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No one is sure just why stuttering happens. Our best guess is that stuttering probably results from a combination of factors, both inborn and environmental. There seems to be a genetic component:
About 4% of children will have a period of stuttering that lasts more than 6 months. Of these, most will recover by late childhood with perhaps 1% persisting into adulthood.
Stuttering usually begins sometime in the first 2-5 years of life, as the child moves from simple two word utterances to more complex sentence structures. This is the point when all children may show some evidence of normal, mild "dysfluency" (stumbling over words, brief interruptions of speech). These dysfluencies are normally temporary and quickly outgrown. A few children continue to stutter, however, and start to show physical signs of tenseness relating to speech.
Normal dysfluency usually arises from about 18 months to three years of age. This stumbling manifests itself as repetitions of sounds, syllables and words, especially at the beginnings of sentences. Older children tend to repeat whole words or phrases at the beginnings of sentences, use fillers such as "ah" or "um," and may switch topics in the middle of the sentence. These dysfluencies are more likely to occur when the child is tired, excited or upset, or are being rushed to speak. Children with normal dysfluencies tend to appear to be unaware of the stumbling, and are not frustrated.
Such normal dysfluency can shade into mild stuttering. Mild stuttering is identified when the child starts to repeat the initial syllable four or five times instead of the normally dysfluent child's one or two repetitions. "Ca-ca-ca-ca-can I have a popsickle?" Sometimes just a sound is repeated, as in "MMMMMMMMAy I have a popsickle?" And importantly, these children show signs of reacting to the way they are speaking. They may avert their eyes, show tension around the mouth, or otherwise communicate at least temporary frustration or embarrassment. Lastly, normal dysfluencies tend to appear and dysappear as well over time. Mild stuttering remains more constant, either every day or in specific situations.
Children with severe stuttering show signs of struggle. They show signs of increased tension, and try to hide the problem and avoid speaking. Severe stuttering develops any time from perhaps 1-1/2 to 7 years, and can either appear suddenly, or after a period of mild stuttering.
Severe stuttering is marked by dysfluencies in every phrase or sentence. There may be facial behaviors such as eye blinking, eyes closed, looking away, or physical tension around the mouth. There may be a rising pitch to the voice during the repetitions, and the child may inject extra sounds such as "um," "uh," or "well" to begin sentences he is afraid he will stutter. Severe stuttering is generally persistent; while some days will be better than others, the child will stutter every day.
Advice for parents:
The first advice for parents of children with mild dysfluency is to attempt to ignore it.
For parents of children with mild stuttering:
If things don't improve within about six to eight weeks, your child should see a speech-language pathologist. If you don't know how to find one, go to the public school for your neighborhood and talk with the counsellor there, even if your child is in the pre-kindergarden age range. She should be able to refer you through the school system for speech evaluation and treatment - at no expense to you. Which is good, since health insurance companies generally do not cover speech therapy for children.
Children with symptoms of severe stuttering need to be sent to a qualified speech-language pathologist immediately.
Digested from The Child Who Stutters: to the Pediatrician, Stuttering Foundation of America. All sorts of great resources here.