Many preschool-aged children experience a period of time when they have trouble getting their words out fast enough. When is it normal?
Mommy, I want to, I want to, I want to, I want to have that one… Sound familiar?? Parents wonder whether their children are truly stuttering or if they will grow out of it. Here’s what you need to know. Let’s start by understanding what normal fluency looks like.
Fluent speech is effortless, smooth, and flowing. While we all occasionally repeat ourselves or stumble over a word, fluent speakers generally produce sentences smoothly.
Disfluency, on the other hand, occurs when a speaker has trouble producing words smoothly.
Stuttering, one type of disfluency, is characterized by the following:
- Repetitions. Repeating whole words (e.g. I want want want pizza), parts of words (e.g. I want pi-pi-pizza), or sounds (e.g. I want p-p-pizza)
- Prolongations. Elongating a specific sound (e.g. I wwwwwant pizza)
- Blocks. Long, unnatural pauses due to difficulty saying a specific word (e.g. I want (long pause) pizza).
- Secondary behaviors. Motor signs that occur while stuttering (e.g. blinking, mouth tension, unusual head movements)
- Normal Preschool Disfluency
What types of disfluencies would you see?
* It is common for children to sometimes repeat phrases or whole words (e.g. I want to- I want to- I want to go; I need the the red one).
* It is also common for children to use fillers (e.g. um) or revise their sentences- (e.g. Mommy gave us…Mommy gave me a special sticker!). - When? It is more typical for children to be disfluent when tired, rushing to speak, excited, or upset.
- Duration? A child with normal disfluency will experience disfluent speech for a few days or weeks, and then go back to speaking fluently for months before showing signs of disfluency again.
- Child’s Reaction? Often the child is unaware and not bothered by his/her speech patterns.
Let’s contrast the above with children who are experiencing more “stuttering-like” disfluencies:
- Stuttering-like Disfluency
What types of disfluencies would you see?
* Repeating parts of words (e.g. I want the mar-mar-marker) or sounds (e.g. I like p-p-p-pink). Both of these repetitions are not common in typically-developing children’s speech and may indicate a fluency disorder.
* Prolonging a sound (e.g. the zzzzzzebra) or experiencing blocks (e.g. I want to (long pause) go) are also more “stuttering-like” behaviors. - When? In contrast to normal preschool disfluency, true stuttering may be observed throughout the day. And stuttering tends to get worse (more severe, more frequent) when the child is tired, rushing to speak, excited, or upset.
- Duration? Unlike normal preschool disfluency, stuttering will last for a longer period of time and not “come and go” in the same way.
- Child’s Reaction? Your child may be more frustrated, embarrassed, or otherwise bothered by his difficulty speaking. You may notice secondary behaviors, such as blinking when trying to talk.
If you are concerned about your child’s fluency, having your child evaluated by a certified speech-language pathologist will diagnose or rule-out stuttering.
Meanwhile:
- Try not to draw any attention to your child’s speaking difficulty
- Maintain eye contact and wait patiently for your child to express himself
- Model speaking slowly- this encourages your child to slow his speech rate too, which naturally leads to more fluent speech
thank you for this informative article about stuttering. i would like to add one thing, coming from a mother who’s child stutters. please do talk to the child about his stutter openly. do ask him how it makes him feel and empathize that it’s really hard on a daily basis.
kids need that support especially from their mother and father
Children definitely need support from their parents! The Stuttering Foundation (www.stutteringhelp.org) has lots of information for families to help, such as a book you can download to talk with your child about stuttering (https://www.stutteringhelp.org/sometimes-i-just-stutter).
For preschool-age children, many choose an “indirect therapy approach,” in which modifications are made to the child’s environment without drawing attention to the child’s stuttering. Because many preschoolers are unaware that they are not speaking fluently, it can be helpful not to impose any extra pressure on the child to produce fluent speech. Some helpful tips can be found here (https://www.stutteringhelp.org/7-tips-talking-your-child-0) on their website.
For my child, sudden stuttering indicated that he was experiencing a strep infection. Once we treated with antibiotics the stuttering resolved. Something for parents to keep in mind and rule out as untreated strep can cause even worse neurological symptoms.
I’ve had the exact same experience. Over the past 3 months he was treated twice with antibiotics and the stuttering went away. Yet now he seems to have a relapse. Any advice how I can get rid of it once and for all.?
A pediatric neurologist who specializes in PANDAS/PANS would probably be a good next step. The neurologist would be able to perform further tests and provide other treatments to help.
Great point! The key here was the that the stuttering started suddenly. A streptococcal (strep) infection can sometimes cause a child to display neuropsychiatric symptoms, such as OCD, tics, or even stuttering. This is referred to as PANDAS: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. Treating the strep infection with antibiotics can resolve the neurological symptoms as well.
Thank you for this article!
My toddler suddenly started stuttering and I got so many comments from outsiders, but I knew that he was ok, he loves talking and couldn’t get the words out quick enough!
BH after a few weeks his speech was back to normal.