Q&A: When stuttering is serious and when it's not

Question: My toddler has been having difficulty getting his words out from time to time. I don’t know whether to regard this as a serious case of stuttering or stammering, or whether it’s just a normal part of speech development. Can you help me tell the difference?

Answer:

There is a "normal stuttering," very common between the ages of two and six, which is actually the result of mental over-processing. In other words, the child’s brain is racing ahead of his ability to express himself verbally. This stuttering, which can be aggravated by anxiety, excitement, self-consciousness or fatigue, is called "normal disfluency." Episodes last usually no more than a few seconds and decrease in frequency as the child gets older. At such times, parents can help the child relax by calmly repeating or narrating for the child what he or she is attempting to say. Such difficulties in communication usually disappear on their own as the child grows and matures developmentally.

There are some secondary mannerisms that can help to distinguish normal disfluency from pathological stuttering. These include: the child struggling noticeably to get the words out; obvious tension and frustration in the child while trying to get the phrase or word spoken; increasing vocal tension resulting in rising pitch or loudness; or very long prolongation (several seconds) of the syllables. There is also cause for concern if the child still stutters while in a calm and relaxed state – in that case, the problem may have neurological rather than merely emotional roots.

When to check with a professional

If any of these secondary signs are present, or if you have the feeling or impression that something is not right with the way your child is speaking after the two-year mark, it would be a good idea to consult with your pediatrician. If he or she agrees there is cause for concern, have the child evaluated by a speech pathologist. Many schools, school districts, agencies and organizations offer free evaluation services. Some educational psychologists are also in a position to act as your child’s advocate, and will go to bat for you with the local district. Your job will be to find out exactly what help is available and where to go in order to get him the best instruction and therapy based on his needs.

Whatever you do, don’t panic. Take steps to get the help you need, but don’t increase the child’s feelings of self-consciousness by spotlighting the issue unnecessarily. Remember that, even at the later stages of development, it is a tricky business to distinguish between normal and pathological behaviour, and that it’s never safe to issue blanket statements. Experts in the field prefer to assess each case on an individual basis since new information is constantly coming to light and there are many exceptions to the rules.