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Ask Dr. Sears: Stuttering in Children

Q:  My daughter just turned 3 and she's having a problem with stuttering. I'm not sure if I should get her evaluated or not. Sometimes it's really bad and sometimes you can't tell if she's having a problem. When should I start to worry?

A: In the usual progression of learning to talk, many 3-year-olds go through a stage called normal disfluency, in which they repeat words and syllables and use fillers like "uh" or "um." Normal disfluencies tend to occur when children are tired or being rushed to speak, and they usually begin to disappear when a child is 4 or 5 years of age. If over the period of six months you gradually notice improvement, there's little reason to worry. About 5 percent of children stutter at some point on their way to becoming fluent speakers, and only 20 percent of these need speech therapy for stuttering.

In some cases, normal disfluencies can progress into stuttering. Here's how to tell the difference: With stuttering, instead of one or two repetitions of a syllable, a child may repeat it four or five times such as, "ca, ca, ca, ca, can..." or "m, m, m, m, mommy." In addition to struggling with speech, stutterers show signs of increased physical tension and often avoid speaking, in an attempt to hide their stuttering. Also, children who stutter usually develop other mannerisms such as eye blinking, tense mouth, looking to the side, and avoiding eye contact. Children often stutter more in stressful situations, such as when put on the spot to perform in front of an audience or when exposed to an unfamiliar environment.

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