Stuttering

WHEN TO SEE YOUR DOCTOR

* You begin stuttering for the first time as an adult.

* Periods of stuttering begin to occur more often, or talking seems to require more effort or sound strained.

* As a parent, you are worried about your child's speech.

What Your Symptom Is Telling You

If you have a child who starts to stutter, the first thing to remember is that he's in illustrious company. Winston Churchill, Marilyn Monroe, Carly Simon and James Earl Jonesto mention just a few famous stuttererseach struggled with the problem.

Stuttering usually does begin in childhood, and it occurs more often in boys than girls. In fact, boys are four times as likely to stutterand the stuttering usually begins just when kids are developing language abilities. It's normal for kids to repeat words, such as, "I wantwantwant that cookie." But a child who stutters repeats sounds instead of wordsas in "I wwwwant that cookie." Doctors say that a child who repeats word sounds more than two times is beginning to stutter.

While researchers are still uncertain about the exact causes of stuttering, they suspect there is a genetic predisposition it tends to run in families. The child who develops persistent stuttering may be experiencing major stress in the home, or he might start stuttering when he's tremendously excited. Either cause can trigger the beginning of stuttering in a child who has inherited the tendency. But stuttering is never the child's fault, according to doctors, so it's essential that the child should not be blamed by parents or teachers.

In adults, the onset of temporary stuttering is very rare, and usually, it's a signal that you need a doctor's attention. The stuttering may come after a ministroke, called a transient ischemic attack (TIA). In rare cases, a head injury or encephalitisinflammation of the brainmay cause someone to stutter who has never had a problem before. If you suddenly begin stuttering, consider it a warning signal and see a doctor immediately.

Symptom Relief

The child who begins to stutter will need a speech therapist rather than a doctor. But professional therapy is only a starting point. The more that parents, teachers and friends can help, the easier things will be for childnot just in childhood, but as an adult as well. Stut tering sometimes goes away on its own, but there are many ways children can be helped to deal with it and feel more in control of their speech.

Here are some pointers on the right way to help a child who stutters.

Get professional help. The ideal time to get help from a speech therapist is when a young preschooler is beginning to stutter, but not yet fighting with it or reacting to it, says C. Woodruff Stark weather, Ph.D., professor of speech, language and hearing at Temple University in Philadelphia. "If you treat children before they enter school, it is usually completely effective," he says. The therapist is likely to tell you to bring in the child for periodic evaluations and counsel you on how to deal with the problem at home.

Listen for the meaning. "Make sure you listen closely when your child talks," advises Charles Diggs, Ph.D., director of consumer affairs for the American Speech Language Hearing Association in Rockville, Maryland. "And sit down and speak directly to your child. Show your child through touch that you are listening and that you care. What's important is to listen for what your child is trying to tell you, not the way it is said."

Don't be a fast talker. If your normal pace of speech is rapid, try to consciously slow down, suggests Dr. Diggs. You provide a good model for your child to follow when he speaks and at the slower pace, you also give him more attention. That creates a better atmosphere for communicating with your child, according to Dr. Diggs.

Create a calm communication zone. "Be sure to give your child a period of undivided attention each day, without competition from other children," advises John Haskell, Ed.D., adjunct assistant professor of speech pathology at Columbia University Teachers College and a speech language pathologist in private practice in New York City. When there are conflicts among siblings, you may have to step in to control them and calm the other kids down. Be sure the child who stutters always gets a turn to speak.

Have a bedside chat. "Have a lot of quiet talks with your child," says Dr. Haskell. A conversation that only lasts 5 or 10 minutes is finebut try to have these chats as frequently as possible during the week. "A daily private time with quiet, relaxed talk about the child's interests will help a lot," says Dr. Haskell. Talk about things that interest your child, but keep the conversation relaxed and undemanding. Or read a story aloud and talk about what's happening in the story. "But avoid asking direct questions, like 'What did you do today?' "

Banish the taboo. A child may feel as if his stutter is an unmentionable topic, just because no one does mention it. Parents can end this taboo by using the direct approach. "Talk about stuttering with your child," Dr. Starkweather says. "Give emotional support in words the child can understand, like 'That was sticky for you to say, wasn't it?' " If you encourage your child to talk about speech, he'll realize that he's allowed to discuss it as much as he wants to.