Part II
Prevention of Stammering
Stammering presents itself in children from around two and a
half years till the age of about nine. Worried parents
initially go to their doctor, who frequently tries to
reassure them that the child 'will grow out of it,' and 'not
to worry.' However, the weeks and months go by and the child
not only does not outgrow it, but the stammer becomes more
severe.
In the last article, we discussed the question of non-
fluency and when one begins to call it a stammer. The truth
is, that much depends on the listener, not just on the
speaker, and the way we judge other's speech. We must bear in
mind that we are not born with a language ready made in our
heads. A child learns language from the people around him. He
usually begins saying words after the age of a year,
gradually progressing to phrases, and then to complete
sentences. In the process, he is going to be groping for
words, mispronouncing words, using the wrong words and, it
must be stressed, hesitating over words.
Many adults, when trying to learn a new language, will spend
much of their time saying 'um' and 'er.' It is definitely
possible for a child who does not have a stammer, to be
diagnosed as having one. It is also true that many children
who stammer, have been regarded as normal speakers for a year
or more before the stammer begins. So there must be something
different happening to their speech pattern.
Take the example of a child of three. He has two or three
older siblings and two younger ones. He is developing
normally but his parents notice that some of the words he
utters take longer than others. They used to be a bit
concerned, but now they are far more worried. The other
children never spoke like that and the hesitations haven't
stopped.
Friends or relatives who call at the house say things like,
"Have you taken him to see someone about that stammer?" Or "I
should stop him doing that before it gets worse." So the
parents tell the child to slow down, relax, think before you
speak, take his time, to say it again and sometimes they tell
him to stop being silly. Often this helps; the child slows
down and repeats the words he has been saying without any
stammering.
When parents begin to correct their child for stammering, he
doesn't even know that there is something wrong with his
speech. Even if he is a particularly sensitive child who has
noticed his non-fluencies, his speech is fine as far as he is
concerned. Now he keeps getting corrected for something he
has not done: but as the correction continues, he gradually
becomes aware of what he is doing and why his parents
disapprove. He begins to try not to do it, and in the effort
of trying, the tension increases. Stress about speaking
develops and the stammer symptoms increase in frequency and
severity.
The more he gets corrected, the more he stammers; the more he
stammers, the more he gets corrected. In this vicious circle,
the child begins to feel badly about speaking. So the short
term benefit of correcting and being rewarded with a few
fluent sentences, is a high price to pay for the long- term
future of both speech stress and increased stammer.
Therapists advise parents to stop all correction of the
stammer. If a mother looks anxious or turns away until her
child has finished speaking, she is giving a perfect example
of negative body language. She is saying in effect that she
doesn't want to watch him speaking. Another mother might
brush away a tear as she watches her son struggle. Others
might look frustrated or annoyed.
Prevention and Treatment of Stammering
Generally speaking, adults who have an established a stammer
can learn to control the problem, with the right kind of help
and guidance, but they rarely overcome it completely. Not so
the young child. Children who stammer can be helped and many
do recover normal fluent speech.
The first thing for parents to do is to make a list of when
the stammer is worse and when it is better. Inexplicably,
most people who stammer have good patches and bad. These can
last hours, days or even weeks and no one seems to know quite
why it happens. Nevertheless, if we can identify the
situations which seem to increase the stammer, it will
provide us with guidelines of which situations to avoid.
The list could read something like this:
When tired, excited, playing outside, when one particular
relative comes, when he gets smacked, when he is forbidden to
do something.
In order to deal with the various situations, we will have to
treat this child differently from the others for a while. Try
to avoid late nights and don't take the child shopping
straight after school, although it might be far more
convenient. Avoid excitement at bedtime, as this tends to
keep children awake, and to try to play down exciting events.
This is difficult in a large family where one often builds up
excitement for an upcoming Yom tov, for example.
If the child is determined to play outside, we might increase
the stammer even more by trying to stop him (forbidding him
to do something). But if we suggest an alternative such as
inviting just one or two friends into the house to play, we
may succeed in avoiding this particular situation for a
while.
Why he should stammer more when a particular relative comes
may seem a mystery. But if you watch carefully, the cause
will usually become apparent. One mother reported that an
aunt used to keep the children guessing as to whether she had
brought them anything, and what it was she had brought them.
The excitement and tension increased the stammer.
Smacking is not appropriate in most cases anyway, and it
isn't too difficult to substitute it with, e.g., withdrawal
of a privilege with an accompanying explanation. Often the
removal of these pressures greatly improves the stammer, but
does not cure it completely.
Apart from your own personal list of things which increase
the stammer, asking questions puts a definite pressure on the
child's speech. When you ask a question, you expect a reply.
Thus the avoidance of asking questions at a time when we are
trying to eliminate the stammer, is maybe the most important
part of the treatment.
Mothers don't realize at all how many questions they ask the
children, all the time. Have you had a nice day? Did you
eat your whole sandwich? What did you do today? Is Yankele
better? Was he in school today? Did you bring anything home?
Shall we go shopping? Do you want a drink? It is
exceedingly difficult to change this, but well worth the
trouble.
You can't stop asking questions altogether. But for a few
weeks, try re-phrasing these questions into statements. It
will still show that you take an interest in your child, but
you will not expect a reply. I had a nice day, I hope you
did too. You must have been hungry at break because you
hardly had any breakfast. You look as if you did painting
today. I didn't see Yankele, I hope he's better. Here's a
drink.
You may be surprised at the results. Many children, not only
the ones with a stammer, answer 'nothing special' when asked
what they did in school, or shrug their shoulders without
volunteering any further information. The less you ask, the
more they seem to want to talk! But as I said, this is the
most difficult part of the change in our approach. It
takes around two weeks to get used to a question-free
conversation. But it will take several months for the stammer
to disappear completely.
One additional point: try to discipline the child a little
less than you normally would. General discipline is
necessary, but it must be consistent and based on reason.
Lack of discipline, inconsistent discipline, and unreasonable
discipline lead to emotional frustration that cause or
increase a stammer. It is essential that parents have the
same rules, otherwise the child will play off one against the
other and once again feel insecure.
Then there is discipline of speech. We have to include things
like "Don't talk so much. Stop asking questions. Don't say
that; it's rude." The standards vary in each home.
Disciplining this child's speech should be dropped for a
while, and reintroduced gradually when there has been no
stammer at all for six months.
Parents who go for professional help often complain that the
speech therapist does nothing except play games with the
child. That is about the only thing s/he wants to do as
therapy. Remove pressure from speech and the stammer will
improve. As I said at the outset, most stammers go away of
their own accord. If your child is one with a persistent
stammer, try all the above strategies for a few months, and
hopefully, the stammer will disappear.
