Stuttering: When Should you Worry?

Stuttering: What is typical stuttering during childhood development and what is not?

Is your child stuttering? Don't worry...yet! It is very common for young children to have disfluencies, or stuttering like speech (i.e. repetitions of words or phrases). Many toddlers and preschool age children are developing more complex language skills, such as expanding their vocabularies and increasing their sentence length. Because communication can be a complex skill, it is common to see some disfluencies, or disruptions in speech, in children as they are learning these language rules. It is also common for children to go back and forth through periods or spurts of disfluency. These disfluencies may be more noticeable during times of excitement, fatigue, or when the child feels rushed to speak.

When should you worry about your child's stutter?

It is common for most toddlers and preschool aged children to have these disfluencies go away on their own after some time (usually within 6 months or less). For a smaller number of these children the disfluencies may persist and may require some help from a professional. So how do you know what to look for as a parent? Below is a chart of typical disfluencies (These show up during development and language growth. These are not likely to develop into continued stuttering) and Nontypical or "stuttering" (These have an increased risk for continued stuttering in children).

Additional Risk Factors for Stuttering. If a child presents with one or more of these additional factors along with the previous "stuttering" chart they are at a high risk of continued stuttering.

• A family history of stuttering.
• Gender: Males are more likely to stutter than females.
• Age of onset: Children begin presenting disfluent speech after the age of 4 are more likely to continue stuttering than those children who present with disfluent speech at a younger age.
• Non speech factors: Negative reactions or emotions when speaking.
• Other speech and language disorders.

What can you do to help your child? 

• Reduce your pace. Speak in an unhurried rate and use frequent pauses between sentences. It isn't helpful to tell a child how they should speak so modeling it yourself is one of the best ways to help them. Speak in a relaxed way so that the child can learn to speak the same way.
• Undivided attention. Keep eye contact and listen to what the child says without interrupting them. Don't tell them to slow down or pressure them to hurry.
• Don't fill in words. Let the child finish what they are saying. Don't add words to what they are saying or finish their sentences.
• Reduce environmental and communicative stress.
• Environmental: Reduce the amount of pressure to speak if there is competition with siblings to talk. You can do this by making sure that everyone gets a turn to speak and that there aren't multiple people speaking at once. If you have a busy schedule then try to give the child some one on one time.
• Communication: Try rephrasing your questions so that they become comments instead. Example: Instead of saying, "What did you eat for dinner?" say, "You had chicken for dinner. I bet that was yummy!" If you do ask a question keep is very simple and don't ask a lot of questions at once.
• Get professional help for your child.
• Your child's pediatrician can provide recommendations for a speech language pathologist.
• You can find a speech language pathologist in your area through: https://www.asha.org/profind/
• If your child is at least 3 years of age they can get a free evaluation at their local public school.
• Some Speech language pathologists specialize in certain areas of their practice. Here is a link to find a stuttering specialist: https://www.stutteringspecialists.org/search/custom.asp?id=1972 

Resources & Additional Information

• asha.org (Stuttering, Fluency Disorders)
• https://www.asha.org/practice-portal/clinical-topics/fluency-disorders/characteristics-of-typical-disfluency-and-stuttering/ 
• https://www.asha.org/practice-portal/clinical-topics/fluency-disorders/#collapse_2
• https://leader.pubs.asha.org/do/10.1044/how-can-you-tell-if-childhood-stuttering-is-the-real-deal/full/
• National Stuttering Association
• The Stuttering Foundation
• https://www.stutteringhelp.org/7-tips-talking-your-child-0=