To a preschooler, the world is a wondrous place, with something new and exciting around every corner. And while his eyes and ears are taking everything in, his brain and mouth are working at lightning speed to express his thoughts and ideas in an intelligible way. It’s no wonder three- and four-year-olds often stumble on words or have trouble putting sentences together. They may repeat the first word of a sentence (“Mom mom mom, can I have a, have a cookie?”) or take prolonged breaks while speaking, as they search for the right words.

This type of stumbling, or dysfluency, is very common in kids this age, as their motor speech apparatus works to catch up with their cognitive skills. About 80 percent of these kids will grow out of it with no need for intervention, and become fluent speakers on their own. But the other 20 percent will develop a true stutter. So how do parents know the difference, and when should they seek professional help?

“The type of dysfluency makes a big difference,” says Dr. Robert Kroll, executive director of the Speech and Stuttering Institute, and a speech and language pathologist. “If the child is only repeating part of a word – such as  “Wh wh where is daddy?” – it’s more concerning than whole word repetition. And if there is any sign of physical struggle: putting his hand to his mouth, grimacing, tilting his head as he tries to get words out, that’s a sign of a potential issue.”

Stuttering usually begins between the ages of three and six, and is about four times more common in boys than in girls. While the specific cause is unknown, it’s believed to have some neurological basis. “Most professionals would now agree that a stutterer’s brain is not wired the same as a person who doesn’t stutter,” says Dr. Kroll. “But where that short circuit is we cannot say.” Stutterers are no less intelligent than their non-stuttering peers and, contrary to what was once believed, stuttering is not the result of bad parenting or psychological problems.

The way stuttering is treated has also changed. “The advice to parents used to be, ‘Don’t worry, he’ll grow out of it. Don’t call attention to it, or it will make it worse,” says Dr. Kroll. “Now we know that early intervention is key. There is absolutely nothing wrong with having an assessment done as early as age three.”

If your child needs treatment, the early intervention approach is usually parent-centered; you are taught how to respond to the child and reinforce fluency. “We can head off a lot of problems with some successful treatment at this age,” says Dr. Kroll. But some kids will continue to need more therapy that focuses more on them and less on the parents.

ADVICE for parents of a child who stutters:

  • Don’t constantly correct your child.
  • Don’t tell him to stop and start again, or to slow down and take a deep breath.
  • Do get down to your child’s eye level. Crouch down when he’s speaking, or even sit on the floor and gaze eye to eye if you can. “For a child who is having trouble getting words out, it makes it much more difficult if he is craning his neck to look up at you while he’s trying to speak,” says Dr. Kroll.
  • Don’t hang on every word or finish his sentences for him. “Listen to what he is saying, rather than how he is trying to say it.”
  • Do keep a positive and relaxed expression on your face while your child is speaking. If you appear frustrated, your child will pick up on it and it will make him self-conscious and might make the stuttering worse.
  • Do create a peaceful, comfortable environment for the child. Chaos or stress in the household will not make a child start to stutter, as was once believed, “but it doesn’t help,” says Dr. Kroll. “It can make stuttering worse. We all speak better in an atmosphere that is calm and peaceful.”
  • Do let him know you understand and sympathize with him – that talking can be difficult sometimes. Give him positive reinforcement when he speaks fluidly.
  • Do get a professional opinion. Start by visiting your family doctor, who can refer you to a certified speech pathologist. “Try to see someone as soon as possible. If there turns out to be nothing of real concern, it puts parents at ease knowing the child is developing normally,” says Dr. Kroll.

Published in May, 2011.

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