Nov 21, 2016

Dr. Gellner: Stuttering can be an embarrassing problem for kids. But how do you know what is normal and what is not normal stuttering? I'll discuss the difference on today's Scope, I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You're now entering "The Healthy Kid Zone" with Dr. Cindy Gellner on The Scope.

Dr. Gellner: As kids learn to speak, they may naturally have some difficulty. Sounding out words is hard. If it wasn't, newborns would already know how to talk. Usually, kids stumble a little with speech as part of their natural development and those issues resolve themselves. There are two parts to normal speech: articulation and fluency. Articulation is how well your child pronounces words. When they can't pronounce certain sounds normally, it's called dysarthria. It's normal between ages one and four.

An example is how kids can't say "Y" sounds clearly and yellow becomes "lellow." About 70% of kids are able to pronounce words clearly from the get-go, but the other 30% have many words their parents can't even understand. By age 4, parents and others should be able to understand at least 90% of what the child says.

Fluency is how smoothly a child speaks. Between 18 months to 5 years, something called pseudo-stuttering occurs, and that is the occasional repeating of sounds or syllables. An example of this would be a child who repeats the "T" sound at the beginning of words, like "t-t-t-train." This happens because the child's mind is ahead of their mouth. They think the words faster than their tongue can make them. Kids do it more frequently when they're tired or overly excited, but it usually resolves itself in time.

Then there is true stuttering or stammering, and it only occurs in about 1% of children and is four times more likely in boys than girls. Children with this often have pauses in their speech, frequently repeat sounds, syllables, or short words and can have facial twitches while trying to carry on a conversation. In most cases, true stuttering is an inherited problem. It can also be made worse when a child who has a normal toddler's speech issues is pressured to improve and they become sensitive to the problem. They try to anticipate the speech issue and then struggle to correct it. The harder they try to make it better, the worse the problem becomes.

True stuttering will become worse and persist into adulthood without treatment. The best thing you can do as a parent of a child with true stuttering, in addition to getting your child into speech therapy, is to have your child relax, talk about things in a calm, no-rush way and don't get mad at them for stuttering. Avoid praising them for good speech too because that sends the message that all other times, their stuttering is a bad thing. Don't complete their sentences for them or interrupt. Above all, don't discuss their speech issues with others in their presence. That's labeling and labels tend to become self-fulfilling prophecies.

If you or your pediatrician have any concerns about what type of speech issue your child has, ask for a referral to a speech therapist. Your child will have a thorough evaluation to determine their diagnosis and what therapy will work best for them.

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