Children and stuttering; Speech disfluency; Stammering
Stuttering is a speech disorder in which sounds, syllables, or words are repeated or last longer than normal. These problems cause a break in the flow of speech (called disfluency).
About 5% of children (1 of every 20 children) ages 2 to 5 will develop some stuttering during their childhood. It may last for several weeks to several years.
For a small number of children, stuttering does not go away and may get worse. This is called developmental stuttering and it is the most common type of stuttering.
Stuttering tends to run in families. Genes that cause stuttering have been identified.
There is also evidence that stuttering is a result of brain injuries, such as stroke or traumatic brain injuries.
In rare cases, stuttering is caused by emotional trauma (called psychogenic stuttering).
Stuttering is more common in boys than girls. It also tends to persist into adulthood more often in boys than in girls.
Stuttering may start with repeating consonants (k, g, t). If stuttering becomes worse, words and phrases are repeated.
Later, vocal spasms develop. There is a forced, almost explosive sound to speech. The person may appear to be struggling to speak.
Stressful social situations and anxiety can make symptoms worse.
Symptoms of stuttering may include:
Feeling frustrated when trying to communicate
Pausing or hesitating when starting or during sentences, phrases, or words, often with the lips together
Putting in (interjecting) extra sounds or words ("We went to the...uh...store")
Repeating sounds, words, parts of words, or phrases ("I want...I want my doll," "I...I see you," or "Ca-ca-ca-can")
Tension in the voice
Very long sounds within words ("I am Booooobbbby Jones" or "Llllllllike")
Other symptoms that might be seen with stuttering include:
Children with mild stuttering are often unaware of their stuttering. In severe cases, children may be more aware. Facial movements, anxiety, and increased stuttering may occur when they are asked to speak.
Some people who stutter find that they do not stutter when they read aloud or sing.
Exams and Tests
No testing is usually necessary. The diagnosis of stuttering may require consultation with a speech pathologist.
There is no one best treatment for stuttering. Most early cases are short-term and resolve on their own.
Speech therapy may be helpful if:
Stuttering has lasted more than 3 to 6 months, or the "blocked" speech lasts several seconds
The child appears to be struggling when stuttering, or is embarrassed
There is a family history of stuttering
Speech therapy can help make the speech more fluent or smooth.
Parents are encouraged to:
- Avoid expressing too much concern about the stuttering, which can actually make matters worse by making the child more self-conscious.
- Avoid stressful social situations whenever possible.
- Listen patiently to the child, make eye contact, don't interrupt, and show love and acceptance. Avoid finishing sentences for them.
- Set aside time for talking.
- Talk openly about stuttering when the child brings it up to you. Let them know you understand their frustration.
- Talk with the speech therapist about when to gently correct the stuttering.
Taking medicine has not been shown to be helpful for stuttering.
It is not clear whether electronic devices help with stuttering.
Self-help groups are often helpful for both the child and family.
The following organizations are good resources for information on stuttering and its treatment:
In most children who stutter, the phase passes and speech returns to normal within 3 or 4 years. Stuttering that begins after a child is 8 to 10 years old is more likely to last into adulthood.
Possible complications of stuttering include social problems caused by the fear of teasing, which may make a child avoid speaking entirely.
When to Contact a Medical Professional
Call your health care provider if:
- Stuttering is interfering with your child's school work or emotional development.
- The child seems anxious or embarrassed about speaking.
- The symptoms last for more than 3 to 6 months.
There is no known way to prevent stuttering.
Blitzer A, Sadoughi B, Guardiani E. Neurologic disorders of the larynx. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 58.
National Institute on Deafness and Other Communication Disorders. NIDCD fact sheet: stuttering. www.nidcd.nih.gov/health/stuttering. Updated March 6, 2017. Accessed March 1, 2018.
Simms MD. Language development and communication disorders. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 35.