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What is stuttering?

Stuttering is a disruption to the flow of speech. The World Health Organisation (WHO) defines it as a “disorder in the rhythm of speech, in which the individual knows precisely what he wishes to say, but at the time is unable to say it because of an involuntary, repetitive prolongation or cessation of a sound” ¹ . Research indicates that stuttering occurs in approximately 5% of children under the age of five ^17,5.

A good way to think about stuttering is to imagine there's a train line going from your brain to your mouth. Normally when you speak, the train carries your message and delivers it to your mouth very smoothly with no bumps. Imagine there are rocks on this train track from your brain to your mouth. The train now gets stuck and makes it harder for the message on your train to reach its destination. That's what it is like to stutter. Getting the message from the brain to the mouth is what is difficult. So although you know what station you want to get to, the train just can't get there. In other words, a person who stutters knows what they want to say, they just have difficulty getting the mouth to say it.

Types of stuttering

There are different types of stutters. Children may have just one or a combination of many stuttering behaviours.

The easiest stutters to recognize are:

Repetitions:. These can be at the level of:
• sound
E.g. ‘c-c-can I have some chocolate?'
• syllable
E.g. ‘can I have some choc-choc-
  choc-chocolate?'
• word
E.g. ‘can-can-can-can I have some
    chocolate?'
• phrase
E.g. ‘Can I - can I – can I have some
      chocolate?'
• sentence
E.g. ‘Can I have some chocolate? Can I have some chocolate?

Repetitions can occur at the start, middle and end of the word or sentence, but are most commonly at the beginning of the sentence. They are often what first comes to mind when thinking about typical stuttering behaviours and are quite easy to recognise.

Blocking: Occurs when there is a stoppage of airflow and therefore the child has difficulty getting sound out. The child may attempt to speak but appears to struggle to get the word out. Blocking usually occurs at the start of a word.

Prolongations: The child seems to ‘stretch' the sound out. It can occur on sounds in any position in the word or sentence and can vary in length.
• E.g. ‘aeeeeeeeeroplane'

Interjections (also known as fillers). Interjections are the frequent insertion of words like ‘um' and ‘ah'.

There are more subtle stuttering behaviours which a Speech Pathologist will be able to identify.

Other behaviours may accompany the primary features of stuttering. These include things like:
• tension and struggle in the face (e.g. lips, cheeks, jaw, forehead
and upper chest)
• lack of eye contact
• effortful body movement to help get the words out (e.g. blinking
or closing the eyes, moving the arms, legs, or hands or moving the
head forward or backward)
• avoiding particular words
• avoiding speaking situations ¹⁵

There are times when a child who stutters may not stutter at all. Particular situations when stuttering is not likely to occur are when the child is:
• whispering
• singing
• talking to animals and babies
• talking alone
• acting and putting on voices ⁸

A child may have one or many of the characteristics described above. Each child is different and will have a different combination of stuttering behaviours.