The Nephew’s Speech

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