Stutter in Young Children
Hi everyone!
I am a graduate student studying speech-language pathology and I am currently in a stuttering class. I was curious about the opinions other have about stuttering therapy for children who are young. Particularly, children who are younger than the age of 5. At what age do you think it is appropriate to begin stuttering therapy? What therapy approaches are best for young children? I am also curious about the perspective of a person who stutters. Did you receive therapy as a young child? What did you like and dislike about therapy?
Stuttering therapy for young children is a controversial topic worth exploring. Unfortunately, I will only be able to touch on it here, but I would encourage you to continue to learn about it. Some 80% to 86% of young children who stutter will recover from stuttering, so 14% to 20% will continue to stutter. We attempt assess a young child’s risk of persistent stuttering, and potential need for therapy, by looking for risk factors. These may include:
Primary risk factors:
1. Family history of persistent stuttering
2. Male biological sex
3. Trends of fluency pattern are flat or increased in frequency
4. Persistence 6-12 months post onset
5. Age at onset after 3.5
6. Repetitions of 2 or more units; quicker tempo
7. Prolongations/Blocks
Secondary risk factors:
• Quantity of stuttering remains severe after 1 year
• Head & neck movement remains frequent and severe after 1 year
• Phonological skills are below normal limits in early phase of stuttering
• Expressive language skills remain advanced over time or present as weak
The assessed level of risk (very low to high) will guide decisions about whether to monitor the child or proceed with a differential, comprehensive evaluation and possible treatment. Early intervention may increase the chances of recovery. Some of the more well-known approaches to preschool stuttering therapy include the Lidcombe program, Palin Parent-Child Interaction (PCT) Therapy, therapy based on the Demands and Capacities Model (DCM/RESTART), and the Family-Focused Treatment Approach for Preschool Children Who Stutter described by Scott Yaruss. While Lidcombe has the largest evidence base, I do not believe we have enough evidence to say that there is a one-size-fits-all, best treatment for every child who stutters. The differential, comprehensive evaluation will guide treatment decisions that are based on individual needs. Wishing you the best in your studies and career,
Rob Dellinger