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The Informed Parent


by Peter W. Welty, M.D., F.A.A.P.
Published on Jan. 01, 2000

Dear Dr. Welty,

My ten and a half year old son has a problem with stuttering, especially when he is excited or nervous. My mother says that there is nothing to worry about, and that he will grow out of it, but my neighbor says that he has a real problem. I tell him to slow down and to think before he speaks, but it doesn't seem to make any difference. Occasionally my husband stutters too. Do you think my son has a real problem? Should he start some type of treatment?

Stuttering is a disorder of speech that may begin when two or three word phrases are first used. In contrast to stuttering, the repetition of sounds, words, and phrases for short periods, known as speech dysfluencies, are normal beginning at age two and decreasing by age six. These children are generally unaware of their speech irregularity and do not react to them with fear, frustration or tension, as do children with a stuttering disorder. These episodes are often associated with visible tremors of the lip tongue, or jaw.

Approximately four percent of children develop stuttering between the ages of two-to-six. Three quarters of these have outgrown it before they reach puberty. Of the one percent who continue to stutter, increased emotional and behavioral symptoms may be seen. Peer teasing and disapproval can make the child respond with increased efforts to speak fluently. This can counteract the situation by leading to longer and more consistent periods of speech aberration. The child will begin to avoid people and situations where speaking is necessary, convincing himself that his speech is shameful.

Heredity may play a role. Boys are more commonly effected than girls, and stress, fatigue and excitement often trigger the pattern.

Discuss your child's speech with his pediatrician. Evaluation can be done through your school, or ask for references to other centers. The major goal of the assessment is to determine whether your child has a stuttering disorder, whether there are emotional or behavioral components, and to devise an appropriate treatment plan with a speech therapist.

As a parent, there are several things you can do to help. It is important to make the environment at home one where your child is not afraid to speak freely. Remember, he cannot control the stuttering, and pressure will only make matters worse. Concentrate on accepting him as he is. Try not to correct him. Do not pressure him to slow down his speech or to repeat a word or phrase.

In general, try to make him feel more relaxed, and listen to him without any sign of anxiety on your part. Avoid situations which seem to bring on stuttering. Share your plans with the babysitters, teachers, relatives and neighbors. With appropriate speech therapy and active involvement in his treatment play, your child will learn to overcome his stuttering.

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