Childhood Speech Dysfluency

Stuttering, or stammering as it is more often called in Europe, is one of the most common childhood speech disorders. It is lumped into the broader category of speech dysfluency. Normal speech dysfluency tends to be differentiated from stuttering in that it is less frequent, less bothersome to children, and less likely to be associated with other signs of stress like tics, physical movements or physical tension around the lips. Varying degrees of speech fluency problems are quite common, and usually resolve within a few weeks when they do happen.

Mild stuttering is often associated with more frequent repetitions of sounds, often about 3% of words affected. It is also sometimes associated with facial expressions like eyelid closing or blinking, looking from one side to another, or pursing of the lips. It is more often present than it is absent, though may sometimes come and go to one degree to another. Mild stuttering tends to resolve more often on its own than does more severe stuttering, and referral is often indicated if there is a high degree of parental concern of if it persists for much more than 2-3 months.

Severe stuttering is really not difficult to recognize as stuttering. In severe stutterers the repetitions occur in about 10% of words, tend to be present in nearly all situations, and are usually quite consistent and don’t fluctuate much at all. These children tend to become quite frustrated, and often become embarrassed. They tend to avoid situations where they will need to speak. Starter words like “um” and “er” may be used often. Speech pathology is generally indicated for severe stuttering, and long-term therapy may be needed for some children and adults. The recent movie The King’s Speech that won the best picture Academy Award in 2011 portrays the king of England and his struggles to fulfill the demands of his role as the King during World War II while overcoming his severe stuttering. It is a pretty realistic portrayal of the state of the art at that time, although progress in speech therapy since then has been significant.

Less than 1% of adults still stutter, with about 80% of childhood stutterers resolving by adulthood. Early referral of severe stutterers may lead to better outcomes, and moderate stutterers should have speech therapy referral if the stuttering persists for more than 6-8 weeks. Children with normal speech dysfluency usually do not require intervention. In summary stuttering is common, more common in men, and tends to resolve in about 80% of cases.