Parenting Advice From Your Physicians at Kaiser Permanente

As parents, it’s easy to worry about almost anything! And something like stuttering, which can affect children in many ways for many years, can understandably generate a great deal of concern. Some degree and type of stuttering can be normal for young children. How does a parent know if how their child’s speech is developing normally, or if they need help for stuttering?

As toddlers learn to talk, sometimes they stumble over their words in a way that makes their speech sound “disfluent” (not smooth)—or like they’re stuttering. They may repeat words or phrases or use filler words like “um.” It’s also normal to hear your child changing the words in a sentence or not finishing their thoughts.

If you think about it, learning to speak is miraculous – and hard work! Kids rapidly learn thousands of words and language rules. It can be completely normal for a young child to stutter at times, and for periods of stuttering to come and go. And it’s even more common for a tired, frustrated, or overwhelmed child to have trouble getting their words out. Usually, this form of stuttering is outgrown.

If stuttering can be normal, when should you worry? Problematic stuttering is more common if you have a family history of stuttering. It’s more often seen in young boys than girls. And if stuttering doesn’t start until around age 3.5, it’s more likely to persist. There are other signs that you can watch for that may indicate your child’s speech is developing atypically.

Because there are ways to treat stuttering, it’s important that you seek help as early as possible. Contact your child’s doctor to ask for a speech and language evaluation if your child:

• Not only repeats words and phrases, but also repeats sounds or syllables. It’s normal for a young child learning to speak to repeat words or an entire phrase like. “Look at the airplane-look-look at the airplane.” It’s more concerning if you hear them, repeating sounds, or syllables like, “L-l-l-l-l-ook at the a-a-a-a-airplane,” or, “Go-go-go-go-away.”
• Prolongs sounds like, “Mmmmmmmmilk please.”
• Has pauses between words “I want ……… go to park.”
• Appears to be physically struggling when speaking. A toddler with typical language development who at times stumbles over words or phrases doesn’t seem to be bothered by this. A child with concerning stuttering often looks upset, frustrated, anxious, or tense.
• Has behaviors when speaking like head bobbing, nodding, or eye blinking.
• Has stuttering lasting for more than six months, or has rapidly worsening stuttering.
• Didn’t start stuttering until they were 4.
• Avoids talking and says that it’s hard to talk.

What Causes Stuttering

There’s no single specific cause of stuttering, but it’s thought to be due to multiple factors. We know genetics play a role in because stuttering tends to run in families. We also know that people who stutter may have differences in their brain functions when sending and receiving speech.

Stuttering Can Be Treated

Treatment starts with an evaluation by a speech therapist. During this evaluation, the therapist will observe and test your child’s speech and language skills. They’ll assess whether your child is stuttering or having age-appropriate disfluencies, or if they have any other issues with how well they use words and understand speech. The therapist will also try to understand how your child’s speech affects how they interact with others and feel about themselves.

Treatment takes two main approaches: direct and indirect. Treatment will be adapted based on your child’s age, how much they stutter, and how it affects them. An indirect therapy approach is aimed at educating parents and caregivers about how they can help the child speak more fluidly. The direct approach teaches children to notice when their speech is fluid or when they’re stuttering and how to slow or adapt their speech. Treatment helps children master skills to improve the way they speak and how they feel about talking.

Older children who continue to stutter may experience stress or bullying and develop low self-esteem as a result. In turn, this can increase the severity of stuttering. Mental health counseling is often helpful to manage these symptoms and help a child deal with the emotional effects of ongoing stuttering.

What Parents Can Do to Help Kids Who Stutter

Your support and positive approach will help decrease your child’s stress and any emotional reactions that can come from stuttering. You can adapt how you communicate with your young child to make it easier for them to respond and engage with you. Try to:

• Not criticize or negatively comment on their speech.
• Be patient as they talk to help them slow their speech.
• Model helpful techniques. Speak in a relaxed way, slowly and clearly with simple, short sentences. Take pauses to gather your thoughts.
• Use your body language and facial expressions to let your child know you’re patient and listening to what they’re trying to say rather than focusing on any difficulty they have with speaking. Don’t rush them!

As always, parent your child with positivity to boost their self-esteem and resiliency. It’s powerful to let your child know often that you love and support them – no matter how they speak.

Resources for Parents

National Stuttering Association
The Stuttering Foundation

American Speech-Language-Hearing Association
Stuttering
Fluency Disorders