Onset of stuttering in early childhood and therapy approaches

Early period refers to the 2.5-7 age group. Yes, it could be as early as 2 years of age that you see an unfluent way of speaking in your child’s speech. Your baby, who first starts to express himself with crying, produces syllable repetitions such as “baba” and “dedede”, and then produces different syllables such as “tada”, after sound production experiments like “aaaa”. These speech production efforts are followed by the first word production around the age of one. Your child, whose number of single words is increasing gradually, will be bringing two words side by side around the age of 2 years. This is usually followed by sentence productions. Approximately 5% of children who produce fluent production up to this point may have subsequent deterioration in speech fluency. These deteriorations usually occur around the age of 3-4 years. These processes can be seen in children at different ages.

Not all nonfluent speech that begins in early childhood is stuttering. Normal developmental dysfluent speech findings can be observed in this age group. It is important to consult a speech and language therapist to distinguish between stuttering and normal developmental dysfluency. The presence/absence of some factors that increase the risk of continuing stuttering and how the process continues will inform the speech and language therapist in deciding whether or not to start therapy. If necessary, it may be recommended to start stuttering therapy even as early as 3 years of age.

In early therapy, speech and language therapists work with the family. They manage the process by observing the communication of families with their children and guiding them. The therapy approaches preferred in this period can be examined under two main headings as indirect (indirect) and direct (direct) therapy approaches. In this age group, the child is expected to change his speech, for example; long-speaking etc., methods are not primarily preferred methods. Indirect therapy methods are methods that aim to facilitate the communication of the child by making arrangements to focus on environmental regulations and the strengths of interaction.

Palin Parent-Child Interaction therapy is one of these approaches. In the direct therapy approach, the presence of verbal or behavioral interventions related to the child’s speech is in question. The Lidcombe approach is an example of these direct therapy approaches. In the Lidcombe Program, parents are taught verbal feedback to say after fluent and nonfluent speech. While the choice of which therapy approach to use may depend on factors such as age and the severity of stuttering, no significant evidence-based difference has yet been demonstrated between direct and indirect therapy methods in terms of therapy effectiveness. In all these therapy methods mentioned, it is not afraid to use the word stuttering in the presence of the child, and all the processes of the therapy are discussed with the child.

If the decision to start therapy is made, the reason for talking openly about stuttering in the presence of the child is to accept from the very beginning that it is not something to be ashamed of and should be hidden. Your child has not done anything wrong. There is no such thing as stuttering sticking to him when spoken to in front of him. On the contrary, hiding the process from him may make your child anxious/embarrassed by giving the impression that there is something wrong with them. The allergy analogy is actually very convenient to explain this issue. Allergy, like stuttering, is a life-long condition, and there is a possibility of passing. There are tools used for treatment. In order to cope with a lifelong allergy, people can manage the allergy by learning well what they need to do. Allergies and stuttering can have very similar aspects. So how much do you hesitate to use the word “allergy” in front of your child?

If you notice that the fluency of your child’s speech is impaired, consult a speech and language therapist as soon as possible before attempting a different verbal or behavioral intervention. Your speech and language therapist will give you the most accurate information on how you can help your child. Waiting to start school can mean years after the onset of stuttering. Waiting in the presence of a stuttering condition may reduce the likelihood of restoring natural speech fluency. Early and correct guidance is very valuable.

resources

Goodhue, R., Onslow, M., Quine, S., O’Brian, S., & Hearne, A. (2010). The Lidcombe Program of early stuttering intervention: mothers’ experiences. Journal of Fluency Disorders, 35 (1), 70–84. https://doi.org/10.1016/j.jfludis.2010.02.002

Jones, M., Onslow, M., Packman, A., Williams, S., Ormond, T., Schwarz, I., & Gebski, V. (2005). Randomized controlled trial of the Lidcombe program of early stuttering intervention. BMJ, 331(7518), 659. https://doi.org/10.1136/bmj.38520.451840.e0

Nippold, MA (2018). Stuttering in Preschool Children: Direct Versus Indirect Treatment. Language, Speech, and Hearing Services in Schools, 49 (1), 4–12. https://doi.org/10.1044/2017_lshss-17-0066

Onslow, M., O’Brian, S., & Harrison, E. (1997). The Lidcombe Program of early stuttering intervention: Methods and issues. International Journal of Language & Communication Disorders, 32 (2), 231–250. https://doi.org/10.3109/13682829709020405

Shafiei, B., Faramarzi, S., Abedi, A., Dehqan, A., & Scherer, R. (2018). Effects of the Lidcombe Program and Parent-Child Interaction Therapy on Stuttering Reduction in Preschool Children. Folia Phoniatrica et Logopaedica, 71 (1), 29–41. https://doi.org/10.1159/000493915

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