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Alternative NamesChildren and stuttering; Speech disfluency
Definition Return to top
Stuttering is a speech disorder that involves involuntary hesitation, repetition ("ca-ca-ca-can"), or prolongations ("llllllike") while speaking.
Causes Return to top
About 5% of children aged 2 - 5 go through a short period of stuttering, but this phase is very brief. For a small percentage (less than 1%), the stuttering progresses from simple repetition of consonants to repetition of words and phrases. Later, vocal spasms develop with a forced, almost explosive sound to the speech.
Stuttering tends to run in families, but it is unclear to what extent genetic factors are important. There is also evidence that stuttering may be associated with some neurological events, such as stroke or traumatic brain injuries. Psychological components tend to make the symptoms worse or better within each case.
Stuttering is rarely considered a psychological problem. Stressful social situations and anxiety, however, can make symptoms worse. Surprisingly, people with significant speech difficulty often don't stutter when singing or when they are alone talking to themselves. Stuttering tends to persist into adulthood more frequently in boys than in girls.
Symptoms Return to top
Symptoms of stuttering may include:
Other symptoms that might be seen with stuttering include:
Children with mild stuttering are often unaware of their stuttering. In more severe cases, children may show greater awareness, accompanied by facial movements, anxiety, and increased stuttering when they are asked to speak.
Exams and Tests Return to top
No testing is usually necessary. The diagnosis of stuttering may require consultation with a speech pathologist.
Treatment Return to top
There is no one best treatment for stuttering. Most early cases are short-term and resolve on their own. In persistent cases, speech therapy may help. Research on therapies is ongoing and should be investigated to determine what kinds of help may be most useful.
Drug therapy for stuttering has NOT been shown to be helpful.
Speech therapy may be helpful in the following if:
Research into therapies for stuttering is ongoing and should be investigated to determine what kinds of speech therapy may be most useful.
The way that family, friends, and teachers respond to a child's stuttering is very important:
Some people who stutter find that they don't stutter when they read aloud or sing.
Outlook (Prognosis) Return to top
In the majority of children who stutter, the phase passes and speech returns to normal within 3 or 4 years. Stuttering that begins after a child is 8 - 10 years old is more likely to last into adulthood.
Stuttering is most common between ages 3 and 5. Parents should avoid expressing too much concern or commenting too much, which can actually make matters worse by making the child more self-conscious.
Possible Complications Return to top
Possible complications of stuttering include social problems caused by the fear of ridicule, which may make a child avoid speaking entirely.
When to Contact a Medical Professional Return to top
Call your provider if stuttering is interfering with your child's school work or emotional development, if the child seems anxious or embarrassed about speaking, or if the symptoms last for more than 3 - 6 months.
Prevention Return to top
There is no known prevention for stuttering.
Gentle attention from the parents without emphasis on the stuttering may help the child feel better about the problem.
Listen patiently to the child, make eye contact, don't interrupt, ignore the stuttering, and show love and acceptance. If the stuttering continues longer than 6 months, the "blocked" speech lasts several seconds, or the child shows obvious facial tensions when stuttering, seek professional help.
References Return to top
Prasse JE, Kikano GE. Stuttering: an overview. Am Fam Physician. 2008;77(9):1271-1276.Update Date: 6/27/2008 Updated by: Rachel A. Lewis, MD, FAAP, Columbia University Pediatric Faculty Practice, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.