Stammering

A resource book for teachers

Trudy Stewart

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317386629
• Edition: 1
• Topic: Education
• Subtopic: Education General

What is stammering? How does it present itself? When does it occur? Why does it happen? What are the most effective strategies you can use to help?

Providing background information about stammering as well as a wide range of tools and strategies, this practical book addresses the key challenges faced at nursery and school. There are separate sections on early years, primary and secondary level and include the most common areas that teachers must consider when supporting children who lack speech fluency, including:

• identifying children at risk of developing a stammer
• how to manage incidents of stammering
• how to manage classroom communication and oral participation
• helping children to make and maintain relationships
• help children to manage feelings associated with stammering
• working alongside speech and language therapists.

Recent changes to the curriculum means that there is now a greater demand on children's communication skills than ever. This book will help you provide the necessary support to a child who stammers by offering a clear explanation of the presentation of stammering and the best ways you manage the occurrence of stammering in a range of school contexts.

Full of tips and advice this book will enable teachers and other professionals to work effectively with a child who stammers. This accessible book is essential for anyone concerned about a child in their care who presents with a stammer, including teachers, student teachers, SENCOs and parents.

1
Stammering

Background information

Kyle is a three-year-old boy who repeats the first sound of each sentence, mainly when he talks to his Gran. She asks him lots of questions and he finds it hard to think of the answers in the time she gives him to answer.

Sophie is in primary school. Her stammer has changed over time and now sounds more like sounds being stretched or prolonged. She sometimes hits her leg to make the sound stop. In school she is finding it hard to cope with situations such as reading aloud and speaking out in front of the class.

Raj is a teenager and attends a large secondary school. You rarely hear him stammer and in class he speaks very little. When he does speak out he uses lots of strategies to avoid stammering, such as switching words, rearranging his sentences and pretending he has forgotten what he wants to say.

Introduction

In this opening chapter, background information on stammering as a speech disorder will be presented: the what, when and why of stammering, factors which can influence fluency and myths associated with stammering.

It is important for teachers to be able to identify specific examples of stammering in children, so there are sections on how stammering presents and the differences between stammering and other disruptions occurring in everyday speech.

The chapter also includes information on the implications of stammering and the consequences for the individual who stammers over a long period of time. These consequences can be physical, emotional and psychological responses which impact on the individual. In order to demonstrate these effects, some examples of adults who stammer will be included in this chapter.

At some point in their lives, 5 per cent of the general population will stammer. This falls to 1 per cent in adults, indicating that many spontaneously recover from the experience. However, determining which individual is likely to recover is not straightforward.

What is stammering?

Defining fluency

‘Fluency’ is a term that can be applied to speech and relates to the flow and timing of the production of language. Speakers can have varying degrees of fluency, with some individuals demonstrating slower, more hesitant speech.

Differences between stammering and normal disruptions in speaking

All of us experience disruptions in the fluency of our speech, especially children who are learning to speak and developing mature language forms. It is important to differentiate these normal disruptions from stammering. Normal interruptions to fluency include:

• phrase repetitions (I want, I want a biscuit)
• interjections (What time is, er, the kick off?)
• silent pauses (… I don’t know the answer)
• hesitations (I think it’s a kind of … food)
• some word repetitions (It’s, it’s so unfair).

Stammering is a speech disorder in which the flow or fluency of speaking is disrupted. In some countries, such as the United States and Australia, it is called ‘stuttering’ but this refers to the same disorder.

The interruptions which characterise stammering often occur at the beginning of utterances, but can also happen on words which carry most meaning in the sentence, such as nouns and verbs. The disruptions tend to be of two main types:

• repetitions of sounds (C-c-c-can I go now?) or syllables (I like bu-bu-burgers) or monosyllabic words (My sister is is is in that class)
• moments when the articulation of a sound appears to have frozen – this can result in sound prolongation, e.g. sssssock, or alternatively the sound is stopped at the larynx (voice box), resulting in no sound being made and the speaker appearing to be stuck or blocked.

Other behaviours occurring with stammering

While attempting to control stammering, an individual can develop other behaviours such as:

• disrupted breathing where too much or too little air is taken in – when a speaker tries to speak on too little air or is unable to control his exhaled air effectively
• issues with rate of speech – a speaker will speed up his talking during a period of fluent speech or slow it down when a difficult word is anticipated
• tense production of sounds – a person puts more effort into his articulation of sounds resulting in forced or ‘pushed’ articulation
• attempts to minimise the impact of or reduce and/or speed up the disruption – the kinds of strategies usually employed involve the speaker putting more effort into talking. In so doing he can show struggle and tension in speech muscles or other parts of the body (e.g. in his shoulders or stomach) and make unusual movements such as facial distortions, tics and/or movement of the limbs.

Avoidance associated with stammering

A person who stammers often develops an aversion and sensitivity to the stammering itself and tries to avoid doing it. The avoidance may take a number of forms.

• Word avoidance – he might avoid saying a word that he stammers on by switching the word and replacing it with a word with a similar meaning. If no similar word is available, he may replace the feared word with a totally different one. This could change the meaning of his sentence but he will regard this as preferable to openly stammering.
• Situation avoidance – in these instances the individual will avoid placing himself in communication situations in which he fears stammering. Children and young people report avoiding situations in which they have to say their name, read aloud, speak in front of groups or ask for items in shops. (Examples for adults who stammer include making introductions, ordering in restaurants or bars, asking for specific items in shops and asking for a ticket on a bus, train or at the cinema or theatre.)
• Relationship avoidance – a person who stammers may be socially isolated because he avoids groups, making and receiving phone calls, or engaging in simple conversations which help to maintain relationships with others.
• Feeling avoidance – an individual might avoid expressing his feelings because he stammers in situations where he feels strong emotions. This can include expressing anger or affection, apologising or saying ‘thank you’.

Over time these avoidance behaviours become part of the stammering itself and compound the difficulties with speech.

The impact of stammering

Stammering is regarded as a speech disorder, but this is not the whole story. Communication is such an important part of life: it plays a major role in the development of relationships and how we portray ourselves to others. Compromising communication can lead to difficulty with relationships, educational and career choices, and fundamentally the way people understand themselves. (There will be more information on this in Chapter 2 on how stammering develops.)

Brian referred himself to a speech and language therapist as an adult. He had spent a lifetime avoiding stammering: when growing up, in school, in university and now in his workplace. He had ended up choosing not to study the subjects he was best at because they involved giving presentations to his peer group.

As a result, Brian was in a career path that was not satisfying. He was socially isolated and unable to ask the woman he liked to go out with him. Stammering had been a major influence in defining the life he was leading. Now he had had enough and wanted to live a different life.

When does stammering start?

Stammering in children

Stammering tends to start between the ages of 2 and 5, often around 3½. This coincides with the time of significant language development in children. There are incidences of stammering starting later, in primary school years and in teenagers; however, these are much less common.

Stammering in adults

Stammering may also begin in adulthood but again it is much less common. This is referred to as ‘acquired stammering’ and differs significantly from that which occurs in children. It’s onset at this time often relates to issues unconnected with development, such as neurological or progressive degenerative conditions, side effects of medicines, trauma or stressful incidents.

Variability

Variability is one of the most challenging issues surrounding stammering. A person who stammers will report his speech fluency changing within a day, and from day to day, as he experiences different speaking demands, different listeners, and feels more or less tired, or more or less confident.

In addition, the stammer can seem to have a life of its own, with a speaker being aware of a cyclical pattern to it’s presentation over time. For example, he may be aware of speaking with greater fluency over a period of months and then perceive a gradual but significant dip over several weeks.

There are a number of well-documented factors affecting variability, some having a positive effect and others a less helpful outcome.

Factors that have a positive effect

It should be noted that while these factors can all improve fluency, not all of them could be used therapeutically to help a child speak more fluently.

Novelty

When a speaker puts on a different way of talking, perhaps using a regional accent, a ‘funny’ voice with a higher/lower pitch, or a change in the rate or volume of speech, the result can be a short-term increase of fluency. This will only last while the new way of speaking is used but once it is habituated, and is no longer novel, the benefits will cease.

Talking when alone, talking to young children and animals

In all of these situations a person who stammers will find his dysfluency significantly decreases and in many cases disappears altogether. It is unclear why this happens but it is suggested by experts that it relates to communication demand. In all of these situations there is little or no demand on the person who is speaking: he is usually the person who initiates and controls the interaction, and the level of language required is not demanding.

Singing

Generally, children and adults who stammer are fluent when they sing. This can be puzzling to the general public who may misinterpret the stammering as something that can be controlled using singing, i.e. ‘Just sing what you want to say.’ What we know about singing is that it is different from speaking in a number of ways: it uses different parts of the brain, a melody is dictated, words are usually provided and it is not interactive (i.e. does not involve spontaneous turn taking). All of these factors usually play a part in establishing fluency in speech.

Listening to white noise or a distracting sound through headphones

This effect has been observed in children and adults. It has formed the basis of some technical aids to fluency since the 1960s, and more recently mobile apps can be purchased to perform the same function. One such example featured in the television programme Educating Yorkshire in 2014: a pupil was encouraged to wear headphones which played music while reading and speaking out. This produced a dramatic increase in his ability to speak fluently. Again it is unclear why this affects ...

Table of contents

• Cover
• Title
• Copyright
• Dedication
• Contents
• Acknowledgements
• Introduction
• 1 Stammering: background information
• 2 The development of stammering in young children
• 3 Problems with fluency in preschool children
• 4 Problems with fluency in primary school pupils
• 5 Helping pupils who stammer manage the demands of primary school
• 6 The demands of secondary school for pupils who stammer
• 7 Helping pupils who stammer manage the demands of secondary school
• 8 Speech and language therapy
• 9 Final words
• References and resources
• Index