Bumpy and Smooth. The anatomy of a stutter. ?>

Bumpy and Smooth. The anatomy of a stutter.

This post was brought to you in partnership with Box Hill Speech Pathology Clinic*

Milla was around three and a half when we first started to notice her stutter. We had already been seeing a speech pathologist for just over a year due to Milla’s autism diagnosis, so it was picked up on fairly early.

Disfluency in young children can be quite common. Many move through this phase with little to no intervention, the stutter resolving itself with time. Box Hill Speech Pathology Clinic have some great resources and information regarding stuttering with children on their website www.speech-therapy.com.au, including some things to consider if you are concerned about your childs stutter. How long has the stuttering been present? Has it gone away and then recurred? How many times has it gone away? What characteristics of stuttering are present?

Stuttering/Disfluency

The characteristics of a stutter may include some or all of the following:

  • Sound repetitions
  • Whole world repetitions
  • Prolongation (involuntary lengthening or prolonging of vocalised speech sounds)
  • Blocking (when the mouth is open to say a sound, sometimes for several seconds, with little or no sound coming out.)
  • Revisions

Milla can display all of these, the severity depending upon different factors including anxiety and tiredness.

Lidcombe Program

Unfortunately for Milla her stuttering was not a phase and we began targeted speech therapy. The first thing our speech therapist told us was not to focus on the stutter itself or make Milla too conscious of it. This can actually inadvertently reinforce and ingrain the stutter further. She then started us on the Lidcombe Program. In a nutshell, the program basically teaches parents to praise and reinforce fluent or ‘smooth’ talking and eventually acknowledge and request self correction of disfluency or ‘bumpy’ talking.

Box Hill Speech Pathology Clinic have a downloadable guide to the Lidcombe Program on their website that goes in to much more detail (and more eloquently worded!) than I have.

The aim of the program is to be quite subtle. At the beginning it revolves around structured short activities, where we would praise Milla for her ‘smooth’ talking when we heard it. Of course, the addition of autism complicates matters somewhat… subtlety is not something Milla picks up on! In fact she would look at us like we were crazy every time we would mention the word smooth. “Smooth 91.5?” she tried to guess one day. (Showing my age with that radio station!)

This is when the speech therapist decided to introduce the word ‘bumpy’. Along with praising the smooth talking, we would also try and get Milla to acknowledge and be aware of the ‘bumpy’ talking. At least now Milla actually knew what in the world we were talking about! These conversations revolved around structured activities. Short games that were supposed to be fun as well as providing an opportunity to assess speech.

At first we could see the improvement in Milla’s stutter. She was aware and could tell the difference between smooth and bumpy speech. It soon became apparent though that Milla was able to manage fluency in the frame of structured activities, however was not able to generalise this outside of these specific tasks. When we would try and include smooth talking praise or bumpy talking acknowledgement during incidental conversations she would become quite frustrated and either deny the bumpy talking or clam up and refuse to talk at all. Our speech therapist introduced verbal cues to try and eliminate the need for vocalising acknowledgement of fluency, however once again; subtlety- not Milla’s strong point!

Last year we decided to take a break from speech therapy for a while and relieve some of the pressure for Milla. Starting school created a whole lot of additional anxiety for our sensitive little Miss and as always we had to prioritise which interventions would be most beneficial for her.

Fresh Perspectives

2017, and we can see that Milla is really struggling with maintaining fluency in her day to day interactions. We’ve decided to try and get a fresh perspective with a new speech pathologist recommended by other families with a child on the spectrum.

Although we have only had one session so far, I am feeling positive. This therapist specialises in working with children with an autism diagnosis. Although Milla’s stutter is not necessarily associated with her autism, the way it needs to be treated is directly affected by it. We will be starting a new program with her called Syllable Timed Speech. I’ve yet to learn much about this, however the basis is slowing the speech right down and speaking rhythmically to a set beat. Currently we are in the process of rating the severity of Milla’s stutter each day from 1-10 for the next month to give the therapist a clearer picture of where she is at.

Ever since Milla’s diagnosis we have learnt the importance of keeping an open mind when it comes to therapy. What works for some kids might not work for others. What works for Milla this month may not work for her next month. All we can do is keep trying to find the right ‘fit’ for her and support her the best we can with what we know.

 

*The therapists mentioned in this post are not associated with Box Hill Speech Pathology

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