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Further Information

Stammering is a low incidence, high need speech, language and communication need (SLCN) that disrupts the forward flow of speech. It usually develops at the pre-school stage when current research suggests it may affect 1 in 12 children. It is most responsive then to early intervention near to the onset of stammering by a speech and language therapist who specialises in that.

Stammering has no single cause, although there may be a genetic link. There is no single or definite cure and there is no single best strategy for supporting pupils. Current research indicates that the cause of stammering has a physiological basis in the brain structure.

Research is ongoing and complex but this statement by Anne Smith of Purdue University, 2008 attempts to draw together current thinking. Her work is discussed in the research section of the BSA web site 

"Stuttering (UK usage stammering) is a neurodevelopmental disorder involving many different brain systems active for speech - including language, motor, and emotional networks. Each infant is born with a genetic makeup that contributes to his or her probability of stuttering, however whether stuttering will develop depends upon experience.

To learn to speak fluently, a child's brain must develop many different neural circuits, and these circuits must interact in very precise and rapid ways. Stuttering emerges in childhood as a symptom that the brain's neural circuits for speech are not being wired normally. For this reason, early intervention is critical, because by shaping the child's experience, we can affect the ongoing wiring process in the child's rapidly developing brain.

The longer the stuttering symptoms persist in early childhood, the more difficult it is for us to change the brain's wiring, and stuttering becomes a chronic, usually lifelong problem."

Over time a number of misconceptions about this complex communication difficulty have arisen. The stereotyping of people who stammer as shy, nervous, anxious individuals is frequently found and yet there is no evidence to support this.

Certainly, the stammering experience itself can lead to worry and anxiety, which will exacerbate the dysfluency. Parents cannot cause stammering, although there may be a genetic link.  Small modifications in the speaking and listening environment at home and in school, which make the child feel supported, can lower these anxiety levels, and may help with fluency.

Other myths that it is caused by being forced to use the right hand when left handed, or that it is linked with intelligence are equally untrue. People who stammer generally show the same spread of intelligence as the rest of the population.

Stammering can emerge at any childhood stage, but most commonly between the ages of two and five. This of course coincides with a period of the rapid development of language skills. It affects both boys and girls equally at first but later boys outnumber girls by as much as 5 to1. It can emerge gradually, but sometimes develops very suddenly. Early intervention at this age gives the best chance of recovery.

Stammering is not common after the pre-school age, affecting about one in eighty children of school age. It is complex, unpredictable and variable and there are different factors contributing to each child's problem and to the development of the stammer. Thus it is impossible to give prescriptive strategies for its management by teachers but there do seem to be some helpful methods of support that are worth trying. These methods are likely to be useful in the management of the whole-class, particularly if there are other pupils with speech, language and communication needs.

Ideally, the child will be receiving support from a speech and language therapist who will be able to offer advice to the staff on managing the child in class. If this is not the case, the school should encourage the parents to consent to referral. In some areas therapists are able to visit the classroom and, after observing the child, give the teacher specific advice. However, it is still useful for staff to be aware of the complexities of the problem so that they feel more confident in their approach to pupils and parents.

Often younger children are not aware of their speech and if there is a stammer present staff should not comment on it, but continue to encourage the child to talk and develop language skills. However, some quite young children may be aware, at a particular moment, that they are having a problem with their speaking.

A supportive comment, showing understanding at the time, can be helpful: "That was a hard word to say, wasn't it?"


If the child is obviously aware all the time of their stammering and seems anxious about it, the teacher should speak with the parents on how to offer the child support. A gentle discussion with the child, that shows that the difficulty is acknowledged, lowers the pressure on the child and allows him to feel that his difficulty is understood.

It's believed that when the demands made on a child who stammers are greater than his capacities then fluency may break down in that situation. In the classroom it is helpful to lower demands during periods of severe stammering. The demands made by other people, the situation, or the language demands of vocabulary, grammar and level of questions should be kept as simple as possible. Liaising with parents allows the teacher to take account of changes in family circumstances that may add to the demands that are affecting the child's fluency.

The covert or hidden stammer

Occasionally a stammer goes undetected in school, as the child hides it by avoiding talking, or generally getting out of situations where that is called for, perhaps by appearing to be very shy and quiet, playing the clown, disrupting the work, or simply by missing a lesson. This covert stammering is very damaging, as so much energy goes into avoidance strategies that the real needs are misunderstood. Girls are more likely to be quiet and withdrawn and the busy teacher may be happy to assume that they are getting on with their work, in their own way.

In reality, the girl may feel very lost and alone with the problem, building up a sense of shame, as it is never acknowledged. Boys are more likely to challenge the teacher and present as uncaring and disinterested in an effort to deny their real problem. Teachers may be moving into disciplinary strategies that label the child, when it is possible that a stammer lies behind the behaviour.

The Development of Stammering

Early Dysfluency

Awareness    

Child is unaware / unconcerned

Stammer

Dysfluencies - mild, unhurried, lacking tension or struggle and usually consists of repetitions of phrases and whole words

Avoidance

Child does not avoid words or situations
   

Borderline Stammering

Awareness

Child has some awareness/some concern, usually when stammering

Stammer

Stammers may be tense, hurried. May be prolongations or blocks as well as repetitions of phrases and sounds.

Avoidance

Child may occasionally avoid words or situations.
   

Confirmed stammering

Awareness

Child is aware and may think about stammering much of the time.

Stammer

Stammers may be very tense, hard attack on words and last several seconds - or may be hidden so that there is less actual stammering and the symptoms may 'go underground' affecting behaviour.

Avoidance

Child may avoid a great deal - change words, avoid situations e.g. the phone, groups, may not make friends, may choose non-speaking subjects at school