[Fifty years of treating stuttering in young children]

Developmental stuttering involves a disruption in the smooth connection of sounds or syllables that is characterised by multiple interruptions within a word, such as repetitions of sounds, syllables and parts of words, elongation of words and blockades. During the course of the past fifty years, three phases can be distinguished in the management of developmental stuttering, characterised by a shift in stress from the environmental factors to the role of the organic, i.e. non-psychological, factors. Initially, the parents of toddlers and pre-school children were advised to pay no attention to stuttering behaviour. Then the problem would disappear the quickest of its own accord. After 1985, the stress came to be placed on reducing the level of expectations, for example by speaking to the child more slowly and using shorter and less complex sentences. Another new aspect was that the parents learned to discuss stuttering with the child in a sympathetic and accepting manner. Since 2000, an approach has been introduced in the Netherlands in which parents are taught to respond verbally to both fluent and non-fluent speech. Emphasis is given to rewarding fluent speech, such as in the Australian Lidcombe Program, but the parents are also taught to react to stuttered speech once in a while. At present, early treatment is accepted as a way of preventing chronic stuttering, even if this means that some children will be treated that would have recovered in any case and even though the exact yield is not yet clear. Clinical practice shows that early treatment almost always succeeds in limiting the severity of stuttering to a mild form.