Stuttering in Children -Helpful tips for parents-Parent Magazine

THIS ARTICLE WAS PUBLISHED IN PARENTS MAGAZINE IN 2007. I AM REPRINTING DUE TO POPULAR DEMAND.

STUTTERING IN CHILDREN...
HELPFUL TIPS FOR PARENTS..
by Lori Melnitsky, MA CCC-SLP

What is stuttering? What causes it? Although, the exact cause is unknown, there are known environmental factors that contribute to stuttering. Ideally, it is the goal of working with young children who stutter to eliminate disfluencies while involving parents in the process. Stuttering is an interruption of the continuous flow of speech. It can be characterized as prolongations (sssssssssnake), repetitions of words (I I I want milk) or phrases (I want I want milk), frequent use of filler words (uh, um), blocking (silence and struggle before saying a word).

Between the ages of 2 and 5, many children experience stuttering. This is often considered a period of normal disfluencies. Why? One reason is that children are still coordinating their speech patterns and acquiring language during this stage. Will these children outgrow it? The majority will, but there is no way of knowing for sure. This is why consulting a speech/language pathologist at the onset is vital.

Did you know that approximately 1 % of the population stutters? Additionally, 4 out of 5 people who stutter are male. Many times there is a family member who stutters. One known fact is that parents are NOT at fault. Also, stuttering is not a contagious disease. No one will start to stutter if they hear another person stuttering.

What are some of the characteristics of normal developmental disfluencies?

1. The child does not exhibit struggle behaviors (such as kicking his foot) or display awareness of how they sound.
2. Disfluent moments can disappear and then unexpectedly reappear days or months later.
3. The child is not avoiding speaking situations or displaying frustration.
4. Easy repetitions of words and short phrases.

When does stuttering become more of a concern?

1. Children who are at risk usually exhibit struggle behaviors while forcing words out (such as unusual breathing patterns, or facial grimacing).
2. They often avoid feared words or speaking situations. Fear and frustration is often visible.
3. Saying “I don’t know” often in response to obvious questions or changing words. These are forms of avoidance.
4. Using filler words often (like, um, uh).
5. Prolongations of sounds (ssssssssnake). Stuttering might become longer in duration.
6. Change in intonation patterns (rising pitch during the period of stuttering).
7. Blocking on words, such as opening mouth with no audible sound coming out. Disruptions in breathing patterns.
8. Stuttering becomes more frequent.


What do you do if you suspect your child is stuttering?

1. Seek out the help of a speech/language pathologist experienced with stuttering. Often, doctors and family members will say ”Wait, the child will grow out of it”. This is often incorrect and increases tension in the family. Always consult with a SLP for advice. They may monitor the child or provide parents with information to help their child. They might use a direct therapeutic approach with the child or with both the child and parents.
2. Be a good listener--pay close attention to what is being said NOT how it is being said. Look directly into the child’s eyes to show that you are truly listening to the message.
3. Reduce questioning. This will decrease demands placed on the child.
4. Avoid putting the child in the spotlight-ex: “Tell Aunt Sue what you did in school today”. This puts too much pressure on the child.
5. Avoid comments like talk slower. Try and model a slow relaxed natural sounding speech pattern. (This is difficult. SLPs will demonstrate this for you).
6. Delay responding to allow for more pauses and reduce time pressure for the child.
7. Don’t ask the child to repeat the sentence. It will only increase awareness and frustration.
8. Most importantly, don’t panic!!! Although we can’t identify who will eventually stop stuttering, we can give advice to parents on how to talk to a child who stutters and model the appropriate way to respond.
9. Remember it is not your fault. Parents are NOT to blame.

All of these strategies will be easier to follow once you have met with a speech/language pathologist.

There are also more direct therapy approaches available if stuttering persists. For the school aged child who continues to stutter, there is still hope. Although the chances of outgrowing stuttering decrease after age 6, there are strategies available to improve communication and decrease stuttering. Children at this age often become highly aware of being different from their peers. It is important to work with a SLP on not only speech strategies, but ways to handle everyday speaking situations.

Remember parents your words, are like candy to a child. They eat them up. Be kind, patient and loving. Most importantly, consult a speech/language pathologist if you suspect your child is stuttering.

For more information, please contact Lori Melnitsky. Lori is a speech language pathologist (SLP) who stuttered severely as a child and specializes in treating children and adults who stutter in Plainview, NY. She is available for therapy, parent workshops at schools, consultations, and presentations at local universities. She is the chapter leader of the National Stuttering Association Adult and teen chapters on LI and founder of the LI Stuttering Connection. She is in private practice and treats children and adults who stutter as well as other speech and language disorders. Lori can be contacted at 516-776-0184 or via e-mail: Lori@allislandspeech.com (www.allislandspeech.com)

Happy and Healthy 2010!

May we all judge our self worth not by how much we stutter or are fluent, but by who we really are inside. If you choose improved fluency as a goal, I am here to tell you it is possible. Peace to all!!

Continuous phonation-How important is it to fluency?

I am back. I didn't think I would get a chance to write another blog before 2010, but I got up early today and had time.

I was recently reading an article about continuous phonation and linking words together. As many of you know, I am a graduate of the Precision Fluency Shaping program. I teach many of the skills I learned along with cognitive modifications and some stuttering modification tools. It was a wonderful program and I recommend it if you live in Virginia. I would recommend either follow up by a local SLP weekly, practice groups or even me via a webcam. The carryover is the tricky part. I like doing this program on consecutive weekends with older teens and adults in groups of 2, 3 or 4.

Getting back to continuous phonation. Many times when I am working with people who stutter, I will close my eyes as I am linking my words together. I don't do this in real life situations, but in exaggerated practice. Why, because it allows me to feel the vibration on the voiced sounds (ex: vowels,and consonants: b, d, g, j, l, m, n, r, v, w, x, y, z). If you put your hand to your throat and contrast cognates g (guh) and K (kuh), you will feel the guh is voiced and a buzzing will occur as your vocal folds meet. This doesn't happen for kuh (unvoiced sound) so you would have to feel the vibration on the vowel. This is how an easy onset starts. People who are naturally fluent do not break up their words and sentences. The sentences and words flow together. In the early years I was so jealous of this. Such an easy task, but so difficult for people who stutter. Later on , I realized I had to almost examine and dissect fluent speech to change my dysfluent speech patterns and treat others who stutter. When my clients link their words together, they are generally increasingly fluent. Many times this has to start with adequate full breath breathing. If you start to exhale all your air and then talk, stuttering and tension will occur. If you don't take in enough air, words will sound pushed and struggle will occur. This is why people who block in the laryngeal area have silent blocks when air capacity is reduced. I know this is hard to visualize in writing. I will try and make a you tube video tomorrow if my new flip camera comes. Continuous phonation and easy onsets are important and require intense practice. Please e-mail me with any questions. Also, SLPs on LI, please e-mail me if I can provide any inservices to your districts. tks Lori

Stuttering goals and New Years Resolutions-Suggestions for realistic goals

Just recently I was reading an old diary of mine. On almost every page I wrote that I hoped I woke up the next morning and my stuttering would disappear. I wondered if I stayed up all night and prayed if I would wake up fluent the next morning. On New Years Eve, I would write my New Year's resolutions, which included I will find a way to stop stuttering this year so I could be free of the talking jail I lived in. I just wanted to say what I wanted to without struggling. I used to wonder what would that feel like? Would it change my personality? The truth is I was a teenager and my goals were too huge and unrealistic. I needed a speech pathologist who specialized in fluency. I needed to meet other teens who stuttered. (I did find some educated SLPs in my 20's who I will always be grateful to and taught me so much.)

I would like to share with you realistic goals to work on your stuttering. As I have said before, stranger things have happened and you can be free of the stuttering bondage. Here are some realistic goals to set. I am planning on writing goals with my clients as of the first of the year.

1. To find a speech pathologist who specializes in stuttering/fluency therapy.
2. To learn at least two new tools to improve fluency.
3. Learn to breath correctly with the help of a stuttering expert. Start by sitting in a chair and putting your hand on your stomach (below your diaphram). Breathing from your shoulders or while raising your shoulders will cause tension and tension leads to stuttering. Feel your diaphram expand.
4. Try and go into your first word easy.
5. Connect your words together.
6. Join facebook-The Long Island Stuttering Connection to connect with other pws.
7. Seek out a stuttering specialist. Some, like me, offer group therapy.
8. Believe in yourself. Even if you have had prior speech therapy and you felt it wasn't successful. Don't give up. Parents-never ever give up on your child-even if they don't seem motivated. Chances are they haven't found the appropriate person to work with.
9. Accept the fact that you stutter but don't give up on improving fluency. You have no idea how severely I stutttered. There were times I could not get a word out. I am grateful for the support and fluency therapy I have received in my life. I still do at times, but the fear of talking is gone (which I think added years to my life)
10. Post a comment on my blog and let me know how I can help you.
11. If you are a teen and are unsure how to decrease stuttering, have your parents contact me. I have had success with teens who stutter and have a great practice group. We have fun and use tools. (the adults have fun too!!)

Most importantly, my best wishes for a happy and healthy 2010. May the economy recover and we all find improved fluency, communication, confidence,good health and peace in our lives. Please post any questions and/or comments. I love knowing others are reading my blog.

The Long Island Stuttering Connection-facebook

Hope everyone is enjoying a relaxing and joyous holiday season. If you are an adult who stutters interested in practicing fluency tools, or a parent of a teen interested or a parent interested in a support group for parents of children who stutter. please join my facebook page, Long Island Stuttering Connection. Also, if you use a device, such as the speech easy or fluency master please join us as well. You are all welcome. This is expanding and please look for meetings and support and practice groups in 2010. Good things are happening on LI for the stuttering community. Thank you to the Stuttering Foundation of America and National Stuttering Association for showing me how important education and support is. As a result of these two wonderful organizations, I am able to go forward with my dream of providing safe meetings for adults and teens to practice fluency tools. I can offer you all visual examples of how to use easy onsets, full breaths, continuous phonaton and empowerment exercises. We can encourage each other and realize the freedom of fluency in a safe environment. (If you stutter, it is ok, it will give us all an opportunity to learn from eachother). I am also hoping to provide everyone with manuals and practice Cd's. This will take financing so I am looking into non-profit status.
I want to wish everyone a happy and healthy new year. To all my clients reading this thank you for allowing me the honor of working with you. To the parents, thank you for trusting me with your children. As 2009 comes to an end, I want to say stuttering is something we do NOT who we are. Believe in yourself and reward yourself for small accomplishments. Be good to yourself. Happy and Healthy New Year to all of you.

Merry Christmas to all who celebrate the holiday!!

PROMPT (Prompts for Restructuring Oral Muscular Phonemic Targets)

Hi everyone-
I want to talk about PROMPT therapy tonight. It is not related to stuttering therapy. It is used for children who have oral motor disorders, oral motor dysfunction, apraxia, dyspraxia and articulation errors. It stands for PROMPTS for Restructuring Oral Muscular Phonemic Targets. You can read more about it on www.promptinstitute.com. It is a touch cue approach where each sound is formed by the speech pathologist through shaping the mouth, stabilizing the jaw, and elevating the tongue. I am certifed in this approach and if you have a child who is apraxic, slow to talk, has limited tongue, lip and jaw movement or minimal success with articulation therapy, I highly recommend it. I have seen two year olds who can't speak start to produce vowels and words. I have seen older children with articulation errors make much faster gains. Please call me to discuss further. This is my other passion besides stuttering therapy. Stay warm everyone.

Two Successful Female Speech Pathologists who Stutter Rise to fluency

Over 25 years ago two teens met at a practice group for people who stutter on LI, NY. We were the only two females out of 20 men in a room of people who stutter. I was 18 and Lisa was 19. The goals of these meetings were to practice fluency tools and that was it. Most of these people were graduates of either airflow therapy or precision fluency. At the time, we were airflow graduates. We were scared that we would stutter and not be able to use our tools effectively. Only fluency was acceptable at these meetings. Stuttering was not allowed. Acceptance was not spoken about at that time. We focused at the meetings and were fluent, but the fear of stuttering was a concern. These were successful business men who wanted fluency for promotions. They weren't going to accept blocking and stuttering from us.

Lisa and I were and are very different in many ways. Lisa was blonde, tall, thin and outgoing. I was more average built with curly hair and painfully shy (I am definitely not shy anymore-LOL). I was the covert stutterer who wanted to hide. We exhanged phone numbers not realizing both of us were petrified to use the phone. (which is funny when I think about it now) We tried to call but hung up when anyone else answered. Luckily caller ID was not invented then. Not to sound old, but they didn't even have e-mails. A few weeks went by and we saw eachother at Hofstra University on the unispan (bridge). We realized we were both attending the same college (this had to be fate). Lisa was a speech pathology major and at the time I was an accounting major. We were so different, but so alike in one way-stuttering. Stuttering had devastated us. It ruined our academic lives and dominated how we interacted with others. I still remember Lisa walking up to me with a big smile and asking if I wanted to go to the Rat (campus eatery) to get a cheeseburger. Those were the best words I had ever heard. I felt so alone at the time. I was a freshman and was afraid to speak. Lisa had been enrolled in speech therapy at the Hofstra clinic. I had taken airflow privately but was having difficulty using it outside of the clinic. When we stuttered, we hit it big time. Blocks and silent pauses as well as facial contortions. She offered to take me to the Hofstra Clinic where I eventually enrolled in airflow therapy. It was exciting at first. We did it together, gave presentations and I even got a job on campus answering phones in the admissions office. We were flying, fluent and life was good. One problem, we never really accepted the fact that we would still stutter and when we did, the shame and embarrassment overpowered us. We were too young to handle these emotions. You might ask, what happened? We crashed and our stuttering came back with a vengeance. We lost control and both felt like failures. Our confidence started nose dying and for years after we couldn't seem to get it back. Lisa had to take public speaking to graduate and failed it several times. It was heartbreaking to watch but yet I have never admired someone so much for sticking to it. She was going to be a speech pathologist no matter what. A few years later, after working in accounting, I decided it was time to stop hiding. I went back for my masters in speech pathology as well. I was told by the first grad school by a speech pathologist who is a board recognized fluency specialist I would never be able to communicate to talk to a parent. If it wasn't for Lisa and my family's support, I might have given up. We stuck together like glue. Lisa is like a sister I never had. She supported me and I her. We eventually decided that we stuttered severely and needed an intensive program. Our stuttering was giving us headaches, causing us to hide and physically and mentally exhausting us. I have to admit by this time our parents and families had spent countless thousands on speech therapy by this time but we were not giving up. Insurance usually didn't pay but we had to do it to survive. Looking back even though money was tight, it was the best money spent. After all, we wanted fluency but most of all self esteem and to lead our lives freely. We took a three week intensive fluency shaping course which helped our speech tremendously. We still had some difficulty when we came home, but always had each other to practice with. We went back for refreshers and it was a long journey. Lisa was more open about her speech than me. She brought it up on interviews and with friends and family. I was still living the lie. I was going to act fluent no matter what. It was killing me inside and I would cringe if the word stuttering was mentioned. So was there any hope? Did these two aspiring speech pathologists make it? Yes, and we soared!!!

I will skip to almost thirty years later. We are now two successful speech pathologists both specializing in fluency disorders. We have walked the walked and talked the talk. We both have wonderful husbands, two beautiful children and two cute dogs, Parker Fudge and Buddie Wallace. We are both fairly fluent but accept that we will probably always stutter. We have talked about it with our children and their friends. We have only heard positive feedback and support. We still use our easy onsets, continuous phonation, pullouts and correct breathing to communicate. We always thought stuttering was the worst thing in our lives when we were younger until we both went through some hard times. Lisa lost her mother and most recently her sister was diagnosed with ovarian cancer. I went through the loss of my husband's job and suffered great stress. It is interesting to note that stuttering no longer is the most important concern in our lives. We both call doctors for our kids when we have to, speak to teachers, speak to parents daily and no longer let stuttering rule our lives. I give presentations and workshops to spread the word about stuttering therapy. I provide individual and group therapy as well. We are stronger for what we have been through and still the best of friends. This blog is dedicated to my dear friend Lisa and her sister, Helene, who is battling ovarian cancer with courage and grace.

Remember, Stuttering does NOT have to rule you. Do not give up. Keep seeking speech therapy. You can accept the fact that you stutter and still be more fluent!! Always reach for the stars and no less. Please contact me if you want to talk more. Have a great night and if you are on the east coast, be careful driving in the snow. Thank you Pam for encouraging me to write this post.

Two teen testimonials of teens who stutter

I would like to share two stories of two teens, one a male (age 14), the other a female (age 17). These two teenagers are very different but share stuttering in common and the pain that often accompanies it. They both came to me with low self esteem due to the fears of stuttering and being perceived as different. I asked the first teen whom I will call Robert to write a blurb how speech therapy has helped him. I remember Robert having a difficult time expressing himself last Feb. As the months went by, I saw a young man come out of his shell. He started to accept the fact that he stuttered, but wanted to improve. He was and is motivated to this day. If he had difficulty with the "B" sound, he would go home and practice that sound all week. When he was afraid to answer the phone, he pushed himself to answer it anyway until the fear subsided. He never stopped practicing with his friends and family. This is what he wrote (12/09):

"When I started speech therapy last February of 2009, I was a moderate stutterer. Before I started speech therapy, I felt really different compared to other people because of the way I talked. But after a few months, I got new tools to control my stuttering. I started seeing results immediately and have been improving ever since. It's not fun to see people giving you a strange face like you have two heads or have people talking about you. I started seeing that in school and it actually made my stuttering worse. But with these tools, I have been able to speak more fluently and raise my confidence. I don't know where I would be without speech therapy."

The next story is about a young woman who will be attending college next year. I am going to post her college essay on my website soon so stay posted. It is called Speechless and it is a gem worth reading. This is what she wrote in my holiday card:

" Thank you so much for helping with my speech for the past 3 months. That's pretty much a Hanukah gift in itself. You've made me much more comfortable in any type of speech situation and have really made me comfortable in my own skin also. You're an amazing teacher and I couldn't have asked for anyone better. Thanks again and I'll be looking forward to another great year of speech class with you."

Amy and her parents are very proud of her accomplishments as I am of her. She just got a job which involves answering phones and practices her fluency tools. She is a wonderful communicator and I know she will have a successful fashion career ahead of her.

I hope these stories give hope to all who stutter, especially teens and their families. Both were realistic in their goals. They weren't looking for perfect fluency and knew they had to keep practicing. They were on a journey and still are. They role played situation after situation until they were able to speak in front of others and on the phone. Everyone who stutters knows the look Robert talked about above. The look when someone who stutters opens their mouth and the words won't come out. Facing the looks of the listener's bewilderment, silent inquiry as to what possibly could be wrong with this person and confusion is devastating. These teens went one step further and educated their listener and the world on what stuttering is. It is a communication disorder, but it doesn't define us. I say more power to them and I applaud their efforts. Happy and Healthy Holiday to all. Thank you for reading and I welcome your comments. Peace to all in the coming year. Lori

Teens and Stuttering

Happy Chanukah to all my friends who celebrate Chanukah. May the lights of the chanukah menorah shine brightly in your lives.

Thank you for all the beautuful notes from my teens who wrote how their fluency improved as well as their self esteem. What a wonderful holiday gift to not let stuttering control you and to be able to talk to your friends and in class! So wonderful to hear.

Also, looking to start a Suffolk County practice group for teens and adults who stutter. Please contact me. tks Lori

Covert Stuttering

I want to recommned a terrific, insightful and honest blog started by a woman named Pam Mertz, whom I first met a National Stuttering Association conference a few years back. She started a blog on covert stuttering ( and a yahoo group) that has taught me so much about covert stuttering. Although I stuttered too severely early on to be called a covert person who stutters, I was always trying to deny the fact that I stuttered. It was only when I became truly honest with my self that I was able to accept myself and use fluency tools. Hence, my fluency dramatically improved as did my self acceptance.

Read it, you will be hooked:
www.stutterrockstar.wordpress.com

Self Esteem and stuttering

What is self esteem? I read this from the link: www.health.org/kid/feeling/emotion -under "What is Self-Esteem?" (The Story of Self-Esteem). It says "Self-Esteem isn't bragging about how great you are. It's more like quietly knowing that you're worth a lot (priceless, in fact). It's not about thinking you're perfect-because nobody is-but knowing that you're worthy of being loved and accepted."
I like this definition. It's what I work on besides fluency therapy. No, I am not a psychologist, but I have taken courses in cognitive psychology and feel it is a vital piece in fluency therapy. I don't believe kids or teens (or adults for that matter) can really improve their fluency without a great deal of self esteem. What do you think?

Stuttering was difficult for me when I was young. I didn't feel what I had to say was important. Why? I don't know. I have a father who praised me constantly. My fluency finally improved as an adult when I thought I was worthy to take my time to use tools and be listened to. How wonderful for me as a speech pathologist to hear from parents that they went to their child's parent teacher conferences and the teacher told them their child volunmeers in class to speak out loud, not allowing stuttering to stop them. How great it is to hear they have been talking more fluently outside the clinic room while exhibiting wonderful self esteem. So proud of all these kids and teens I work with and everyone else who stutters for having courage to believe in yourself and follow your dreams.