Is it Really Stuttering?

Normal Disfluency

Children with normal disfluencies between 18 months and 3 years will exhibit repetitions of sounds, syllables, and words, especially at the beginning of sentences. These occur usually about once in every ten sentences.

After 3 years of age, children with normal disfluencies are less likely to repeat sounds or syllables but will instead repeat whole words (I-I-I can’t) and phrases (I want…I want…I want to go). They will also commonly use fillers such as “uh” or “um” and sometimes switch topics in the middle of a sentence, revising and leaving sentences unfinished.

Children may be disfluent at any time but are likely to increase their disfluencies when they are tired, excited, upset, or being rushed to speak. They also may be more disfluent when they ask questions or when someone asks them questions.

Their disfluencies may increase in frequency for several days or weeks and then be hardly noticeable for weeks or months, only to return again.

Mild Stuttering

Mild stuttering may begin at any time between the ages of 18 months and 7 years, but most frequently begins between 3 and 5 years, when language development is particularly rapid. Some children’s stuttering first appears under conditions of normal stress, such as when a new sibling is born or when the family moves to a new home.

Children who stutter mildly may show the same sound, syllable, and word repetitions as children with normal disfluencies but may have a higher frequency of repetitions overall as well as more repetitions each time. For example, instead of one or two repetitions of a syllable, they may repeat it four or five times, as in “Ca-ca-ca-ca-can I have that?”

They may also occasionally prolong sounds, as in “MMMMMMMommy, it’s mmmmmy ball.” In addition to these speech behaviors, children with mild stuttering may show signs of reacting to their disfluency. For example, they may blink or close their eyes, look to the side, or tense their mouths when they stutter.

Another sign of mild stuttering is the increasing persistence of disfluencies. As suggested earlier, normal disfluencies will appear for a few days and then disappear. Mild stuttering, on the other hand, tends to appear more regularly. It may occur only in specific situations, but it is more likely to occur in these situations, day after day. A third sign associated with mild stuttering is that the child may not be deeply concerned about the problem, but may be temporarily embarrassed or frustrated by it. Children at this stage of the disorder may even ask their parents why they have trouble talking.

Severe Stuttering

Children with severe stuttering usually show signs of physical struggle, increased physical tension, and attempts to hide their stuttering and avoid speaking. Although severe stuttering is more common in older children, it can begin anytime between ages 5 and 7 years. In some cases, it appears after children have been stuttering mildly for months or years. In other cases, severe stuttering may appear suddenly, without a period of mild stuttering preceding it.

Severe stuttering is characterized by speech disfluencies in practically every phrase or sentence; often moments of stuttering are one second or longer in duration. Prolongations of sounds and silent blockages of speech are common.

The severely stuttering child may, like the milder stutterer, have behaviors associated with stuttering: eye blinks, eye closing, looking away, or physical tension around the mouth and other parts of the face. Moreover, some of the struggle and tension may be heard in a rising pitch of the voice during repetitions and prolongations. The child with severe stuttering may also use extra sounds like “um,” “uh,” or “well” to begin a word on which he expects to stutter.

Severe stuttering is more likely to persist, especially in children who have been stuttering for 18 months or longer, although even some of these children will recover spontaneously. The frustration and embarrassment associated with real difficulty in talking may create a fear of speaking. Children with severe stuttering often appear anxious or guarded in situations in which they expect to be asked to talk. While the child’s stuttering will probably occur every day, it will probably be more apparent on some days than others.

Parents of children who stutter severely inevitably have some degree of concern about whether their child will always stutter and about how they can best help. Many parents also believe, mistakenly, that they have done something to cause the stuttering. In almost all cases, parents have not done anything to cause the stuttering. They have treated the child who stutters just like they treat their other children, yet they may still feel responsible for the problem.

They will benefit from reassurance that their child’s stuttering is a result of many causes and not simply the effect of something they did or didn’t do.

Tips for Speaking with Someone who Stutters

• 1. Don’t make remarks like: “Slow down,” “Take a breath,” or “Relax.” Such simplistic advice can be felt as demeaning and is not helpful.

• 2. Let the person know by your manner that you are listening to what he or she says — not how they say it.

• 3. Maintain natural eye contact and wait patiently and naturally until the person is finished.

• 4. You may be tempted to finish sentences or fill in words. Try not to do so.

• 5. Be aware that those who stutter usually have more trouble controlling their speech on the telephone. Please be patient in this situation. If you pick up the phone and hear nothing, be sure it is not a person who stutters trying to start the conversation before you hang up.

• 6. Speak in an unhurried way — but not so slowly as to sound unnatural. This promotes good communication with everyone.

Tips for Talking with Your Child

• Reduce the pace. Speak with your child in an unhurried way, pausing frequently. Wait a few seconds after your child finishes before you begin to speak. Your own easy relaxed speech will be far more effective than any advice such as “slow down” or “try it again slowly.” For some children, it is also helpful to introduce a more relaxed pace of life for awhile.

• Full listening. Try to increase those times that you give your child your undivided attention and are really listening. This does not mean dropping everything every time she speaks.

• Asking questions. Asking questions is a normal part of life – but try to resist asking one after the other. Sometimes it is more helpful to comment on what your child has said and wait.

• Turn taking. Help all members of the family take turns talking and listening. Children find it much easier to talk when there are fewer interruptions.

• Building confidence. Use descriptive praise to build confidence. An example would be “I like the way you picked up your toys. You’re so helpful,” instead of “That’s great.” Praise strengths unrelated to talking as well, such as athletic skills, being organized, independent, or careful.

• Special times. Set aside a few minutes at a regular time each day when you can give your undivided attention to your child. This quiet, calm time — no TV, iPad or phones — can be a confidence builder for young child