Something blocking your words? Want to say something but cannot get it out?

When did you discover this?

Stuttering has generally been believed to stem from psychological factors, caused by nervousness or fear. Speech therapist Dr. Thomas Law from the Department of Otorhinolaryngology, Head and Neck Surgery at the Chinese University of Hong Kong admits: "In fact it is only half of the story. If we compare the verbal ability of humans to the mobile phone, the function is the same; sometimes it is extremely difficult to communicate due to the poor transmission network.” In addition, many parents think that children with stuttering problem suffer from damages to the brain, but Dr. Law said it is not necessarily true. Take the analogy of the mobile phone, just because network problems cause the transmission to fail does not mean that the phone itself is broken.

Dr.Thomas Law from the Department of Otorhinolaryngology, Head and Neck Surgery at the

Chinese University of Hong Kong

Facing stuttering head on – start by understanding the condition

Most parents would ask: "When children are just beginning to learn to speak it is usually not very fluent, but when will we discover that they stutter?" Stuttering emerges with the progress of language development, so generally cases will appear around 2-3 years of age when children are babbling. However, when they begin to encounter sentences with more complex phrasing or require more subtle articulation from a simple “Mamma Mamma” to “Mommy, I want to drink”, then parents will more easily detect differences between their child and other children.

Common to people that suffer from stuttering is a characteristic non-stop repetition of a particular word, such as repeating “Oh, oh, oh” at the beginning of a sentence. Secondly, in mid-speech they appear to have forces applied to a pressure point such that the word is forced back and unable to be articulated; thirdly, sufferers will prolong words with short sounds; lastly, they show unusual expressions and actions such as blinking and gesticulations.

The scientific community has yet to come up with a real answer for the cause of stuttering in preschool children, but the consensus of current research shows that there are physical and psychological factors. Physiological aspects of the condition are due problems with the transmission of nerve signals from the brain, causing the patient to stutter during speech despite normal muscle function, and is classified as a motor speech disorder. Symptoms caused by psychological factors are not apparent in normal conversation, but when the person is nervous, tired or affected by negative emotions then the stuttering becomes obvious. Contrary to popular belief that stuttering can be caused by psychological factors, Dr. Luo states: “Psychological factors will only exacerbate the stuttering, but it is not a cause of the condition.”

Genetic and gender influences

About 1% of the world population suffers from stuttering, and according to foreign studies, about 5% of pre-school children under 6 years of age stutter. In general children are more prone to stuttering if there is a family history; also, men have a higher chance of suffering from the condition compared to women, with studies showing that the ratio of male to female children that stutter is 2:1.

Impact of stuttering varies between individuals, with the brunt of the force directed at communication. Problems generally occur at particularly long and complicated sentences, or accents applied for emphasis in speech. Dr. Law says that with gradual and progressive practice, children can generally be cured: “The so-called golden age of treatment is before six years of age, and once you miss out the success rate for treatment of stuttering declines. At primary and secondary school when there are school and extra-curricular activities to attend to, the capacity to engage in treatment will be greatly reduced, making the condition even more difficult to manage. "

When it comes to the treatment of stuttering, Law noted that: "About 80 percent of children before the age of 6 can correct the issue without any intervention, so when parents ask for treatment at the early stages, I generally will observe the condition for the first year and proceed with treatment if the symptoms persist.” However, if the children are already six years of age or older, male and have a family history of stuttering, the speech therapist will commence treatment as soon as possible.

Involving parents in the therapy

There are two common therapies used to treat childhood stuttering. The first is the Lidcombe Program where the main focus is for parents to practice often with their children. This is combined with appropriate encouragement and guidance to allow the child to speak fluently.

Dr. Law points out that the most difficult aspect of the treatment process is whether the parents can detect the symptoms of stuttering in their children: “Speech therapists play the role of a facilitator to the parent. Since parents spend the most time with the children and can observe subtle changes to their children along the course of their daily life, they play the most important role in the treatment process.” The other type of therapy is linking exercises, which in simple terms is to talk in a manner like a robot for a few minutes daily.

The Golden Rules of Treatment

As part of the treatment process, the speech therapist will establish treatment goals in consultation with the parents, teaching them how to observe and learn to score their children's performance. At a certain stage, they will explain treatment techniques to the parents, such as how to guide their children through doing the exercises. Through observation and reflection of the parents, the therapist can then analyze with the parent on areas they need to address. 

"I remember this one parent who was taking these exercises with the child very conscientiously. On a follow-up visit I praised the child for the improvement in speech fluency, but the parent told me that the stuttering symptom merely changed from a sudden pause in the sentence to a forceful tremble, and that’s when I observed this subtle change.” Admittedly, this mutual collaboration between the speech therapist and the parent can increase the effectiveness of the treatment, ultimately benefiting the child.

Dr. Law found that:"The increase in interviews and language training also increases the opportunity for children to speak, making it easier for parents to discover language problems of their children earlier on." In fact, by paying attention to the treatment, once the parents and children become proficient, over time the child will be able to speak fluently without doing any exercises.  

Speech therapy works like a game in that you must first get the child engaged. Indeed, toys can open a conversation between speech therapists and children, allowing the treatment to progress .