Clinical Reference Systems: Pediatric Advisor 10.0
Spanish version

Descriptions

1. Characteristics of normal dysfluency and dysarthria

   "Normal dysfluency" and "psuedostuttering" are the terms used to describe the normal repetition of sounds or syllables children make when they are learning to speak between 18 months and 5 years of age. "Normal dysarthria" and "mispronunciation" are the terms used to describe the incorrect pronunciation of many children as they learn to speak; sounds are substituted or left out, so that some words become hard to identify.

2. Characteristics of true stuttering (stammering)
   • repetitions of sounds, syllables, or short words
   • hesitations and pauses in speech
   • absence of smooth speech flow
   • more frequent when child is tired, excited, or stressed
   • fear of talking
   • four times more likely in boys than in girls.

3. Causes of dysfluency, dysarthria, and true stuttering

   Normal dysfluency occurs because the mind is able to think of words faster than the tongue can produce them. It increases when the child is tired or overexcited. The cause of normal dysarthria is usually genetic. In most cases, true stuttering is also an inherited problem.

   It can also occur when a child with normal dysfluency or dysarthria is pressured to improve and in the process becomes sensitive to his inadequacies. Soon thereafter the child begins to anticipate speaking poorly and struggles to correct it. The child becomes tense when he speaks, and the more he attempts to control his speech, the worse it becomes.

4. Incidence

   Normal dysfluency occurs in many children. True stuttering occurs in only 1% of children. Normal dysarthria occurs in 30% of children between the ages of 1 and 4 years. They say many words that their parents and others can't understand. About 70% of children have the ability to pronounce words clearly from the time they start to speak.

5. Expected course of dysfluency, dysarthria, and true stuttering

   Normal dysfluency lasts for approximately 2 or 3 months if handled correctly. Unlike normal dysfluency, normal dysarthria is not a brief phase but instead shows very gradual improvement over several years as a child develops. The speech of at least 90% of the children who have dysarthria becomes completely understandable by age 4. The speech of 96% of these children becomes completely understandable by age 5 or 6. Without treatment, true stuttering will become worse and persist into adulthood.

Helping Your Child Cope with Normal Dysfluency and Dysarthria

The following recommendations should prevent these disorders from developing into true stuttering.

1. Encourage conversation.

   Sit down and talk with your child at least once a day. Keep the subject matter pleasant and enjoyable. Avoid asking for verbal performance or reciting. Keep speaking time low-key and fun.

2. Help your child relax when stuttering occurs.

   Mild stuttering that's not causing your child any discomfort should be ignored. When your child is having trouble speaking, however, say something reassuring such as "Don't worry, I can understand you." If your child asks you about his stuttering, reassure him that, "Your speech will get easier and someday the stuttering will be gone."

3. Don't correct your child's speech.

   Avoid expressing any disapproval, such as by saying, "Stop that stuttering" or "Think before you speak." Remember that this is your child's normal speech for his age and is not controllable. Do not try to improve your child's grammar or pronunciation. Also avoid praise for good speech because it implies that your child's previous speech wasn't up to standard.

4. Don't interrupt your child's speech.

   Give your child ample time to finish what he is saying. Don't complete sentences for him. Don't allow siblings to interrupt one another.

5. Don't ask your child to repeat himself or start over.

   If possible, guess at the message. Listen very closely when your child is speaking. Only if you don't understand a comment that appears to be important should you ask your child to restate it.

6. Don't ask your child to practice a certain word or sound.

   This just makes the child more self-conscious about his speech.

7. Don't ask your child to slow down when he speaks.

   Try to convey to your child that you have plenty of time and are not in a hurry. Model a relaxed rate of speech. A rushed type of speech is a temporary phase that can't be changed by orders from the parent.

8. Don't label your child.

   Labels tend to become self-fulfilling prophecies. Don't discuss your child's speech problems in his presence.

9. Ask other adults not to correct your child's speech.

   Share these guidelines with baby sitters, teachers, relatives, neighbors, and visitors. Don't allow siblings to tease or imitate your child's stuttering.

10. Help your child relax and feel accepted in general.

    Try to increase the hours of fun and play your child has each day. Try to slow down the pace of your family life. If there are any areas in which you have been applying strict discipline, back off.

Call Your Child's Physician During Office Hours If:

• Your child is over age 5.
• Your child has true stuttering.
• Your child has associated facial grimacing or tics.
• Your child has become self-conscious or fearful about his speech.
• Your family has a history of stuttering in adulthood.
• Speech is also delayed (no words by 18 months or no sentences by 2-and-1/2 years).
• Speech is totally unintelligible to others and your child is over age 2.
• Speech is more than 50% unintelligible to others and your child is over age 3.
• Speech is 10% unintelligible to others and your child is over age 4.
• The dysfluency doesn't improve after trying this program for 2 months.
• You have other questions or concerns.

Resource

The Stuttering Foundation of America offers free publications on stuttering. Their address and phone number are:

The Stuttering Foundation of America
5139 Klingle Street, N.W.
Washington, D.C. 20016-2654
1-800-992-9392