Stuttering in children and adults : Speech therapist in Málaga and online
Stuttering is a speech disorder that can affect children and adults, and for which a speech therapist can make a significant difference.
What is stuttering?
Stuttering, also called dysphemia, is a speech fluency disorder characterized by repetitions of sounds, syllables or words, speech blocks and prolonged pauses between sounds. It is the most common speech disorder in pediatric age, with a multifactorial etiology.
In Spain, more than 467,000 people stutter according to the Spanish Stuttering Foundation, which represents 2% in adults and 5% in children. Worldwide, it is estimated to affect 72 million people.
When does stuttering appear?
The most common form is developmental dysphemia, which accounts for about 80% of cases. It occurs in children who are developing language skills, usually between the ages of three and eight years, and typically appears in patients with previous normal language development.
Approximately 5% of children go through a period of stuttering lasting six months or more. Three out of four children who begin to stutter recover fluency before reaching adolescence, leaving 1% of the population with a chronic problem.
Risk factors that increase the likelihood of stuttering becoming chronic include: being male, having a family history, having delayed language development, or stuttering lasting more than 18 months.
Causes of stuttering
In children with stuttering there is an alteration in the development of the brain areas involved in language, with a largely genetic basis. Up to 70% of patients who stutter have a family history.
From a neurological point of view, a difference has been identified in the brain circuitry that monitors speech, specifically in the arcuate fasciculus, which connects the areas of speech production and speech perception. It is important to note that stuttering is not related to intelligence or emotional factors as a direct cause, although stress and anxiety can aggravate symptoms.
Stuttering in children: when to consult a speech therapist?
Not all childhood dysfluency requires immediate intervention. It is normal for young children to go through periods of dysfluency as they develop language. However, it is recommended that a speech therapist be consulted if:
- Stuttering persists for more than 6 months
- Child shows facial or body tension when speaking
- There are frequent blockages or very marked repetitions.
- The child begins to avoid talking or showing frustration.
- There is a family history of chronic stuttering.
Early intervention makes a difference. The earlier action is taken, the greater the likelihood of resolution.
Treatment of stuttering in children: the Lidcombe Program
One of the most scientifically proven treatments for preschool children is the Lidcombe Program, a behavioral intervention program in which parents play a central role.
A randomized controlled trial demonstrated that the Lidcombe Program is an effective treatment for stuttering in preschool children. The results showed that stuttering ceased to be present, or remained at very low levels, between two and seven years after treatment.
A second trial conducted with German-speaking children confirmed these results: the group treated with the Lidcombe Program showed a significantly greater reduction in stuttered syllables compared to the control group.
Especially relevant for patients seeking remote care: a clinical trial evaluated the efficacy of the Lidcombe Program administered by telehealth, with telephone consultations from home, obtaining a 73% reduction in the frequency of stuttering at 9 months. This confirms that online speech therapy is a valid and effective option.
Stuttering in adults: can it be treated by a speech therapist?
Yes, although the approach is different from that of children. In adults, the goal is not always perfect fluency, but to improve communication, reduce anxiety and work on the relationship with one’s own speech.
Behavioral treatments based on speech restructuring represent the most evidence-based interventions for adults who stutter. Cognitive-behavioral therapy (CBT) helps to reduce social avoidance, improve beliefs about stuttering, and change the way the person manages his or her disfluency.
A CBT program applied to an adult who stuttered showed significant improvements: reduced anxiety, increased self-esteem and decreased frequency of stuttering, with changes measured on validated scales before and after the intervention.
How does a speech therapist work with stuttering?
The speech therapy approach to stuttering is always individualized and takes into account the patient’s age, profile and environment. In general terms, it includes:
- In young children: work with parents, indirect techniques, reduction of communicative pressure, etc.
- In older children: fluency techniques, work on awareness and attitude towards speech.
- In adults: speech restructuring, CBT, work on communication anxiety and self-esteem.
The sessions can be done in person or completely online, with the same proven effectiveness.
Speech therapist for stuttering in Malaga and online
If you or your child has difficulty with speech fluency, do not wait for the problem to become chronic. A speech therapy assessment can determine whether it is a normal developmental dysfluency or a stuttering that requires intervention.
I offer speech therapy sessions in Spanish, French and English, both in person at my office in Mijas (Malaga) and online for patients from all over Spain and abroad.
- Jones, M., Onslow, M., Packman, A., Williams, S., Ormond, T., Schwarz, I., & Gebski, V. (2005). Randomised controlled trial of the Lidcombe programme of early stuttering intervention. BMJ, 331(7518), 659. https://doi.org/10.1136/bmj.331.7518.659
- Lattermann, C., Euler, H. A., & Neumann, K. (2008). A randomized control trial to investigate the impact of the Lidcombe Program on early stuttering in German-speaking preschoolers. Journal of Fluency Disorders, 33(1), 52-65. https://doi.org/10.1016/j.jfludis.2007.11.002
- Lewis, C., Packman, A., Onslow, M., Simpson, J. M., & Jones, M. (2008). A phase II trial of telehealth delivery of the Lidcombe Program of Early Stuttering Intervention. American Journal of Speech-Language Pathology, 17(2), 139-149. https://doi.org/10.1044/1058-0360(2008/014)
- Jones, M., Onslow, M., Packman, A., O’Brian, S., Hearne, A., Williams, S., Ormond, T., & Schwarz, I. (2008). Extended follow-up of a randomized controlled trial of the Lidcombe Program of Early Stuttering Intervention. International Journal of Language & Communication Disorders, 43(6), 649-661. https://doi.org/10.1080/13682820801895599
- Reddy, R., Sharma, M. P., & Kandavel, T. (2017). The efficacy of cognitive behavior therapy in an adult who stutters. Journal of Neurosciences in Rural Practice, 8(1), 131-134. https://pmc.ncbi.nlm.nih.gov/articles/PMC5270279/
- Boyle, M. P., & Gabel, R. (2020). A systematic review of interventions for adults who stutter. ResearchGate. https://www.researchgate.net/publication/341044829
- Theys, C., De Nil, L., & Thijs, V. (2015). Approach and management of stuttering. Pediatrics Primary Care, 17(65), e41-e47. https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139-76322015000100011
- Fundación Americana de la Tartamudez. (s.f.). Prevalencia e incidencia. https://www.tartamudez.org/prevalencia-e-incidencia/
