What is stuttering anyway? And: is that bad? Gisela Erdelen often hears such questions. She is the deputy head speech therapist at the State School for Speech Therapy at the University Hospital Gießen and Marburg in Marburg. Her specialty: stuttering and other so-called speech flow problems.
With her, pupils learn, under supervision, the targeted application of therapies that the school itself also offers affected children and adults. In an interview with the RHÖN health blog, the expert explains how stuttering develops, who suffers from it in particular, and in which cases therapy should be started.
Ms. Erdelen, how often does stuttering occur in the population?
Stuttering affects just under one percent of adults and just under five percent of all preschool children. This means that most children lose their stuttering again by puberty. If the stuttering persists afterward, it usually lasts for life. This means that it no longer disappears completely even with the help of therapy.
What are the reasons that stuttering develops in the first place?
Basically we are talking about a coordination problem. To explain: speaking is a very complex process. The person has to hear, formulate, and then select the motor skills that ultimately bring about the speech movements. For this he has to coordinate a lot of muscles. This can lead to coordination problems. Stuttering occurs more frequently in children because they develop motor skills and speech at the same time. Vocabulary and grammar also increase in preschool age. So it is not completely absurd that the development is sometimes a bit bumpy. As the central nervous system matures, these bumpy spots are overcome in most, but not in all.
As a parent, when should you assume that your child’s stuttering could reach problematic proportions?
We only know after puberty whether stuttering accompanies a person for life. Nobody can predict that. Before puberty, 80 percent of those affected completely lose stuttering again. It is very important at all times: do not panic! I advise all parents who are concerned about their child’s stuttering: keep listening to what your child wants to tell you. It used to be said: It is best not to pay attention to stuttering! Of course, that is difficult to practice. Simply because it’s something noticeable. So, if you, as a parent, notice your child stumbling in the middle of a sentence, you shouldn’t worry about it any further, but ask yourself: What is my child actually trying to tell me? The point here is clearly to deal with the content, not the way in which it is said.
Can you clarify this thought again?
If, in a conversation, I address how the other person says something to me, this represents a disruption of communication and a burden on the conversation. For example, if I tell my interlocutor to speak more slowly, then he will have the feeling that he is doing something wrong. But if I try to listen carefully and say “I understood”, then communication is good.
When should parents be concerned about their child’s stuttering?
Exactly when you notice concern on the part of the child and when the child is obviously reluctant to speak, hits his mouth when he stutters, or says, for example, “I can’t speak at all!”. In a nutshell:
As soon as you, as a father or mother, notice the child’s emotional reactions to stuttering, you should do something about it.
You should also get help if you are worried as a parent. Simply because there are always interactions in the family. If anyone is concerned, it affects the others too. For example, if the parents hold their breath every time the child stutters, the child will notice this. This sets in motion a negative downward spiral that has a lasting impact on the child. That should be avoided. The aim must be that the child continues to enjoy speaking. If you can observe that the stuttering is developing further, for example the child starts to screw up his eyes or clench his fists, the parents should consult experts. The same applies in cases where children begin to avoid speaking where they have spoken before.
What do you do when, as a therapist, you sit across from stuttering children?
Our approach may sound strange at first, but we are actually trying to teach children to stutter on purpose. This should teach you to “stay soft” when stuttering, i.e. not to build up any efforts. So it’s about “good stuttering” that we want to teach them. We also suggest that they shouldn’t be scared of stuttering.
The aim is to reduce what are known as secondary symptoms such as exertion, avoidance and emotional reactions. By the way, this form of therapy is called “KIDS”, which is the abbreviation for “Children are allowed to stutter”.
The children learn from us that stuttering is not a bad thing and that you don’t have to make an effort. Our intention is to steer the child to a level that makes remission, i.e. a regression of the stuttering, likely. We can have little or no influence on the stuttering itself. After all, we cannot reach into the patient’s brain and take out the coordination problem. But what we can do is make sure that stuttering does not develop any further and that it does not grow into a problem. Stuttering doesn’t have to be a problem. Many children stutter. We want to prevent the child from being teased and having a hard time.
If it turns out that a patient should be affected by stuttering for the rest of their lives: does therapy make sense in this case too?
Yes. Stuttering can be changed at any age. We expressly offer our stuttering therapy for adults as well. Here we practice dealing with the symptoms, i.e. taking it gently, slowly and consciously. Otherwise speaking is absolutely unconscious. Nobody cares about lip and tongue movements, or about the basic tension that arises when speaking. The aim is for the patient to switch to “hand control” at the moment of stuttering, at a point where speaking is otherwise completely automatic. And that can be learned at any age. So even if the stuttering persists for life, we can work with the patient to ensure that it is not particularly noticeable and that it does not trigger negative feelings.
Your expert for speech therapy:
Deputy head teaching speech therapist at the State School for Speech Therapy at the University Hospital Gießen and Marburg at the Marburg location