Fluency/Stuttering

Many of us have struggled with stuttering at one point in our lives, or we've known someone who has. We may hesitate when speaking, use fillers (“like” or “uh”), or repeat a word or phrase. These are called typical disfluencies. For many children, stuttering is simply a natural part of learning language and putting sentences together, and they’ll eventually outgrow it. For others, it may persist throughout their life.

What is Fluency and when is Stuttering normal?

Stuttering is a speech disorder involving frequent disruptions with the normal fluency and flow of speech. There are two main types of fluency disorders: stuttering and cluttering. If you stutter, you may sound like you're trying to say a syllable or word, but it's getting “stuck” or “bumpy” and not coming out smoothly or fluently. If you clutter, you may speak at a very fast rate, merging words or cutting off parts of words. Stuttering is more common than cluttering. A child who stutters repeats or prolongs sounds, syllables, or words. Stuttering is different from repeating words when learning to speak. Stuttering may make it difficult for a child to communicate with others.

Developmental Disfluency

It is not uncommon for young children to have disfluencies in their speech (e.g., word or phrase repetitions). In fact, normal disfluency often starts between the ages of 18 and 24 months and tends to come and go up to the age of 5. This is the most common type of stuttering in children. It may happen when a child’s speech and language development lags behind what he or she needs or wants to say.

Causes of Stuttering

Unfortunately, doctors and scientists do not know the exact cause of stuttering. However, many experts believe there are several risk factors that contribute to stuttering. If any of these situations apply to you, it’s especially important that you speak with a doctor or speech-language pathologist.

• A family history of stuttering: While there is still uncertainty about whether stuttering is genetic and inherited by family members, nearly 60% of all stutterers have someone in their family who also stutters or stuttered.
• Child development: Children who have other speech and language disorders have a higher chance of stuttering than children who don’t.
• Neurophysiology: It has been observed that some children who stutter process language in different parts of their brain than children who don’t stutter. This may interfere with how the brain sends messages to the muscles involved in speech.
• Family dynamics: Some children's stuttering has been linked to high family expectations and a fast-paced lifestyle.
• Late or adult-onset stuttering: This often occurs when stuttering symptoms appear later in life and are not attributed to a speech-motor or neurological issue, such as when someone experiences a stroke, tumor, or trauma.

Symptoms

Each child’s communication development is different. A child may have symptoms of stuttering that are part of his or her normal speech and language development. If the symptoms last for 3 to 6 months, he or she may have developmental stuttering. Symptoms of stuttering may vary throughout the day and in different situations. Your child’s symptoms may include: 

• Repeating sounds, syllables, or words, for example, repeating a sound as in W-W-W-What
• Prolonging sounds, for example, Mmmmmmine
• Using frequent interjections or fillers such as “um” or “like,” for example, I am going - um um like...
• Talking slowly or with a lot of pauses
• Stopped or blocked speech. The mouth is open to speak, but nothing comes out.
• Being out of breath or nervous while talking
• Hard eye blinking, trembling or shaking lips when speaking
• Increased stuttering when tired, excited, or under stress
• Being afraid to talk

The symptoms of stuttering can be subtle or obvious to others. If you have concerns about your child’s speech fluency, visit your Pediatrician. 

When should I seek professional help for stuttering?

As with most developmental issues, the best prevention is often early intervention. Speak with your Pediatrician if you are concerned about your child's stuttering. In many cases, your doctor may refer you to a speech-language pathologist, also known as a speech therapist. Speech therapists are the most qualified professionals to evaluate and determine whether your child is at risk for long-term problems. 

Signs that suggest your child’s stuttering is more severe, and that you should seek a speech evaluation, include:

• Your child’s stuttering is getting worse over time
• They make body or facial movements when speaking
• Their speech is especially strained
• Your child is actively avoiding situations that require talking
• Stuttering continues after your child has turned 5 years old
• Older children and adults whose lives are impacted by stuttering should also speak with their doctor or a speech therapist. Often, achieving better communication and coping strategies to manage stuttering is a lifelong process.

Diagnosis

Your child’s healthcare provider will ask you about your family history. He or she will also ask you about your child’s stuttering symptoms. The provider will usually suggest that your child see a certified speech-language pathologist (SLP), a communication specialist who can diagnose and treat speech, language and feeding problems. 

The SLP will:

• Ask many detailed questions about your child’s speech development.
• Administer a full battery of formal and informal assessments to diagnose and/or rule out a fluency disorder
• Recommend speech therapy if warranted 

Treatment

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. There is no cure for stuttering. Early treatment can prevent stuttering from continuing into adulthood. Various techniques and strategies are used to teach your child skills that can help him or her speak more fluently. 

If you have concerns regarding your child’s speech fluency, schedule a fluency assessment now.