Should I wait or seek speech therapy now?
When a preschool child begins stuttering, it can be confusing for parents because it doesn’t usually happen gradually. For many three- and four-year-olds, the onset of a fluency disorder is very sudden, with stuttering immediately appearing to be quite severe.
Here are some statistics:
An estimated 5-8% of all preschool children will go through a period of stuttering
The onset of stuttering is typically between 30-48 months of age
Around 80% of preschool children who begin stuttering will recover, with or without treatment
Sources: Bloodstein & Ratner (2008), Yairi & Ambrose (2005), and Yairi & Ambrose (2013)
So how do you know if your preschool child will recover without treatment? And if you wait, will it reduce the chances of recovery?
When a speech-language pathologist assesses a preschool-aged child for stuttering, she will analyze the risk factors for persistent stuttering. These risk factors include family history of stuttering, sex, age at onset, frequency of stuttering-like disfluencies, and speech and language skills. When all these factors are taken into consideration together, a decision can be made about whether it would be appropriate to begin treatment right away or to wait and monitor your child’s speech.
We know that one of the most important risk factors is family history. If a child has a first-, second-, or third degree relative (this includes parents, siblings, grandparents, aunts, uncles, cousins, great-grandparents) who stuttered, it is more likely that stuttering will persist (Walsh et al., 2020). This is regardless of whether the relative recovered or continued to stutter.
A speech-language pathologist will assess your child’s production of stuttering-like disfluencies. These include sound/syllable repetitions, sound prolongations, and blocks. These are the hallmark characteristics of stuttering and are differentiated from typical disfluencies that are often seen in preschool children: hesitations, revisions (changing the words in a sentence), interjections (uh, um, like), and word/phrase repetitions. When frequency of stuttering-like disfluencies is considered along with a risk factor like family history, a decision about whether to treat stuttering can be made confidently. For example, if there is a history of stuttering in your family and your child has more stuttering-like disfluencies than typical disfluencies, it would be best to begin treatment right away because the chances of persistence are high. On the other hand, if you have a family history of stuttering but your child has a low frequency of stuttering-like disfluencies and strong articulation and language skills, you can wait and monitor any changes in your child’s speech because the chances of persistence are lower.
One thing to keep in mind is this: if your child is showing a heightened awareness of his stuttering, any tension, or is becoming hesitant about communicating, treatment should begin right away. Your speech-language pathologist will help you to talk about stuttering with your child in an open, accepting way in order to ease some of his frustration and/or anxiety.
And finally, waiting and monitoring your child’s speech for a period of a few months probably won’t have a significant impact. In the Lidcombe Program, an evidence-based treatment for preschool stuttering, it has been shown that delaying treatment until the child is at least four years old results in less treatment time overall (i.e., less weekly sessions with clinician before reaching treatment goals). It is helpful to be in communication with a speech-language pathologist during this monitoring phase so that any changes to your child’s speech can be addressed immediately.
Many preschool children go through a period of stuttering, and of those children, most will recover with or without treatment. A licensed speech-language pathologist can assess the risk factors for persistent stuttering and help you make an informed decision about whether speech therapy is necessary. For your child, delaying treatment for a period of a few months and monitoring his speech may be a good option.
If you are in the North Los Angeles Area and your preschool-aged child has started stuttering, you can schedule a free phone consultation with me here.
Resources:
Bloodstein, O., & Ratner, N.B. (2008). A Handbook on Stuttering (6th ed.). New York, NY: Thomson-Delmar.
Walsh, B., Christ, S., & Weber, C. (2021). Exploring Relationships Among Risk Factors for Persistence in Early Childhood Stuttering. Journal of Speech, Language, and Hearing Research, 64(8), 2909-2927. https://doi.org/10.1044/2021_JSLHR-21-00034
Yairi, E., & Ambrose, N.G. (2005). Early Childhood Stuttering: For Clinicians by Clinicians. Austin, TX: Pro-Ed.
Yairi, E., & Ambrose, N.G. (2013). Epidemiology of Stuttering: 21st Century Advances. Journal of Fluency Disorders, 38, 66-87. https://doi.org/10.1016/j.fludis.2012.11.002