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Tips on Distinguishing Children who Stutter vs. Normally Disfluent Children

If your child has difficulty speaking and tends

If your child has difficulty speaking and tends to hesitate on or repeat certain syllables, words, or phrases, he may have a stuttering problem. But he may simply be going through periods of normal disfluency that most children experience as they learn to speak. Here are some tips to help you understand the difference.

The Normally Disfluent Child

1. The normally disfluent child occasionally repeats syllables or words once or twice, li-li-like this. Disfluencies may also include hesitancies and the use of fillers such as "uh", "er", "um".

2. Disfluencies occur most often between ages one and one-half and five years, and they tend to come and go. They are usually signs that a child is learning to use language in new ways. If disfluencies disappear for several weeks, then return, the child may just be going through another stage of learning.

The Child with Mild Stuttering

1. A child with milder stuttering repeats sounds more than twice, li-li-li-li-like this. Tension and struggle may be evident in the facial muscles, especially around the mouth.

2. The pitch of the voice may rise with repetitions, and occasionally the child will experience a "block" -- no airflow or voice for several seconds.

3. Disfluencies may come and go but are now present more often than absent.

4. Try to model slow and relaxed speech when talking with your child, and encourage other family members to do the same. Don't speak so slowly that it sounds abnormal, but keep it unhurried, with many pauses. Television's Mr. Rogers is a good example of this style of speech.

5. Slow and relaxed speech can be the most effective when combined with some time each day for the child to have one parent's undivided attention. A few minutes can be set aside at a regular time when you are doing nothing else but listening to your child talk about whatever is on his mind.

6. When your child talks to you or asks you a question, try to pause a second or so before you answer. This will help make talking to your child less hurried, more relaxed.

7. Try not to be upset or annoyed when stuttering increases. Your child is doing his best as he copes with learning many new skills all at the same time. Your patient, accepting attitude will help him immensely.

8. Effortless repetitions or prolongations of sounds are the healthiest form of stuttering. Anything that helps your child stutter like this instead of stuttering tensely or avoiding words is helping.

9. If your child is frustrated or upset at times when his stuttering is worse, reassure him. Some children respond well to hearing, "I know it's hard to talk at times...but lots of people get stuck on's okay." Other children are most reassured by a touch or a hug when they seem frustrated.

The Child with More Severe Stuttering

1. If your child stutters on more than 10% of his speech, stutters with considerable effort and tension, or avoids stuttering by changing words and using extra sounds to get started, he will profit from having therapy with a specialist in stuttering. Complete blocks of speech are more common than repetitions or prolongations. Disfluencies tend to be present in most speaking situations now.

2. Research speech-language pathologists who specialize in stuttering, or you may contact a nearby university or hospital clinic for referral assistance. Speech pathologists should have a Certificate of Clinical Competence from the American Speech-Language-Hearing Association.

3. The suggestions for parents of a child with mild stuttering are also appropriate when the child has a severe problem. Try to remember that slowing and relaxing your own speaking style is far more helpful than telling the child to slow down.

4. Encourage your child to talk to you about his stuttering. Show patience and acceptance as you discuss it. Overcoming stuttering is often more a matter of losing fear of stuttering than a matter of trying harder.

This material was compiled by Dr. Barry Guitar, University of Vermont, and Dr. Edward G. Conture, Vanderbilt University.