Stuttering, Ages 3 to 6

How can I tell if my child has a stuttering problem?

The mind of a preschooler is buzzing with questions, commands, and mangled lyrics to Sesame Street songs. Your child is probably still learning how to turn his thoughts into intelligible sounds, and mistakes are bound to happen. Your child may pepper his speech with "um" and "uh" or frequently repeat words or phrases. ("Hey, hey, hey, hey mom. Can I, uh, have a story? A story?") He might also repeat the first sound of a word once or twice, li-li-like this. These speech patterns are completely normal. Left on his own, your child will quickly outgrow these missteps.

Other quirks of speech, however, might signal the start of a more serious stuttering problem. Watch for these signs:

• Frequently repeats the sound at the beginning of a word three or more times (ki-ki-ki-ki-kitten)
• When stuck on a word, often replaces the normal vowel sound with "uh" (buh-buh-buh-bicycle)
• Drags out certain sounds (m-m-m-motorcycle)
• Speaks quickly
• Has long pauses in odd places, even within words
• Tenses up and shows obvious distress while struggling to speak
• Has extra trouble talking when feeling nervous or uncomfortable

Why does my child stutter?

Nobody knows what causes stuttering. Many researchers think that small glitches in a child's brain might interfere with the timing and rhythm of his speech. Just as some kids have trouble catching fly balls, some simply don't have the verbal coordination to speak clearly. Stuttering can run in families, and it's four times more common in boys than in girls. The condition has nothing to do with intelligence, and it's definitely not a sign of bad parenting or hidden psychological problems. Stressful events such as moving to a new house or going to a new daycare can make stuttering worse, but they don't cause the problem in the first place.

At least one British study of 8- to 12-year-olds showed children who grow up in a bilingual home were more likely to stutter than kids who grew up in a home where a language other than English was exclusively spoken. According to the study, the children began stuttering at about 4 years old. However, stuttering did not affect the children's educational achievement, according to the eight-year study.

How can I help my child improve his speech?

Whether your child stutters or is simply still learning the tricks of language, he needs your understanding and support. Your encouragement will help him find his voice and stop any minor problems from getting worse. Here are some basic rules of thumb to follow:

• When your child stumbles during a sentence, keep normal eye contact and calmly wait for him to finish.
• Talk to him in slow, relaxed tones. (Think Mister Rogers.)
• Set aside time each day for pleasant, stress-free conversations.
• Listen to your child instead of criticizing him. Telling him to "start over" or "slow down" can just feed the problem by making him feel nervous and self-conscious.
• Let him know that you understand and sympathize with his problem. When he finishes a taxing sentence, he'll be glad to hear that "talking can be tough sometimes" or that his hard work is making you proud. If you pretend the stuttering doesn't exist, your child might assume it's an unspeakable crime.

Do I need to take my child to a speech therapist?

If you suspect your child is developing a stuttering problem, schedule an appointment with a speech therapist for an evaluation. Don't wait too long; children who get help when their stuttering is just beginning have an excellent chance of gaining completely normal speech.

A therapist can tell you if your child's speech is a normal part of growing up or a real cause for concern. If she does spot a problem, the therapist may simply counsel you on the best ways to talk with your child. For children of this age, having understanding parents can be the best therapy of all.

Some children will need one-on-one therapy sessions. When working with preschoolers, speech therapists often use games and other techniques to slow the rate of speech. If your child can learn to take his time without feeling flustered, he'll almost certainly conquer his stuttering. The therapists may teach you how to conduct these sessions at home. Not surprisingly, the lessons seem to soak in even faster when parents deliver them.

Further Resources

The Stuttering Foundation of America
(800) 992-9392
http://www.stutterSFA.org

References

Michael Lawrence, David M. Barclay III, Stuttering: a brief review. American Family Physician.

Howell, P et al. The effects of bilingualism on stuttering during late childhood. published online. doi:10.1136/adc.2007.134114 Archives of Disease in Childhood 2009;94:42-46 http://adc.bmj.com/cgi/content/abstract/94/1/42

National Institute on Deafness and Other Communication Disorders. Stuttering. http://www.nidcd.nih.gov/health/voice/stutter.html