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Stammering, Selective Mutism/reluctance to speak

Stammering

Stammering means that someone’s words may not always flow as easily as expected when they talk. This is known by many different terms - stammering, stuttering, bumpy talking, sticky words, getting stuck… all these words mean the same thing. Stammering may involve repeating words or sounds, holding onto sounds, or blocking (where no sound comes out).  Some children are aware that their words are getting stuck and can feel frustrated or worried by this.

Stammering often develops when a child is between 2 and 5 years old and it is seen across all cultures, classes, religions, languages and levels of intelligence. Stammering is not caused by any single thing. Different combinations of things may make an individual child more likely to stammer. These things may include:

  • Speech and language skills
  • Physical development
  • Genetic factors
  • Psychological factors including personality
  • Environmental issues including competition to talk, trying to keep up with other fast talkers, changes in routine or events such as moving house

 

Stammering is not something we need to ‘cure’ and not all children will ‘grow out of it’. Stammering is a different way of talking rather than being something ‘wrong’ with how your child talks.

It is important to give your child the right support to help them learn to understand their stammer and reduce any anxiety associated with it so that your child can be a confident communicator both at times when they stammer more and when they are stammering less. Parents and families have a very important role building children’s confidence as communicators. Speech and Language Therapy can support you to know how best to do this. If you are worried about your child stammering, please seek a referral to our department.

Please see some advice videos about stammering on our advice videos free to download page.

It is fine to talk to your child about stammering. This can seem scary for you as a parent at first, but the best way to help a child understand what’s going on when they stammer, and know that it’s OK to talk this way, is to talk openly about stammering.

Try commenting on the stammer occasionally when you hear it. Talk about it in a calm, relaxed way after your child has finished talking. You might say something like, “I heard a bump /sticky word then. You’ve got so much to tell me about the party, your words are all trying to get out at once and you bumped. Sometimes this happens when some people talk.”

Your child may want to talk about their stammer with you, or they may not respond. Either reaction is OK. You don’t need to acknowledge it every single time your child stammers, but let them know stammering is OK to talk about.

When you talk about stammering, be aware of the words you use to describe it, whether you’re talking directly to your child, or to other people. Words adults use can influence the way a child thinks and feels about their communication. If we say ‘the stammer was really bad today’ or ‘today was such a good day, Jamie didn’t stammer!’ a child may start to think they are bad / their communication is bad because they stammer and they are only seen as ‘good’ when they don’t stammer. Talking about stammering as something that happens ‘more’ or ‘less’ on different days will feel more comfortable to a child than being told their stammer is ‘bad’ or their talking is ‘good’ on days when there is less stammering.

Try not to talk for your child, or let others talk for them. Children who stammer will want to share their own ideas and might get frustrated if other people talk for them, or guess and finish sentences for them. Encourage an atmosphere of listening to each other, waiting for someone to finish when they’re talking and respecting turns to talk within your family.

A common response when listening to someone who stammers is to suggest they ‘stop and start again’ or ‘take a deep breath’ before talking. Although this can seem like logical advice, it can be frustrating for the child who stammers. Children can take things literally, and may develop a disrupted breathing pattern before talking. It is more helpful to wait and give the child time to talk.

There are lots of resources available online to help children who stammer and their parents. EPUT Children’s Speech and Language Therapy recommends the following resources:

  • STAMMA is the UK charity for people who stammer and their families. It offers lots of useful information for parents and has links to different support groups. Find their parent page here: For Parents | STAMMA
  • STAMMA has a helpline run by volunteers who are able to listen to any questions you have about your child’s talking, and offer general advice. Details of ways to contact the helpline can be found here: Our helpline—here for you | STAMMA
  • Penguin is a new mobile app designed to support parents and caregivers of children who stammer during the early stages, often whilst waiting for a Speech and Language Therapy assessment. The app offers lots of easy to follow, helpful general advice and can be downloaded from https://www.benetalk.com/
  • You can find lots of information online about stammering. Some is more useful than others, we hope the above links will signpost you to more helpful support available. You will also see lots of YouTube videos talking about stammering, ways to help children and people’s personal experiences of stammering. Again, some of these are more useful than others. Some we like are:

https://www.youtube.com/watch?v=czMT-xZ71_4
https://www.youtube.com/watch?v=9aWSkk0UTH0
https://www.youtube.com/watch?v=IGN0BB0HaCo

Reluctance to speak and Selective Mutism

Sometimes, a child who is speaking comfortably in some situations (such as with their family at home) feels less comfortable talking in other situations, usually outside the home or with less familiar people. It is not uncommon for a child to take a little time to ‘warm up’ and engage with someone new or when they are in an unfamiliar place, but if you notice your child is consistently uncomfortable to speak in different places or with different people around, there may be more to it than ‘just shyness.’

For some children, expectations to speak to different people or in different settings can lead to high levels of anxiety. Children experiencing high anxiety in this way may appear ‘frozen’ or ‘blank’ and unable to speak in the situation. A child presenting in this way may be stated to have ‘reluctance to speak’ or a diagnosis of selective mutism (also known as situational mutism) may be considered.

The role of Speech and Language Therapy is to diagnose selective mutism (if appropriate) and to help children to be the most confident communicators they can be. Key adults around the child have an important part to play building communicative confidence and it is important to know how to help children who are not yet comfortable to speak in different situations. A speech and language therapist can help guide key adults in a child’s life to support them to feel less anxious about speaking and ensure everyone is following the same consistent advice to help stop the child becoming confused.

Please see some advice videos about reluctance to talk on our advice videos free to download page.

Sometimes children are not ready to speak in some situations. This can be due to shyness, but if it persists, it could tell us that the child is experiencing anxiety when they are expected to talk outside the home setting / with people they are less comfortable with. Without meaning to, sometimes adults put children under pressure to speak – asking lots of questions, prompting the child to say ‘please’ or ‘thank you’ or through well-meant comments such as, ‘Don’t be shy, you know me! You can talk to me!’ If the child’s reluctance to talk is rooted in anxiety, these very well intentioned comments can be interpreted as pressure to talk, which increases anxiety rather than reducing it. The child isn’t deliberately being ‘awkward’ or ‘stubborn’ when they aren’t talking – they feel anxious (something they probably can’t explain or fully understand) and their anxiety is getting in the way of them talking, even if they really want to!

The following general strategies can be used to try to help a child feel more relaxed and comfortable. As anxiety reduces, the child may feel easier about talking.

Reassure the child that it is all right if they aren’t ready to talk yet. Tell them it is OK if they aren’t comfortable talking yet, as long as they’re having fun at nursery / playing at the park / at their friend’s house. Use of the word ‘yet’ lets the child know that you are confident they will feel easier about talking at some point.

Make sure the child is able to let you (or other key adults if you won’t be present) know if they want or need something. Until the child is ready to talk, let them know you will check in with them every so often through the day to see if they need the toilet or, perhaps they can come and stand next to you to let you know they need something.

Try not to ask a child who is reluctant to speak lots of questions. It can be very tempting to use questions to encourage speech, but for a child who feels anxious about talking, this can just add to the pressure they feel. Use comments instead. This lets the child know you are enjoying engaging with them without the same level of pressure to respond that questions involve. You might say ‘I see lots of lovely animals here’ rather than, ‘what are these animals called?’ This leaves a gap in the conversation for the child to respond (if they feel comfortable to) without the pressure to answer a direct question.

It can be hard to know what to do or say when other people comment on a child not talking. It’s helpful to say something like, “Jamie talks a lot at home, he isn’t ready to talk in nursery yet

In a similar way, sometimes someone might draw attention to a child who is starting to feel comfortable to talk, often because they are excited to hear the child’s voice. Unfortunately, reacting with excitement when a child is comfortable to speak for the first time somewhere new can increase the anxiety they feel. Prepare people to react as if it is ‘no big deal’ if they hear the child speaking, as this will stop extra attention being drawn to the child experimenting with speaking more.

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