Stuttering & speech

Common signs

• Blocks, where speech stops and no sound comes
• Repeating sounds or syllables: “b-b-ball”
• Stretching sounds: “sssssun”
• Tension, or blinking or nodding while trying to get a word out

Stuttering often gets worse when talking to groups or on the phone, and is often easier when singing or reading aloud with others.

Stammering can happen more when a child has a lot to say, is excited, or feels under pressure.

Developmental stuttering appears in young children while they are learning speech and language, and is the most common type. A rarer kind can start later, after a stroke, head injury or other brain injury.

About 5 to 10 percent of all children stutter for some period, most often between ages 2 and 6. About 75 percent of children recover. For others, it can continue into adult life.

Cluttering is different from stuttering. Speech is very fast and hard to follow, with lots of “uh”s and “um”s and unexpected pauses.

A speech-language pathologist can tell the difference and help with both.

Stuttering likely comes from several factors working together, and genes play a role. Small differences in how efficiently the brain’s speech areas work may also be involved.

Around 2 in 3 people who stammer have a family history of it. Boys are 2 to 3 times as likely as girls to stutter.

Stuttering is not caused by anything parents have done. Stuttering caused by emotional trauma is considered rare.

Speech disorders affect how sounds are made or how smoothly speech flows. In apraxia of speech, it is hard to put sounds and syllables together.

Language disorders can affect understanding what others say, or sharing thoughts and ideas. Developmental language disorder slows down the learning of language skills, and some children don’t talk until age 3 or 4.

Speech or language delays can come from hearing loss as well as from a speech or language disorder. That’s why a hearing test is often part of an evaluation.

The first three years are the most intensive period for learning speech and language. By 6 months, most babies recognize the basic sounds of their home language.

Everyday ways to build language

• Giving them time and showing you are interested
• Repeating their words back correctly, without saying “that’s wrong”
• Talking, reading and singing together every day
• Working with school or early intervention on support plans

Some people hide their stutter, avoid certain words, or skip situations like phone calls because they worry about how others will react.

A child who suddenly stops raising their hand, or always lets a sibling order for them, may be avoiding talking. Gently noticing this can open a conversation.

When children can’t make themselves understood, they may get frustrated, have meltdowns, go quiet, or avoid talking at school. Others may think they aren’t smart, when the problem is getting ideas into words.

Listeners can help by not teasing, not showing impatience, and not drawing attention to the way a person speaks.

Speaking up when words might get stuck takes real courage. Many therapies also work on the worry around speaking, not just the speech itself.

What parents can do

• Create a relaxed home with lots of chances to talk
• Focus on what your child says, not how they say it
• If they bring it up, talk openly and let them know some bumps are okay
• Speak slowly and calmly yourself
• Wait for them to finish: don’t finish their sentences

Try

• Keep natural eye contact and a calm face
• Let them finish, even if it takes a while
• Respond to the message: “Oh, you saw a fox? Tell me more!”
• Avoid “slow down” or “take a breath”, which can add pressure

A few minutes a day of calm, child-led play gives your child a relaxed chance to talk. Turn off screens, follow their lead, and enjoy being together.

Ideas

• Make it a family rule that no one finishes others’ words
• Stop teasing at home quickly and firmly
• Take turns at dinner so everyone has time to talk
• Connect with local support groups for children who stutter and their families

Ideas

• Ask the child privately what helps them
• Don’t make them read aloud or present without talking it through first
• Give extra time to answer without rushing
• Stop teasing quickly and firmly

Therapy often includes practicing feared situations, like saying their name or ordering food. Teachers can support this practice gently.

Ideas to agree with the child

• Answering earlier rather than waiting their turn
• Choral reading with a partner or group
• Presenting to a smaller group first
• Recording a presentation if live talk is too hard for now

For children aged 3 and older, families can call any local public elementary school and ask for an evaluation through the school system.

Some children talk easily at home but can’t speak in certain places, most often at school. This is called selective mutism, and it is a form of anxiety. The child is unable to speak, not refusing to speak.

Never pressure, bribe or punish a child to make them talk. Gentle, step-by-step therapy helps, and getting help early makes it easier.

AAC covers every way of communicating besides speech: gestures, pointing to pictures or letters, writing, and apps or devices that speak out loud.

People of all ages use AAC, including children under 3. No test score or skill is needed first. Some people understand far more than they can say.

Some children with speech or language differences are also autistic, have ADHD or have sensory differences. A full assessment helps make sure all their needs are seen.

Genes and differences in how the brain’s speech areas work seem to be involved. Stuttering caused by emotional trauma is rare.

A person who stutters knows what they want to say. The words just get stuck on the way out.

Don’t finish their words for them, even when trying to help. Focus on what they say, not how they say it.

Many children do recover, but therapy is often successful in pre-school children, so early advice is recommended.

1. Talk to your child’s doctor and share your concerns.
2. Under age 3: contact your local early intervention system for a free evaluation. You don’t need a doctor’s referral or diagnosis to call.
3. Age 3 or older: call any local public elementary school, even if your child doesn’t go there, and ask for an evaluation.
4. Don’t wait. Acting early can make a real difference.

Therapy for young children often teaches parents how to support easier speech at home. For older children, the main focus is on what a person says, rather than how they say it, and on feeling comfortable talking at school and with friends.

Depending on the evaluation, a speech-language pathologist may suggest home activities, group or one-to-one therapy, or a check with an audiologist or developmental psychologist.

In the U.K., parents in many areas can contact children’s speech and language services directly. In other countries, ask your child’s doctor or school.