What is stuttering?
Stuttering, sometimes referred to as stammering or diffluent speech, can be very humiliating for a child. This speech disorder is different than normal repetition of words, which children often do when learning how to talk. Normal developmental stuttering often begins between 18 months and 5 years old. Your child might begin to repeat words or phrases, have trouble pronunciation of words, leave out words or sounds, or speak some words that are hard to recognize.
Children with true stuttering have some normal developmental speech problems, but are then pressured to speak better. The child then becomes aware of his speech and struggles to speak better, which actually makes the speech worse.
- Normal developmental stuttering and speech difficulties happen in about 90 percent of children.
- Normal developmental speech problems usually improve over about two to three months.
- Some mispronunciation of words may be present with a child for several years.
- True stuttering happens in only about 1 percent of children. True stuttering occurs more often in boys than in girls.
- True stuttering, if it is not properly treated, often worsens in adulthood.
How Boston Children's Hospital approaches stuttering
We have a devoted Speech-Language Pathology Program dedicated to examining speaking disorders, such as stuttering.
Stuttering | Symptoms & Causes
What are the symptoms of stuttering?
These speech styles are part of true stuttering:
- repeating words, sounds, or syllables
- talking slowly or with a lot of pauses
- having an uneven rate of speech
- stuttering more when tired, excited, or under stress
- acting fearful about talking
What causes stuttering?
The exact mechanical causes of stuttering are not completely understood, but it is thought to be a hereditary condition.
What are the different types of stuttering?
- Developmental stuttering. This is the most common type of stuttering which occurs in children. As their speech and language processes are developing, they may not be able to meet verbal demands.
- Neurogenic stuttering. Neurogenic stuttering is also a common disorder that occurs from signal problems between the brain and nerves and muscles.
- Psychogenic stuttering. Psychogenic stuttering is believed to originate in the area of the brain that directs thought and reasoning. This type of stuttering may occur in people with a mental illness, or those who have experienced excessive mental stress or anguish. Although stuttering may cause emotional problems, it is not believed to be the result of emotional problems.
Stuttering | Diagnosis & Treatments
How is stuttering diagnosed?
Our physicians will take a detailed history of your child's development. A speech-language pathologist will also evaluate your child's speech and language abilities.
How can I help my child manage her stutter?
It is important to remember that every child develops speech at different times. If your child is having speech problems, keep the child's physician involved in the evaluation of your child. The following are some suggestions to help with normal speech difficulties your child might have, and help to prevent your child from developing true stuttering difficulties:
- Encourage your child to talk to you about fun and easy topics in a non-stressful place.
- Try to make talking fun or make it a game.
- Do not interrupt your child while he/she is speaking, even if your child is making mistakes or having trouble.
- Do not ask your child to repeat something you do not understand. Attempt to guess what your child is saying and continue on with the conversation.
- Do not have your child practice certain sounds or words. This will make your child uncomfortable about his/her speech.
- Do not try to slow your child's speaking. Try to talk with your child in a calm, quiet place and be a model of speaking slowly. Asking your child to slow down will only frustrate your child.
- Ask other adults not to correct your child's speech and do not talk about your child's speech problems in front of him/her.
- Listen attentively to your child.
- Wait for your child to say the words without saying them for him/her.
- Talk openly about the stuttering if your child brings up the subject.
- Avoid asking your child to speak for you.
The goal of treatment is to focus on relearning how to speak, or to unlearn incorrect ways of speaking. Although there is no cure for stuttering, early intervention may keep stuttering from becoming a life-long problem. Speech and language evaluation is suggested for children who exhibit stuttering or struggle with speech for more than six months. Medications and electronic devices to treat stuttering are sometimes used.
When do speech difficulties become a concern?
Your child's physician will make this determination with you and your child. The following are some of the warning signs that child might have true stuttering or other speech problems and not just normal developmental difficulties:
- your child stutters after the age of 5
- your child is fearful of talking or does not talk
- there is a family history of stuttering
- your child is not saying words by 18 months
- other people cannot understand any words that your child is saying and your child is over 2 years old
- if your child is older than 3 years old and about half of what your child says is not understood by others
- repetition of words or phrases continues for more than six months and after trying the above recommendations