected
- behaving in ways that may cover up the stammer: being quiet and hardworking, being difficult, and even trying to dominate other children
- compromising on what they would like to do or say and seeing situations as an exposure of their stammering
- judging opportunities solely in terms of their stammer: for example school trips, visits to friends’ houses, and then deciding to avoid them
- planning ahead in their talking so that they are continually worrying about choice of words
- talking so quietly that you cannot hear what is said
- worrying about friendships, simple social demands such as buying sweets, paying bus fares,
telephoning, and feeling generally worried about what is coming next - effects on confidence and self esteem
General advice for teachers
“Talking is putting thoughts into words: it clarifies thinking that may be later expressed into writing and it can also motivate and stimulate ideas.” The Rose Report, 2009.
The curriculum places considerable emphasis on the skills of talking and listening in the classroom. Teachers are aware that many children including children who stammer may need support to develop these skills. Often the most effective management of a child’s stammer happens when the adults around them alter their own communication style.
Show the children that you are interested in what they are saying, not how they are saying it.
Try to maintain natural eye-contact when they are having difficulty talking. Listen attentively to the child; avoid signalling impatience by looking at a watch, frequently nodding your head, etc. When the child has finished talking, echo back some of what the child has said so that they know the content of what they have said is important.
Don’t finish the child’s sentences – this can be frustrating for the child as they often want to finish
their own sentences! Inappropriate intervention from adults can be more of an upset to the child than the stammer itself.
Be as supportive as you can
Respond to a speech difficulty in the same way that you would with any other difficulties that arise as they develop their skills, such as when they trip over or spill things. If you feel it’s appropriate,
acknowledge the difficulty in a matter-of-fact way, so that the child doesn’t feel criticised. Avoid labelling the difficulty as stammering if possible. If the child is very aware of their stammer, you could use expressions like “bumpy speech” or “getting stuck”, or ask the child for their own words if you think they might have their own way of describing it already.
Ensure that the other pupils are supportive in their talking, listening and behaviour. Some children who stammer experience teasing or bullying, and parents are often understandably worried about this. The key to preventing teasing or bullying is effective circle time or PSE activities that emphasise the diversity of people. In some schools, children who feel different in some way are encouraged to give a short talk to the class to create some empathy with their feelings. If a child who stammers has the confidence to do this with support that can be helpful. It is advisable for the teacher to consult with the parent and a Speech and Language Therapist before considering an approach with the child.
The Speech and Language Therapist can sometimes be available to teach both school staff and children about stammering, if you and the child’s family agree that this is something the child would like to happen. Call your local Speech Therapy department if you feel your school would benefit from some training.
If you speak quickly, slow down your own rate of speech. Telling the child to slow down, start again or to take a deep breath is unhelpful. By slowing down your own rate of talking and using plenty of natural pauses, you are showing the child there is no need to rush and the child is likely to mimic your rate of talking. Pausing for a few seconds before you answer or ask a question can also help the child to feel less rushed.
Talk to the child about their speech on a one to one basis, and be encouraging if the child gets upset about their speech, just as you would if they were upset about any other difficulty
You might want to raise the subject by asking them how they feel about their talking. There is generally no need to press the subject if you don’t feel it is an issue. However, give the child plenty of opportunities to raise the subject with you on a one to one basis, by staying behind at break time or at the end of the day.
If the child is trying to chat with you and starts to stammer, he / she may start to give up if they are
finding it particularly difficult. You may say something like “Don’t worry; talking can be tricky sometimes and I understand.” Try to be as reassuring as possible. If the child is fairly open about their stammer, you may want to discuss ways in which you can help them. For example, they may really dislike reading in front of the whole class and would like to reduce the amount they have to do this. Generally speaking, if a child does not seem aware of their stammer, it is not advised to draw attention to it.
Observe the child’s speaking patterns but try to remain calm and resist seeing it as a ‘problem’
Stammering is not caused by the adults around the child, but anxieties in parents and other familiar adults can be passed on to the child, who may feel they are doing something wrong.
The more calm adults around the child remain, the more likely is it that the child will be calm. Generally, the calmer the child feels, the more fluent they will be when they are talking.
Reduce the number of questions you ask
This is difficult to do when you are trying to teach. If you must ask questions, always give the child plenty of time to answer one question before asking another. This way, they are less likely to feel under pressure. Keep your sentences short and simple and wherever possible, instead of asking lots questions, simply comment on what the child has said, thereby letting them know you are listening. For example instead of saying “Kate, what have you decided to write about?” you could turn the question into a comment and say “Wow, what you’ve done looks really interesting!” and wait for the child to respond, if they want to.
Take turns to talk so that everyone in the class can speak without being interrupted
This will reduce the amount that the child is interrupted or that he / she interrupts others. When the child knows they have plenty of time to express themselves, they are more likely to be fluent, or at least feel more comfortable.
Monitor the child for underachievement
Children who stammer have the same innate range of abilities and personality traits as children who do not. Remember that just because the child has difficulty with the expression of speech does not mean they have difficulty understanding language. It is easy to underestimate the ability of a child who stammers as he may not always be able to express his thoughts and ideas. Teachers should track achievement in relationship to the potential of the child, using whatever cognitive tests are favoured in their school.
If you need any further advice or have any questions, please call the Wirral Community NHS Trust Speech and Language Therapy team on 0151 514 2334 and ask to speak to a speech and language therapist.
For further information the Stamma website is useful.
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