• Stuttering information

What is stuttering?
Stuttering is the condition in which the flow of speech is broken by abnormal stoppages (no sound), repetitions (st-st-stuttering), or prolongations (ssssstuttering) of sounds and syllables. There may also be unusual facial and body movements associated with the effort to speak.

Aren’t all people nonfluent to some extent?
Yes. Almost all children go through a stage of frequent nonfluency in early speech development. Adults may interject syllables (“uh”) and occasionally repeat words, phrases and sounds, but these nonfluencies are accepted as normal and usually are not a cause for concern.

Does stammering mean the same thing as stuttering?
Most people use the terms interchangeably.

What causes stuttering?
We still do not know for a fact what causes stuttering. It may have different causes in different people, or it may occur only when a combination of factors comes together. It is also quite possible that what causes stuttering is quite different from what makes it continue or get worse. Possible influences include incoordination of the speech muscles; rate of language development; the way parents and others talk to the child; and other forms of communication and life stress.

Is stuttering caused by emotional or psychological problems?
Children who stutter are no more likely to have psychological problems than children who do not stutter. In general, there is no reason to believe that emotional trauma causes stuttering.
At what age is stuttering likely to appear?
Stuttering typically begins at a very early age (usually between 2 and 5 years), but will occasionally appear for the first time in a school-age child and, more rarely, in an adult.

If I think my child is beginning to stutter, should I wait or seek help?
You should seek a professional evaluation as soon as you become concerned. Most children outgrow their nonfluency, but others will not. The problem of stuttering may be prevented from developing if treated early enough.

Once stuttering has developed, can it be treated?
Yes, there are a variety of successful approaches for treating both children and adults. There are no published scientific data that indicate the general superiority of any one of these approaches.

Can stuttering be “cured”?
It is best to avoid thinking in terms of an absolute “cure” for stuttering. Stuttering is not a disease. The goal should be to progress toward improved fluency and success in communicating.
What should I do when I hear a child speaking nonfluently?
Children may be unaware that they are speaking nonfluently. Do not call attention to the nonfluent speech pattern.

Do not say “Stop and start over,” “Think before you talk,” “Talk slower,” or “Cat got your tongue?” Listen patiently and carefully to what the child is saying, and do not focus on how it is being said.

What should I do when I hear an adult stuttering?
Adults who stutter need the same patience and attention to their ideas as speakers who don’t stutter. Don’t look away and don’t hurry them or fill in words. This attempt to help can create anxiety and self-consciousness and make the problem worse.

Who can help with this problem?
A speech-language pathologist who has had experience in dealing with the stuttering problems of children and adults. The speech-language pathologist is the professional who is trained at the master’s or doctoral degree level to evaluate the person who stutters and prepare a plan to improve speech.

Information taken from the American Speech- Language-Hearing Association (ASHA) website.

• Pragmatic Language

Pragmatic Language Tips
Social language use is known as pragmatics.

There are several ways parents and teachers can help children use language appropriately in social situations.

Use of Different Language Functions

Ask questions or make suggestions to help a child use language for different purposes:
Desired Language Function
Suggested Question or Comment
Comment “What did you do”‘ or “Tell me about …
Request”Tell your friend . . .” or “What do you want?”
Question ” Ask me . .”

Respond to a child’s intended message rather than correcting the pronunciation or grammar; but provide an appropriate model in your own speech. For example, if a child says, “That’s how it doesn’t go,” respond, “You’re right. That’s not how it goes.”

Take advantage of naturally occurring interactions to increase use of different language functions. For example, practice greetings at the beginning of a day; have children ask peers what they want to eat for snacks; have children request necessary materials to complete an art project.

Adaptive Language Use
Role play conversations that might occur with different people in different situations. For example, set up a situation (or use one that occurs during the course of a day) in which a child has to explain the same thing to different people. For instance, a child might be asked to teach the rules of a new game to a younger child and to an adult. If the child’s explanations are the same for each listener, model different language patterns for an adult and a child listener.

Encourage use of effective persuasion. Ask children what they would say, for example, to convince their parents to let them do something. Discuss different ways to present a message:
polite (“Please may I go to the party?”) vs. impolite (“You better let me go.”);
indirect (“That music is loud.”) vs. direct (“Turn off the radio.”).
Discuss why some requests would be more persuasive than others.

Conversation and Narration Skills
Comment on a child’s topic of conversation before introducing a new topic. Add related information. This will help a child say more about a particular topic.

Provide visual prompts such as pictures, objects, or a story outline to help a child tell a story in sequence.

Encourage a child to rephrase or revise an unclear word or sentence. Provide an appropriate revision by asking “Did you mean .

Non verbal signals are important to communication.
For example, talk about what happens when a facial expression does not match the emotion expressed in a verbal message, e.g., using angry words while smiling.

Use of suggestions such as these will help foster appropriate pragmatic language skills with children who might otherwise be at a disadvantage during social interactions.

• Language Development

The development of spoken/oral language normally occurs without formal teaching. It develops as a result of exposure to spoken language.

Problems with language development may not be recognized for a long time unless the child simply fails to begin talking.

Oral language is the basis for learning reading and written language and for benefitting from instruction in other areas. It is important to identify children whose language is not developing normally so that more specific stimulation and actual intervention can begin as early as possible.

Language problems, like other learning disabilities, are called by several different names including: delayed language, language disorder, language disability, specific language disability, etc. Some people distinguish between children who appear to be developing all aspects of language at a slower rate (delayed language) and those who do not appear to be developing language in the expected way or have uneven language development (language disability). Regardless of the label, language problems should be assessed.

A language evaluation must include a hearing test since hearing loss is one reason for delayed language acquisition. Speech-language pathologists typically do the testing for spoken language disabilities. When children are of school age, the evaluation must include the language of instruction and reading and written language.

Like other types of learning disabilities, language disabilities differ in type and severity. In young children there are many known milestones that can be observed by parents and preschool teachers. Some of these are listed on the enclosed sheet along with some activities to encourage language development.

Even mild problems in spoken language can have an impact on learning in school. A child should enter first grade with the majority of the language needed for learning. Problems in understanding language will affect almost every aspect of school: following directions, learning vocabulary, understanding instruction, reading comprehension, etc. Problems in using language are often seen in children who do not understand. Some children understand spoken language but have difficulty expressing themselves. A common problem seen in expressive language is difficulty recalling words they know (word retrieval problems). These children understand the word, know it when they hear it, but cannot always call it up when they need it. These children may say, “you know that thing you sweep the floor with”; “I know it, but I can’t think of the word”; “Umm,umm, I forget”; etc. Retrieval problems can make children unwilling to participate in class because they interfere with a child’s demonstration of what he/she has learned. For example, children may have learned color or letter names, but are unable to give the names when asked. These children can point to the color or letter when the name is said to them.

Some children have difficulty with spoken grammar. They omit words or word endings or get words in the wrong order. Some have difficulty putting their ideas into words in an organized way.

Problems in pronunciation of words can be the result of mishearing sounds (Starvation Army/Salvation Army), getting sounds in the wrong order (aminal/animal), or difficulty producing specific sounds (fum/thumb). Problems with the sound system of language have been reported in many children who have difficulty learning to read. While some speech sounds are acquired later than others, children who have many sounds they cannot make and are difficult to understand may have later problems with phonics.

Language activities with young children are fun for them and can stimulate more language. Reading to children and talking about the pictures and the “story” is an important activity. Making certain new vocabulary is used in many ways and in different situations helps children learn new words.

It is important to have children’s language evaluated if there is any concern. Too often, parents are told “he’ll outgrow it” or “just wait, she’ll talk when she’s ready”. This is not good advice when the child is not doing what is expected for his/her age. Speech-language pathologists can determine what the problem is, if any, and make recommendations for working with the child. Oral language is important for social development and effective communication, as well as being the foundation for school learning. Problems should not be overlooked or disregarded.

• Articulation information

What is articulation?
Articulation is the process by which sounds, syllables, and words are formed when your tongue, jaw, teeth, lips, and palate alter the air stream coming from the vocal folds.
What is an articulation problem?
A person has an articulation problem when he or she produces sounds, syllables. or words incorrectly so that listeners do not understand what is being said or pay more attention to the way the words sound than to what they mean.
Is an articulation problem the same as “baby talk”?
An articulation problem sometimes sounds like baby talk because many very young children do mispronounce sounds, syllables, and words. But words that sound cute when mispronounced by young children interfere with the communication of older children or adults. Older children and adults have so many severe errors that their articulation problems are very different from “baby talk.”
What are some types of sound errors?
Most errors fall into one of three categories- omissions, substitutions, or distortions. An example of an omission is “at” for “hat” or “oo” for “shoe.” An example of a substitution is the use of “w” for “r.” which makes “rabbit” sound like “wabbit,” or the substitution of “th” for “s” so that “sun” is pronounced “thun.” When the sound is said inaccurately, but sounds something like the intended sound, it is called a distortion.

What causes an articulation problem?
Articulation problems may result from physical handicaps, such as cerebral palsy, cleft palate. or hearing loss, or may be related to other problems in the mouth, such as dental problems. However, most articulation problems occur in the absence of any obvious physical disability. The cause of these so-called functional articulation problems may be faulty learning of speech sounds.

Is an accent an articulation problem?
It can be for some persons. We all have accents- Southern, Eastern, Northern, Western, Chicago, Pittsburgh, Brooklyn, or Boston. An accent may be a problem if it interferes with a person’s goals in life.

Can ear problems during infancy have any effect on late sound development?
Children learn their speech sounds by listening to the speech around them. This learning begins very early in life. If children have frequent ear problems during this important listening period. they may fail to learn some speech sounds.

Will a child outgrow a functional articulation problem?
A child’s overall speech pattern will usually become more understandable as he or she matures. but some children will need direct training to eliminate all articulation errors. The exact speech pattern of the individual child will determine the answer to this question.

Do children learn all sounds at once?
Sounds are learned in an orderly sequence. Some sounds, such as “p,” “m,” and “b,” are learned as early as 3 years of age. Other sounds, like “s,” “r,’ and “l,” often are not completely mastered until the early school years.

At what age should a child be producing all sounds correctly? Children should make all the sounds of English by 8 years of age. Many children learn these sounds much earlier.

How can I help a child pronounce words correctly?
By setting a good example. Don’t interrupt or constantly correct the child. Don’t let anyone tease or mock (including friends or relatives). Instead, present a good model. Use the misarticulated word correctly with emphasis. If the child says, “That’s a big wabbit,” you say “Yes, that is a big rabbit. A big white rabbit. Would you like to have a rabbit?”

Can an adult with an articulation problem be helped?
As most articulation problems can be helped regardless of a person’s age, but the longer the problem persists, the harder it is to change. Some problems. such as those relating to nerve impulses to the muscles of articulation (dysarthria), are particularly difficult and generally will require a longer period of help than a functional disorder. Other conditions that may influence progress in a child or adult include hearing ability, condition of the oral structures such as the teeth, frequency of help obtained, motivation, intelligence, and cooperation.

Who can help?
Contact a speech-language pathologist if you are concerned about speech. The speech-language pathologist can advise whether professional help is indicated and how to arrange for assistance. The speech-language pathologist can also give you guidance or provide services to help prevent or eliminate a problem. Early help is especially important for more severe problems.

Is it important to correct an articulation problem?
When you consider the possible impact an articulation problem may have on one’s social, emotional, educational, and/or vocational status, the answer becomes obvious. Our speech is an important part of us. The quality of our lives is affected by the adequacy of our speech.

Speech services in the elementary school are delivered in a variety of ways. Services are based on student needs from assessments of skills.

Please contact me with any questions or concerns you may have with your elementary students communication skills.

• Speech services in the high school

Speech services in the high school

Speech services in the high school are delivered in a variety of ways depending on the needs of the student.

Please contact me with any questions or concerns with your child’s communication skills.