CHOC Children's
GROWTH AND DEVELOPMENT :: Preschool (4 to 5 Years)

Stuttering

What is stuttering?

Stuttering, sometimes referred to as stammering or diffluent speech, is a speech disorder. This is different than normal repetition of words that children may do when learning to speak. Normal developmental stuttering may occur when the child is between the ages of 18 months and 5 years. This may include repeating words or phrases, poor pronunciation of words, leaving out words or sounds, and speaking some words that are hard to recognize.

True stuttering may occur in a child that has some normal developmental speech problems who is then pressured to speak better. This child then becomes aware of his/her speech and struggles to speak better, which actually makes the speech worse.

While every child is different and will learn to speak at different times, the following are some of the speech styles that are part of true stuttering:

  • repeating words, sounds, or syllables
  • talking slowly or with a lot of pauses
  • the rate of speech is not even
  • an increase in the stuttering when the child is tired, excited, or under stress
  • a child that is afraid to talk

Normal developmental stuttering and speech difficulties happen in about 90 percent of children. True stuttering happens in only about 1 percent of children. True stuttering occurs more often in boys than in girls.

Normal developmental speech problems usually improve over about two to three months. Some mispronunciation of words may be present with a child over several years. True stuttering often worsens in adulthood if it is not properly treated.

What causes stuttering?

The exact mechanical causes of stuttering are not completely understood, but it is thought to be a hereditary condition.

What are the different types of stuttering?

There are several types of stuttering, including the following:

  • developmental stuttering
    This is the most common type of stuttering which occurs in children. As their speech and language processes are developing, they may not be able to meet verbal demands.
  • neurogenic stuttering
    Neurogenic stuttering is also a common disorder that occurs from signal problems between the brain and nerves and muscles.
  • psychogenic stuttering
    Psychogenic stuttering is believed to originate in the area of the brain that directs thought and reasoning. This type of stuttering may occur in people with a mental illness, or those who have experienced excessive mental stress or anguish. Although stuttering may cause emotional problems, it is not believed to be the result of emotional problems.

How is stuttering diagnosed?

In addition to a complete medical history and physical examination, diagnosis of stuttering may also include:

  • detailed history of the development of the disorder
  • evaluation of speech and language abilities by a speech-language pathologist

Managing normal developmental speech problems:

It is important to remember that every child develops speech at different times. If your child is having speech problems, have your child's physician involved in the evaluation of the child. The following are some suggestions to help with normal speech difficulties your child might have, and help to prevent the child from developing true stuttering difficulties:

  • Encourage your child to talk to you about fun and easy topics in a non-stressful place.
  • Try to make talking fun or make it a game.
  • Do not interrupt your child while he/she is speaking, even if the child is making mistakes or having trouble.
  • Do not ask your child to repeat something you do not understand. Attempt to guess what the child is saying and continue on with the conversation.
  • Do not have your child practice certain sounds or words. This will make the child uncomfortable about his/her speech.
  • Do not try to slow your child's speaking. Try to talk with your child in a calm, quiet place and be a model of speaking slowly. Asking your child to slow down will only frustrate your child.
  • Ask other adults not to correct your child's speech and do not talk about your child's speech problems in front of him/her.
  • Listen attentively to your child.
  • Wait for the child to say the words without saying them for him/her.
  • Talk openly about the stuttering if the child brings up the subject.
  • Avoid asking the child to speak for others.

Treatment for stuttering:

Specific treatment for stuttering will be determined by your child's physician based on:

  • your child's age, overall health, and medical history
  • extent of the condition
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference

The goal of treatment is to focus on relearning how to speak, or to unlearn incorrect ways of speaking. Although there is no cure for stuttering, early intervention may keep stuttering from becoming a life-long problem. Speech and language evaluation is suggested for children who exhibit stuttering or struggle with speech for more than six months. Medications and electronic devices to treat stuttering are sometimes used.

When do speech difficulties become a concern?

Your child's physician will make this determination with you and your child. The following are some of the warning signs that child might have true stuttering or other speech problems and not just normal developmental difficulties:

  • your child stutters after the age of 5
  • your child is fearful of talking or does not talk
  • there is a family history of stuttering
  • your child is not saying words by 18 months
  • other people cannot understand any words that your child is saying and your child is over 2 years old
  • if your child is older than 3 years old and about half of what the child says is not understood by others
  • repetition of words or phrases continues after six months and after trying the above recommendations

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It is important to remember the health information found on this website is for reference only not intended to replace the advice and guidance of your healthcare provider. Always seek the advice of your physician with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your physician or 911 immediately.

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