How can I tell if my child is stuttering

Does your child battle to complete sentences sometimes? Repetition of sounds and words is a common part of speech development. Here’s what you need to know about ‘disfluency’, and when to take action.

What is ‘normal disfluency’?

Between the ages of 18 months and 7 years, many children pass through stages of speech disfluency (interruptions in the smooth flow of speech) associated with their attempts to learn how to talk.

Normal disfluencies between 18 months and 3 years include repeating sounds, syllables, and words, especially at the beginning of sentences (t-t-t-table/ ta-ta-ta-table). You might hear these sounds in one in ten sentences, says speech and language therapist for Nubabi, Carianne Vermeulen.

After the age of 3, children with normal disfluencies might repeat whole words (I-I-I can’t) and phrases (I want…I want…I want to go). They will often also use fillers such as “uh” or “um” and sometimes change topics in the middle of a sentence, revising and leaving sentences unfinished, says Carianne.

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

These patterns are all parts of normal speech development and you needn’t be concerned. (However, if you are worried, check in with a speech therapist.)

How can I tell if my child is stuttering?

Stuttering typically begins between the ages of 2 and 5 years. Some children show signs of stuttering as young as 18 months or show no signs until the age of 12 or 13 years. Many children go through a stage of development during which they repeat words and phrases, draw out sounds, or have other disfluencies. In most cases, this “stuttering” is considered normal disfluency.

For some children however, seemingly normal disfluencies are actually signs of early stuttering – a developmental speech disorder – says Carianne.

In about half of all cases it begins gradually over the course of many months. In the other half of cases the stuttering begins suddenly, within about two weeks. Early stuttering may not progress smoothly, rather it comes and goes in cycles. Left untreated stuttering may become more severe over time. There are some common signs of stuttering to look out for:

Eight signs your child is stuttering

1. Part-word (syllable) repetitions usually the first syllable of a word, such as “da-da-da-daddy”.
2. Substitution of the “schwa” or weak vowel in a repetition, instead of saying “bay-bay-baby”, the child may say “buh-buh-baby”.
3. Prolongation of a sound or holding onto one sound for a longer time than necessary, such as “mmmmommy.”
4. Tremors uncontrollable movements of the jaw, lips or tongue when speaking dysfluently.
5. Pitch and volume rise when repeating or prolonging a sound, pitch and loudness may increase.
6. Struggle and tension visible difficulty getting the word out; this may include but is not limited to eye blinking/ movements, facial grimaces, lip, limb, or torso movements.
7. Moment of fear a brief, fleeting expression of fear when approaching certain words or sounds or during a moment of stuttering.
8. Avoidance unusually long or an unusual number of pauses, avoidance of certain words or of speaking altogether, postponing a word until the child can say it smoothly.

Stuttering risk factors

Certain factors may place children at risk for stuttering. Knowing these factors will help you decide whether or not your child needs to see a speech-language therapist. If your child has early disfluencies and one or more of these risk factors, it may be worth consulting a therapist.

• Family history Almost half of all children who stutter have a family member who stutters. There is less risk if the family member outgrew stuttering as a child.
• Age at onset Children who begin stuttering before age 3 1/2 are more likely to outgrow stuttering; if your child begins stuttering before age 3, there is a much better chance she will outgrow it within 6 months.
• Time since onset Between 75% and 80% of all children who begin stuttering will begin to show improvement within 12 to 24 months without speech therapy. If your child has been stuttering longer than 6 months, or if the stuttering has worsened, he may be less likely to outgrow it on his own.
• Gender Girls are more likely than boys to outgrow stuttering. In fact, three to four boys continue to stutter for every girl who stutters. This may be due to biology as well as interactions with family and other people. What’s important is that if your child is stuttering right now, it doesn’t necessarily mean he or she will stutter the rest of his or her life.
• Other speech and language factors A child who speaks clearly with few, if any, speech errors would be more likely to outgrow stuttering than a child whose speech errors make him difficult to understand. If your child makes frequent speech errors such as substituting one sound for another or leaving sounds out of words, or has trouble following directions, you should be more concerned.

What you can do to help

It is important to remember that parents do not cause stuttering. Still, there are several things you can do to help your young child learn to speak more fluently:

1. Modelling an easier, more fluent way of speaking

Speak slowly. Children tend to be more disfluent when they or the people around them talk more quickly. The key to talking slowly is to use pauses, between words and between phrases. For example (the dots indicate pauses approximately 1 second long): “One fish…….two fish………red fish…….blue fish.” Try this when reading (Dr Seuss books are great for this), then apply the same pace to conversational speech. Another way to relax the pace is to reflect a child’s sentence back to them, more slowly, and expand on it. For example, “You want to play outside now? (pause) Okay, that would be fine.”

2. Reducing demands

There is sometimes an irresistible urge to try to help children by telling them to “speak more slowly” or to “stop, take a deep breath, and think about what you want to say.” This only makes a child more self-conscious about his speech. The same is true about finishing a child’s words or making seemingly supportive comments about his or her fluency; it’s best not to make any comments of ‘corrective’ remarks. Rather listen to and respond to the content of what your child is saying.

3. Minimizing the time pressures

As well as speaking slowly, pausing for a second or two before answering your child’s questions gives your child the time he or she needs to ask and answer questions, and it helps teach him not to rush into responding during his own speaking turns. Try not to hurry your child up when speaking or in any other part of his daily routine.

A speech-language therapist will be able to help your manage any disfluencies like stuttering. It’s important to remember that a child can feel distressed when having difficulty expressing him- or herself, and a parent who is patient, accepting and understanding can go a long way to overcoming this early challenge.