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Stuttering in children

Talking to people can be hard if you stutter. You may get stuck on certain words or sounds. You may feel tense or uncomfortable. You might change words to avoid stuttering. Speech-language therapists can help.

About Stuttering

We all have times when we do not speak smoothly. We may add "uh" or "you know" to what we say. Or, we may say a sound or word more than once. These disfluencies are normal if they happen every once in a while. When it happens a lot, it may be stuttering.

People who stutter may have the following types of disfluencies:

Blocks. This happens when you have a hard time getting a word out. You may pause for a long time or not be able to make a sound. For example, "I want a ...... cookie."Prolongations. You may stretch a sound out for a long time, like cooooooooooookie.Repetitions. You may repeat parts of words, like co-co-co-cookie.

Stuttering can change from day to day. You may have times when you are fluent and times when you stutter more. Stress or excitement can lead to more stuttering.

Stuttering is more than just the blocks or repetitions in your speech. It can also make you tense your body or struggle to talk. Stuttering may get in the way of how you talk to others. You may want to hide your stuttering. So, you may avoid certain words or refuse to talk in some situations. For example, you may not want to talk on the phone if that makes you stutter more.

Signs of Stuttering

The following types of disfluencies happen when you stutter:

Part-word repetitions – "I w-w-w-want a drink."One-syllable word repetitions – "Go-go-go away."Prolonged sounds – "Ssssssssam is nice."Blocks or stops – (pause) "Come here."

You may tense up your face or body when you have a block or stop.

These types of disfluencies happen to many people and are not stuttering:

Adding a sound or word, called an interjection – "I um need to go home."Repeating words with more than one syllable – "Here is my puppy-puppy-puppy."Repeating phrases – "He is-he is four years old."Changing the words in a sentence, called revision – "I had-I lost my tooth."Not finishing a thought – "His name is ... I can't remember."

Causes of Stuttering

Stuttering usually starts between 2 and 6 years old. Many children go through normal periods of disfluency lasting less than 6 months. Stuttering lasting longer than this may need treatment.

There is no one cause of stuttering. Possible causes include the following:

Family history. Many people who stutter have a family member who also stutters.

Brain differences. People who stutter may have small differences in the way the brain works during speech.

Here are some risk factors for stuttering:

Gender. Boys are more likely to stutter than girls,family recovery patterns.

Children with family members who stopped stuttering are more likely to stop, too.

Mood and temperament. For children who stutter, mood and temperament may lead to more stuttering. Frustration or tension can cause more disfluencies. Being excited or feeling rushed can make you stutter more.

You may stutter more if other people tease you or bring attention to your speech. Your stutter may embarrass you. Or, you may feel more anxious about talking.

Triggers. Some life events may "trigger" stuttering. For example, a young child may start to stutter when he learns a lot of new words fast. He may be able to say one or two words fluently. But, he may stutter when he uses longer sentences.

When to Get Help for Your Child

Does your child stutter? You should get help from a speech-language pathologist, or SLT, as early as possible. Early help can reduce the chances that your child will keep stuttering. You should contact an SLT if any of the following things happen:

Your child's stuttering has lasted for 6–12 months or more. Many children have disfluencies in their speech. However, if your child seems to stutter for more than 6 months, you should contact an SLT.Your child starts to stutter late. Stuttering may be more likely to last if your child starts stuttering after 3½ years old.Your child starts to stutter more. Listen to your child, and make note of how often he stutters. See an SLT if his stuttering stays the same or gets worse.There is a family history of stuttering. Does someone in your family also stutter? Your child may be at a higher risk for stuttering.Your child has another speech or language disorder. Does your child have problems following directions or answering questions? Does she have problems saying sounds clearly? These may be signs that stuttering will last. An SLT can help test her speech and language skills.Your child struggles when talking. Your child may have trouble dealing with stuttering. He may tense up or struggle to talk. See an SLT if your child avoids talking or tells you that it is too hard to talk.Your child's speech worries you or your family. Do you worry about your child's speech? Has another family member said something about your child's speech? An SLT can help find out if your child stutters or not.

Testing for Stuttering

It's not easy to tell if your child stutters. Stuttering is more than disfluencies, so it is important to see an SLT for testing. The SLT will look at the following things:

How your child reacts when she stutters. Does she get upset?

How your child tries to "fix" his speech.

Does he start over?

Stop talking?

How stuttering impacts the way your child talks to or plays with others.If stuttering makes it harder for your child to do well in school.

The SLT will use this information to decide if your child stutters or not. Your child may be learning a lot of words or new speech sounds. This can cause her to repeat sounds or phrases, which is normal. The SLT can help tell the difference between these types of disfluencies and stuttering.

The SLT will also test your child's speech and language. This includes listening to how your child says sounds and words. The SLT will test how well your child understands what others say and how well she uses words to talk about her thoughts.

Treatment for Stuttering

There are different ways to help with stuttering. A treatment team usually includes you, your child, other family members, and your child's teacher. Treatment will depend on any or all of the following:

Your child's speech and language skills

How much your child stutters

How your child reacts when she stutters

How stuttering impacts your child's everyday life

How others react to your child when he stutters

For children who are 2–6 years old, treatment may focus on either of these two things:

Direct strategies—working with your child to change how he speaks.Indirect strategies—finding ways to make it easier for your child to talk. This may include slowing down your own speech and asking fewer questions.

You are an important part of your child's treatment. The SLT can help you learn more about

how to respond when your child stutters; changes you can make to improve your child's fluency; and what to do to improve how your child feels about talking.