Stuttering: An Overview

October 07, 2008

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Stuttering: An Overview

by Robert Needlman, M.D., F.A.A.P.
reviewed by Robert Needlman, M.D., F.A.A.P.

It's easy to take a child's ability to speak for granted-unless he struggles with his words. In fact, 1 child in 20 goes through a period of stuttering, and 1 in 100 has a long-standing problem. Stuttering can be a huge source of stress, shame, and social disability for children and their parents, or it can be a challenge that they tackle and overcome together. So much depends on how you view the problem!

What stuttering is and isn't
At some point while they are learning to talk, most young children have a hard time speaking smoothly. Usually this is between ages two and five years or so. They repeat the first word of a sentence several times before they get the whole sentence out. They insert a lot of "ums," "uhs," or "ands." They stop in the middle of sentences, then start new ones.

These normal difficulties or "disfluencies," are not stuttering. Stuttering begins when a child starts to show more pronounced difficulties. For example, instead of repeating a whole word, he begins to repeat fragments of words, such as "Ma-ma-ma-ma-mommy," and this happens every few words or even more often. At other times, a sound lasts longer than it should, as in "mahhhhhhhhhmy."

The next stage in the development of stuttering is when the child becomes self-conscious about his speech problem. He begins to screw up his face with frustration; he moves his mouth but nothing comes out, or, at other times, he blurts out the words in a rush, perhaps in an unusually loud voice. Many children with these problems avoid talking, or try to hide their difficulty by saying as little as possible.

Should you be concerned?
Many children stutter for a short time during early childhood, then grow out of it on their own. You don't want to make an issue of a passing phase, but stuttering is one of those problems that is easier to treat when you start early. It becomes much more difficult after a child has developed a negative emotional response.

When I evaluate a child who stutters, these are the signs that lead me to make a referral to a speech and language pathologist sooner rather than later:

More severe stuttering, for example, stuttering in more than half his sentences, with multiple repetitions (more than three or four repetitions of each syllable), and frequent "blockages" (when no sound comes out despite clear effort).

Stuttering that has been going on for more than six months. At this point, the problem is less likely to resolve itself on its own, and the child's frustration is probably rising.

Signs of a negative emotional response, such as tense facial muscles, turning red with the effort not to stutter, avoidance of speaking, and self-deprecating statements (for example, "I'm stupid!"). These signs are especially important, because negative emotional responses make it much less likely that the stuttering will get better on its own.


RELATED INFORMATION

			Stuttering

Created April 08, 2001
Reviewed September 18, 2004

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