Dysfluent Speech - When Should I Worry?
A question that I have been asked a lot recently is whether it is normal for children to emit dysfluent speech and when as a parent should you worry?
This is a great question and can be a bit tricky to answer. It is not unusual for children between the ages of 18 months to 5 years of age to exhibit what is referred to as a developmental dysfluency. This occurs typically during the window of time in which children are rapidly acquiring language. There is so much going on at that time including organizing one’s thoughts, retrieving the right words, and putting them into cohesive sentences so that they make sense. It truly is amazing that not all children exhibit a period of disfluent speech!
Of course, there are those children that may not go through a phase of developmental dysfluency but rather go straight into stuttering. So, as a parent how can you differentiate between developmental dysfluencies and early signs of stuttering and when do you need to worry? To best answer this question, let’s break down development dysfluencies a bit more.
What characterizes normal developmental dysfluency?
· Repetitions of sounds
· Repetitions of syllables
· Repetition of words
Most of these repetitions will occur at the beginning of sentences and tend to occur at a somewhat low rate, about once per every ten sentences.
As children reach closer to the age of 3 years, their developmental dysfluencies may change. You may notice that they start to repeat whole words or short phrases. It is also not uncommon for them to insert fillers such as, “um” or “uh.”
Your child’s dysfluency may increase in frequency when they are tired, excited, are rushed to speak or when they are upset. Sometimes you may notice that they have more dysfluencies when they are asking a question or answering a question.
Interestingly, you may also notice that while they have periods of dysfluent speech, they also have periods with low rates or even no dysfluencies.
Children with developmental dysfluencies typically are not aware of their dysfluent speech and as such do not seem to be bothered by it.
What is Stuttering?
As mentioned previously, some children may go on to develop a mild stutter. While mild stuttering typically emerges at 18 months-7 years of age, it most frequently begins between the ages of 3-7 years.
While the characteristics of stuttering often mimic those of normal developmental dysfluency, the frequency of occurrence is higher. Also, in addition to repeating sounds, syllables and words, stutters also repeat syllables (e.g., “ple…ple….ple….ple…please).
Additional characteristics of stuttering:
· May blink or close their eyes
· May avoid talking
· May look away
· May tense their mouth when talking
· May show signs of embarrassment
In addition to the frequency of dysfluent speech be higher for those that stutter, it is important to note that the consistency of which they exhibit dysfluent speech also increases. Unlike normal developmental dysfluencies which can include periods of time with low rates of dysfluent speech to periods of having no dysfluency, stuttering tends to occur with increased persistence.
What should parents do when their child exhibits dysfluent speech?
Regardless of if your child is going through a phase of normal developmental dysfluency or showing signs of a mild stuttering, there are a few things that you can do when talking to your child:
· Talk to your child using a relaxed and slowed rate of speech
· Limit the number of questions you ask
· Wait for your child to get their words out
· Try not to interrupt your child
· Find time during the day that you can provide undivided attention to your child
· Respond positively when your child stutters
· Talk to your child about their stuttering
When to seek support?
While research suggests that as many as 70% of all children who start stuttering will outgrow it on their own with no speech therapy, it is difficult to know which children will not. Further, research also indicates that if a child has been stuttering longer than one year, the likelihood that he or she will outgrow it without any speech therapy is reduced.
Therefore, if your child has been exhibiting dysfluent speech for 6 months or more, it is a good idea to have them evaluated by a speech-language pathologist. However, if there is a family history of stuttering, your child is avoiding talking, showing secondary characteristics (e.g., eye blinking, tense mouth, etc.), and it has been less than 6-months since they have started stuttering, it still may warrant seeking the guidance of an SLP.