Stuttering Throughout the Lifespan

 What is stuttering? It can be characterized as a break in the forward flow of connected speech often resulting in repetitions of words, parts of words or whole words. Blockages of airflow can occur in which no sound is being produced or sustained sounds (i.e. mmmmmmm-monkey). It is not abnormal for children of a young age to have disfluencies in their speech as a result of the rapid language development occurring. Research has shown that about 5% of children are likely to be disfluent at some point in their development, typically around age 2.5 to 5 years old. It is not uncommon for children to transition between fluent and disfluent speech, with disfluencies that can often be triggered by a rush to complete a thought, excitement or exhaustion. 

What should I look for?

In most situations stuttering will resolve itself after a short period of time. In other instances stuttering will continue as children develop. During language development, children are rapidly increasing their vocabulary. The sequence and complexity with which they use words can result in a disruption in the coordination of a smooth sentence. 

Typical 

• Repeating phrases and whole words (I want to- I want to play;please-please-go get it)

• Use of filler words (uh or umm)

• No tension of physical struggle when speaking 

• No negative reaction or frustration 

• No family history of stuttering 

• Disfluencies last less than 6 months 

Not Typical

• Repeating sounds or syllables (s-s-s-snake)

• Sound prolongations (mmmmee)

• Blocks: Child appears to be attempting to make a sound but cannot. 

• Secondary physical behaviors that may accompany a stutter including 

• Hand tapping

• Eye blinking 

• Throat clearing 

• Facial grimacing 

• Family history of stuttering 

• Disfluencies last longer than 6 months 

What does treatment look like?

At Building-Blocks Therapy services our trained speech-language pathologists are instrumental at supporting both children, adolescents and adults who stutter by providing strategies to modify speech and reduce tension during stuttering events. Our therapists use strategies to bring awareness to the rate of speech and to normalizing stuttering. Stuttering modification techniques can include stretching initial sounds or sliding into words to decrease tension and consequently disfluencies. Our therapists work hard to treat the whole person including any negative thoughts, feelings and beliefs revolving around their stutter. 

Treatment for adults who stutter often will address the underlying feelings such as guilt and shame that can be associated with stuttering. It is helpful to consider the analogy of an iceberg coined by Dr. Sheehan. The stutter, dysfluent speech and secondary behaviors are most noticeable and prevalent, just like the tip of an iceberg. However, it is the negative thoughts, feelings and beliefs that lie below the surface that make up a majority of the iceberg. As this analogy illustrates, strategies for impacting fluency on the surface are beneficial in the short term however, it is the focus on the feelings below the surface that can bring about long term change. 

https://www.healthychildren.org/English/ages-stages/toddler/Pages/Stuttering-in-Toddlers-Preschoolers.aspx

https://www.stutteringhelp.org/blog/sheehan-stuttering-analogy 

A Guide to Myofunctional Disorders

What are Myofunctional Disorders?

Myofunctional disorders are conditions that affect the muscles and functions of the face impacting how an individual breathes, swallows and speaks. They can be caused by thumb sucking, tethered oral tissue, or just the way the shape of the face developed.

What are myofunctional red flags?

• Open mouth posture

• Slow/picky eating

• Teeth grinding

• Thumb sucking

• Snoring

• Sleep difficulties

• Bags under eye

• Speech difficulties

• Misalignment of teeth

• Jaw pain

• Coughing/choking

• Noisy/messy eating

Other red flags exist, please speak to your provider about other signs/symptoms you or your child may be experiencing.

Who is a candidate for myofunctional therapy?

Myofunctional therapy is suitable for a wide range of individuals starting from around age 4 and extending to adults. A therapist is still able to work with children under the age of 4, though it may look a little different. The therapist uses feeding techniques that are rooted in myofunctional techniques.

What can I expect during therapy?

The goals of myofunctional therapy are to improve oral muscle function and habits across the lifespan. It aims to correct muscle imbalances, compensatory movements, promote proper swallowing and nasal breathing. Therapy consists of teaching the smaller steps to break down the process of oral range of motion until it becomes a rote generalized movement.

What can impact treatment?

The progress of myofunctional therapy can be impacted in a variety of ways. Your clinician is committed to communicating any observed barriers and possible solutions including:

• Upper airway resistance

• Enlarged tonsils/adenoids

• Nasal congestion

• Difficulty following home program

• Current orthodontic treatment

What are oral tethered issues?

Sometimes a myofunctional evaluation reveals tethered oral tissues (TOTs). TOTs are connective tissues in the lips, tongue and/or cheeks restricting the full oral range of motion for feeding and/or speech. After an evaluation, TOTs should be released if they are having a functional impact. 

At Building Blocks we strongly recommend pre and post-op therapy when treating TOTs. This aids in:

• Decreasing the risk of scarring following release.

• Decreasing the risk of re-attachment.

• Overall improvement in functional skills for feeding and speech.

At Building Blocks Therapy Services, our therapists are trained in myofunctional therapy approaches to support your child’s feeding and swallowing. If you have questions about myofunctional therapy please visit www.buildingblocksgr.com or call (616) 570-925.