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• The child stutters for weeks or months, between periods of fluency. Stuttering for more than six months is a sign of a risk.

• Stuttering when excited or upset, when having a great deal to say, or under high environmental demands.

• Length of time creating speech. Sounds are delayed at least a half-second.

• Struggle and speech-production muscle tension, such as a rise in vocal pitch (caused by tensing the larynx), blocking
airflow and stopping vocal sounds, wide mouth opening or tongue swelling, or irregular breathing patterns.

• Stuttering only on the first word of a sentence or phrase.

• Stuttering on both content and purpose words (“like,” “but,” “and,” or “so”).

• Secondary or flight behaviors, such as eye blinking, nodding, facial frowning, quivering lip, raising eye brows, flaring
nostrils.

• Fear or avoidance of certain sounds or words. Word substitution begins.

• Halts become common, in addition to repetitions and delays.

• Stuttering becomes persistent, without periods of smoothness.

• Stuttering occurs on content words—major nouns, verbs, and adjectives.

• Stuttering varies among situations, such as talking on the telephone, speaking to strangers, or when excited.

Stuttering often gets worse when the child is excited, tired or distressed, or when feeling self-conscious, rushed or
pressured. Speaking in front of a group or talking on the telephone can be particularly difficult for this group of children.
While reasons are unclear, most people who stutter can speak without stuttering when they talk to themselves and when
they sing.

Causes of Stuttering

Scientists suspect a combination of motives causing stuttering in children. The exact structure that makes up stuttering is
unknown. Researchers don't know precisely the causes of stuttering, but the fact that stuttering tends to run in families
gives reason to believe that many forms of stuttering are genetic in origin.
The most common form of stuttering is thought to be developmental, occurring in children who are in the process of
developing speech and language. This casual type of stuttering occurs when a child's speech and language abilities exceed
his/her verbal demands. Stuttering happens when the child searches for the correct word. Developmental stuttering is
usually outgrown.

Another common form of stuttering is neurogenic (originating in the nerves). Neurogenic disorders result from signal
problems between the brain and nerves or muscles. In neurogenic stuttering, the brain is unable to coordinate effectively the
different components of the speech system. Neurogenic stuttering may also occur following a stroke or other type of brain
injury.

Other forms of stuttering are classified as psychogenic or originating in the mind or mental activity of the brain such as
thought and reasoning. Whereas at one time the major cause of stuttering was thought to be psychogenic (mental or
emotional processes), this type of stuttering is now known to report for only a minority of the individuals who stutter.
Although individuals who stutter may develop emotional problems such as fear of meeting new people or speaking on the
telephone, these problems often are a consequence of stuttering rather than causes of stuttering.

Expert statements that stuttering develops gradually in stages seems controversial. Some parents report that their children
woke up one morning stuttering severely. These children went from normal pauses to severe stuttering overnight. The
children appear to have skipped the developmental stages in between. Could a child’s immune system instead attack brain
cells in the left caudate nucleus (speech motor control area), and the child wakes up from an infection with severe
stuttering? Scientists and clinicians have long known that stuttering may run in families and that there is a strong possibility
that some forms of stuttering are, in fact, hereditary. No gene or genes for stuttering, however, have yet been found.

Treatment

Most children outgrow stuttering on their own, and no stuttering treatment is needed. If your child's stuttering last longer
than six months, or beyond age 5, speech therapy may be useful to help decrease stuttering.

There are a variety of treatments available for stuttering. Any of the methods may improve stuttering to some degree, but
there is at present no cure for stuttering. Stuttering therapy, however, may help prevent developmental stuttering from
becoming a life-long problem. Therefore a speech evaluation is recommended for children who stutter for longer than six
months or for the child who’s stuttering is accompanied by challenging behaviors.

Presently many accepted therapy programs for persistent stuttering focus on regaining speech skills or adjusting flawed
ways of speaking. The psychological side effects of stuttering that often occur, such as fear of speaking to strangers or in
public, are also addressed in most of these programs.
Stuttering in children- Speech language disorder - what is stuttering.  Bright Tots information on child development
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Stuttering In Children
Stuttering affects individuals of all ages but occurs most frequently in young children between the
ages of 2 and 6 who are developing language. The average age of stuttering in children is 2 ½
years old. Stuttering rarely begins after age six; 65% of preschoolers who stutter spontaneously
recover, in their first two years of stuttering. These children grow up to have normal speech.
However, children who stutter longer are less likely to recover without treatment. Only 18% of
children who stutter up to five years recover suddenly. The peak age of recovery is three and a
half years old. By age six, a child is unlikely to recover without speech therapy.

Among preschoolers, boys who stutter outnumber girls who stutter about three boys for one girl.
The majority of girls recover fluent speech, while the boys don’t. By fifth grade the ratio is about
four boys who stutter to one girl who stutters. This ratio remains into adulthood. Some
pediatricians tell parents to “wait and see” if a child outgrows stuttering on his own.

Children who stutter should see a speech-language pathologist as soon as possible. To find a
Stuttering in Children

speech-language pathologist for your child, start by calling your local elementary school. The board of education provides free
speech therapy to children as young as three years old. If your child stutters at two or three and you get the child into speech
therapy right away, many see a full recovery, within months, without relapses. A small push may get the child back onto the
normal development path. If your child is in grade school and has stuttered for five years, he or she will need additional
speech therapy to get back onto the normal development track.

Normal Pauses in Speech is not Stuttering

At two or three years old, children are quickly developing communication skills. Their brains are growing rapidly. A child’s
language skills may develop faster than his/her verbal skills. The child wants to communicate but can’t easily and freely
produce speech. All children have normal pauses in speech as they learn words and vocal communication. Normal pauses
aren’t stuttering, and don’t need to be treated by a speech-language pathologist. Normal interruptions and repetitions that tend
to be single, for instances “That my-my ball.

A child who doesn’t noticeably struggle or show signs of visible pressure, frustration or
embarrassment is normal. These errors happen when the child is planning a long or
complex sentence. Brief silent pauses are considered normal, such as when directing
another person’s attention, when concerned about the listener’s reaction, and when
interrupting or being interrupted. Normal imperfections may occur when the child’s
language skills exceed his speech motor skills. Changes in the child’s environment may also
cause temporary normal flaws; this could involve parents’ divorce, the birth of a sibling, or
moving to a new home.

Early signs of Stuttering

• Part-word repetitions (not whole-word repetitions). Repetitions become rapid, tense, and
irregular. A sound or word is repeated three or more times.

• Pauses and flaws on more than 10% of words.
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