A mother of a child who stutters told me that a prior speech-language pathologist said that there was nothing she could do to help her son, now that he had turned 7. Evidently, the SLP had heard that there was no cure for stuttering after age 7 and made an assumption that there was no point in continuing therapy.
I was shocked to hear childhood stuttering therapy characterized in this way—though nowhere near as shocked as the parent was. Here’s how I tried to salvage the situation:
First, I apologized to the parent for the way this information had been presented to her. I tried to calm her fears, and I assured her that is was not true that there was “nothing that she could do.”
Then, I explained that, yes, it is true that the likelihood of recovery diminishes significantly the longer a child stutters, and I explained that it is true that there is not “cure” for stuttering in the school-age years and beyond. But, I also explained to her that the situation simply isn’t cut-and-dried…It’s not like, “Happy Birthday, you’re going to stutter for the rest of your life!”
It’s more the case that, the longer a child stutters, the more we need to prepare him to cope with stuttering in an effective way so it does not cause a burden in his life or hinder him from doing what he wants to do or saying what he wants to say.
Of course, the increased chance of recovery for young children is one of the main reasons that many specialists prefer to treat sooner rather than later. There is an argument to be made by those who prefer to wait a bit before initiating treatment (specifically, that many children do indeed recover on their own), but I prefer to be cautious and offer treatment and support as soon as it appears that the child is at risk for continuing to stutter—or, when the parent or child is concerned about stuttering.
As for the specific age, it is true that the likelihood of recovery diminishes quite a bit around 6 or 7 or 8. The reason seems to be associated with the reduction in neural plasticity, similar to the way that it is harder for many people to learn new languages after a certain age. But, it is not a hard-and-fast limit, and it is never the case that there is nothing that we can do!
I use the age of the child (and the age of the problem) as an approximate guide for the types of goals I'm likely to pursue in therapy:
For a child younger than about age 7 (ish, or so), I typically focus on goals related to helping the child develop typically fluent speech, while still working to ensure that the child develops healthy, appropriate communication attitudes - just in case he does continue stuttering.
For a child older than about age 7 (ish, or so), I recognize that the likelihood of continued stuttering is greater, so I place a greater emphasis on communication skills and communication attitudes, while still working to ensure that the child has tools for managing fluency as needed. It's all about the balance between the goals, and goals shift as the child ages and as the likelihood of a recovery from the stuttering behavior diminishes.
The bottom line is that we should never tell parents that there is nothing we can do! Just because there is no cure for stuttering in school-age children and above does not mean that we are helpless, and it does not mean that the child is doomed. [which is what this parent felt she was being told]
There is tremendous hope for helping children who stutter overcome the burden of stuttering, regardless of whether or not they continue to stutter. That is what we want to focus on, not whether or not there is a cure.
For even more information, check out this blog entry, "What if my child doesn't recover?" and the parent dialogues in Early Childhood Stuttering Therapy: A Practical Guide.
