Stammering may be a normal part of a child’s speech development between the ages of two-and-a-half and six years: the child’s brain races ahead of his ability to get the words out. A young child who stammers should not be teased because he may become worried or self-conscious about it and stammer even more. It is better not to correct a stammering child; instead, parents should be patient and wait until he is ready with his story. They should not complete his sentence even if they already know what he is trying to say. A child older than six years or so who carries on stammering can be helped by speech therapy. Emotional problems may make some children reluctant to open their bowels. Passing hard stools can be painful, adding to the problem. Such children may start to soil their underwear because loose stools above the hard stool that is waiting to be passed leak around it. Soiled underwear may also be caused by
Sudden, involuntary lack of control of the anal sphincter in a normally clean child. Because this can become a habit, parents should sort out why it happened the first time. Occasionally such a habit begins after the experience of not being able to get to the lavatory in time; the child becomes nervous of soiling himself again and is unable to stop next time. Emotional factors are sometimes to blame; the child may have a strained relationship with his family or peer group. This is a more difficult problem to solve, perhaps requiring skilled and sympathetic help for the family. The family doctor, the child’s teacher or a psychotherapist are the people to look to for advice and help.
It is all to easy for parents to underestimate the emotional conflicts of a young child. They may assume that any evident distress cannot possibly have the same scope and depth of feeling as that experienced by an adult. In fact, a child’s anxiety may not only be equally as strong, but also made more acute by his inability to express his emotional turmoil and by adult attempts – however well-meaning – to brush aside what he is going through. Even a child as young as five or six years of age may have the equivalent of a ‘nervous breakdown’, often characterized by a more or less complete withdrawal from the immediate environment, sudden fits of temper, or unusual behaviour. If the problem does indeed seem serious, professional help should be sought – which may involve family counselling.