What is stuttering?

Stuttering is a speech difference that is rooted in how your child’s brain works. It is characterized by disruptions in their flow of speech, like repeating sounds or getting stuck on words. Over time, stuttering can cause your child to experience feelings of frustration or anxiety about speaking. This can lead to your child avoiding situations where they need to talk but fear they will begin stuttering.  

Symptoms of stuttering

Stuttering usually begins when children are learning to speak, typically during their preschool years. About 5% of children start stuttering, but for most, it lasts less than a year. Around 1% may continue to stutter throughout their lives.

It is important to watch for signs that your child might be struggling with their speech. Signs may include: 

• Tension or frustration when speaking 
• Receiving frequent comments about their speech 
• Noticing they are interrupted by others when speaking 
• Avoiding speaking situations altogether 

Causes of stuttering  

Stuttering tends to run in families and can be passed from parent to child (genetic). It is also influenced by your child’s language abilities, the way they think and learn information (cognition) and how well they regulate their emotions (emotional functioning). It is important to remember that stuttering is not caused by stress, emotional trauma or anxiety, even though those factors can make it worse at times.   

Testing and diagnosis for stuttering 

Here at Children’s Hospital of Philadelphia (CHOP) the first step in diagnosing your child will be a stuttering evaluation by one of our speech-language pathologists (SLP). The evaluation process will involve your entire family. As parents or caregivers, you will be asked to answer general questions about your child’s medical history, developmental and social history, and speech and language development.  

You will also be asked to answer more specific questions like: 

• When did your child's stuttering begin? 
• How much does your child appear to be hindered by their stuttering? 
• Which situations appear to make your child’s stuttering more or less severe? 
• Do stuttering and/or other speech, language, reading and attention difficulties run in your family? 
• What does your child like to do?  
• What is your child good at?  
• What does your child not like to do?  
• What are four or five words that best describe your child?  

Our SLPs will be interested in the whole child, not just the stuttering. Depending on your child’s age, the SLP will explore their feelings and attitudes about talking to others, and the impact it has on them in different environments (home, school, etc.). They will review how people react to their stuttering and what people say to them when they stutter.  

Next, the SLP will work with you to develop a plan of action. This may include strategies you can use at home or bringing your child to speech therapy at CHOP.   

Treatment for stuttering

When children stutter, they often feel anxious about speaking. Unfortunately, they may also face teasing or bullying. This might lead to them avoiding talking to people altogether. That's why therapy for stuttering goes beyond just reducing the stuttering behaviors.   

Stuttering therapy focuses on helping your child cope with the challenges of stuttering by doing exercises to make them feel more comfortable with speaking, gradually face situations where they might stutter, and change any negative thoughts they have about stuttering. The goal is to help them communicate confidently and not let stuttering hold them back.   

FAQs about stuttering therapy

How many therapy sessions will my child need?   
Stuttering therapy is unique to everyone. Some families may only need a handful of sessions, while others may need more support over a longer time. 

What happens in stuttering therapy with preschoolers?   
With very young children, the focus will usually center on reducing communication demands. As parents and caregivers, you will learn strategies for best supporting your child and promoting more effective communication. Therapy sessions will actively include the SLP, your child and your family. Practice at home, and modeling of behaviors are a common part of this play-based therapy.    

What happens in stuttering therapy with older children and teenagers?   
As children get older, the chances that they will always stutter increases. Your child’s ability to take responsibility for their therapy also increases. Because of these two factors, therapy will focus less on fluency and more on reducing the impact of stuttering. Children and teens who stutter can learn to be excellent communicators. They will also learn to recognize more challenging situations and problem-solve ways to be successful.    

How will I know if stuttering therapy is helping? 
Stuttering therapy is about communication and feeling comfortable talking with others. Signs of progress include your child talking more at home or with friends, participating more in class and talking more openly about their stuttering.

Ways you can help your child with stuttering at home

• Avoid offering suggestions to "fix" your child's stuttering. A natural impulse is to tell your child to slow down, relax or take a deep breath before speaking. Although these suggestions sometimes appear to help, they often increase your child's frustration and anxiety.   
• Listen attentively to what your child is saying, not how they are speaking. Use natural facial expressions, eye contact and other body language to provide positive feedback.   
• Speak using a relatively slow rate of speech with frequent pauses. Give your child extra time to speak by pausing for several seconds before responding.   
• Reduce interruptions and competition for speaking by promoting turn-taking and listening skills for all family members.   
• Promote open and honest conversation about stuttering.    

If you have concerns about your child’s speech, we are happy to talk with you and discuss your fears.