Why stuttering is surprisingly common, when to worry, and what to do. Plus, red flags to listen for.
First words are exciting to hear—but thrill can turn to worry if a child begins to get “stuck” on certain sounds or develops trouble getting words out. Is stuttering a temporary glitch? Or an ongoing cause for concern?
It can be either—and it’s always worth listening for, says Jody Vaynshtok of Sound Speech and Hearing Clinic in San Francisco, a second-generation speech language pathologist.
Toddlers commonly stutter, but most grow out of it, she says. And when it does persist into preschool and beyond, there are many ways to help kids work with and overcome their speech patterns.
Here are some useful insights on early stuttering from Vaynshtok, who’s also on the staff of the Hearing Loss Clinic at the University of California, San Francisco:
Everybody stutters sometimes! We just don’t think about it that way. Most adults have occasional normal disfluencies: saying um, like, well, saying things twice, using incomplete phrases, or starting a sentence and then stopping and starting over.
At ages 2 to 3, we see lots of stuttering because it’s when kids’ brains and language abilities are rapidly developing. Children often need the extra processing time to get their thoughts out, which can sometimes be heard as repetitions or revisions in their speech. Clinicians have key points they’re looking for to rule out normal disfluencies and to identify disfluencies that could benefit from intervention.
Key numbers: About 65 percent of kids who stutter at age 3 will continue to do so, as will about 85 percent of those who are still stuttering at three-and-a-half. Overall, about 8 percent of kids ages 3 to 5 stutter.
Boys outnumber girls 2:1 at age 3. By age 5, it’s 4:1, the same as for adults. If a boy is stuttering at two-and-a-half and also has a family history of stuttering, that’s an indicator to start therapy because there’s an increased chance it could be a lifelong thing.
If there were an Oscar for stuttering, it would go to: The King’s Speech (2010), a movie that got a lot right. It showed that the scared feelings involved with stuttering can take down even a powerful person—but that anyone has the ability to work through it. Stuttering is too often depicted as the trait of a jokey or not-smart kid. I loved that it showed you can be extremely bright and a great individual but just have this thing that stops you from getting words out easily.
It also illustrated how the feedback loop between the ear and the brain works. Some people can be fluent for short periods of time when music is playing or when speaking in tandem, just as we saw in the movie.
Science still isn’t 100 percent sure what causes stuttering. Recent research links it to neurological differences. There’s something in the brain’s feedback loop that gets caught. We often see increased disfluencies when someone is stressed or anxious. Any emotional time can be the trigger, from something relatively small, like finding a new favorite activity, to your parents going though a divorce or moving to a new school.
Red flags to listen for in a child: Repeating part of a word (da, da, daddy) or broken words (d-d-daddy). You might also hear stuttering more when a child is excited and talking fast.
Sometimes parents don’t catch what we call secondary characteristics of stuttering. These can have an emotional component, like embarrassment or anxiety about talking (to the point of not talking). Or they can be tics, like dropping all words that start with “p” (saying ice pop instead of popsicle) because the child has noticed “p” words are hard to get out. Even very young kids can get really fast at substituting words they want to avoid. Some kids develop body tics, like blinking or wiggling to help the word come out. Or they may move an arm a certain way because they spoke fine when they did this once before.
I often hear, “My pediatrician doesn’t believe me.” Kids may not talk a lot during an exam, so you’ll probably notice it before the doctor does. In fact, two-thirds of stuttering cases are first diagnosed by a parent. Try taking a video of your child talking at home that you can play later for your child’s doctor. This can also be helpful to a speech therapist.
Pediatricians sometimes wait to refer to speech therapy in a 2- to 3-year-old. As long as they’re monitoring it, that’s great, but it also can’t hurt to seek an evaluation if you’re concerned. Early intervention can be helpful in reducing those secondary characteristics and tics.
Something parents worry about but shouldn’t: That they need to whisper about the stuttering in front of their child, as if their child doesn’t know about it. Your child knows more about it than you do. Kids who stutter are fully aware of it. “My words get stuck,” they’ll tell me. Or, “I can’t get the words out sometimes.” Some parents think they’re protecting their child by putting off getting it evaluated because they don’t want to label him or her, or they’re resistant to starting down a path of therapy. But if you have concerns, it’s worth finding out what’s going on. An evaluation is play-based; your child won’t even know what’s going on.
Something parents don’t worry about but should: Other parents ignore stuttering because they think their child will grow out of it. Many will, but you’ll get a lot of peace of mind in checking it out. And, if needed, early intervention can make a tremendous difference for your child.
What parents can do to help a stutterer: Avoid filling in words for your child or talking over him. We often have an urge to want to fill in when a child gets stuck on a word. But that says to your child, “My words aren’t worth hearing.”
Also: Avoid drawing negative attention to the stuttering. Your child can see you physically hanging on every word—like bobbing or shaking your head. Be sure, too, to ask others, including siblings, not to fill in words, make fun of the stutter, or imitate the stutter.
If I could tell parents one thing: It would be to not get overly anxious and worried about stuttering—which I know is easy to say and hard to do! The young brain is so plastic, it can be manipulated with lots of positive reinforcement. Giving negative reinforcement, on the other hand, can make things worse.
The general public sees stuttering as not just a speech issue but as an intellect issue. That’s absolutely not the case.
Speech therapy with young kids is very play-based. I’ll bring out cars and a road map, and we play and talk, showing them how to slow down their speech to match other motor movements. We bring parents back, too, to show them how to reinforce positive behaviors and track progress at home.
You might have to educate your child’s teacher, since many don’t know that it’s a disorder that needs intervention and support. At preschool age, what the teacher says is gold. She could bring it up at circle time, for example, and talk about how some kids have trouble getting words out and that’s okay. There are also great books to read at storytime, such as Stuttering Stan Takes a Stand or Wendi’s Magical Voice.
When early intervention isn’t enough—for that 1 percent who continue to stutter—there’s still plenty to do that can help. Breathing strategies and other techniques can help the person speak more easily and deal with the anxiety that builds up.
It’s a supportive new world for those who stutter. Older kids often love support groups, where they see that they have peers who talk the same way and it’s okay. The National Stuttering Association is a great place to find support groups. And support groups can be a good source of advice for families with kids of all ages.
Photos from top: Suzette/Flickr, kilokon.tw/Flickr, David Goehring/Flickr, Will Mann/Flickr, mari del carmen gomez/Flickr