Stuttering and the Young Child

by Melanie Potock, M.A., CCC-SLP
Speech Language Pathologist
Pediatric Rehabilitation Department
Boulder Community Hospital's Mapleton Center
Boulder, Colorado

Many young children between the ages of 1 1/2 and 5 have periodic speech disfluencies. Disfluencies are disruptions in the smooth flow of single words, phrases, or conversational speech. As children learn to negotiate the complexities of the English language, they may appear to have trouble speaking smoothly.

They may repeat syllables or whole words once or twice, such as "ba-ba-ball." They may hesitate or fill in the pauses with markers, such as "uh," "um," or "well." Sometimes, these disfluencies come and go for weeks or months at a time. These disfluencies can be part of normal language development, or they may be early signs that a child has a predisposition for stuttering.

What is the difference between typical disfluencies and stuttering?

Disfluencies are interruptions in the smooth flow of single words, phrases, or conversational speech. True stuttering impacts not only the flow of words, but also has specific behaviors associated with the disruption in flow. Not all of the behaviors are present for every child. Some of the behaviors to watch for are:

Consistent disturbance in speech production

• Frequently repeating sounds three or more times
• Prolongation of a word or part of a word in many speaking situations

Awareness of his/her own difficulty speaking as evidenced by the following reactions to the disruptions in flow

• Tension, tremors, or struggling in the muscles of the eyes, lips, cheeks, chin, throat, or chest while speaking
• Consistent presence of "starters," such as "um" or "so"
• Rise in pitch associated with repetition of sounds
• "Blocking" on words demonstrated by no voice and/or airflow while attempting to speak
• Anxiety or fear in a child's face as he/she anticipates his/her need to speak a difficult word
• Avoiding or "talking around" a specific word

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How do I know it is not "true" stuttering?

If your child exhibits one or more of the behaviors noted above, he/she might be developing a true stuttering problem. If parents have any concerns about their child's speech fluency, the first person to consult is their child's doctor. The doctor may refer the child to be evaluated by a certified speech language pathologist who specializes in fluency disorders.

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What causes stuttering?

Researchers vary on their opinion of what causes stuttering. However, most researchers agree that the following factors are associated with increases in normal disfluencies:

• Difficulty with fine motor coordination and/or timing of the respiratory and oral motor muscles
• Interpersonal stress
• Disturbing, stressful events that are unanticipated by the family
• Certain stages of complex language development

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My child's playmate stutters. Will my child learn to stutter too?

Although this is a common myth, stuttering is not contagious. However, a child can be a positive influence on his/her friend's speech if the child is aware of some of the ways that he/she can help. (Please refer to "What can I do at home to help my child.")

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My grandfather stuttered. Is it inherited?

Researchers do not know if stuttering is an inherited trait. It is true that stuttering seems to run in some families, but a specific gene for stuttering has not been identified. Family studies show that many stutterers have a predisposition for stuttering, but it is unclear what physical markers exist that may prove inheritance. In twin studies, stuttering occurs more often in identical twin pairs than in fraternal twin pairs. Again, it appears from the twin studies that stuttering is inherited, but the inherited physical marker is unclear.

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Could an upsetting event in our lives have caused this?

Emotional stress may aggravate stuttering, but it is not considered to be a cause. Children who may be vulnerable to stuttering will often become more disfluent during stressful times.

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Is this my fault as a parent?

Current research indicates that parents do not cause stuttering. However, you can play an important role in facilitating normal fluency in your child's speech.

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What can I do at home to help my child?

Parents should keep the following advice in mind when talking with their child:

• Be aware of your own rate of speech during conversations. Speak in a slow, relaxed, yet natural manner. By doing so, you will be subtly modeling a slower conversational speech rate for your child. A slower rate also is less taxing to the listener and, thus, less stressful for your child.
• Respond to what your child is saying, not to the stuttering. Focus on the content, not the way it is presented.
• Be careful not to interrupt your child or to finish the sentences for him/her. Wait patiently until your child is done talking, and support him/her by gentle responses that say "I'm listening," such as head nods, eye contact, smiles, and verbal markers (e.g., "uh-huh").
• Count to three before replying. Avoid speaking immediately when your child pauses or stops talking.
• It is easy in a hectic day to pick up the pace, hurry from one activity to another, and rush about. Try to make a conscious effort to prepare your child for transitions between activities and tell him/her the plan for what will happen next.
• Take a look at common stressful moments at home. For example, is it always hectic in the morning before daycare? Or, does tension increase in the evening when you are preparing dinner? How do these moments affect your child's fluency? What can you do as a family to ease the tension?
• Examine your daily routine. Is it highly structured, mildly predictable, or total chaos? A predictable daily routine, which also allows for flexibility, is ideal.
• Ask fewer questions, and only one at a time. Wait and listen intently while your child answers. Respond with interest. Again, focus on the content and not on the stuttering.

Encourage family members, baby-sitters, and teachers to speak in a relaxed rate, to listen carefully to your child, to give appropriate eye contact, to respond positively to your child's comments, and to allow your child to finish his/her thoughts.

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Maybe my child will just grow out of it.

Many children who show signs of mild disfluencies do "grow out of it." However, because typical disfluencies may mimic early signs of stuttering, it is highly recommended that parents consult with a doctor. It is worth the peace of mind to know that 1.) your child's disfluencies are typical for his/her age and development, or 2.) your child's stuttering can be helped significantly through early intervention with a certified speech language pathologist.

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Links to other information

For additional information on childhood stuttering, please contact the Stuttering Foundation of America, P.O. Box 11749, Memphis TN 38111-0749.

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About The Author: Melanie Potock, MA, CCC-SLP

Melanie Potock is a certified speech language pathologist and national feeding specialist.  She is the co-author of the award winning Raising a Healthy Happy Eater and the pediatrician-approved Baby Self-Feeding, which focuses on safe feeding practices when offering babies solids. Her advice has been shared in Parents Magazine, Dr. Oz The Good Life, Fit Pregnancy, Huffington Post, PBS Parents.com and more.  Her on-demand video course at www.ParentingintheKitchen.com has helped parents all over the world who struggle with picky eaters learn how to raise babies, toddler and older kids who love healthy food. She can be reached at www.mymunchbug.com.

Copyright 2012 Melanie Potock, M.A., CCC-SLP, All Rights Reserved