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Claudia Patricia Groesman is the General Secretary of the Spanish Foundation for Stuttering, which was created five years ago by parents of children who stutter, with the purpose of informing and raising awareness among all those families who are affected by this difficulty in speech and in the communication of children, and try to improve their quality of life. In this interview, we talk about childhood stuttering, the innovative Lidcombe method, and the work the Foundation does.
- What can parents of children with stuttering expect from the Fundación Española de la Tartamudez?
Support, letting them know that they are not alone, and that if we get the child's environment to know about their disfluencies, that the teachers, family members and friends know how to interact and how to behave when faced with a child who gets stuck or repeats, we can make the child happy, later, we will look for the most appropriate treatment.
- What can cause disfluencies? Emotional problems? Child bilingualism? Genetic factors?
Unfortunately, it is not known exactly what the origin of stuttering is, although it is true that experts agree that there are several factors that suggest that its appearance is due to a combination of bio-psycho-social factors: genetic predisposition, and factors , neurological, psychological, social, etc.
It is known that there is a genetic component in stuttering, which influences that a person may have a greater predisposition to stuttering. It is more frequent within the family, although the child who has a relative who stutters, will not always stutter.
- In general, when does the problem of stuttering begin in children?
Usually, the onset of the problem in 80% of cases occurs between 2 and 5 years, but there may be earlier cases. The onset of disfluencies coincides with the period of great development of language and speech in the child, at the time of transition from sentences consisting of one or two words to the use of complex sentences.
The child's effort to speak correctly, together with a family environment that demands more precision and other factors related to age and development, can favor the appearance of repetitions, hesitations and prolongations of sounds.
In most children, these babbling gradually diminish until it completely subsides, but in other cases they continue and even get worse. In fact, in the latter cases, speech becomes more tense, muscle blocks appear when speaking, and they may respond to speech requests with fear, frustration, or bewilderment.
It is important to clarify that we are not talking about "stuttering children". 5% of children have disfluencies between the ages of 2 and 5, and since there is an 80% possibility of remission, we cannot and should not catalog or hang a poster, with the psychological burden that this implies. That is why we speak of children with disfluencies or children who stutter, the first term being the most convenient.
- What is stuttering. How is it classified?
Stuttering are interruptions in the fluidity of people's speech, which are accompanied by muscular tension, fear and stress, which are the visible expression of the interaction of certain biological, psychological and social factors. Repetitions are normal (typical disfluencies) if they are not accompanied by effort or discomfort when speaking (gestures-tension).
It is common to hear in the speech of preschool children these typical disfluencies such as: but but; me me; qua-when; what was it; pu-pu-I can; that of those that of; etc. But sometimes, faced with a demand from the environment, some children try to avoid these repetitions and make an effort to speak, so that the message is continuous. This effort puts strain on the muscles of speech and the body in general. Increased tension increases disfluency.
Malfluences accompanied by tension cease to be typical and become atypical disfluencies, such as: prolongations of sounds: "ppp papa", repeating sounds or syllables more than two or three times: "pa pa pa pajarito", blocking or getting stuck when speaking, observing tension or clear effort when speaking: "closing your eyes" , "grimace", "move your neck or hands" as if to help yourself when you are blocking.
- Do the cases of stuttering increase or decrease?
Society is increasingly aware that stuttering exists and that it is not a mental problem without remission. Over time there are more and more specialists on the subject, and families are much more informed, with which the child receives earlier and therefore more effective preventive treatment. It is not that there are fewer disfluent people, but that there are more and better treatments and more information for families and those affected.
- How is the conventional treatment of stuttering. Can it be completely corrected? Who are the specialists involved in the treatment?
There is no valid treatment for everyone, it is like a tailored suit, and must be a multidisciplinary, psychological-speech therapy treatment. Not everyone gets to correct their stuttering, which is true, is that the sooner the problem is identified, the first step is for parents to obtain the guides with the corresponding guidelines to interact with the child, extending this information to the whole family, teachers and the child's environment (see guidelines for parents and teachers in Fundación) and the second step is to turn to a specialized professional to carry out an examination and diagnosis. These two steps are vital to help avoid chronic disfluencies.
- At home, what can and should not the family do to help the communication of a child with disfluencies?
It is very important to recommend reading the guides, both for parents, teachers and pediatricians. Being informed about how to interact with the child is the best thing we can do, not to raise perfect children, but to help them to become happy adults. Some tips for parents:
- Know how to listen to the child without rushing him.
- Give him time to speak, so he can comfortably express his message.
- Do not interrupt him when he speaks or allow him to interrupt others: respect turns to speak.
- Ask him questions one by one and only those necessary.
- Modify your own language so as not to accelerate and avoid dizzying rhythms
- Talk to him in short sentences and in easy language appropriate for his age.
- Don't say things like "stop, start over", "don't hurry", "speak slowly". These types of corrections increase tension.
- Simultaneously use non-verbal communication: caress him, look at him, touch him, accept non-verbal games.
- At school, what can teachers do so that a stuttering child does not feel uncomfortable or differentiated from others.
For the child to feel comfortable and secure within the school environment, the knowledge of this difficulty and the understanding by the teacher is usually enough. In this way we will be able to help him live, one of the most difficult stages, being able to become a happy adult.
School is an environment in which children spend many hours a day, where many activities are carried out that require the use of language and interaction, being a place where they can live negative experiences that can become traumatic for the child .
School is often the place where most of the attitudes that disfluent children have usually develop in response to teasing from their peers. However, an informed teacher can intervene by facilitating attitudes of understanding and openness to diversity.
Stuttering is a speech difficulty that affects communication. School can be stressful for some children. For those who are afraid to read aloud, to speak in class, to answer questions, to act, and / or to speak at breaks, producing particular anxiety. We usually recommend treating the child in the most normal way possible.
The school serves as training for the adult stage, where it will not receive special treatment. Forcing him to shame or humiliation would be wrong, having a "privileged" treatment could stimulate a discriminatory attitude, affecting his safety and self-esteem. Possibly the best solution would be to talk to him, create a joint strategy; The information given by the stuttering speech therapist is often very helpful.
- Some tips for interacting with a child with disfluencies.
1. Keep in mind that stuttering does not affect people's intellectual capacity. Just because a child is disfluent does not mean that he is not capable of learning.
2. The student should not avoid stuttering. Allowing him to speak as naturally and comfortably as possible and with the least tension, if you try to avoid it, your self-esteem will be influenced by the communication problem and this would trigger vicious attitudes.
3. Do not encourage him to perform any artifice to avoid blockages: stamping his feet, snapping his fingers, breathing deeply, etc. This leads to "nurturing" the blocks.
4. Value content more than form, showing a lot of interest in what it says and not in how it says it. When the child blocks or repeats he becomes very sensitive to what he "reads" on the face of the listener: not making strange faces or showing anxiety.
5. Not constantly evaluating your verbal behavior. Do not show that we are aware of your blockages, and above all, do not interrupt your message, or complete what you say or finish the sentence.
6. Listen to him relaxed without criticism or judgment, giving him all the time necessary to speak.
7. Highlight the valuable aspects of your personality in front of other classmates by creating an environment of understanding within the classroom.
8. Encouraging him to participate in group discussions and tasks, such as favoring theater games and adopting different roles, this will increase his self-esteem, but never forcing him to do so. It is very important that parents, family and the school work together, with the same line, this will make it easier for the child to feel comfortable in both places.
You can read more articles similar to Stammering. How to help and treat a child who stutters, in the Language category - On-site speech therapy.