When to Seek Professional Help if Your Child Stutters
Abby Barnes, M.S., CCC-SLP
Did you know that many kids show signs of stuttering at some point in childhood? In fact, between 5% and 10% of all children will stutter for a few weeks or several years throughout their life. This often happens between the ages of 2 and 6 years old.
While approximately 75% of these children will naturally overcome their stutter with time, the remaining 25% may need professional help to help avoid stuttering into adulthood.
So how do you know if your child's stuttering is a temporary bump on the road to acquiring language skills, or if it's more serious and persistent? In other words, when is a stutter considered a "clinical stutter" that may need speech therapy?
To help answer this question, let's review typical fluency development in children, when stuttering is considered a clinical issue, and what to expect during a speech fluency evaluation.
How does speech develop in children?
When children begin to talk, many will experience speech errors in how they pronounce certain sounds and words. This is normal--rarely will a young child's speech be 100% accurate. It can take time for speech to develop and become more mature sounding.
Likewise, as children begin using longer phrases and sentences, occasional stuttering may occur. During times of significant vocabulary growth, children often stutter. This is likely due to the more complex motor-planning needed for them to coordinate longer sentences.
What does stuttering sound like?
Here are some examples of different types of stuttering that you may observe in your child’s speech:
Repetitions: Repetitions are a type of disfluency, or speech interruption, where a word, syllable, or sound is repeated more than three times. Here’s an example: “I w-w-w-w-w-w-want a snack.”
Prolongations: Prolongations happen when a sound is prolonged or held for an abnormally long period of time, such as, “I fffffffffffffffffound my shoe.”
Signs that a stutter is not normal
As we mentioned, stuttering can be a typical part of language development. However, if a stutter lasts longer than 3 to 6 months, this could be a sign that the stuttering has become a clinical issue. It may be time to seek a professional opinion from a speech therapist.
Here are some other signs that your child may be experiencing abnormal fluency development and could benefit from a speech evaluation:
You notice repetitions, prolongations, or blocks (pausing of speech) that are consistent in everyday speech
Your child avoids talking or has a lack of confidence
Your child avoids saying certain words in order to prevent their stutter
Your child expresses concern about their speech
You notice abnormal body movements (eye blinking, jerky jaw movements, foot stomping, etc.) that happen while your child speaks
You notice your child getting out of breath while speaking
It's extremely helpful to contact a speech therapist early on, before the stutter has had a long time to progress.
If fluency is found to be normal during your child's evaluation, that’s great! It will put your mind at ease. But if fluency is not typical, then early intervention is preferred, as it can prevent stuttering from worsening and persisting. The sooner you can get on top of stuttering, the better!
What happens during a speech evaluation for stuttering?
If you choose to see a speech therapist for your child’s fluency, your first appointment will likely be a comprehensive speech evaluation. Let’s discuss what this evaluation looks like.
First, your speech therapist will likely give you a case history form to fill out, or ask you questions about your child’s medical and developmental history. Be sure to mention if there is any family history of stuttering.
The speech therapist will do an oral-motor evaluation to assess the strength and function of your child's oral musculature. This is done to rule out any physical or motor issues that could affect speech.
Your child will also likely be screened for articulation and language abilities. If the speech therapist feels it is appropriate, a formal evaluation for these clinical areas may be performed. However, most of the formal testing will likely focus on speech fluency.
In order to assess speech fluency in depth, the speech therapist will use a variety of techniques to test different aspects of the stutter.
In order to assess speech fluency in depth, the speech therapist will use a variety of techniques to test different aspects of the stutter. If your child is old enough to read, they may be asked to read a short story out loud in order to assess reading fluency. The therapist will then engage your child in conversation or ask them to tell a short story. This will assess speaking fluency. If your child is not reading yet, the therapist will likely obtain a couple of different speaking fluency samples.
After performing these tests, the speech therapist will count the number of stuttered syllables in each speech sample, as well as the total number of syllables spoken. This helps the therapist calculate the percentage of syllables stuttered. If this is done via a normative assessment, this numeric data can better explain where a child’s speech fluency skills fall when compared to peers their same age.
While numeric data is important, the speech therapist will consider your child’s speech as a whole. Speech therapists are continually assessing a client’s speech during the entire evaluation.
While numeric data is important, the speech therapist will consider your child’s speech as a whole.
Finally, the speech therapist will look for any secondary behaviors that could be present. Secondary behaviors are physical behaviors related to the stuttering. These can include eye blinks, abnormal jaw movements, foot stomping, clenching fists, etc. These behaviors are learned by the child over time as they attempt to avoid stuttering. Be sure to mention if you see any of these behaviors at home.
How can you help your child with their stutter?
If you think your child is stuttering, here are some simple things you can do to support them at home.
Give your child plenty of time when you're talking together. Don’t rush them.
Don’t react negatively to any stuttering you hear.
Don’t interrupt your child.
Let your child know how much you enjoy talking with them, and provide plenty of praise and encouragement.
