What is Stuttering?
Stuttering is a disorder where speech is interrupted by repeated movements and/or fixed postures of the speech mechanism. These are sometimes accompanied by signs of struggle and tension. Stuttering ranges from mild to severe, and may also be quite variable within individuals, i.e. in preschool-age children, stuttering may come and go over days or months, and in older children and adults, stuttering may vary according to the communicative context.
What causes Stuttering?
Stuttering is a physical condition underpinned by a slight “glitch” in the way the brain plans speech production. The cause of stuttering is unknown at the moment. There are many theories and popular beliefs about what causes stuttering. However, despite considerable scientific research, the cause of the disorder remains a mystery. Stuttering is thought to be a physical disorder and is not thought to be caused by psychological factors such as nervousness or stress, or parenting practices or the way parents communicate with their children when they are young. However, psychological factors such as anxiety or stress can make stuttering worse. Stuttering tends to run in families (though this is not always the case), and it is generally accepted that this is because genetics is involved in the cause.
When should I seek treatment for my child's stuttering?
Most children will stutter for a time and this tends to happen around the time their language development has a large increase (around 2-3 years old). Sometimes stuttering disappears by itself (known as natural regression). The rate of recovery and the average time taken to recover is not known, but it is important to begin treatment of stuttering sometime within 12 months of onset, as it is known that few children will have recovered without treatment by then. At present it is not possible to say whether an individual child will recover naturally or will require treatment. Stuttering treatment tends to be most appropriate for preschool age children although it is proven to work on primary school age children also. Preschool children may respond better due to several reasons –
• they have a little more 1:1 time with their parents to complete the daily therapy practice at home,
• they are less aware of the stuttering and have less superfluous behaviours (such as blinking or head movements) or social anxiety because of their stuttering,
• they are better able to rewire their fluent brain pathways indefinitely (sometimes older children or adults are not able to stop stuttering, but rather change the way they speak so it sounds fluent).
What treatment is available for Stuttering?
There are different types of treatments available for young children, adolescents and adults. The Lidcombe program works for preschool and early primary school age children. For teenagers or adults with a residual stutter there is a program called the Camperdown program. There are other treatments offered by some therapist, however, for the treatment of pre-school children who stutter, the only treatment with independently replicated, randomised clinical trial evidence is the Lidcombe Program.
What does the Lidcombe Program Involve?
The Lidcombe Program is a behavioural treatment administered by a parent or carer in the child's everyday environment. Parents learn how to do the treatment during weekly visits with a speech pathologist. During these visits, the speech pathologist teaches the parent by demonstrating various features of the treatment, observing the parent do the treatment, and giving the parent feedback about how they are going with the treatment.
The treatment involves the parent commenting directly about the child's speech. The parent comments positively when the child speaks without stuttering and only occasionally when the child stutters. The parent does not comment on the child's speech all the time, but chooses specific times during the day in which to give the child feedback. The parent also learns to measure the child's stuttering by scoring it each day.
The Lidcombe Program is conducted in two stages. During Stage 1, the parent conducts the treatment each day and the parent and child attend the speech clinic once a week. This continues until stuttering either disappears or reaches an extremely low level. Stage 2 is the maintenance part of the program, aimed at keeping the stutter away for at least one year. This maintenance part of the program is essential because it is well known that stuttering may reappear even after a successful treatment.
How do I know it will work?
Independently replicated clinical trials show that the Lidcombe Program does work to get rid of stuttering. Children differ in the time they take to complete the Lidcombe Program. However, on average it takes about 12 visits to the clinic to get to the point where stuttering has gone or is at an extremely low level. After that, it is important to complete Stage 2. There is good evidence that when the decision is made to begin Lidcombe Program treatment that it is much better than natural recovery. With what is called a meta-analysis, it has been shown that a stuttering child who receives the Lidcombe Program has seven or eight times better odds of not stuttering than a child who does not receive the Lidcombe Program.
Source: Australian Stuttering Research Centre http://sydney.edu.au/health-sciences/asrc/what_is/index.shtml