Why do most children "stutter" in preschool? - When should parents be concerned?

From physiological dysrhythmia... to persistent stuttering

The rapid development of a child's speech and language begins at the age of 2-3 years, when the child moves from the stage of using two-word phrases to using complex sentences. The child's efforts to learn to speak and the anticipated psychological stress that accompanies normal speech and language development may be the immediate reasons that trigger the emergence of short syllable or sound repetitions, hesitations, and sound elongation.

So most children between the ages of 2 and 6 show dysrhythmias (stuttering symptoms), but this can be seen as a period of "normal" or developmental stuttering where the child's demands for fluency are not matched by his or her abilities. Therefore, these physiological dysrhythmias (repetition of syllables or sounds, hesitations and prolongations of sounds) constitute an evolutionary phase in speech development and differ significantly from stuttering both in the frequency of occurrence and in the way they are produced and in the absence of negative emotions and secondary behaviours. In the case of physiological dysrhythmias, the symptoms resolve on their own without therapeutic intervention and usually last less than 3 months.

However, there are cases where the symptoms last for more than 6 months and instead of subsiding they become persistent, indicating that this is more than just a developmental phase in speech development. Therefore, a percentage of children who present with physiological dysrhythmias will, over time, progress to the initial persistent stuttering. This progression for some children will be slow and sequential, but for others it will be brief and sudden.

In other words, when a child goes through this stage and it lasts for a long time the chances of a full recovery are significantly reduced.

At this stage stuttering periods are more frequent and in many children there are not even long periods of fluency.

What are the factors that are likely to contribute to the onset of the initial persistent stuttering?

Inherent and environmental factors play an important role. In addition to genetic predisposition and environmental pressures (i.e. the demands made by the child's environment in relation to his or her abilities), there is also the child's own awareness of the difficulty. This awareness, due to the increased severity and/or duration of the symptoms, will lead to the development of secondary behaviours and in some cases negative emotions.

Symptoms of stuttering

  • At least three times repetition of sounds, syllables of a word
  • Lengthening of sounds in words longer than one second
  • Repetition of monosyllabic words
  • Obstructions
  • Insertions
  • Reviews

Secondary behaviours and emotions

  • Instantaneous closing of eyes
  • Shaking of hands or head
  • Lip plumping
  • Tightening of the neck muscles
  • Phrases (word substitutions to avoid problematic words)

After the onset of stuttering, unpleasant feelings and beliefs such as:

  • Failure
  • Embarrassment
  • Phobias
  • Disappointment
  • Low self-esteem

But what are the causes of stuttering?

One of the first or most common questions a parent will ask the clinician is "Why is my child stuttering?" But the answer is neither simple nor easy. The causes of stuttering remain universally unknown. So no one can say with certainty what the cause of this phenomenon is, nor how it can be most effectively treated. What is certain is that stuttering is not caused by a single factor. For its occurrence, the existence of several factors is necessary. The most known factors involved in the occurrence of stuttering are:

  • Genetic - Hereditary factors
  • Neurogenic Factors
  • Environmental Factors
  • Combination of factors

Early intervention prevents the development of permanent habits that affect social, academic and later professional success. When children are referred to a speech and language therapist in a timely manner, treatment is more effective, even in cases of severe stuttering.

We recommend that parents ...

  • Listen carefully to their child when they talk.
  • Speak to him themselves at a slow pace and with frequent pauses.
  • Give it the time it needs to express itself, without interrupting it and without correcting it.
  • Identify the occasions when he or she speaks best and make an effort to repeat this to encourage it.
  • Contact a specialist immediately for help as soon as they notice that the child shows signs of stuttering. Time is precious.
  • To realise that environmental factors have an important influence on the child's speech.

Parents should not ....

  • Use expressions such as "calm down", "think before you speak" or "speak more slowly", etc.
  • Emphasize the way the child speaks.
  • Interrupt it when it talks.
  • To complete its suggestions, criticise it or expose it to difficult situations.
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