Stuttering

Stuttering is a disorder in which the flow of speech is broken when speech sounds are disrupted (also called disfluencies). Stuttering is also referred to as stammering.

Stuttering consists of:

• Word or part-word repetitions
• Prolonging or lengthening of speech sounds
• Additions in speech sounds
• Blocks (no sound is made)

Children who stutter may develop associated behaviors (for example, eye blinking) and avoid saying words that make them stutter. They may also avoid situations in which they have to talk.

Prevalence:

• In the United States, approximately 3 million people stutter.
• 4 times as many males stutter than females.
• Approximately 5% of all children go through a period of stuttering that lasts 6 months or more. Three-quarters of those will recover by late childhood, leaving about 1% with a long-term problem.

Stuttering impacts daily activities. The best prevention tool is early intervention.

Patients can be seen by Texas Children's experts in Ear Nose and Throat (Otolaryngology) and Speech, Language and Learning.

Causes & Risk Factors

The exact cause is not known. However, evidence suggests that genetics plays a role. 

Risk factors include:

• A family history of stuttering
• Stuttering that has continued for 6 months or longer
• Presence of other speech or language disorders
• Strong fears or concerns about stuttering on the part of the child or the family

Symptoms & Types

Symptoms usually appear between the ages of 2½ and 4 years.

It may be hard to tell the difference between stuttering symptoms and normal phases of learning to talk. There are, however, some signs that your child is developing a stuttering problem.

Symptoms include:

• Repeating sounds more than twice (li-li-li-li-like this). The facial muscles, especially around the mouth, may tense up.
• The pitch of the voice may rise with repetitions and the child may experience a block, with no voice for several seconds.
• The child may avoid using certain words and using extra sounds when starting to talk.

About 75% of preschoolers who begin to stutter will eventually stop. It is not possible to say with certainty whether your child will continue to stutter into adulthood.

Diagnosis & Tests

If you think your child has a stuttering problem, it is best to seek medical help early.

The speech-language pathologist:

• Performs tests, observations and interviews designed to estimate your child's risk for continuing to stutter
• Engages your child in a variety of speaking tasks and then notes the number and types of speech sounds in which your child's talking is disrupted (disfluencies)

Treatment & Care

Treatment activities will vary depending upon the child's level of awareness. 

Treatment and care include:

• For younger children who are not as aware they are stuttering, parents are initially taught to model smooth speech by how they talk to their child.
• Parents are encouraged to provide feedback in a positive way.
• For older children, a more direct behavior modification approach is used. 

The goal may be more to lessen the impact of stuttering than to completely eliminate disruptions in how easily and smoothly your child talks.

Living & Managing

The speech-language pathologist will give you tips on how to help your child outside of appointments. Day-to-day fluency takes mental effort. It is not reasonable to expect that a child who stutters will be able to control the smoothness of his or her talking at all times of the day in all situations.

Some tips for parents or caregivers:

• Reduce the pace at which you talk to your child. Speak in an unhurried way and pause often.
• Wait a few seconds after your child finishes talking before you begin to talk.
• When you ask questions, try to resist asking them one immediately after the other. Wait to hear your child's answer to one question before you ask another.
• Praise strengths that are not related to talking. For example, "You played really well at baseball today."