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HOME/Child Development and Behavior/Stuttering In Young Kids: When To Be Concerned

Stuttering In Young Kids: When To Be Concerned

Stuttering In Young Kids: When To Be Concerned
February 24, 2017
52 Comments
By: Katrina Zeit Purcell

When you see your child beginning to struggle to get words out, it can be concerning. This is especially true if your child, who previously had no difficulty speaking, has now suddenly begun stuttering for unknown reasons. Fortunately, approximately 75% of those children who show signs of this type of speech behavior will eventually recover. However, that does not minimize the level of concern that families experience once the behavior begins to emerge.

As a parent, how do you know when to accept stuttering as a normal part of development and when to be more concerned? The answer is not always a simple one.

When children are learning how to communicate, many will experience some forms of speech breaks during their development. Most of these episodes are often overlooked and considered a typical developmental pattern. In those cases, the speech does not sound struggled or forced, there is typically no awareness on the child’s part, and the flow of talking does not appear to be seriously impeded.

Stuttering is quite different, however, and typically occurs at about the same time. The speech characteristics are not similar, although the child may still not demonstrate any level of conscious awareness. All of these behaviors usually occur when children are acquiring the complex skills involved with learning to talk. It is also at about the same time when other complex, ever-expanding developmental skill sets (walking, potty-training) are emerging.

The culmination of all these new skills at one time are thought to place just enough stress on the child’s overall developmental system to trigger some form of breakdown. That breakdown appears to impact speech production the most, inasmuch as so many different systems must interact together in order to account for all the necessary components underlying the way in which speech is produced.

In most cases, differentiating between what is considered stutter-like versus non-stutter-like is often accurately made by parents themselves. Parents are often very accurate when identifying those behaviors that do not seem typical. Below is a list of the behaviors that are considered stutter-like compared to those that are not.

Examples of non-stutter-like behavior:

  • Hesitations between words (“I want some …. milk”)
  • Interjections, such as “um,” “uh,” “well, or “like”
  • Revisions within utterances (“The dog is – the dogs are playing”)
  • Repetitions of phrases (“I want to … I want to go”)

Examples of stutter-like behavior:

  • Repetitions of words usually more than one time (“I I I … I want a banana”)
  • Repetitions of sounds (“M-my”) or syllables (“Ba-baby”)
  • Sound prolongations (“I— (prolonging sound) I live in C—-Cincinnati.”)
  • Vocal blocks in which no sound comes out (“M {block} my name is {block} … M Max.”)

Emotional Reactions to Stuttering

In addition to taking note of how stutter-like disfluencies sound, it is also very important to be aware of any emotional reactions that your child may demonstrate in response to his or her stuttering. The following reactions may be a cause for concern:

  • Awareness of difficulty with speaking (saying, “I can’t say it.”)
  • Frustration from stuttering
  • Shame or embarrassment with talking
  • Refusal to talk to strangers due to a fear of stuttering
  • Escape or avoidance behaviors (e.g. abnormal movements during speech such as jerking or forceful eye blinking, head nodding, or using of many filler words, such as “um”)

When Stuttering Persists

The majority of children do tend to recover from stuttering. Determining the difference between a child who is stuttering and a child who is simply passing through a developmental stage can be confusing. Here are some factors, which may indicate that your child is at greater risk:

  • Family history of stuttering
  • Age at onset (if your child began stuttering after age 3 ½ years)
  • Time since onset (if you child has stuttered for longer than 1 year)
  • Gender (males are 3 to 4 times more likely than females to persist in stuttering)
  • Speech is difficult to understand with many speech sound errors
  • High frequency of disfluencies (more than 10 stutters per 100 words)
  • Higher percentage of stuttering-like disfluencies (stutters comprise more than 50% of total disfluencies); these include:
    • Repetitions of sounds, syllables, and one syllable words
    • Tense pauses accompanied by muscular tension in the jaw and/or mouth
    • Prolongations (elongating a sound or syllable)
    • Silent blocks (voice stops)
    • Higher number of times a word or sound is repeated — often more than two times
    • Increased degree of tension during speech
    • Higher sensitivity to stress

Variability in Stuttering

It is important to note that stuttering is highly variable in its nature and frequency among children and even within the same child. A common saying is, “The only constant with stuttering is its variability.” While there is actually some overlap between a young child who is stuttering and one that is passing through the developmental disfluency period, there are clearly very discernible differences. However, one area of similarity is the impact of environmental influences on fluency.

All children will generally have more difficulty speaking smoothly under certain conditions: when interrupted or interrupting; commanding or directing another person; responding to a request to change their own activity; telling a story or providing a narrative; or when excited or tired.

Also, children often exhibit more disfluency during vacations, holidays, and visits from relatives. Similarly, disfluency increases when the child is exposed to psychological stress such as a birth of a sibling, moving homes, divorce, or other events that disrupt the normal life routine. Stress due to the COVID-19 pandemic could bring about an increase in disfluency.

When to Seek Help

Your child should be evaluated by a speech-language pathologist who specializes in stuttering if:

  • You have a concern about your child’s speech
  • You notice tension, facial grimaces, or struggle behaviors during talking
  • Your child avoids situations in which he or she will have to talk
  • Your child expresses concerns about speech
  • Your child avoids saying certain words or sounds

Getting Your Child Help

Diagnosing stuttering can be difficult as stuttering is a complex disorder and no one child stutters in the same way. For children that do continue to stutter, early treatment can substantially reduce and sometimes eliminate their stuttering.

Speech therapy is the most effective treatment, and there are different kinds available, depending on each child and family. In addition to working on a child’s speech skills, therapy can also help build the child’s confidence in communicating. Families and patients are counseled and given support throughout the therapy process.

To learn more about our division of Speech-Language Pathology, call 513-636-2371 or email speech.pathology@cchmc.org.

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TAGS:
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  • stuttering
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About the author: Katrina Zeit Purcell

Katrina Zeit Purcell, MHA, MA, CCC-SLP, is a speech-language pathologist at Cincinnati Children's and coordinates the speech pathology division’s public relations projects. Katrina is a member of the fluency team, specializing in evaluating and treating preschool, school-age, and adolescent stuttering. Additionally, she served as a final editor for Language in My Life, an interactive guide for caregivers that offers practical, easy-to-follow and fun suggestions for stimulating a child’s speech and language development at home.

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Comments

Mokwena Sbongile February 26, 2015 at 12:59 pm

Hey Katrina, hope to find you well. Can I briefly ask if you understand the concept of Atypical dysfluencies vs atypical fluencies.

Thank you.
Sbongile Mokwena, South africa

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    Katrina Zeit Purcell March 5, 2015 at 10:26 am

    Hi Mokwena, I think what you might be asking is “What is the difference between atypical and typical disfluencies?” As children learn to communicate, some will exhibit developmental disfluency, or normal interruptions in speech, typically between the ages of 2-5 years. However, as children get older, they may develop atypical disfluencies. Additionally, some young children may produce atypical disfluencies from onset. Examples of atypical disfluencies are described in the paragraph above and are defined as repetition of words, repetition of sounds, sound prolongations and vocal blocks.

Cassie December 31, 2015 at 3:52 pm

Hey Katrina,
I have a question, My son is almost 11 and has had a continuous stuttering issue. And in the past 4 months it has gotten extremely bad. There is no family history of it, and he had no issues growing up til now. Is it typical for late childhood on set of stuttering?

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    Katrina Zeit Purcell January 11, 2016 at 3:43 pm

    Hi Cassie,

    The short answer is that onset of stuttering in late childhood is more rare, however, it does occur. Stuttering is a complex issue and I would need more background information, such as how long he’s been stuttering, when you first noticed it, any medications he’s started/stopped, and if the stuttering is impacting his interactions with others.

Kel September 4, 2016 at 3:30 am

I have been reading and reading. After 6 months of treatment from my 4 year old i see no changes and it breaks my heart. I am waiting for him to “grow out of it” but i feel this is unrealistic. Any advise for a distraught mother? I get so frustrated at his lack of progress.

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    Katrina Zeit Purcell September 6, 2016 at 1:23 pm

    Hi Kel,

    I am sorry to hear about your frustrations related to your son’s stuttering, a situation which can be difficult and stressful for the entire family. It would be hard for me to offer you advice in this format, without knowing your child’s history, treatment plan, and any incremental progress. If you haven’t already, I recommend relaying your thoughts to your child’s speech pathologist, and if you’re still having concerns, a second opinion is never a bad idea.

      Dedee March 10, 2019 at 3:35 pm

      Hi Katrina,
      My 31/2 year old grandson is starting to stutter now for past 4 weeks it does not occur all the time but I’m noticing it more often , my grandson sees a speech therapist weekly and she has not mentioned anything to his mother, I feel mom should mention this concern now. We are hoping you can give us advice now on what should be done

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        Katrina Zeit Purcell March 11, 2019 at 11:28 am

        Hi Dedee,

        It’s not unusual for a small percentage of children to experience a period of stuttering in their development, typically between the ages of 2 ½- 5. Also it is not unusual for some children to begin this experience while they are in speech therapy for other reasons (language/speech developmental delays). If this is the case, then it would be appropriate for the parent to discuss the concern directly with the SLP. There may need to be a change in focus for the current treatment or possibly a short break from the current treatment with a home management approach. If the SLP cannot answer these questions or does not have a good working knowledge of stuttering in the preschool population, then the advice of an SLP who does seems warranted. Good clinical decision-making is best made when all family and child factors can be assessed and addressed.

Rob Schneider February 27, 2017 at 6:36 am

This is very clever and very helpful.

Dr.Brian March 2, 2017 at 5:56 pm

great article full of helpful information Dr.Brian McKay

Bobby March 15, 2017 at 9:38 pm

Respectfully I think title to this article puts an unnecessary negative twist on stuttering. I do believe that some good points are made and I encourage you to all that you can to help your child with this challenge. As someone that has dealt with a stutter their entire life, the impactful people that influenced me were people that didn’t acknowledge but accepted my stutter as apart of me.

Instead of being ashamed, I embraced it and worked thru it. Not seeing it as a weakness, but just part of me. I used it as a character builder. I was a leader in my high school, I have done public speaking, lead as manager of 300 people, currently operate a small business, and succeed in many ways of my life. Yes, I sometimes get aggravated, sometimes I have to start over, but I never let this get the best of me. I’m sure we all have hurdles that we must overcome.

I consider myself a successful extroverted, talkative person. I don’t even use Stutting to define any part of me and I’m sure most people who know me wouldn’t either.

Children that have a speech impediment are very tuned into “special treatment” and it shapes them. Allow your children to define their speech impediment or any struggle, don’t make it define them. Let them tell you what they need help with and stand behind them and support them. Give them the information and let them make decisions as it makes sense to. I am a product of defining the stutter and not letting it define me. You can find peace with any struggle if you look at other areas of your life it improves.

I realize that in some ways I am the opposite of a normal Stuttering person, but I believe with the correct influences and support that I could be the norm. Reguardless on if there is a “cure” or not, you can have a life that is not defined by a stutter even if it stays with you.

Never be concerned about your child having a stutter, simply know that just as with other children, you are helping them shape who they are! Help them just as you would other kids, don’t coddle them and protect them from life. Instead prepare them and give them the confidence to be Great!

    KJ July 7, 2017 at 3:42 am

    As a mother with a child that stutters, this comment is beautiful and I agree with it 100%. Thank you for voicing your personal journey with stuttering and making it known that it certainly should never define you.

    ET January 30, 2020 at 2:44 pm

    Thank you for this statement. I have an 8-year old daughter who stutters, and we have made every effort to make sure that it is just one, minor, at times inconvenient but not at all negative, aspect of who she is. She stutters, we roll with it. She doesn’t (so far) seem to have any negative feelings about it (other than occasional frustration when a word is particularly hard for her to get out, but again we roll with it). When we meet someone else who stutters, she’ll sometimes say something like “hey I stutter too!” without any stigma attached. She is also fortunate to have a teacher who ensures that the entire classroom is empathetic and respectful, and it’s wonderful. Future teachers may be less sensitive, but at least now we have a great model as she grows. And if anyone ever has an issue with it in future, that will be THEIR problem, not hers. Thanks again for this inspirational statement!

    Camil September 22, 2021 at 9:39 am

    Thanks so much for the write-up Bobby! As someone who continues to suffer from stuttering I was so sad when I noticed my 22 month old started stuttering too. It has become so severe that sometimes she can’t even speak. My aim is to support her in as many ways that I can.We live in Cameroon and unfortunately do not have as many resources available about stuttering neither do we have a good number of speech pathologists. Like it’s commonly said here in Cameroon “ we are together “

Is my child stuttering? What is normal dysfluency… – speech bubbles June 24, 2017 at 8:26 am

[…] Cincinnati Children’s Blog […]

thelovelysummer March 6, 2018 at 6:58 pm

Can someone define Atypical Disfluencies?

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    Katrina Zeit Purcell March 13, 2018 at 11:46 am

    Atypical disfluencies, or stutters, are more likely to be produced by children who are truly stuttering:

    EXAMPLES OF STUTTERING, OR ATYPICAL DISFLUENCY, WHICH CAN FALL INTO THE MORE CONCERNING CATEGORY:
    Repetitions of words (“I I I … I want a banana”)
    Repetitions of sounds (“M-my”) or syllables (“Ba-baby”)
    Sound prolongations (“I— (prolonging sound) I live in C—-Cincinnati.”)
    Vocal blocks in which no sound comes out (“M {block} my name is {block} … M Max.”)

    Children who are exhibiting revisions, multisyllabic whole-word repetitions, and interjections may be experiencing normal disfluency or developmental stuttering

Imran July 19, 2018 at 6:49 am

Hi Katrina, Hope you are doing well! I am looking forward for your advise for my son who is 2 and half year old. Till last week he was one most talkative child and was very clear on his talks. But from last week out of no where he started stuttering and it is mostly the starting alphabet of word for example :- mmmmother or nnnaugty.What I have noticed he is mostly struggling with the word starting from alphabet “M” and “N”. From yesterday he try to cover his face when stuck in his sentence. One of the point I would also like to mention that we move in to a new house recently(15 to 20 days).Earlier we used to live with grand parents and other family member but now we have to move to different city .Now in the day time he use to live with his mother only. But I have not noticed anything like that he is not liking here. He seems to be playing whole day and seems happy too.
Please advise if there is something we can do overcome this situation for our child.Thanks!!

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    Katrina Zeit Purcell July 30, 2018 at 12:54 pm

    Thank you for reaching out. First, don’t panic. Many children go through a period of stuttering during their preschool years as they are developing their speech and language skills. Sometimes, the stuttering emerges following a change or disruption in their normal routine, such as moving to a new home. The vast majority of children recover from their stuttering independently. We recommend that parents create a helpful, fluency-enhancing environment to aid the child in his recovery. Things you can do include:
    – Talk in a slow, easy relaxed way to your child, pausing frequently
    – Let your child know that you are listening by giving him eye contact
    – Do not interrupt your child or finish his words for him
    – Pause after your child says something before you respond to slow down the pace of the conversation
    – Repeat back some of your child’s stuttered utterances in a smooth, slow way
    – Let your child know that talking can be tricky. Once in a while, reassure him after a severe stutter that it is ok and that sometimes speech can be bumpy when children are learning to talk.

    If your son continues to stutter for 4-6 months, seek an evaluation from a licensed speech-language pathologist. The number one risk factor for the stuttering to persist is family history of stuttering. Please go to https://www.cincinnatichildrens.org/health/s/stuttering for more information.

Elizabeth November 15, 2018 at 9:50 am

Hi, I have a question about my son. I look forward to your feedback. It took him a little longer to begin talking than average and he still has a hard time saying some sounds. The letter f and s are particular difficult and he would leave off the first letter of many words when he began talking. But he did not have any kind of stutter (that I noticed). He is now 4.5 years and he suddenly Monday morning woke up and is stuttering. It’s usually the beginning of the sentence and sometimes in the middle. “Mmm-mommy can I have…” “I- I I I want to ggg-o….”

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    Rachel Camper November 15, 2018 at 12:56 pm

    Hi Elizabeth,

    I would be happy to help facilitate an answer to a question. What are you specifically looking to have answered?

      Elizabeth November 15, 2018 at 9:59 pm

      I think it cut off some of my post earlier. Just advice of what to do, I read the above article to give him time to slow down conversations, etc. And I will do that. Is this something that is common to start and stop quickly? Also when should I think about getting a speech therapist? And is there something that could have triggered it to start? (We haven’t moved and we have a 1 year old but no new siblings)
      Also we find it so strange that he went from normal to this overnight, does it usually happen like that? Sorry for so many questions ! And thank you

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        Katrina Zeit Purcell November 26, 2018 at 5:49 am

        Thank you for reaching out to us about your concerns. I am sure that the unexpectedness of your child’s stuttering has left you wondering what might have caused this to happen and what you might do now to help.

        It is not unusual for some children to suddenly begin stuttering overnight. In fact, we now know that a fairly large proportion of children who do begin to stutter do so in that manner. That, in and of itself can be very disconcerting to a parent given the abruptness of the onset. You should also know that this particular type of onset does not necessarily predict the course of stuttering or recovery probabilities. In addition, it is also important to understand that a recovery period for a child who has begun stuttering may last for a while in some cases. While there are some who appear to improve and recover relatively quickly, others may take a bit longer and during that time, experience a lot of variability moving from more stuttering to less stuttering for weeks or months at a time. Inasmuch as the stuttering has just begun recently, there is probably no immediate need to have your child evaluated right away. Of importance, however, is to monitor how you child reacts when he is stuttering or whether he even is aware of the behavior at all. Reactions may take the form of frustration, upset or obvious struggling to get the word out. On the other hand, he may not even notice the changes in his speech apart from just taking a bit longer to get his words out. Allowing him ample time to get his words out is most appropriate now as is a relaxed, non-emotional response to the behavior itself.

        A phone consultation with a qualified professional may be the most appropriate next step inasmuch as you mentioned some concerns about speech sound difficulties and late talking as well. A professional can also ask you some additional questions that may help determine next steps for helping you to better manage this at home or possibly making an appointment.

        Visit the Stuttering Foundation’s website to find a speech-language pathologist in your vicinity who specializes in stuttering at: https://stutteringhelp.org/referrals-information

        Thank you again for contacting us. Best of luck in helping your son.

      jaanu November 16, 2018 at 3:53 am

      Hi,
      I have a question about my 12yrs old daughter , she often says she is having chest pain on the left side while breathing would like to know what could be the reason
      * she didn’t get hurt anywhere.
      when i took her to pediatrician he advised due to puberty attaining age , due to hormonal changes in the body and tissues may get stretch may be that is the cause.

      but am worried about my child’s condition some times she is not able to breathe normally , she breathes through her mouth. kindly suggest what to do further.

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        Rachel Camper November 17, 2018 at 5:21 am

        Hi Jaanu,

        I am sorry to hear that your daughter is experiencing chest pain. If you haven’t already, please read this blog post and view the video, which may help you determine which symptoms are worrisome, as well as next steps: https://blog.cincinnatichildrens.org/healthy-living/6-questions-to-ask-when-your-child-complains-of-chest-pain/

stevie boy January 19, 2019 at 8:24 am

Hi Katrina,

My 2 and a half year old son has just started stufferring over the last couple of weeks but within the last 48hrs it has been really bad, sometimes not able to actually say the word after repeating the first letter numerous times & my concern is how rapidly this has got worse. Both myself and my wife are finding this heartbreaking to watch and it’s even making me upset just writing this. Could it have been the fact that he has just started potty training at the same time this has developed? Any advice or peace of mind would be much appreciated.

thank you

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    Katrina Zeit Purcell January 23, 2019 at 7:30 am

    Thanks for contacting us about your son. What you are explaining is not unusual. Some children who develop stuttering at this age have fairly strong and severe symptoms very abruptly while others may do so in a more gradual fashion. Some never develop that kind of response to the difficulty (it is likely an emotional reaction that he is having due to the difficulty he is experiencing getting his words out), some of which is quite unconscious.
    The harder he tries, the more severe it seem to become. I know this can be very difficult to see as your son starts to struggle in this way. If you can keep your own reactions calm and steady, acknowledging his difficult in a matter-of-fact way by simply saying, “that seemed a little hard for you to say, when I was little like you, sometimes my words got stuck too.” You can also ask him if he would like you to help him say it. You are actually acknowledging the difficulty, commenting on it without emotion, and letting him know that this kind of thing happens sometimes when little children are learning how to talk. You are normalizing the situation for him in this way. Hopefully you will begin to see a reduction in the struggle, although the stuttering may remain for a while. You don’t need to say this every time he struggles. Maybe a few times during the day at most. Our goal is to reduce any negative emotion that the child may be feeling while he is having this developmental experience. The stuttering may continue for months. If you feel he is getting worse or it has persisted too long, I would go to the Stuttering Foundation of America website and find a specialist, or someone who has experience treating children who stutter in your area.

Melissa February 7, 2019 at 11:07 am

Hi Katrina,
My 2 1/2 year old started stuttering the end of her words. Specifically words that end in t, c, k, ch, and sh. It started overnight one day. No sign of it the previous day or anything prior. I didn’t see this in your examples above. What would this type of stuttering be? Is there a cause? Should we have her seen by a speech therapist? Anything will be helpful.
Very concerned.
Thanks,
Melissa

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    Katrina Zeit Purcell February 13, 2019 at 1:30 pm

    Hi Melissa,

    The type of disfluency you describe may not actually be stuttering but some other less common type of disfluency. Typically with stuttering the repetitions of sounds/syllables occur at the beginning, not the end of a word. Sometimes as children are processing they may tend to repeat a sound/syllable over again before moving on to the next word. i would probably recommend an evaluation of her speech and language skills at this time as well as an assessment of this disfluent behavior. Typically kids who do this are a bit older, and in those cases are not aware of the behavior. My guess is she probably is not aware of it, which is a good thing. Sometimes kids who do this also demonstrate stuttering behavior as well. Given your situation, an evaluation would be recommended.

      Asif April 30, 2019 at 11:40 pm

      Hi ketrina,

      My self Asif and my son 9 yrs old ,he was born normal,and no any we can notice stuttering problem after 6 yrs old…he is very good speaking without hesitation…but after 6 yrs we noticed he stuttering (some word only like..paa…papa are u all ok…. please bring pe…pen from me) so some word lenth more than normal.. today I read your page and we got actual this problem match with my son ..Repetitions of sounds (“M-my”) or syllables (“Ba-baby”)

      What can i do …I am Indian…and in my town no have any kind of guline for my son stuttwring disease…

      Which doctor can help??
      What is exercised for its

      I noticed his mouth very open when his perticular word…

      When He sing a song ok..no any kind of stuttering ….

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        Katrina Zeit Purcell May 20, 2019 at 1:20 pm

        Thanks for reaching out to us! The speech behavior you described sounds like stuttering. Oftentimes, people who stutter can sing fluently (without stuttering). There are several ways to treat the stuttering and this usually depends on a variety of different factors. I am hesitant to suggest anything specific without knowing your son. However, if you look at the Stuttering Foundation of America website at: https://www.stutteringhelp.org/

        you will find some self-help materials and other resources that should be helpful if there is no one in your area who is available to assist you. If you have any further questions, please feel free to contact us.

    Jordan August 11, 2020 at 11:33 pm

    Hi Melissa,My son has the same exact issue right now. Since you wrote this a year ago, how did you end up handling it and did it go away?

    Huy August 30, 2021 at 2:59 pm

    Hi Melissa,I’m reaching out as we have recently observed similar situation with our 2 1/2 year old. We see that your message was from over 2 years ago and were wondering how things are with you

Robin February 10, 2019 at 1:34 pm

Hi Katrina,
My son had a developmental stutter at 3.5 years old that lasted for about a month right after his baby brother was born. Then it disappeared and there was absolutely no sign of a stutter until the end of this past summer when he was almost 8 years old. It has become very prominent. Along with it there have been some bizarre sensory issues, and for a while he had a tic with his throat which recently improved. However along with all of this there has been a lot of issues in school this year with behaviors. We’ve brought him to his pediatrician, child psychologist, neurologist, and occupational therapist. Nobody seems to have any clear answers. The OT test was just completed and shows a lot of sensory issues (but not at the level of SPD), and a lot of visual processing issues. We are desperate for answers and I feel like something is being missed here. Do you have any ideas or clues as to what causes a very quick onset to a stutter at almost 8 years old. Looking for any other clues or ideas please! Thank you.

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    Katrina Zeit Purcell February 13, 2019 at 1:29 pm

    Hi Robin,
    Your son’s situation is not very typical for developmental stuttering in that most of the children who begin to stutter do so between 2 ½-5 years of age. A smaller minority of kids have later onsets as you have described and the suddenness of the onset, which at a younger age is not unusual, is more rare when children are older. A neurology consult would have been my first recommendation given the associated tics and suddenness of onset, however, you have already done this. Another possibility for the late and sudden onset could be trauma of some kind, although this too is very rare and you have already seen a psychologist, so that can potentially be ruled out as well. It just simply may be a case of late onset developmental stuttering that has been precipitated by some unknown trigger possibly lying under the surface since preschool. We can never be 100% certain of the cause especially if it is developmental in nature.

    I would highly recommend a fluency evaluation by someone who specializes in this area. Given the length of time he has been stuttering and the worsening of symptoms, I would anticipate he has or is becoming more negatively aware of his difficulty. This should be managed immediately as part of his speech treatment.

    Best of luck.

RachC April 16, 2019 at 1:07 am

Hello Katrina, thank you in advance for your time! I have a precious 38 month old daughter, whom was an early and advanced talker. She spoke clearly and never stuttered. Over the span of 2 days she began to stutter and over the last 3 days it has become severe. So to reiterate over the last 5 days she has gone from speaking very very well to barely being able to get a few words out. For example, she will say:
“b-b-b-b-b-b-b-b-b-b-b-b-b-b-u-u-u-u-u-u-tterf-f-f-f-f-f-f-f-f-f-f-f-f-f-f-f-f-f-f-f-fly” for butterfly. She previously spoke in complex sentences and then today just started pointing what she wanted so she did not have to speak. I made an appointment with her pediatrician yesterday and the Doctor did not seemed concerned. She said if the stuttering persists for 6 months then have her evaluated. I have now read enough to feel that this is somewhat normal. However, my question to you is; does early intervention help the stuttering to go away quicker? It is so hard to watch her struggle, I can feel her frustration and it breaks my heart! I remain very calm and patiently wait for her to finish the words she is trying to say and then repeat back the word/sentence to let her know I am listening and will wait for her to get her thought out. I am just finding it so hard to think I should just wait it out for 6 months. That seems so incredibly long! Also, for preschoolers that “outgrow” this, do you see an average amount of time it takes for them to stop stuttering? I am happy to start therapy asap if it will help her now to be less frustrated and hopefully move through this process a little quicker.

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    Katrina Zeit Purcell April 18, 2019 at 6:26 am

    Thanks for reaching out to us with your question. The information you shared is not uncommon among children who begin to stutter at this age. The onset of stuttering for a sizable portion of children can be sudden and significant escalating sharply over a period of days. As a parent, this is difficult to watch inasmuch as the struggle your child is experiencing can be emotionally painful. Your reaction to this behavior will be important in terms of mitigating further exacerbation of the problem. We always suggest that parents remain as calm and non-emotional as possible when their child is struggling to communicate.

    This may seem difficult in light of your concern, however, if she perceives that you are calm and essentially non-emotionally reactive, she will likely respond similarly. That does not mean that we would simply ignore the difficulty she is having, we just don’t react emotionally in response to it. The best way to respond to those extremely painful stuttering events is to simply wait and acknowledge her difficulty, and try to normalize it by responding calmly, “ I noticed that was hard to say, would you like mommy to help you say it?” or, I noticed that was hard to say, when I was your age I had trouble saying some words too.” You don’t need to say this every time she stutters, just at those moments when she looks as if she is really struggling or appears frustrated or fearful.

    As far as intervention is concerned we would not suggest anything direct at this time, just making some changes in the home communication environment and responding appropriately to the stuttering. Waiting for 6 months is not necessarily realistic either. Each case is individual and a variety of factors need to be considered. If you feel that your child continues to experience difficult talking I would recommend reaching out to a Speech-Language pathologist in your area who has experience treating children who stutter. The recovery time for children can vary widely so this may be something that will continue for a while. Again, there are many factors that need to be considered as all cases are not necessarily the same.

    I hope this has been helpful to you.

Kathy April 30, 2019 at 6:31 am

Hi Katrina my grandson of 12 has started stuttering extremly bad, so that he takes ages to tell my what he wants to. His grandfather had a mild stuttering. But he has been through a lot of trauma losing his mommy ( my daughter) at the age of 5 years then I noticed the mild stuttering. 3 years later his daddy passed away due to a heart attac in the car while driving and he saw everything. What can we do to help him?

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    Katrina Zeit Purcell May 20, 2019 at 1:18 pm

    Hi Kathy,

    Given the fact that grandfather stutters it is not unusual for other family members to also be effected. It sounds like the changes in the stuttering could be due to the cumulative effects of the negative emotional events in his life as well as other negative experiences he may be having at this time (social relationships, school requirements). I would encourage you to explore therapy for the stuttering that includes skills to manage his speech as well as his thoughts and emotions (counseling). A qualified speech pathologist who has experience treating stuttering should be able to help you. If there are none in your area, you may want to look at the Stuttering Foundation of America website at: https://www.stutteringhelp.org/
    You will find some self-help materials and other resources that should be helpful to you. If you have any further questions, please feel free to contact us.

Kiskasmommy May 26, 2019 at 7:55 pm

Hi. My daughter is 3 1/2 and is stuttering her l’s I’m concerned she says them over 10 times before she can get what she needs too out.???

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    Katrina Zeit Purcell June 3, 2019 at 1:26 pm

    It’s not unusual for some children to experience a period of stuttering at which time they may begin to repeat whole words or parts of words over again several times before moving forward with their message. It’s important to allow your child ample time to get her words out, not interrupt or offer suggestions such as slow down or take a breath. Giving time for kids to organize their thoughts is important. If you notice she is beginning to become upset or frustrated by this you can simply acknowledge her difficulty by saying, “that seemed a little hard to say, when mommy was little sometimes her words sounded like that too.” I would only recommend doing this if she is beginning to react to the difficulty. If not, give her plenty of time to say what she wants to say. Take a look at the Stuttering Foundation of America website at https://www.stutteringhelp.org/ where you will find materials for parents that should be of some help to you. If this persists beyond several months you may want to contact a speech pathologist in your area for advice.

Noma June 19, 2019 at 4:52 pm

Thank you for the article. The day I brought a new born from hospital, my 4 year old toddler started stuttering. I have been worried as she had never had that problem before. It is the same day that her grandma arrived to help take care of the new born so now I know that my toddler’s stuttering could be due to excitement from seeing her grandma or it could be due to psychological stress from the arrival of her sibling.

Katy October 5, 2019 at 10:25 am

Hello my son is 13 and has had just a few episodes where he stuttered like he never has. I don’t know if this is related but for the past couple years he has been making more bathroom trips and staying a long time. The stuttering really threw me and it threw him til I think. Anyway I am watching it closely but am very concerned. I put a lot of pressure on him to do well in school. I have read that emotional stress can cause it so I am not talking about academics with him. He had a speech impediment when he was younger and into early middle school but he seems to have outgrown that. He is not athletic or coordinated.

Kristy February 16, 2020 at 8:59 pm

My son is 16 year’s old and has been stuttering since he started talking. He was diagnosed as being on the Autism spectrum when he was in pre-K. He has been in speech therapy since pre-k. I’m concerned because since he started his 9th grade year he has started this cough like thing when he is stuttering. And has not shown any sign of going away. Should I be concerned? Should I get him a referral from his primary care doctor to see a neurologist? He is on disability and is in special education at school. He did go from extended service class to a bigger special ed class room in his 9th grade year. No traumas or bad experiences. No medications. He has been off medication for more then a year. When he was taking medications it was resperdone and trazodone. He took respredon twice a day and trazodone once at bed time. He is very active with his Autism like cant sit still does a lot off jumping off and on through out his days. I started giving him melatonin to help with sleeping and we keep him active during the day. We preferred him more active then being very sleepy. He also had got up to 240 on meds. Since he has been off. He has gotten close to a healthy weight of 214. He us eatting healthy and staying active. He seems much happier. Just started this coughing thing when he stutters which is always it annoyed him. I read scarey stuff online that could be causing it. So after reading your site and comments and responses I decided to try and reach out to you. I love my son very much and just need some advice from a specialist.

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    Katrina Zeit Purcell March 9, 2020 at 12:13 pm

    Hello and thanks for reaching out to us at Cincinnati Children’s. That is wonderful news that your son is eating healthy, staying active, and seems much happier. The coughing you describe that he is doing when he stutters sounds like it could be a secondary behavior of stuttering. People who stutter will produce secondary behaviors in attempt to escape or avoid stuttering at times. They can also be a response to the tension a person feels when he stutters. It sounds like your son would benefit from seeing a speech-language pathologist who specializes in stuttering. You can find one in your area by visiting the Stuttering Foundation of America website at: https://www.stutteringhelp.org/. The SFA website also has a brochure on autism and stuttering at https://www.stutteringhelp.org/content/autism-spectrum-disorders-and-stuttering as well as other materials for parents that should be of some help to you. Finally, it is always important to have your child be seen regularly by his primary care physician regarding his overall health, medications, and development.

(Arya) the 5 year old February 28, 2020 at 8:23 pm

Hi There! I am the daughter in law of a very large family and the reason I’m leaving this message is to get the answer I desperately need. My fiancee younger sister (she’s 5) has suddenly began stuttering. I’ve been in her life since she was 2 years old! She has NEVER stuttred once before and let me tell you, this girl loves to talk! And now all of a sudden she’s been stuttering for the past week. It’s at least once or twice a day now. I noticed it first happend when she was telling me a story and she kept making these stressed out, almost constipated faces out of no where and then she kept repeating the word “I uh.. i -I-I-I” I just tried to call her down and every day since then she just randomly stutters. It’s always when she’s getting excited or she’s just gotten a time out so I don’t kbow….please help! -California

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    Katrina Zeit Purcell March 9, 2020 at 12:11 pm

    Thank you for reaching out to us about your concerns. I am sure that the unexpectedness of your family member’s stuttering has left you wondering what might have caused this to happen and what you might do now to help. It is not unusual for some children to suddenly begin stuttering overnight. In fact, we now know that a fairly large proportion of children who do begin to stutter do so in that manner. Additionally, many preschool children go through a period of disfluency and the vast majority of them recover from stuttering. There are identified risk factors, such as family history, for stuttering to persist. Children who are stuttering, often stutter when they are excited or during emotional situations. Excitement and heightened emotions do not cause the stuttering to occur, rather, just help bring the stuttering out in a child who is predisposed to stutter. I encourage you to contact a licensed speech-language pathologist who specializes in stuttering near your home. You can find one in your area by visiting the Stuttering Foundation of America website at: https://stutteringhelp.org/referrals-information After finding out more information about your family member, the speech-language pathologist can help determine, based on your family member’s risk factors, the next steps for helping you to better manage this at home or possibly making an appointment for an evaluation. Additional resources can be found at https://www.stutteringhelp.org/. Thank you again for contacting us. Best of luck in helping your fiance’s younger sister.

Worried Momma May 22, 2020 at 9:58 pm

I’m heartbroken. My daughter, who just turned three, has started stuttering out of nowhere. She was speaking beautifully and really building her vocabulary. All of a sudden, in a matter of a week, she is stuttering so bad, that she puts her hand over her mouth, tries to say the word in a high pitched voice, and sometimes gives up and says “I can’t.” Nothing about her routine has changed other than the fact that I am home now because of the stay at home order. She is recently potty trained, but that was super easy for her. I’m a nervous wreck and it breaks my heart to see her struggle so much. My first reaction was pretty noticiable as I thought she was just being silly. Now, I’m very calm and let her finish her thought and try to be as encouraging as possible. I’m at a loss and am constantly on the verge of tears.

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    Katrina Zeit Purcell May 29, 2020 at 6:24 am

    Dear Worried Momma,
    A sudden onset of stuttering can be very upsetting for parents. You are being supportive by staying calm and being encouraging. I also recommend that you repeat back what your daughter says, modeling a slow rate of speech, adding pauses in-between your phrases. Be assured that nothing you are doing is causing your daughter to stutter, however, how you respond to her can be helpful. This blog post may give you more ideas on how to respond in a helpful way and create a fluency-enhancing environment in the home: https://blog.cincinnatichildrens.org/how-to-help-a-preschooler-who-begins-to-stutter. Additional tips can be found at https://www.stutteringhelp.org/. If you would like additional professional guidance, do not hesitate to reach out to a speech-language pathologist near your home. He or she may be able to consult over the phone and give you some ideas before an in-person appointment is warranted. Our contact information is 513-636-4341 or speech.pathology@cchmc.org.

grace June 5, 2020 at 11:47 pm

I started developing a stutter as soon as I could talk. I went to speech therapy for a couple years but then it went away around 8 years old but then came back a year or two later and I am now 16 years old and still have a stutter. My family has no history of a stutter and I really dont know how I developed this stutter.

Stuttering progressing May 13, 2022 at 12:48 am

My daughter moved from another country in December 2020 where they spoke a different local language and started preschool in March of 2021, she was 3 at the time. As she was learning English she would stutter but suddenly during the Christmas holidays the stuttering has gotten so much worse and even her School Principal expressed concern. I am heartbroken as I don’t know what to do to help her.

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    Katrina Zeit Purcell May 16, 2022 at 6:02 am

    I recommend that you obtain a fluency evaluation due to concerns with stuttering for your daughter. Given that she has been stuttering for one year now and that her stuttering severity has increased, it would be worthwhile having a speech-language pathologist assess your daughter’s stuttering directly. Severe stuttering can be very upsetting for parents. While you are waiting for her evaluation appointment, you can support your daughter by staying calm and being encouraging. It can be helpful if you repeat back what your daughter says, modeling a slow rate of speech, adding pauses in between your phrases. Be assured that nothing you are doing is causing your daughter to stutter; however, how you respond to her can be helpful. Additional tips can be found at https://www.stutteringhelp.org/. Thank you for reaching out to us.

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