Stuttering

Stuttering occurs in approximately 5 percent of all children, but continues in only about 1 percent, or less, of adults. 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 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 younger than 5-years-old. 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 who has some normal developmental speech problems but is pressured to speak better. This child then becomes aware of his or 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.

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 that 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.

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.

How can parents manage normal developmental speech problems?

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

• Encourage the child to talk about fun and easy topics in a nonstressful place.
• Try to make talking fun or make it a game.
• Do not interrupt the child while he or she is speaking, even if the child is making mistakes or having trouble.
• Do not ask the child to repeat something you do not understand. Attempt to guess what the child is saying and continue on with the conversation.
• Do not ask the child to practice certain sounds or words. This will make the child uncomfortable about his or her speech.
• Do not try to slow the child’s speaking. Try to talk with the 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 the child’s speech and do not talk about the child’s speech problems in front of him or her.
• Listen attentively to the child.
• Wait for the child to say the words without saying them for him or her.
• Talk openly about the stuttering if the child brings up the subject.
• Avoid asking the child to speak for others.

What is the treatment for stuttering?

Specific treatment for stuttering will be determined by the child’s doctor based on:

• The child’s age, overall health, and medical history.
• Extent of the stuttering.
• Expectations for the course of the condition.
• The family’s 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 lifelong problem. Speech and language evaluation is suggested for children who exhibit stuttering or struggle with speech for more than six months.

When do speech difficulties become a concern?

Caregivers can work with their child’s doctor to decide when a child’s stuttering is a concern. The following are some of the warning signs that a child might have true stuttering or other speech problems, and not just normal developmental difficulties:

• The child stutters after the age of 5.
• The child is fearful of talking or does not talk.
• There is a family history of stuttering.