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Sometimes, when the avalanche of words becomes so much that we start to tune it out, we close our eyes and think, “Why did we teach this child how to talk?”

We’re not serious (most of the time). The worst thing that can happen is that they stop talking.

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That’s why, if a child develops a stutter, we want to be equipped to handle the situation in the most gentle way possible.

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The statistics associated with stuttering are not alarming: around five per cent of children go through a period of stuttering; one per cent of adults stutter. It happens in all countries and in all languages. Yet numbers don’t matter to a child who is struggling or a parent who worries a speech difference will have negative repercussions.

Developmental stuttering is common, according to N.D.G. speech pathologist Leetal Cuperman, and usually goes away on its own.

“It tends to emerge during the preschool years because at that time their language is developing a lot. They have so many demands on their system that they don’t have the capacity to handle it,” she says.

Cuperman’s top piece of advice to caregivers is to be as calm as possible. They should wait, listen and not draw any attention to it.

“There’s a tendency with parents — and it’s natural, they want to help — to finish their sentences, give them the word or tell them to calm down and take a deep breath,” she says. “But you can be totally calm and still stutter.”

Taking a deep breath isn’t helpful because it can have the opposite effect and make them more tense, she says. “Their speech mechanism is more fragile than someone else’s and it doesn’t take as much to knock it over.”

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Everyone has bumps when they talk and not all stuttering is a disfluency, though it can have neurological and genetic components. Cuperman’s mother, brother and uncle stutter; her stuttering began when she was four or five.

The benchmark in deciding whether to seek treatment is the level of distress. If the stuttering has being going on for more than six months and child is bothered, experiencing teasing and bullying, or the caregiver has concerns, they should seek a referral. Speech therapy is available privately and through the public system.

“You don’t have to change your kid,” Cuperman says, though it can be a struggle to moderate your own reactions and that of friends or family who might interrupt the child or finish their sentences for them. She compares stuttering with other neurodivergencies that should not come with stigma and shame.

In her practice, she works with the caregivers as much as the child. She educates them and helps them “to not just act calm, but be calm. The goal is to give a message to the child that there’s nothing wrong with them, there’s nothing broken about them.”

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Strategies can including teaching the child fluency, showing them how to pause and breathe while they are speaking and a more behavioural approach that reinforces fluent speech and does not give too much attention to stuttering. Caregivers can learn to continue the therapy during normal conversations they have at home. It has to be fun and pleasant for the child, Cuperman says.

“Stuttering is essentially like a problem of coordination,” she says. “The person’s having trouble coordinating their breathing with their phonation, with their articulation, with their thinking, and with listening to themselves. Usually the most fragile part is at the beginning, when they start talking or right when they’re trying to take the breath.”

Another approach is called the stuttering modification approach, but Cuperman thinks it should be called “the stuttering acceptance approach.”

“On the surface, all that other people see is the occasional stuttering and maybe some jerkiness or pauses or other movements. But under the surface, there’s a lot of other stuff: the fear of stuttering, the shame when it happens, the guilt that you didn’t do anything about it, that you didn’t do what the speech therapist told you. There are all these mental gymnastics that happen because people who stutter often know which words are gonna be difficult for them.

“They might do all sorts of things like change around the words they’re going say, and that is very draining.”

The acceptance approach chips away at those issues until all that’s left is the stuttering. Then they can learn some fluency techniques, but “it’s not about other people. It’s what they choose.”

More information is available via Leetal Cuperman’s Speech Therapy N.D.G., speechtherapyndg.com.

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hjuhl@postmedia.com

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