A quality improvement survey at The Children's Hospital of Philadelphia found that 74 percent of families who had concerns about stuttering initially contacted their healthcare providers for advice. Because you are likely to be the first to professionally assess a child's stuttering, you should be aware of certain severity risk factors.

These include:

• The amount of physical and emotional struggle in the child
• The level of parental concern regardless of stuttering severity
• The amount of stuttering behaviors the child demonstrates

To help your patients:

• Consider how children react to their stuttering and whether they are making life decisions based on their speech. The level of fluency alone is not a true indicator of severity.
• Remember that stuttering is episodic and situational. Therefore, severity should not be based on a single interaction or speech sample that may not be truly representative.
• Refer to a speech-language pathologist who is adequately qualified to work with stuttering. Be certain that the speech-language pathologist has sufficient training and clinical experience in dealing with people who stutter.