What should you do if your child stutters?

Emilio started stuttering when he was about three years old. And his mother, Brenda Beltran from Zurich, was distraught. «I stuttered badly as a child too,» she says, «and it caused me a great deal of distress.» She wanted to spare her son the shame and exclusion she had experienced. The mother of three still stutters to some extent today – «but I've developed strategies to suppress it.»

Stuttering takes many forms. It manifests itself in the repetition of sounds («K ​– ​K ​– ​K … cat»), prolonged sounds («Wwwwwater») or in blocks – when speech simply comes to a halt in the middle of a word. That is the audible aspect.

Stuttering isn't just limited to speech – it unsettles the child and everyone around them.

Wolfgang Braun, speech therapist

In reality, however, these symptoms are merely the tip of the iceberg – there is much more to it: the loss of control that those affected experience when they cannot control their speech as they would like. The associated uncertainty, the shame. And above all: the fear of conversational situations («I do know what eight plus two is – but should I really put my hand up if the answer might not come straight away?»).

A multi-layered phenomenon

«Stuttering is therefore a multi-layered phenomenon,» says Wolfgang Braun, speech therapist, lecturer and head of the Support Centre at the Zurich University of Special Education (HfH). «Stuttering is not limited to speech output alone – it unsettles the child affected and everyone around them.»

Speech disfluencies first appear in 80 per cent of children between the ages of two and five. However, only some of them go on to develop a fluency disorder, as stuttering is known in technical terms. Because if a child of this age goes through phases of word repetition («and you know and you know and you know, at nursery, there's, there's, there's»), this does not necessarily mean that stuttering is beginning, says the speech therapist: «At this age, children have a lot on their minds, so this can often be attributed to developmental disfluency.»

However, if this phase lasts longer than six months, it is worth showing the whole thing to a specialist. «If only to avoid unnecessary anxiety for both the child and the parents.»

Overall, between one and five per cent of all children stutter, with three to four times as many boys as girls affected. «The male speech system appears to be more fragile and prone to disruption,» says Braun. Among adults, the figure is one per cent – meaning that speech fluency disorders affect between 82,000 and 83,000 people in Switzerland. Across the entire German-speaking world, in turn, over a million people stutter.

The earlier a child starts therapy, the greater the chances of having a positive impact.

Stuttering can be hereditary

The causes of speech disorders vary widely. In 70 per cent of children, stammering can be attributed to neurogenetic factors. If, for example, a parent or grandparent has stammered, there is a greater likelihood that the child will also stammer. However, Braun clarifies: «It is not the stammering itself that is inherited, but the predisposition.»

Alexander Zimmermann, on the other hand, who worked as a speech therapist at Inselspital Bern until his retirement and now continues to practise in private practice, points out that psychodynamics also play a role: Many developmental challenges, such as the need for autonomy during the «terrible twos» , the arrival of a new sibling, or parents who are under pressure or ill – «this may cause the child to hold back in their expression and start stuttering». This makes an individualised approach to therapy, supported by discussions with parents, all the more important.

Find out more and ease feelings of guilt

In general, parents should seek help and advice sooner rather than later. «That doesn't necessarily mean therapy straight away,» Braun emphasises. Instead, the initial focus is simply on gathering information and alleviating feelings of guilt («Am I being too strict with my child? Am I doing something wrong in my parenting?»). However, the following principle also applies: the earlier a child starts therapy, the greater the chances of having a positive impact.

If a child struggles with stammering, this often makes the speech disorder worse.

For younger children of nursery age, the focus is primarily on helping them deal with their symptoms in a more relaxed manner. For example, care is taken to ensure that the child does not struggle against the stuttering, as this usually exacerbates the speech disorder. Instead, a so-called stuttering modification approach is often employed.

The aim is for the child to become an expert in their own speech and to learn effective strategies for managing their stammer; rather than trying to force their way through the disfluencies, they learn to deal with them calmly («Stammering is okay, I don't need to be afraid of it»).

Don't make a fuss

«It's important that parents don't treat their child's stammering as a taboo subject – if only because otherwise a child will imagine all sorts of terrible things,» says Wolfgang Braun. «It's like when you've had a stomach ache for a few days and eventually start to think anything is possible – from a stomach ulcer to bowel cancer.»

That's why parents are best advised not to make a big deal out of stuttering, but simply to say: «I've noticed that you sometimes find it hard to get the words out. Shall we go and see someone who knows about this?»

Starting school presents new challenges for children who stutter: how can they participate actively in lessons? Is support, such as measures to compensate for disadvantages, necessary? «Bullying is also a common problem at this age,» says Alexander Zimmermann. Therapy at this stage therefore focuses on coping strategies, such as: «How can you respond to this and stand up for yourself?»

Mental distress increases during puberty

For young people aged 13 and over, the chances of a cure for stammering are considered to be significantly lower. «At that stage, we are dealing with established stammering,» says Zimmermann. In this age group, stammering often leads to avoidance behaviour that needs to be examined more closely: is the young person deliberately avoiding situations where they have to speak, for example by no longer attending training sessions, in order to avoid having to stammer?

During their school years, and particularly during puberty, young people who stutter often find their distress increasing – because they are now looking to their peer group for guidance and want to be anything but different. «Adolescence is often another suitable time for therapy,» says Zimmermann. «Because if those affected are really suffering, they are also more motivated to engage with the process.»

However, the aim of therapy changes at this age: the focus is no longer on achieving permanent fluency, but on helping young people to deal with their stammering with confidence. In other words, the emphasis shifts to the idea that «stammering isn't wrong, it's just different»; young people should therefore accept their speech disorder as part of their personality.

This also raises questions such as: Should I mention in my application that I stutter? «Of course, you can't generalise about this,» says Wolfgang Braun, «but generally speaking, being open about it takes a huge weight off your shoulders. Trying to hide your stutter takes an incredible amount of energy.»

Stuttering is an invitation to reflect on oneself and one's family circumstances.

Theresa Illmer, a person with a speech and language disorder and a speech and language therapist

The key message of the stuttering camp

The realisation that «others feel exactly the same as I do» can also be helpful. For the past 25 years, Wolfgang Braun has been organising camps on Lake Constance for young people aged between 11 and 18 who stutter. A week spent exploring oneself, one's speech and nature.

«Here I can say my name – and nobody starts laughing,» says Braun, quoting one of the participants. The camp's central message is: «Stuttering is okay.» The aim is to support the participants in their personal development. It takes courage to put your hand up in the classroom. Or to choose a different dish from the person next to you in a restaurant – so that you have to say as little as possible.

Theresa Illmer from Schaffhausen has stuttered since she was four years old, «sometimes more, sometimes less». She still remembers clearly the feeling of loneliness and isolation she experienced during her childhood and teenage years. «Stuttering is so unpredictable and variable,» she says. «And it's just frustrating when it suddenly happens in the middle of a conversation.»

Today, the 27-year-old is herself a speech therapist, co-president and specialist advisor at Versta, the association for people who stutter and their families. Illmer underwent therapy until she was eight, «then I was considered to have completed my treatment and was coping really well – until I moved up to secondary school, when I started stuttering more again, even though I had mastered all the therapeutic speech techniques perfectly.»

In fact, transitions such as starting school, moving up to secondary school or beginning an apprenticeship often make stuttering worse. New situations can trigger feelings of anxiety and embarrassment once again («What if someone notices that I stutter?»).

A helpful discussion with those affected

«Although my stammer is often inaudible to others, I notice immediately when I get stuck,» says Theresa Illmer. «This is accompanied by a very unpleasant feeling of constriction and a loss of control: you know what you want to say, but you just can't say it at that moment.»

The self-help group was particularly helpful to her: getting to know other people facing the same issue, and realising that she isn't alone. «Precisely because there are still so many stereotypes and stigmas surrounding stuttering today (‹She's probably really nervous›), some of which we've internalised ourselves (‹I can't do that because I stutter›), this kind of exchange is incredibly important.» Thanks to her experiences in this supportive environment, Theresa Illmer has learnt that stuttering connects people in a special way and also has its positive and humorous sides.

Building confidence is at least as important as improving language skills.

Brenda Beltran, mother of a child affected by the condition

What advice does she give to parents, both as someone who stutters herself and as a speech therapist? «Stuttering is an invitation to reflect on yourself and your family circumstances,» says Illmer. It is a learning environment in which the main focus is on patience and waiting. Being patient with the fact that the child speaks differently. Waiting until they have finished speaking («And otherwise making it clear why you don't have time right now»).

Focus on what is being said, not how it is said. Do not finish people's sentences («Many people who stutter find this patronising,» says Illmer) and avoid giving advice such as «Speak more slowly» or «Take a breath first» – this only makes children feel insecure.

School and stammering

And what should be borne in mind when it comes to school? «The bad news is: there's no magic formula,» says Wolfgang Braun. «The good news is: it's all a matter of negotiation – and, above all, needs to be discussed on a very individual basis between the person who stutters and the teacher.»

For some pupils, it makes sense to be called on in class in a specific order. For others, however, that is a nightmare scenario. Some benefit from not having to give their presentation live in front of the whole class and being allowed to record it on video at home to play it back at school. Others would prefer not to have such special treatment. One thing is certain: «Unfortunately, teachers learn little to nothing during their training about how to deal with pupils who stutter.»

That is precisely why it is important for parents to stay involved at school and to keep standing up for their child's needs – something Brenda Beltran has also learnt over the past few years. Her son Emilio is now twelve years old. Through him, she has come to terms with her own stammer and is now an active member of the Versta board.

Cut down on media consumption

Her advice to parents of children who stutter is: don't panic, but stay calm. And even if it's difficult – especially if you have personal experience of stuttering – don't project your own worries onto your child. «Because the people around the child have a significant influence, through their reactions, on whether or not the child who stutters feels distressed,» says the mother of three.

What she still admires very much today: «The fact that Emilio has the confidence to speak up – I didn't have that self-assurance as a child. It's probably easier for him because he receives support and recognition.»

Brenda Beltran also emphasises the need to reduce media consumption. «This actually applies to everyone. But I've noticed that the sheer volume of images, text and videos that bombard us at an incredible speed makes it even harder for people who stutter to organise their thoughts and express them.»

Parents should also make a conscious effort to highlight their child's strengths – rather than always focusing on their weaknesses. «Building their self-confidence is at least as important as improving their language skills,» says Beltran.