To the Teacher of the
Nonfluent Child

Peter R. Ramig, Ph.D.

This page contains guidelines, suggestions, and general information for classroom teachers who have a child in their class who repeats, prolongs, or hesitates when he or she speaks. The process of learning to speak is a highly complex task. As a result, children may repeat sounds and words, hesitate, and stumble on words during the developmental stage of speech. For most children, such "errors" are only normal nonfluencies. For some children, however, these behaviors can be the beginning signs of stuttering. Below is a list of danger or warning signs to look for in a young child's speech. Some of these signs can occur randomly in any child's speech; however, frequent and consistent appearance of one or more should be brought to the attention of the school speech-language pathologist.

STUTTERING DANGER OR WARNING SIGNS

1. Multiple part-word repetitions -- Repeating the first letter or syllable of a word, such as t-t-t-table or ta-ta-ta-table.

2. Prolongation -- Stretching out a sound, such as r--------abbit.

3. "Schwa vowel" -- Use of the weak (schwa in German) vowel. For example, instead of saying "bay-bay-bay-baby," the child substitutes "buh-buh-buh-baby."

4. Struggle and tension --The child struggles and forces in his attempt to say a word.

5. Pitch and loudness rise -- As the child repeats or prolongs, the pitch and loudness of his voice increase.

6. Tremors -- Uncontrolled quivering of the lips or tongue may occur as the child repeats or prolongs sounds or syllables.

7. Avoidances -- An unusual number of pauses; substitution of words; interjections of extraneous sounds, words, or phrases; avoidance of talking.

8. Fear -- As the child approaches a word that gives him/her trouble, he/she may display an expression of fear.

9. Difficulty in starting and/or sustaining airflow or voicing for speech -- This is heard most often when the child begins sentences or phrases. Breathing may be irregular and speech may occur in spurts as the child struggles to keep his/her airflow and voice flowing.

CHARACTERISTICS OF THE ONSET OF STUTTERING

1. Some children begin stuttering as soon as they begin combining words, but most do not start until approximately one year later (2 ½ to 3 years old.)

2. Stuttering often begins gradually and its progression can be episodic, containing oscillations in severity across communicative tasks and time.

3. Repetitions of syllables which occur on the initial words or utterances are the most frequent type of nonfluency occurring in children beginning to stutter.

4. Stuttering for most children is very frustrating and embarrassing. As a result, the child may begin to act out in class and avoid speaking situations as much as possible.

GENERAL INFORMATION AND GUIDELINES

Do's and Don'ts

1. Teachers can be helpful in providing the speech-language pathologist with a broader picture of the child's classroom speech behavior.

2. Try to treat the child's stuttering casually and matter-of-factly.

3. When the child is experiencing nonfluencies, 

PLEASE DO NOT:

a. Tell him/her to stop stuttering

b. Tell him/her to think about what he is going to say

c. Answer or fill in for him/her

d. Look concerned or pained

e. Appear angry or impatient

f. Tell him/her to take a deep breath before speaking

g. Ask him/her to stop and start over

h. Suggest changing pitch

i. Suggest avoiding or substituting words

j. Reinforce nonfluency by attending more to it than to fluency

k. Pretend nonfluencies do not exist

l. Express pity

INSTEAD:

a. Try to act the same as you do when he/she is fluent.

b. Remain calm and listen to what he/she is saying.

c. Try to show that you enjoy talking with him/her.

d. If he/she seems especially excited or in a hurry, we suggest responding: "I have time and I want to hear what you have to say." This is different from telling him/her to speak more slowly or to take a deep breath. Instead, you are telling him/her in a supportive way that it is alright to slow down everything, not just speech.

4. If the child has fluent speaking days and nonfluent speaking days, allow more classroom participation on more fluent days and less participation on nonfluent days.

5. If you are unsure if you should require an older elementary-age child who stutters to give oral reports, we suggest talking to the student about it privately. You might tell him that you realize he sometimes has trouble talking, and that you are willing to arrange some options for delivering his report.

6. When the young child is experiencing a period of increased nonfluency, try to provide him with successful speaking experiences by encouraging fluency-enhancing speaking situations such as choral speaking, singing, recitation of nursery rhymes, rhythmic speaking, role-playing using puppets, etc.

7. To increase the child's fluency during reading group activities, begin the reading passage speaking in unison with the child. If the stuttering child speaks or reads in unison with you, he usually will not stutter. This is called the choral speaking (or reading) effect. We suggest following this procedure with other students so the nonfluent child will not be singled out as different.

8. Try to avoid intimidating questioning of the child.

9. Avoid discussing the child's speech differences in his presence. If, however, he broaches the topic, be empathic and try to reassure him that everyone finds it difficult to talk at times.

10. Avoid using the word "stuttering" to describe the child's speech when talking to him. Instead, use descriptive words such as: "gets stuck," "bumpy speech," "hard talking," etc. However, if the child is well aware of his nonfluencies and refers to them as stuttering, it would be unnatural for everyone else to avoid using the word.

11. After a nonfluent utterance, you might repeat back the content of what the child said. This will help you make sure you are attending to the content of what he said and help to reduce his memory of the nonfluency. In addition, you are showing the child you are listening.

12. Be careful not to convey a sense of time pressure while talking. Behaviors can purposely be modeled to reduce this sense of time pressure by speaking more slowly. Speech should be evenly paced and not contain fast rushes followed by long pauses. "Brisk" turn taking and frequent interruptions also convey a sense of time pressure and should be minimized.

13. Talk openly with the child about stuttering if he/she expresses desire to do so, but do not make a big issue out of it.

14. A child develops his/her attitudes about talking by observing others. Take advantage of every opportunity to see that the child experiences some form of success and praise.

15. Try to remove the stigma attached to stuttering which the child may be experiencing. One way to do this is by occasionally modeling unforced stuttering behaviors so he realizes everyone is nonfluent sometimes and that it can be done easily and without tension.

16. Be aware that the child may become very frustrated if he experiences a great deal of severe nonfluency. Try to provide a way for him/her to express this frustration.

TEASING IN SCHOOL

Teachers should intervene if the nonfluent child is teased or harassed by other students. When the nonfluent child is absent, consider using the following discussion strategies with the class:

a. Explain patiently and clearly that teasing is impolite and unkind.

b. Discuss the fact that everyone has his or her weaknesses and strengths. Explain that the child sometimes makes mistakes when he talks and this is no reason to make fun of him.

c. If the teasing continues, it may be necessary to ask the speech-language pathologist to also talk to the children.

We hear many fallacies regarding the cause(s) of stuttering. Experts on stuttering openly acknowledge the causes are unknown. However, research on stuttering supports possible neuromotor influences. Few specialists on stuttering support a totally psychological cause or base for the problem. However, there is little doubt that stuttering can be significantly increased by stress created from feelings of embarrassment, inadequacy, shame, and frustration.