Better Care

Facts about stammering:

Stammering (otherwise known as stuttering or dysfluency) is a disruption in the flow of speech. It varies from child to child but is characterised by one or more of the following:

  1. Repetitions of part of a word e.g., “b…b…ball”
  2. Repetitions of a whole word e.g. ‘my, my, my house’
  3. Prolongations (stretching out) of speech sounds e.g. ‘fffffffffffffffffind it’.
  4. Blocking of sounds, where the mouth is in the correct position, but no sound comes out.

Useful Websites 

Further advice and support may be found on the links below:

The British Stammering Association:

Action for Stammering Children:

Stammering may be accompanied by: 

  1. Feelings of isolation, frustration and embarrassment.
  2. Excess tension or tightness in the face or upper body when producing a word.
  3. Excess body movements when speaking e.g. rapid eye blinks, facial tics, head jerks, clenching hands.
  4. Tremors of the lips or jaw
  5. Unusual breathing patterns e.g. taking a big breath before talking or holding their breath whilst talking.
  6. Avoiding or changing words e.g. A child may say that they have forgotten what they were going to say or change a word in a sentence e.g. ‘I went to the s-s-s...I went out’
  7. Avoiding situations e.g. speaking in class.

Stammering is relatively common in young children usually coinciding with the time children’s speech and language skills start to rapidly develop. For many children, their stammer will resolve naturally, 5% of children will stammer at some point and approximately 1% will continue to stammer into adulthood. Stammering is 3 to 4 times more common in boys than in girls and is more likely to persist if it has been happening for more than 12 months.

Stammering occurs all over the world, in all cultures and social groups.

Parents do not cause stammering. The causes of stammering are not yet fully understood. Research points to  two possible factors which  influence the onset of stammering:

  1. Physiological factors: Research has shown that a family history of stammering, gender and possible structural differences in the brain are all factors that may influence the likelihood of a stammer developing and persisting.
  2. Linguistic factors: Children who stammer may have delayed speech and language skills or speech and language skills that are advanced for their age.

There are two possible factors that may maintain stammering:

  1. Environmental factors: Certain lifestyle factors may have an influence on stammering. These do not cause stammering but may influence how it presents.
  2. Psychological factors: A child’s temperament, the parent’s and child’s anxiety around stammering and the child’s awareness of stammering can also be influencing factors.

The impact of these factors and how they interact is different for each person.

Potential effects of stammering on communication development:

Stammering affects children in different ways. Some children may be unaware of their stammer and not negatively impacted by it. If the stammer persists, older children can begin to think negatively about themselves due to their stammer. They may feel embarrassment, frustration, anxiety about talking and lack of confidence. They may also be teased due to their stammer. They may start to avoid words they think they’ll stammer on and avoid talking in certain situations or to certain people. Speech and language therapy can help to support a child or young person with their stammer to minimise the impact it has on their life so that they are able to reach their full potential.

Intervention offered:

There is no “cure” for stammering but if children are seen for therapy in the early years before school, the impact of the stammer may be reduced. Once children are around the age of 7, it is less likely that they will stop stammering but therapy for older children supports them to manage their stammer and to be confident communicators.

Children who stammer are seen for an initial assessment screening session following referral. If it is felt by the assessing therapist that the child’s stammering is having a negative impact and/or the child is at risk of continuing to stammer, s/he will be placed on the therapy waiting list.

The child will be reassessed when taken on for therapy and if s/he still meets service criteria s/he will be seen for a period of further assessment and exploration of the stammer and the possible causal factors. This initial period of exploratory therapy may include problem solving with the child and/or parents and liaison with school.

Following this, further therapy will be offered if required. This will be dependent on the child’s age and needs. There are three broad types of therapy that can be offered and often a mix of therapy approaches can be beneficial:

Indirect therapy                                                                                                                    
This type of therapy is usually offered first. It involves working on adult-led strategies to increase the child’s capacity to speak more fluently and communicate more effectively and confidently, but not working directly on the stammer itself. It is focused on supporting parents/carers to reduce any environmental, psychological or linguistic demands on the child to enable him/her to speak more fluently.  For example, with a younger child this may involve a parent reducing questions asked or simplifying language used with the child. Or, with an older child or teenager, it may involve encouraging good turn-taking among family members at home or talking more openly and positively about stammering within the home setting. 

Direct work on the stammer
This type of therapy can be offered if there are no further environmental changes to be made or the child has already had indirect therapy. It involves working on  managing the stammer itself through learning fluency techniques such as breathing and  management of “blocks” and “repetitions”.  

We also offer Lidcombe therapy for young children.

Working on feelings and acceptance of the stammer
This type of therapy is offered to older children and teenagers up to age 18. It may take place on a 1:1 or in groups for children or teens who stammer. The aim of therapy is to develop a young person’s understanding of stammering and to help the young person reduce negative thoughts and feelings about their stammer and reduce avoidance behaviours. This can be done through use of Cognitive Behavioural Therapy (CBT) techniques and Solution Focused Brief Therapy. For most young people, group therapy is highly beneficial in reducing negative feelings and feelings of isolation.

Simple strategies to support your child to be more fluent:

  1. Avoid asking your child to stop, calm down or slow down and start again.
  2. Children benefit from having time to think and plan what they want to say. Give your child the time needed to finish their words and sentences and avoid finishing words and sentences for them. As an adult you can set the pace for your child by speaking at a slower rate and pausing before you speak, your child will then feel able to take their time which will help them to speak more fluently. We can often talk over each other or interrupt each other when talking in a group situation; this can be difficult for a child who stammers. Encourage turn taking in conversations at home to ensure that everyone has time to speak.
  3. Focus on what your child is saying, rather than how they are saying it e.g. focus on the message/information they are giving you, not on whether it is always clear or a bit “bumpy”.
  4. We all ask questions, but as a response is expected, they can put pressure on a child, especially if asked a lot. If asking a question, avoid questions that are too complicated for your child, give them lots of time to respond and avoid asking another question before they have answered the first. Reduce questions when possible and use more commenting to open up conversation e.g. instead of asking your child what they did at school today, perhaps talk about what you did today.
  5. Talk openly and positively about stammering, with your child, in the home environment. There are lots of famous people that stammer and having positive role models, can have a beneficial impact on a child that stammers.
  6. It is worth remembering, that everyone experiences dysfluency in conversations or pressured speaking situations e.g. talking in a big meeting. So we need to reassure children that everybody finds talking difficult sometimes.