Diagnosing Stuttering In Children With Asd
Only a professional, who specializes in paediatric development can diagnose ASD. Since it is a complex disorder that has widely varying signs and symptoms, diagnosis can occur between the ages of 2 and 8 years. There can be a sudden onset of stuttering in children with autism due to emotional stress, changing environment and/or social challenges.
Children with ASD have multiple issues with communication and social interactions. Hence it is challenging to notice speech disfluencies like stuttering until they reach school-age. The interaction between ASD and speech fluency disorders is a nascent area of research.
Speech-language pathologists, who are also familiar with ASD in children are the ideal candidates for the diagnosis and therapy of speech disfluency in children with ASD. Their experience and knowledge-based evaluation should help in distinguishing between the other childhood fluency disorders that may affect those with ASD from stuttering.
The evaluation of the SLP can help in determining whether the speech problem lies in the production of speech or the organization of language and the likes. Understanding the root of the problem will determine the course of therapy. After several sessions of conversation or storytelling with the child, the SLP may decide to go forward with word-finding, storytelling or narrative language activities to find the language deficits.
Stuttering & Autism Spectrum Disorder: Diagnosis & Treatment In Children
August 12, 2020
Autism, it is a term we have been hearing often in our social circles, and even on the screen. TV series like Atypical have done justice to portray the life of someone who a little different from the masses and how life transpires for those around them.
Despite several controversial publications, opinions and judgements, we can proudly say that people who fall in the autism spectrum may not be neurotypical, but they are gifted and incredibly special in their own ways.
How Many Children With Autism Stammer
Autism and stuttering may have a long-standing relationship. Sadly, there is no objective data that quantifies the incidence of stuttering among the population with ASD. Modern research is providing the scientific community with evidence of an intricate relationship between autism and stuttering, cluttering and/or word-final disfluencies.
According to studies published by Kathleen Scaler Scott , stuttering like disfluencies are common in those with Aspergers Syndrome. Shriberg et. al. states that 67 out of 100 males with Aspergers syndrome exhibit disfluent speech as compared to 40 out of 100 with high functioning autism. However, right now, no study can conclusively state how many children with ASD also stutter.
Is Cluttering Speech Common In Autism
Right now, there isnt conclusive research about how many people clutter. Its a rare disorder overall, but it has been identified in patients with autism. Cluttering and stuttering occur in plenty of neurotypical people, though autism, attention hyper-deficit disorder , learning disabilities, and auditory processing disorders are common co-morbid conditions among people who clutter.
Getting A Cluttering Diagnosis
As mentioned above, cluttering often goes undiagnosed in children. Since it typically appears during toddlerhood, parents can mistake it for the normal errors kids make as they learn to speak. Despite communication issues, people who clutter can usually make themselves understood, so the parents see no need to access speech services. As they grow, others may view their speech patterns as a simple quirk rather than a fixable problem.
Dr. David Ward, a specialist fluency clinician and author of Stuttering and Cluttering, writes that often, adult cluttering referrals come via work colleagues and line managers who are concerned that the individuals chances of promotion are being compromised due to that persons lack of clarity in speech. Quite often, the clutterer is surprised that others have difficulty understanding them
Keep an eye out for any speech-language problems so your child can get help before adulthood. Listen to his/her speech rate to determine if its too fast or irregular. Observe for any disfluencies like skipped syllables, incomplete sentences, and more.
Children on the autism spectrum are usually monitored for communication problems, anyway, so you might already have a speech-language pathologist on your team. If you dont, reaching out to one will be your first step in getting a cluttering diagnosis.
Stuttering And Autism Spectrum Disorders
MEMPHIS, Tenn. A new brochure published by the Stuttering Foundation seeks to answer questions and give helpful tips for parents and professionals dealing with stuttering and autism spectrum disorders including both Aspergers syndrome and autism.
Treatment for stuttering is based upon each childs needs, and this is particularly true when autism is present. A child with autism who stutters may find social interaction and self-monitoring more difficult. Therefore, stuttering treatment will focus on using speech in social settings.
Speech-language pathologist, Kathleen Scaler Scott of the University of Louisiana at Lafayette, offers some timely tips on what parents can do to help:
1. Have a consistent organized schedule.
2. Keep instructions simple, clear, and concise.
3. Provide visual cues, concrete examples and drawings to increase the childs understanding.
4. Use good speaking habits yourself such as keeping eye contact and listening to what your child is saying, not to how he is talking.
5. Allow him time to finish his thoughts.
These tips are valid for working with all children, adds Jane Fraser, president of the Stuttering Foundation. They are not just for children who struggle with their speech.
For more information on stuttering and a free copy of Autism Spectrum Disorders and Stuttering, visit the Stuttering Foundation at www.stutteringhelp.org or call toll-free 800-992-9392.
Ef In Typical Development
EF follows a predictable developmental timeline , emerging in infancy as the ability to direct attention and progressing into the complex abilities required for goal-oriented behaviors in adulthood . EF supports language development , and WM supports novel vocabulary acquisition by allowing children to attend to, analyze and hold linguistic representations and rules over time . In preschool- and school-age children, stronger WM, attention and inhibitory control are correlated with better expressive and receptive language skills . This association may extend beyond childhood, as both children and adults with stronger EF are more successful in learning a new language . The relationship between EF and language are likely bidirectional. Language may facilitate EF performance by helping children to construct representations by labeling conditions, allowing them to reflect on and use rule structures that underlie EF tasks . In typically developing children, steeper vocabulary growth at age 3 years predicts EF abilities at age 5 years . Higher inhibitory control is associated with greater task perseverance among children, and higher EF is positively associated with vocabulary . Further evidence for the relationship between language and EF comes from childrens self-talk during EF tasks. Four- and 10-year olds who use self-talk during the Tower of London task showed faster performance and required a smaller number of moves to completion .
Pressured Speech And Psychotic Episodes
Psychosis is when someone loses touch with reality to the point that they experience hallucinations and/or delusions . Among other symptoms, someone having a psychotic episode may exhibit pressured speech.
Psychosis can be caused by a condition such as the aforementioned schizophrenia and bipolar disorder, head injuries, dementia, or sometimes just extreme emotional distress.
Autism Or Autism Spectrum Disorder Refers To A Broad Range Of Conditions Characterized By Challenges With Social Skills Repetitive Behaviors Speech And Nonverbal Communication
Recovered stuttering may be less genetically controlled, with evident but less prominent family history, governed perhaps equally by genetic and environmental factors. Stuttering, also known as stammering and dysphemia, is a speech disorder in which the flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words. According to the centers for disease control, autism affects an estimated 1 in 54 children in the united states. For example, autistic women may be quieter, may hide their feelings and may appear to cope better with social situations. Aggressively trying to stop the stuttering or aggressively trying to stop the stuttering or stammering will only make things much worse. General resources related to neurogenic stuttering disorders. Profound autism moderate mild asperger syndrome. Get information on stuttering, a speech disorder that occurs most often in children but also affects less than 1% of adults. By observing others 24 years experience adhd and autism. Learn more about autism here. For this reason, people often refer to autism as autism spectrum disorder . Autistic individuals vary widely in their strengths and need for support. Poor social skills, sensory integration difficulties and speech and language problems encompass the typical behavioural signs.
Children With Apraxia And Periods Of Dysfluency
As children with apraxia are in therapy for a period of time, they may experience phases of system overload, when the demands for speech motor complexity appear greater that the capacity to handle them. It can be quite frustrating to the parent and therapist alike to all of the sudden be faced with yet another aspect of communication breakdown just when the child appeared to be making such good progress! The book Stuttering and Related Disorders of Fluency , edited by Richard F. Curlee, Ph.D., contains two particular chapters that may be helpful. Chapter 7 is titled Treating Children Who Exhibit Co-Occurring Stuttering and Disordered Phonology and Chapter 9 is titled Perspectives on Stuttering as a Motor Speech Disorder.
My first recommendation, when disfluency erupts in children with apraxia who have not demonstrated prior disfluent speech, is: Dont panic. As difficult as it is to hear a child struggle intensely with fluency control, I have seen many children with very severe rapid onset of disfluency move out of it either as quickly as it began, or over time without any direct focus. A response of tension and anxiety from the listener can further contribute to increased speaking tension for the child. That doesnt mean that there are not some adjustments that can be made in therapy as well as in the home, especially when the disfluency persists over time.
Stuttering: How Much And How Often Children Do It
How much and how often children stutter varies a lot. Some children stutter only occasionally throughout the day. Other children stutter on almost every word they say.
Stuttering can also change a lot from day to day, week to week, or month to month. Sometimes a child stops stuttering completely for days, weeks or months, and then starts stuttering again.
Parents say that particular situations can make their childrens stuttering better or worse. For example, if a child is excited, tired or angry, she might stutter more.
Pressured Speech And Autism: Is There A Connection
July 15, 2021
Another speech phenomenon sometimes found in people with autism is pressured speech. What causes this type of speaking, and what kind of treatment is available? Lets take a look.
Pressured Speech And Manic Episodes
Many people with bipolar disorder cycle between two different types of mood episodes that can prove disruptive to their daily life. One type is a depressive episode, in which someone will experience extreme symptoms of depression. The other type is a manic episode, in which someone will experience hyperactivity and be prone to risky behaviors.
Pressured speech frequently occurs during manic episodes as the person tries to express their uncontrollably racing thoughts.
Emotions And The Environment
As children become aware of their disfluencies, negative feelings related to speaking may increase tension and further affect their ability to communicate. Depending on their temperament, some children may experience more emotional arousal and anxiety when speaking than others.
Emotional factors are difficult to measure, and cannot be considered the primary cause of stuttering. However, negative emotions may place an additional cognitive burden on children who stutter during a critical period of language development.
Interventions For Autistic Children With Pressured Speech
How you treat your childs rapid talking will depend on what causes it.
If your child has cluttering and/or stuttering, a speech-language therapist can help him/her practice articulating clearly, slowing down, and using natural pauses. Breathing exercises, reading, and talking in an exaggerated voice are just a few strategies therapists can use with children who struggle to be understood.
You may suspect that his/her behavior is related to one of the mental health conditions discussed above. In that case, its always best to seek medical advice from an experienced professional.
People with bipolar disorder are typically treated with some form of medication. Lithium is one of the most common, but because of its intense side effects, mood stabilizers like valproic acid are often considered safer for people on the spectrum. Drugs are used in conjunction with an approach like cognitive behavioral therapy. This teaches patients how to manage their emotions and thoughts for improved mental health.
Bipolar can also be treated with antipsychotic medicationwhich obviously treats psychosis as well. These drugs reduce the occurrence of delusions and hallucinations. Some people may only need to take antipsychotics temporarily, while others may need to manage lifelong symptoms.
If your child deals with manic or psychotic episodes, know that it can take time to find the right treatment and dosage.
Ef In Other Developmental Disorders And Children With Comorbid Conditions
Deficits in EF are frequently reported in speech-language, and neurodevelopmental disorders such as attention deficit hyperactivity disorder and autistic spectrum disorder . In preschool- and school-age children, specific language impairment is associated with weaker EF . Children with ADHD show lower performance on tasks requiring WM, attention and inhibitory control compared to typically developing children . The degree of EF deficits may vary across disorders. For example, parent-ratings of children with reading disability suggests higher EF than for children with ADHD or ASD .
Comorbidity is commonly reported in neurodevelopmental disorders, with potential implications for EF development. Children with comorbid conditions show more profound EF deficits compared to children without comorbidity . For example, children with multiple diagnoses of ADHD and anxiety or conduct disorders show slower completion time, higher error rates and more perseveration on EF tasks which necessitate WM, attention and inhibitory control, relative to children with ADHD without comorbidity . These findings are consistent with parent reports of lower EF in children with comorbidity compared to children without comorbidity . It is noteworthy that chronic health conditions are also associated with impaired EF. For example, children with medical conditions such as diabetes and sickle cell anemia show significant impairments in attention and EF tasks compared to children without those conditions .
For This Reason People Often Refer To Autism As Autism Spectrum Disorder
Recovered stuttering may be less genetically controlled, with evident but less prominent family history, governed perhaps equally by genetic and environmental factors. Autism, also called autism spectrum disorder , is a complicated condition that includes problems with communication and behavior. However, distinguishing the two is important for diagnosis and treatment. General resources related to neurogenic stuttering disorders. However, stutterers can, with training, learn to substitute more acceptable stuttering has five other widely practiced treatments. Autistic individuals cannot properly relate to other humans and live in emotional. Aggressively trying to stop the stuttering or aggressively trying to stop the stuttering or stammering will only make things much worse. When stutterers try to control their stuttering, it becomes worse. Poor social skills, sensory integration difficulties and speech and language problems encompass the typical behavioural signs. Autism is a neurodevelopmental condition that can affect a person’s feelings, behavior, and social interaction. Autistic individuals vary widely in their strengths and need for support. Are stuttering and autism related? It can involve a wide range of symptoms and skills.
Stuttering And Autism How Are They Linked
My son stutters. The way he speaks can vary massively and does so from hour to hour, from sentence to sentence. Sometimes he will speak fluently and extensively, for several minutes in a row. Stuttering and Autism are inextricably linked for him.
Sometimes it will take him several minutes to get a single word out. Some days the ones when he feels so much stress that he cannot function he retreats into silence because the words simply will not come.
They get stuck on the sticky tape in my brain and they just wont come out of my mouth mummy.
Wikipedia says this of stuttering:
Stuttering, also known as stammering, is a speech disorder in which the flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words or phrases as well as involuntary silent pauses or blocks in which the person who stutters is unable to produce sounds.
As with many other hidden or less obvious disabilities, stuttering is often misunderstood by the public. The beginning of this clip from Gogglebox, in which the viewers are watching Educating Yorkshire, perfectly illustrates how many people react to a stutter before they fully understand:
My son is 6 years old. At the moment, his age means that many people are more tolerant of his speech difficulties. Most children his age have trouble with fluency at some stage or another. However, even now, there are those that lose patience with him.
Brain Activity In People Who Stutter
While no one factor determines stuttering, the predominate theory suggests that a combination of genetics, language development, and the environment can influence the brain activity of people who stutter.
The areas of the brain responsible for language may look and work differently in people who stutter. Findings from brain imaging studies indicate that there is more right hemisphere activity in adults who stutter, with less activity in the left hemisphere areas typically responsible for speech production. Some people who stutter have more difficulty processing auditory information and slower reaction times on sensory-motor tasks. In general, research has shown that the pathways in the brain responsible for language look and function differently when stuttering occurs.
Theoretical Implications For Ef In Stuttering
WM models offer a unified framework for integrating EF components affected in stuttering. The unity/diversity theoretical model of EF proposes that underlying components are correlated but dissociable . EF holistically results from the interaction of these distinct domains with each responsible for complimentary control . Baddeley and Hitchs three-factor model and more recently, Baddeleys four-factor model conceptualize WM as a storage system for verbal/auditory information , and visuo-spatial information . The phonological loop and visuospatial sketchpad are overseen by an attention controller , and episodic buffer for integration of material in the phonological and visuospatial subsystems . There is robust evidence which suggest that the WM system is crucial for EF behavior, and deficits within this system in whole or within each domain, are correlated with behavioral issues . Thus, the development of EF may related to specific behaviors in CWS. In other words, CWS with behavioral challenges, including those related to self- and socioemotional regulation, and attention may have weaker EF. Nonetheless, how EF maps onto chronicity is unclear. It is plausible that CWS with EF deficits, reflected by behavioral challenges, that do not resolve with age may have a higher risk for chronicity.
What You Can Do If Your Child Stutters
If you notice that your child has a stutter, its important to seek professional help.
Start by contacting a speech pathologist. The speech pathologist will assess your childs stuttering and work out whether to treat your childs stutter straight away, or whether to wait and check your child regularly.
Some children will grow out of stuttering on their own, but theres currently no way to know which children will do this. Its always best to consult a speech pathologist rather than to assume your childs stuttering will go away by itself.
What I Wish People Knew
Ultimately, I wish that those who lose patience with my son would give him the benefit of the doubt. His stutter may disappear as he grows or it may not. Either way, I do not want people to treat him differently because of it. His peers already sometimes lose interest and walk away when he is talking to them.
This is, of course, through no fault of their own. Small children have short attention spans and they do not know why he is taking so long to say something. But it is painful to watch when I know how much it takes for him to attempt social interaction with other children.
I hope that, as he grows, his peers learn to accept his idiosyncratic way of speaking, of which his stutter is only one facet. This can only happen if parents are also aware and teach their children to act with patience and kindness when talking to someone who struggles with some aspect of language or speech.
Stuttering and autism make my son unique. He son has so much to say he is witty, amusing and full of incredible ideas and infectious enthusiasm. You will not regret giving him the time he needs to voice his thoughts, I promise.
If you have enjoyed this post and found it useful, here are some ways you can support Someones Mum:
Stuttering In Students With Asperger’s
Mr. Matthews has two students with diagnoses of Asperger’s in his inclusive fifth grade class. Asperger’s is an autistic spectrum disorder that often impacts students’ communication skills, social skills, and sometimes other developmental abilities. Mr. Matthews has noticed that his two students with Asperger’s are actually very different from one another, and one of them, Connor, struggles significantly with a stutter, or disrupted, dysfluent speech that can make him very difficult to understand.
After talking with some specialists, Mr. Matthews learns that stuttering is a common problem for students with Asperger’s. He decides to explore why stuttering is common for these students and what he can do to help Connor speak more fluently and smoothly.
Part Ii: Speech Disfluency In Autism Spectrum Disorders: Clinical Problem Solving For Pervasive Developmental Disorder Not Otherwise Specified And Asperger Syndrome
Below continues our examination of disfluencies in Autism Spectrum Disorders, as introduced in Part I of this paper. In Part II, we examine two additional diagnoses within the autism spectrum.
Case Three: Pervasive Developmental Disorder, Not Otherwise Specified
Background:C3 was a 5-year-old male who was referred to a private speech and language clinic by his mother with concerns regarding social interaction. C3 was recently diagnosed with Pervasive Developmental Disorder, Not Otherwise Specified by a neurodevelopmental pediatrician. Cognitive testing revealed scattered skills, with particular needs in the area of perceptual performance. C3 was noted by his preschool teacher to like to be “in charge,” and to have difficulty accepting other children’s ideas for play themes. He was also noted to have difficulty transitioning between activities.
Language Profile:Language skills were within the average range on standardized testing. C3 was noted to have difficulty accurately reading and responding to nonverbal communication. He was also reported to have stereotyped interests, such as topic focus upon “Thomas the Tank Engine” in conversation. He could provide an organized narrative, but his conversation skills were characterized by monopolizing conversational topics and turns, and abruptly shifting from a topic presented by his partner back to a topic of his choosing.
Case Four: Asperger Syndrome
Pulling it all together
Risk Factors For Stuttering
How do you know whether a stuttering child has a temporary developmental problem, or a more serious speech disorder that warrants intervention? According to the Stuttering Foundation, the following factors put your child at greater risk:
- Family. Your child is at higher risk if they has one or more family members who stutter in adulthood.
- Age. Children who begin stuttering before they reach age 3Â½ are more likely to outgrow it.
- Length of time stuttering persists. If your child’s stuttering habit lasts longer than 6 months, it is less likely that they will outgrow it.
- Gender. Boys are three to four times as likely as girls to stutter.
- Other speech and language deficits. If your child has other problems speaking and being understood, it is less likely that they will outgrow their stutter.
When To Get Help
You should get advice if you have any concerns about your child’s speech or language development.
Treatment for stammering is often successful in pre-school age children, so it’s important to be referred to a specialist as soon as possible.
Talk to a GP or health visitor about your concerns. If necessary, they may refer your child to a speech and language therapist for an assessment.
In many areas, you can phone children’s speech and language services directly and refer your child yourself.
Stamma has more information and support for people who stammer and parents of stammering children. You can call the helpline on 0808 802 0002 from Monday to Friday 10am to midday and 6pm to 8pm to find out about the services available in your area.
If you’re an adult who stammers and it’s having a significant impact on your social and work life, you may want to ask a GP to refer you to an SLT.