Stuttering

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It began at the end of November suddenly and caught me off guard. It was like he was stuck in a sentence and could not get the rest of it out. I had heard him say it before? Right?

Johnny went through a period of stuttering or as the professionals call it is having dysfluencies in his speech. This is a compilation post of what we have been experiencing since November, how Johnny is doing and how he has slowly fought through it.

November:

The Speech Pathologists say that dysfluencies or stuttering typically happens when a child makes an advancement in their speech and lanugage and their brain is having trouble connecting everything together. Along with Autism, Johnny has motor speech delay or “Childhood Apraxia of Speech” which makes producing words with his mouth, tongue and jaw a challenge and a physical and mental workout. Johnny is attempting to say a lot longer sentences right now going from 3 – 4 words to 6 – 7 words and is pushing his body to catch up to his cognitive ability. Imagine if you will his mind is processing thoughts and idea like a 5-6 year old and in some activities higher but his mouth or speech is working at the level of a 2 year old. We have been told to stop practicing our “sound targets” for motor speech and to reduce the expectations of speech on him. This is easier said then done because Johnny wants to talk very badly and seems to not want to let this stop him.  Johnny has finished his first speech block of 10 weeks of speech production therapy for his motor speech delay using the PROMPT method.  I am in email contact with the SLP and video recording clips of Johnny in order to get advice to help him through this.

December:

We know that the stuttering is sign of forward development but right now it doesn’t feel that way. The simplest sentences like “I want….” are a struggle to get out and sounding like “I I I I want I I I want want want….” and then instead of spitting out what he wants he goes back to the beginning because of course we and all the professionals have taught him the proper way to request. The hardest part is to sit in front of him and NOT FINISH HIS SENTENCE FOR HIM. We just want him to say it and its so hard to watch him struggle but we have been told to try and be relaxed, calm and patient so he finds a way to deal with the anxiety he must be feeling as he fights through this latest hurdle. The catch is that the anxiety or increased expectations he is placing on himself because he “knows” he can now speak about certain things and is having trouble will only increase the stuttering so you end up in a loop. I cannot imagine how frustrating it can be for him sometimes but yet he is so determined.  Its not always easy to understand everything he is saying right now but the point is he is trying really hard right now. The Autism SLP from his school wants us to try and encourage him to communicate more with his Communication/PECs Book that he uses more at school but he doesn’t seem happy about that.  The motor speech SLP wants us to reduce the expectations on Johnny right now and be calm and give him time to speak.

The Christmas holidays are fun and exciting for Johnny but at the same time I wonder if the axiety and missing his Grandpa are also adding to the dysfluency challenge.  At least we will have 2 weeks off from school for him to settle down into a home routine and just have fun.

January:

The dysfluencey is still not improving and we are worried that he is going to reduce what he says at school because he will fear what other children will say when he stutters. We have warned his kindergarten teacher about the dysfluency but it seems Johnny is not stuttering at school but at the same time is using very simple sentence to request. He has figured out on his own that this is the way to communicate right now and reduce expectations on himself. His afternoon communication group where he talks more has decided to slow down how they talk to him to keep everything relaxed so to reduce the dysfluency as well.

Second Week of January:

The new hurdle is reading. Since October, his kindergarten class has been learning a simple book every week and Johnny has really latched on to reading. Reading out loud is now not easy and as his anxiety increases so does the stuttering. For the first time he resists sitting with Daddy or Mommy to “finger hop” and read a book together. This has never happened in his 5-1/2 years.

At Johnny’s regular private OT Appointment Johnny was trying to say long sentences to the OT of 6-8 words and was struggling to get the words out but when he sat on this rope/wooden ladder on the floor that she placed down for an obstacle course something happened. He sat and did the motions of “ROW ROW ROW YOUR BOAT” and sang it wit the OT perfectly. We were both flabbergasted because we just heard him stutter like crazy.

Third Week of January:

“The Engine Goes Fast” was a book he didn’t want to read at all so we needed to figure out a new strategy. Johnny has been doing so well with reading we didn’t want the speech challenge to have us move backwards and yet he needs to try and practice new sounds. So we decided to REALLY load on lots of praise and tell him how much we love hearing his voice as he reads to us and we miss hearing him do this. It worked.

I asked the school’s Autism SLP if singing might help with the stuttering because Johnny doesn’t have any dysfluencies when he sings and she said “Singing, strangely enough, tends to eliminate the dysfluency in speech production. Sometimes steady beats (through clapping, tapping feet, metronome) helps with pacing as well.” Let the singing begin.

Update the last week of January:

We are noticing a change now. Johnny is not fighting to get the words out like he did last week. I wrote in Johnny’s communication booklet to the EA asking if he is stuttering at school and they have not noticed anything at all and they are happily reporting that he now increasing what he says to everyone at school. We have noticed the same thing at home. Johnny is trying to talk so much to us that he is now trying to argue with his sister using words and talk on top of our conversations trying to get heard just like any other child his age.

Three months ago I was worried that as we finally moved forward that we were taking the pervaberial two steps back. His Daddy kept telling me it will pass but it won’t be easy. Motor speech delay is hard but when I watch Johnny literally push the words out of his mouth and see the force of his determination then I know he will push through it.

First Week of February:

The dysfluencies are nearly all gone.  We are introducing new phrases for him to say in conversation and he it is time to start working on his sound production targets.   Yesterday when he got off the school bus he was literally bursting with happiness, singing really loud and had the biggest smile on his face.  I also got a call from his motor speech SLP who does the PROMPT method and she is able to see him for another speech block beginning the last week of March.

*picture credit and for more info: http://fall09stuttering.providence.wikispaces.net/Effects+of+Stuttering

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