Stuttering affects individuals of all ages but occurs most frequently in young children between the ages of 2
and 6 who are developing language. The average age of stuttering in children is 2 ½ years old. Stuttering
rarely begins after age six; 65% of preschoolers who stutter spontaneously recover, in their first two years
of stuttering. These children grow up to have normal speech. However, children who stutter longer are less
likely to recover without treatment. Only 18% of children who stutter up to five years recover suddenly.
The peak age of recovery is three and a half years old. By age six, a child is unlikely to recover without
Among preschoolers, boys who stutter outnumber girls who stutter about three boys for one girl. The
majority of girls recover fluent speech, while the boys don’t. By fifth grade the ratio is about four boys who
stutter to one girl who stutters. This ratio remains into adulthood. Some pediatricians tell parents to “wait
and see” if a child outgrows stuttering on his own.
Children who stutter should see a speech-language pathologist as soon as possible. To find a speech-
language pathologist for your child, start by calling your local elementary school. The board of education
provides free speech therapy to children as young as three years old. If your child stutters at two or three
and you get the child into speech therapy right away, many see a full recovery, within months, without
relapses. A small push may get the child back onto the normal development path. If your child is in grade
school and has stuttered for five years, he or she will need additional speech therapy to get back onto the
normal development track.
Normal Pauses in Speech is not Stuttering
At two or three years old, children are quickly developing communication skills. Their brains are growing
rapidly. A child’s language skills may develop faster than his/her verbal skills. The child wants to
communicate but can’t easily and freely produce speech. All children have normal pauses in speech as they
learn words and vocal communication. Normal pauses aren’t stuttering, and don’t need to be treated by a
speech-language pathologist. Normal interruptions and repetitions that tend to be single, for instances “That
A child who doesn’t noticeably struggle or show signs of visible pressure, frustration or embarrassment is
normal. These errors happen when the child is planning a long or complex sentence. Brief silent pauses are
considered normal, such as when directing another person’s attention, when concerned about the listener’s
reaction, and when interrupting or being interrupted. Normal imperfections may occur when the child’s
language skills exceed his speech motor skills. Changes in the child’s environment may also cause temporary
normal flaws; this could involve parents’ divorce, the birth of a sibling, or moving to a new home.
Early signs of Stuttering
• Part-word repetitions (not whole-word repetitions). Repetitions become rapid, tense, and irregular. A sound
or word is repeated three or more times.
• Pauses and flaws on more than 10% of words.
• The child stutters for weeks or months, between periods of fluency. Stuttering for more than six months is
a sign of a risk.
• Stuttering when excited or upset, when having a great deal to say, or under high environmental demands.
• Length of time creating speech. Sounds are delayed at least a half-second.
• Struggle and speech-production muscle tension, such as a rise in vocal pitch (caused by tensing the
larynx), blocking airflow and stopping vocal sounds, wide mouth opening or tongue swelling, or irregular
• Stuttering only on the first word of a sentence or phrase.
• Stuttering on both content and purpose words (“like,” “but,” “and,” or “so”).
• Secondary or flight behaviors, such as eye blinking, nodding, facial frowning, quivering lip, raising eye
brows, flaring nostrils.
• Fear or avoidance of certain sounds or words. Word substitution begins.
• Halts become common, in addition to repetitions and delays.
• Stuttering becomes persistent, without periods of smoothness.
• Stuttering occurs on content words—major nouns, verbs, and adjectives.
• Stuttering varies among situations, such as talking on the telephone, speaking to strangers, or when excited.
Stuttering often gets worse when the child is excited, tired or distressed, or when feeling self-conscious,
rushed or pressured. Speaking in front of a group or talking on the telephone can be particularly difficult for
this group of children. While reasons are unclear, most people who stutter can speak without stuttering
when they talk to themselves and when they sing.
Causes of Stuttering
Scientists suspect a combination of motives causing stuttering in children. The exact structure that makes
up stuttering is unknown. Researchers don't know precisely the causes of stuttering, but the fact that
stuttering tends to run in families gives reason to believe that many forms of stuttering are genetic in origin.
The most common form of stuttering is thought to be developmental, occurring in children who are in the
process of developing speech and language. This casual type of stuttering occurs when a child's speech and
language abilities exceed his/her verbal demands. Stuttering happens when the child searches for the correct
word. Developmental stuttering is usually outgrown.
Another common form of stuttering is neurogenic (originating in the nerves). Neurogenic disorders result
from signal problems between the brain and nerves or muscles. In neurogenic stuttering, the brain is unable
to coordinate effectively the different components of the speech system. Neurogenic stuttering may also
occur following a stroke or other type of brain injury.
Other forms of stuttering are classified as psychogenic or originating in the mind or mental activity of the
brain such as thought and reasoning. Whereas at one time the major cause of stuttering was thought to be
psychogenic (mental or emotional processes), this type of stuttering is now known to report for only a
minority of the individuals who stutter. Although individuals who stutter may develop emotional problems
such as fear of meeting new people or speaking on the telephone, these problems often are a consequence of
stuttering rather than causes of stuttering.
Expert statements that stuttering develops gradually in stages seems controversial. Some parents report that
their children woke up one morning stuttering severely. These children went from normal pauses to severe
stuttering overnight. The children appear to have skipped the developmental stages in between. Could a child’
s immune system instead attack brain cells in the left caudate nucleus (speech motor control area), and the
child wakes up from an infection with severe stuttering? Scientists and clinicians have long known that
stuttering may run in families and that there is a strong possibility that some forms of stuttering are, in fact,
hereditary. No gene or genes for stuttering, however, have yet been found.
Most children outgrow stuttering on their own, and no stuttering treatment is needed. If your child's
stuttering last longer than six months, or beyond age 5, speech therapy may be useful to help decrease
There are a variety of treatments available for stuttering. Any of the methods may improve stuttering to
some degree, but there is at present no cure for stuttering. Stuttering therapy, however, may help prevent
developmental stuttering from becoming a life-long problem. Therefore a speech evaluation is recommended
for children who stutter for longer than six months or for the child who’s stuttering is accompanied by
Presently many accepted therapy programs for persistent stuttering focus on regaining speech skills or
adjusting flawed ways of speaking. The psychological side effects of stuttering that often occur, such as
fear of speaking to strangers or in public, are also addressed in most of these programs.