Image by Sasin Tipchai from Pixabay

September 23, 2019

Stuttering is a very common pediatric complaint. The movie, the King's Speech, about King George the 6th of England, highlights the difficulties faced by those with speech impediments. Stuttering is a speech fluency problem where the spoken language is repeated as sounds, syllables or words.

5 in 100 children will stutter at some time in their life. The fluency dysfunction usually lasts for months and self resolves. Of these stuttering children, a small subset do not self resolve and persist into adulthood just like King George. This group will need further interventions to reduce the problem and help the adult achieve normal fluency.

The rule of thumb in pediatrics is to refer a child for speech therapy evaluation if the stuttering has lasted for greater than 6 months and/or the child has significant anxiety related to the issue. We also recommend referral earlier if a child has a strong family history of a first degree relative with severe or moderate adult stuttering.

There are many interventions that have been tried as outlined in the Baxter article. Mindfulness, cognitive behavioral therapy and targeted speech therapy all have shown benefit over time. Essentially, anything that can reduce stress can have a meaningful benefit.

From the parent's perspective, here are some critical things to keep in mind: It is important that parents and caregivers support children who stutter. They can do this by reducing the judgement and anxiety provoking punitive behaviors that some people engage in. Other thoughts:

1) Do not finish a child's sentence. Be patient and listen.
2) Try not to criticize a child for stuttering. Children who stutter do not have command over the ability to stop
3) Try to model slow and evenly paced speech for the child to emulate
4) Try and reduce the baseline household stress as stress can exacerbate all anxiety type disorders
5) Discuss the child's stuttering with school teachers to help them know what your plans are
6) Discuss with your child that stuttering happens and that most children outgrow it naturally. Empower them to believe in resolution.

Dr. M

Legg Medical News Today Article
Baxter Intern J of Language and Communication Disorders