Everything You Need to Know About Stuttering/Stammering in Children

• repetitions of single or multiple sounds or words, 
• prolongation of sounds, 
• pauses during the speech, 
• word substitutions and 
•  non-verbal physical gestures or sighing.

Will stuttering resolve spontaneously?

Children experience a phase of dysfluency in speech during the time they learn to communicate verbally. During this period, they try to express themselves as fast as they can and search for words. This is known as developmental dysfluency and most children outgrow it. This is more apparent when the child has a lot to say, is under pressure or is excited. This is termed as ‘developmental dysfluency’. These children don’t need any treatment and overcome in a few weeks to months. However, in children above 5 years of age, with persistence of symptoms or increase with time, a diagnosis of stuttering should be considered.

What is the age of onset and what are the aggravating factors?

The age of onset of stuttering can be insidious or more sudden.   stuttering occurs in 5% of children and is 4 times more common in boys than girls. The risk of stuttering is three times higher when there is a first-degree relative with stuttering. 

Stress and anxiety can exacerbate stuttering. Initially, the child may not be aware of the symptoms. As the disorder progresses, the dysfluencies become frequent and interfering. At this stage, the child starts developing mechanisms to avoid stuttering and emotional responses. The child may have motor movements like 

• twitching of facial muscles, 
• tremors of the face or lips, 
• eye blinks, 
• fist clenching and breathing movements. 

Stuttering is often absent during singing, oral reading, and talking to pets.

What are the consequences of stuttering?

• • The child may avoid speaking and social gatherings and may develop anxiety, shame, low self-esteem and even depression. 

• The academics and social communication of the child are affected. 

• These children are also often victims of bullying, which further worsens their emotional state. 

• Children who are aware of their stuttering often get stressed in their effort to hide it from others, which has a negative impact on their entire personality.

What are the conditions that may be associated with stuttering? 

 Stuttering can also be a part of a behavioural disorder such as 

• Attention deficit hyperactivity disorder (ADHD), 
• Autism spectrum disorder (ASD), 
• Anxiety or conduct disorder and
•  Learning disability. 

In such cases, a detailed medical evaluation and psychological assessment would be necessary. Stuttering may also be acquired when a child who otherwise spoke fluently starts stuttering. These children need a complete medical and psychological evaluation to rule out neurological conditions that may cause the stuttering.

When should we seek medical advice?

Consult a Developmental paediatrician and speech therapist in the following conditions;

• In children above 5 years and

• if stuttering persists beyond 4 weeks 
•  if there is a positive family history or
•  in cases where stuttering affects the child’s functioning. 

Also, Stuttering has to be differentiated from speech dysfluencies due to hearing impairment, Tourette’s disorder and side effects of certain medications.

Is stuttering treatable?

Treatment is effective when started early. Developmental Pediatrician assesses the development of the child and also screens for any associated neurodevelopmental conditions.

Treatment needs to be started when stuttering persists for more than 4 weeks. Treatment is based on the severity of stuttering. Treatment mainly involves speech and behavioural therapy. A speech therapist will plan the strategies based on the child’s severity. 

A few common Strategies and techniques used include:

• Breathing techniques while speaking 
• Relaxation techniques
• Speaking slowly and in a relaxed manner  
• Gradual building of confidence 
• Behaviour strategies to overcome anxiety and fear
• Electronic devices and Apps are now available to help people who stutter.

More than 80% of children with stuttering show remarkable improvement with timely and correct intervention in the form of speech and behaviour therapy.

Dr.S. Perumal Sathya M.D(Paed), IAP-FDBP

 Developmental & Behavioural Paediatrician  

 Rainbow Hospitals, Chennai