Stuttering or Dysfluency?

"Sad and Angry" by Basia, 2012

Question: 

My three-year-old daughter has begun repeating many words and sounds. It doesn't seem to bother her. Is this normal or it is stuttering? Otherwise she is growing and developing normally.

Answer: 

Many toddlers and preschoolers between the ages of 2 and 5 are just going through a stage of development when they stutter. Stuttering is a form of dysfluency,

an interruption in the flow of speech. Children commonly repeat whole words and phrases and may interject fillers such as "uh" and "um" into their speech. This is called "normal dysfluency." When you consider that children of this age are still learning how to speak, developing coordination of the muscles used for talking, learning new words, putting words together into sentences, and discovering how to ask questions and influence outcomes with their words, it's easy to see why they acquire dysfluencies. Although many parents worry about it, most of these children will outgrow the stuttering and will have normal speech as they get older.

"Angry Girl" by Basia, 2012

What Causes Stuttering?

The causes of stuttering are not precisely known - it is a very complicated and involved condition. However, more is known about the environmental factors. Stress, for example, can affect stuttering. To be clear - Parental behavior does not cause stuttering.

A fact - three times as many boys as girls stutter.

Early Signs

The first signs of stuttering may appear after the second birthday or when a child is beginning to put words together to form sentences. To parents this may be upsetting, but it is a normal stage in speech development. Showing patience with your child and adopting a cautious, accepting, and informed attitude are best during the preschool years. A child may be dysfluent for a few weeks or several months, with symptoms disappearing and perhaps appearing again. Most children who begin stuttering before the age of 5 will lose the dysfluency.

The School Years

When children enter elementary school, they sharpen their communication skills. Usually, dysfluency drops to very low levels. If stuttering continues in the school-age child is old enough to be aware of the problem and may be embarrassed by it. Classmates and friends may draw attention to it. However even children with chronic, severe stuttering can be helped with learning strategies that can enhance communication.

When to Seek Help

Your child may benefit from professional intervention, especially if:

• you are concerned or anxious about his speech
• repetitions of whole words and phrases become excessive
• sound and syllable repetitions begin to happen more frequently
• your child appears to be struggling with speech
• the dysfluencies start to be effortful or strained
• you notice increased facial tension or tightness in the speech muscles
• you notice vocal tension resulting in rising pitch or loudness
• your child chooses to avoid situations where he would have to talk

If your child's speech is characterized by some of these warning signs, you should consult a speech and language pathologist at your child's school or medical office.

What Parents Can Do

There are several steps you can take to provide a nurturing environment for your child:

• Let your child to speak for herself, and allow to finish her thoughts and sentences. Pause before responding to your child's questions or comments.
• Avoid corrections or criticisms such as "slow down," "take your time," or "take a deep breath." These comments will only make your child think she is doing something wrong.
• Maintain natural eye contact with your child. Try not to look away or show signs of being upset.
• Talk slowly to your child. This takes practice! Modeling a slow rate of speech will help with her fluency.
• Speak slowly and clearly when talking to others in your child's presence.
• Provide a calm atmosphere in the home. Try to slow down the pace of family life.
• Avoid distractions such as radio or television.
• Encourage activities that do not require a lot of talking when your child is more dysfluent.
• Allow talking to be fun and enjoyable.
• Use family mealtime as a conversation time.
• Avoid having your child speak or read aloud when she doesn't feel comfortable or when the dysfluencies increase.
• Don't require a child to speak correctly at all times.
• Never tell your child to think before a talk.
• Never tell your child to start over.