Stuttering during the preschool years
Stuttering in school-age children
Stuttering During the Preschool Years
Many preschoolers go through periods with stuttering and/or speech disfluencies. Stuttering is different than "normal disfluency". Normal disfluencies include behaviours such as repeating a whole word ("many, many"), using "fillers" such as "um", or restarting a sentence ("I'm gonna...Watch me run!"). These types of disfluencies are a normal part of language development and still occur occasionally in adulthood.
Stuttering involves difficulty starting or a repetition of motor movements. Stuttering can be repetitions of whole words or parts of words ("D-D-D-Danny" or "my-my-my-my"). It could also involve prolonged sounds ("mmmmm-mom"), or blocks where a word won't come out ("gimme.........that"). Stuttering can also involve muscle tension and frustration.
Stuttering most often starts between the ages of 2 and 4 years and is experienced by about 5% of children. While approximately 80% of children who start to stutter will naturally recover, about 20% are at risk of persistent stuttering. While we cannot predict at onset which children will naturally recover and which will not, speech-language pathologists (S-LPs) are able to determine relative risk based on a number of factors.
During the initial assessment, an S-LP measures and analyzes aspects of a child's speech and stuttering behaviours, classifies the types of disfluenceis exhibited, makes visual observations during the child's speech production, takes a detailed case history, and identifies the presence of risk factors. Based on this information, the S-LP can make recommendations about whether a child is likely to be exhibiting normal disfluencies, whether they should be monitored and reassessed within a few months, or if treatment should be started.
It is never too early to speak with an S-LP about your concerns. Below is a checklist of factors that may mean a child is more likely to experience persistent stuttering. If you check 'yes' to any of the items below, it is recommended that you consult with an S-LP.
Risk factors for persistent stuttering:
[ ] there is a family history of stuttering and the child is male
[ ] the child shows muscle tension or experiences frustration when stuttering
[ ] the child is exhibiting blocks ("gimme...........that")
[ ] the child is exhibiting prolongations ("mmmmmom")
[ ] the stuttering has not improved or has gotten worse over the last 6 months
There are various approaches to treating early stuttering in the preschool years, including the Lidcombe Program and those that fall under the umbrella of the Demands and Capacities Model. At Shoreline, we provide treatment using a Family-Focused Approach (Demands and Capacities Model) or the Lidcombe Program. Both approaches are effective with preschool children, and the choice of treatment approach is dependent upon the needs of each child and their family.
Click here to hear Dr. J. Scott Yaruss briefly describe a Family-Focused Approach:
Click here to learn about the Lidcombe Program: http://www.lidcombeprogram.org/
Parents often ask how long treatment will take. As with many types of communication intervention, young children who stutter are quite variable in how much treatment they will require. When using a family-focused approach, the initial phase of parent training usually requires 6-8 sessions (each 45-60 minutes long). For 2/3 of children, stuttering will be eliminated after this phase of treatment. If a child then requires direct treatment, length of treatment can vary from a few sessions to up to a year (Yaruss, 2006). When using the Lidcombe Program behavioural approach, Phase 1 may take up to 28 sessions (typically weekly), although the median number of sessions required is 15 (Packman et al., 2014). Phase 2 takes one year (frequency of sessions is reduced).
To speak with one of Shoreline's S-LPs about your concerns, please contact us here.
Download our information handout on early childhood stuttering.
Stuttering in School-aged Children
Description in development.
If you have questions, you can request a free 30-minute exploratory meeting. Please note that such a meeting is not a clinical assessment.
Resources and Links
"Stuttering: For Kids, By Kids"
from The Stuttering Foundation
"The Age Factor in Stuttering"
by E. Yairi
Canadian Stuttering Association
"Top 3 Things When Meeting Someone who Stutters"
"When I Stutter" Documentary
References on this Page
Packman, A., Onslow, M., Webber, M., Harrison, E., Arnott, S., Bridgman, K., . . . Lloyd, W. (2014). The Lidcombe Program treatment guide. Retrieved from http://www.lidcombeprogram.org/wp-content/uploads/2015/04/Lidcombe-Program-Treatment-Guide-March-2014.pdf
Yaruss, J. S., Coleman, C., & Hammer, D. (2006). Treating preschool children who stutter: Description and preliminary evaluation of a family-focused treatment approach. Language, Speech, and Hearing Services in Schools, 37, 118-36.