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Communication Disorders
Communication Disorders

Fluency Program

What is stuttering?

Stuttering, sometimes referred to as dysfluency, stammering, bumpy speech, or sticky sounds, is a speech disorder where the normal flow of speech is disrupted by sound, word or phrase repetitions, sound prolongations/stretching, silent blocks, silent pauses, broken words, revisions, incomplete phrases and/or interjections. 

Other symptoms that might be seen with stuttering include eye closing, looking away from listener, head or body movements, neck, jaw, lip or tongue tension. Children with mild stuttering are often unaware of their stuttering. In more severe cases, children may show greater awareness, accompanied by extra effort and fear when speaking. These children may begin to avoid speaking situations and socially withdraw when they expect to stutter.

Developmental stuttering or normal non-fluency is typically heard in the speech of children between the ages of 18 months and 5 years for brief periods of time (lasting less than 6 months) and usually disappears without intervention within 2 to 3 months . Normal developmental stuttering is present in approximately 80 to 90 percent of children when they are learning to talk.

True stuttering happens in about 1 percent of children, where males out number females in a 4 to 1 ratio. The onset of stuttering can be gradual or sudden.

What causes stuttering?

The exact causes of stuttering are not completely understood or known. One thing we do know for sure, is that stuttering is a complicated problem with no single cause and no single cure. Stuttering is likely the result of many factors  (speech and language, cognitive, physical, environmental, genetic and personality) interacting together in different ways for different people.  Stuttering is rarely considered a psychological problem. Stressful social situations and anxiety, however, can make symptoms worse. Surprisingly, people with significant speech difficulty often don't stutter when singing or when they are alone talking to themselves.

Stuttering Risk Factors:

  • Family history of stuttering or other speech and language problems ( a family member who still stutters
  • Age at onset (after age three and a half years)
  • Time since stuttering first started (stuttering six to 12 months or longer, even if it fluctuates)
  • Other speech-language delays (sound errors, difficulty following directions)

How is stuttering diagnosed?

An assessment of stuttering involves obtaining sufficient background information and history about the child’s stuttering and its development,  including the child’s reaction to the problem and how the family is currently dealing with the problem. Information on the child’s medical history, physical development and speech and language development will also be obtained. The child’s speech and language abilities will be assessed by a certified Speech-Language Pathologists and will include speech sampling  in different settings (clinic, school, home) and with different people (clinician, parent, sibling) in order to get a representational sample of the child’s fluency. Repeated samples at different times under different circumstances may be necessary if the child is having a “good” talking day during the assessment as fluency fluctuates in young children. Speech samples will be evaluated for total number of dysfluencies, different types of dysfluencies, duration of individual stuttering moments, speech rate and associated motor behaviours and reactions and feelings associated with the speech problem. This is done in a warm and friendly environment in a play based format.

How to help your child:

The following are some suggestions to help with the normal speech difficulties your child might have. They also serve to promote a positive communication environment, which may foster fluency:

  • Be a good listener and take turns talking. Communication should be a fun and shared experience.  
  • Speak in an unhurried way with frequent pauses and eye contact.
  • Do not tell your child to slow down as this may frustrate him/her. Try to talk with your child in a calm, quiet place and be a model of speaking slowly.
  • Reduce the number of direct questions you ask your child and try to comment more on what your child is saying or doing. Let him/her know you are listening and interested in what he/she is saying and not how he/she is saying it.
  • Do not correct or interrupt your child while he/she is speaking, even if the child is making mistakes or having trouble. Tell others to ignore it as well. Wait and allow your child the time to get his/her words out on their own.
  • Do not ask your child to repeat something you do not understand. Attempt to guess what the child is saying and continue on with the conversation.
  • Do not have your child imitate or practice certain sounds or words (unless advised by your Speech-Language Pathologist). This will make the child uncomfortable about his/her speech and more aware of his/her difficulty.
  • Talk openly about the stuttering if the child brings up the subject and try to convey the message that you accept him/her as is.

Treatment for stuttering:

There is no cure for stuttering but early intervention may keep stuttering from becoming a life-long problem.  This clinic does not prescribe medications, electronic devices or perform surgeries to treat or prevent stuttering.

The best treatment type for your child’s stuttering will be determined by your child's Speech-Language Pathologist based on:

  • Your child's age, overall health, and medical history
  • Severity of the problem
  • Treatment readiness
  • Your level of interest and commitment to treatment  

One treatment approach focuses on teaching the physical movements that a person needs to make in order to speak fluently.  It takes time to unlearn incorrect ways of speaking. Parents will be trained on these motor behaviour or speech techniques and will learn more effective ways for managing fluency in the home.  

Treatment may be in the form of parent training workshops, weekly individual or group sessions or summer intensive treatment programs.

You should consult a Speech-Language Pathologist if:

  • Your child has been stuttering for greater than 6 months
  • Your child stutters after the age of 5
  • Your child is fearful of talking or does not talk
  • There is a family history of stuttering
  • Repetition of words or phrases continues after six months and after trying the above recommendations
  • Your child is showing signs of frustration, anxiety or embarrassment with respect to his/her speech
  • Your child’s speech pattern is interfering with school work or emotional development
  • You are worried or concerned

Coping with Teasing:

Lots of children encounter teasing. Here are some suggestions for you to discuss with your child and his teacher. Try to come up with some ideas together and pick two or three to try out. Simply talking about teasing and strategies to deal effectively with teasing will make you and your child feel better.  

  • Tell a friend
  • Tell your parents
  • Tell your teacher or adult you trust
  • Ignore them
  • Ask them to stop
  • Walk away
  • Tell the parent of the person who is teasing you
  • They may just be curious, try and explain what stuttering is and that you are not doing it on purpose
  • Write down your thoughts and feelings, this does not have to be shared with anyone
  • Tease back
  • Cry
  • Avoid them
  • Talk to someone else
  • Stick with your friends

How to help yourself:

You may notice that you don’t always stutter. When is it easier for you to speak and with whom? Do you have tricks that help you speak better? Do they work sometimes or all the time? What works for you? Here are some tips and ideas  from other children who stutter:

  • Try not to feel rushed or pressured to speak quickly
  • Talk a bit more slowly
  • Say what you want to say
  • Don’t be so hard on yourself
  • Pause for a moment before you start to speak
  • Visualize yourself speaking smoothly
  • Don't expect the worst, aim for the best
  • Be proud of yourself for trying
  • Don't force  or push the words out
  • Take care of yourself by getting rest, eating well and staying active
  • The faster you try to speak the less you say
  • Be open about your stuttering rather than trying to hide it
  • Find something you love to do and do it often (music lessons, playing a sport, reading, drawing, hanging out with friends…)

Useful Stuttering Links:

Early Abilities (formerly Toronto Preschool Speech and Language)

The Speech and Stuttering Institute in Toronto  

The Stuttering Home Page

National Stuttering Association

Stuttering Foundation of America

American Speech-Language-Hearing Association

Institute for Stuttering Treatment and Research (ISTAR)

Speech-Language Pathology & Audiology Canada (SAC)

Canadian Stuttering Association