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The Nephew’s Speech

May07

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Dear Amy,

I’m stuck in a situation that I do not know how to handle. I am a preschool teacher at a private nursery. I do not have my Bachelor’s Degree yet but I’m in the process of completing it. I have a cousin whose son attends my class. My cousin’s son is 5 years old and he has a serious stutter. Through my education I know that his stutter needs some professional intervention. I do not know how to tell my cousin that this is a serious problem and should be checked out. My family really doesn’t see me as a professional and I’m afraid they might get upset if I say something. She is also a single mother and doesn’t have the money to pay for a speech pathologist. When I have suggested it before she just said, “Well I was like that when I was young, and I’m ok!” Which as a teacher when parents say that to me it means denial. I don’t know how to make her get help for my nephew. Please Help!!

Thank you!

Is there a reason the suggestion must come from you, personally? If your nephew does indeed have a severe stutter, other people at his school have surely noticed it, no? Does the school have any process in place for making “official” suggestions or recommendations to parents in regards to speech delays or other communication problems? Is there a way to get the school director/principal involved in the discussion (and remove yourself)?

I’m sure it depends on the preschool, but most schools offer SOME kind of feedback or report on each child’s academic progress and overall development. If your nephew is difficult to understand in class, the school should absolutely be communicating this to his mother and recommend he be evaluated, in a neutral yet official way that clearly separates your role as Auntie from the situation.

Of course, it’s possible that they have said something to your cousin about it in the past and were met with the same “oh, he’ll outgrow it” answer. And some kids do outgrow stuttering without any intervention at all! This is true, and the question of whether stuttering children need speech therapy — and if so, at what age — is actually quite hotly debated. (If it were MY kid, I’d still let professionals make the determination, but that’s just me.)

Since a large percentage of stuttering children outgrow the problem without any intervention, how do you figure out when to stop waiting it out? Here are the risk factors for a childhood stutter becoming a chronic problem that is less likely to resolve on its own, from the Stuttering Foundation’s website. They suggest that any child for whom two or more of these factors are true be evaluated by a speech therapist:

Family history. Almost half of all children who stutter have a family member who stutters. The risk that the child is actually stuttering instead of just having normal disfluencies increases if that family member is still stuttering. There is less risk if the family member outgrew stuttering as a child.

Age at onset. Children who begin stuttering before age 3 1/2 are more likely to outgrow stuttering; if the child begins stuttering before age 3, there is a much better chance she will outgrow it within 6 months.

Time since onset. Between 75% and 80% of all children who begin stuttering will stop within 12 to 24 months without speech therapy. If the child has been stuttering longer than 6 months, he may be less likely to outgrow it on his own. If he has been stuttering longer than 12 months, there is an even smaller likelihood he will outgrow it on his own.

Gender. Girls are more likely than boys to outgrow stuttering. In fact, three to four boys continue to stutter for every girl who stutters.

Other speech and language factors. A child who speaks clearly with few, if any, speech errors would be more likely to outgrow stuttering than a child whose speech errors make him difficult to understand. If the child makes frequent speech errors such as substituting one sound for another or leaving sounds out of words, or has trouble following directions, there should be more concern. The most recent findings dispel previous reports that children who begin stuttering have, as a group, lower language skills. On the contrary, there are indications that they are well within the norms or above. Advanced language skills appear to be even more of a risk factor for children whose stuttering persists.

(Source)

So your nephew has a parent who stuttered, but who outgrew her own stutter. That’s good, except her odds were better from the start, being a girl instead of a boy. Your letter doesn’t mention how long the problem has been going on or when it started, both of which are really important factors.

If you know he’s been stuttering for a long time, or developed it later (after age three), then yeah. You’re probably right on, and should escalate your concerns to other people at the school. At age five, he should qualify for a free evaluation from the school district, in case it’s the price tag on private speech therapy that’s making your cousin extra hesitant. (Another question: What does your nephew’s pediatrician say??) And even though he attends a private preschool, the public school district can provide him with speech therapy, provided they conclude that he needs it after an evaluation.

There’s also the less-awesome option of sitting around and waiting for him to start kindergarten, and for a teacher there to refer him to the speech therapist for an evaluation, if the stutter continues and makes it difficult for him to communicate clearly in class. But that could be a costly decision for your nephew, just because everybody wanted to avoid a confrontation. I think you are in the better position now, being both a caring relative AND a concerned education professional, to make a more serious push/nudge in the direction of “heeeey, what’s the harm in getting this checked out?”

Talk to the other teachers or higher-ups at the preschool and mention your concerns. Ask them if they’re noticed the stutter (it’s possible there’a situational thing going on?) and said anything to your cousin. Ask what procedure or process the school has in place for making suggestions about developmental or communication delays. (You’ll likely see many other red flags in your career in early childhood education, so it’s good to know what you are expected to do when you suspect other parents are missing or ignoring potential problems.) Get the school to talk to her.

And then do your best to balance out your insight/guidance on what you’ve read about stuttering (“this is a great site/book/organization etc.”), while not letting your role as educator take over your interactions. I’m sorry it sounds like your family doesn’t fully respect your career or credentials, but I doubt ignoring obvious warning signs in hopes of not rocking the boat will help in that regard. (Think years later, if the stutter never improves, and everybody is wondering why you didn’t say anything.) But I’d still try to hand off the message to a non-related messenger, if at all possible. In the meantime, you’re his aunt and her cousin first, and you love them and support them both, no matter what.

Photo source: iStockPhoto/ Thinkstock

About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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5 Responses to “The Nephew’s Speech”

  1. Lisa May 08 at 11:15 am Reply Reply

    My son had a severe lisp at around age 5, so much so that he avoided saying the “S” sound at ALL (We still call snakes “nakes,” because come on. That is CUTE.) His daycare teacher, also someone without a college degree, recommended that we have him looked at, as she had noticed that the other kids were starting to make fun of him. She also said there was a free service provided by a co-op of speech pathologists that came to the daycare to work with other kids and would I like them to take a look at Alex?

    I wasn’t in DENIAL, per se, we had just thought that it would all work itself out with age. So we had him checked out, and yeah. It was bad. But this co-op gave him some exercises, and recommended that his kindergarten teacher (this was the summer before kindergarten) follow up with the school district’s SP. He ended up growing out of it by the middle of K.

  2. Shannon May 08 at 3:50 pm Reply Reply

    I’m a pediatric SLP and I feel for you. It’s hard to be in your position, even when your family knows what you do for a living. Denial can be STRONG. That said, I really, really encourage you to do whatever you can to get the little boy help. Stuttering can be one of the most debilitating speech challenges because if you wait too long, it can be very, very hard to remediate and it can literally impact everything in a person’s life. But, if you do get help early enough, you can make a HUGE difference. I would find out what school district they live in and find out how to contact that district’s Child Find program. As Amy said, he can get a free evaluation through the district. The pediatrician is another excellent route. Most health insurances will cover a speech language evaluation, even if they don’t cover therapy. 

  3. Lindsey May 08 at 4:09 pm Reply Reply

    I stuttered badly as a child and avoided talking in public or in class, preferring to whisper to my sibling or parents and asking them to relay. I was evaluated as a 6 year old, and did speech therapy in the public schools in addition to a couple summers of a week-long speech camp. My stutter almost completely disappeared by age 12, and happens once in a blue moon now, as an adult. I also find it ironic that I now have zero fear of public speaking! Working with children as an adult, I always encourage parents to get these concerns evaluated, as I am a living example of the benefits of early intervention.

  4. Chane May 09 at 12:13 pm Reply Reply

    It can be hard to to find methods that work for children with speech difficulties. Did you get a chance to read this article in the New York Times about parenting: Teaching a Deaf Child Her Mother’s Tongue. The author also has a book published by the Feminist Press. You can check it at here: If a Tree Falls

  5. Erin Mantz, ASHA May 10 at 9:57 am Reply Reply

    Early intervention is key. A speech language pathologist can evaluate kids to determine how well they say sounds and use words and work with them to help them say words and sentences without stuttering.
    To find a speech-language pathologist where you live, go to http://www.asha.org/findpro/.

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