Dr. Alan Greene on Toddler Stuttering
We have an extremely verbal 26-month-old son. We have noticed he is beginning to stutter. Is this a normal speech pattern? Will it pass? Is this something we should be concerned about?
When a child stutters, parents are often told to relax, that the stuttering is a phase that will soon be outgrown, and that nothing need be done. This advice can be unfortunate.
Treatment of stuttering is more effective the earlier it's begun. By needlessly delaying evaluation, parents can miss an important window of time when their child's stuttering is most treatable. On the other hand, many children go through a developmental stage of speech disfluency that's often confused with true stuttering. This normal disfluency does disappear over time without need for treatment.
If a 2-year-old begins to repeat syllables, short words, or phrases (su-su-such as this, or such as... such as... such as this) about once every 10 sentences, and begins to use more filler words (um, with uh pauses or er hesitations), is this normal disfluency or stuttering?
Children with true stuttering tend to repeat syllables four or more times (a-a-a-a-as opposed to once or twice for normal disfluency). They mmmmmay also occasionally prolong sounds. Children with stuttering show signs of reacting to their stuttering -- blinking the eyes, looking to the side, raising the pitch of the voice. True stuttering is frequent -- at least 3 percent of the child's speech. While normal disfluency is especially noticeable when the child is tired, anxious, or excited, true stuttering is noticeable most of the time. Children with true stuttering are usually concerned, frustrated, or embarrassed by the difficulty.
About 4 percent of all children will have true stuttering for at least six months, most commonly between the ages of 2 and 5. Most of these will recover by late childhood, but about a quarter of them will develop severe, chronic stuttering. Whenever parents suspect that their child has true stuttering, it's important to bring it to their pediatrician's attention -- it's easily treatable, unless you miss the window of time when treatment is so effective.
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