When to be Concerned About Stuttering

“Stuttering is just the tip of the iceberg,” says Gillette Children's speech-language pathologist and outpatient lead, Graham Schenck, PhD.

“The iceberg you see on the surface is stuttering,” Schenck explains. “But underneath the surface there’s a larger chunk of ice that is made up of negative emotions, pressure and teasing associated with stuttering.”

October 22 is International Stuttering Awareness Day and a time to highlight the compassion and skill speech-language pathologists can bring to help families deal with this speech concern.

Stuttering is one of the most common reasons children come to Gillette for a speech evaluation. Stuttering affects about 70 million people worldwide, including 3 million people in the United States. It typically is first noticed when children are between 2 and 4 years of age and boys are four times as likely than girls to stutter. Stuttering is neurological, meaning it is a brain issue, but the exact cause is still unknown.

Schenck says most children go through a typical developmental stuttering stage before kindergarten. “Most children will recover spontaneously before the age of 6,” he says. “But it’s important for families to know that if their child is still struggling with stuttering when they enter school, we have lots of resources to help.”

There are some simple things parents should look for to tell if their child’s speech needs to be evaluated. “There’s typical disfluencies and atypical disfluencies,” Schenck says. “A typical situation would be a 2- to 4-year-old child who wants to communicate the following sentence: ‘Mommy, I want to go to the store.’  Instead, that child says something like, ‘Mommy I want, I want, I want to go to the store.’ Another example of this would be if the child said, ‘Mommy, I want to go to the umm, umm, store.’ In those examples the child is not showing any physical struggles with speech and instead they are grasping for words or dealing with the sentence structure.”

An example of an atypical speech pattern would be if a child is physically struggling to produce speech or if they repeat part of a word. “An example of atypical speech,” Schenck says, “would be if a child said, ‘Mmmmm Mommy, I wwwwwant to go to the sssstore.’

U.S. President Joe Biden has brought more awareness to stuttering. Biden is open about his struggles with stuttering and shared his own approach to improving his speech by reciting poetry in from of a mirror as a teen.

During the 2020 presidential campaign 13-year-old Brayden Harrington came to a Biden event in New Hampshire with his father. Owen Harrington brought his son to see Biden because Brayden stutters and was inspired by Biden to not allow speech issues to limit his future. Biden encouraged Brayden to not let stuttering define him and asked for the Harrington’s phone number so he could call Brayden and share his own tips for overcoming stuttering.

“President Biden is an interesting case,” Schenck says. “The president does a nice job of using fluency shaping techniques to hide his stutter. The field is somewhat divided on whether a person should stutter openly or not. Some people and speech-language pathologists are more open and accepting of stuttering in front of others and actually encourage it to desensitize the patient to the stigmas of stuttering. There’s another camp that would rather be more covert. They don’t want people to know they stutter and they focus on precision fluency enhancement programs.”

Schenck has personal experience with stuttering and as a teenager he worked with a speech-language pathologist in his hometown in Illinois to build fluency and confidence.

“I had a great experience working with my speech-language pathologist and that sparked my interest in the field,” Schenck says.

“Personally, I don’t want people to know I stutter,” Schenck says. “I take longer pauses. I incorporate fluency strategies so the stuttering is not perceived. In my opinion, stuttering is a very challenging and silent disability. But there is real help and I want families to know speech-language pathologists are here.”

Parents who are concerned with their child’s speech/fluency should speak to their pediatrician and ask for a referral to a speech-language pathologist to evaluate their child.

“Early intervention is key,” Schenck says. “We would like the opportunity to help any family who is concerned about their child’s speech. We have a large team of highly trained and skilled specialists at Gillette. We collaborate frequently with primary pediatricians and school therapists to optimize care and give each child the support they need.”

For parents, the most important thing is to support your child and get a professional evaluation. Graham Schenck adds, “Parents should avoid bombarding their child with questions and should focus on reducing the communication demands on their child. If a child feels stressed and pressured to communicate constantly and quickly, that could exacerbate stress and make their stuttering worse. Patience, understanding and medical support are the keys to helping your child.”