Why Has My Toddler Just Started Stuttering?

When you’re raising a toddler, you want everything to proceed by the book: when they startsleeping through the night, when they start enjoying solid foods, when they start walking andtalking. But when things don’t happen exactly when or how you’ve read they might, it can be stressful, like if your toddler begins to stutter.

“You are not the cause of your child’s stuttering. It is a myth that parents and caregivers cause stuttering by talking about it or bringing attention to it,” says Danielle L. Karthik, MS, CCC-SLP, a speech-language pathologist atMGH Chelsea HealthCare Centerin Chelsea, MA. “There are many factors that contribute to the onset and development of stuttering in a child, and many things we can do to support them and the family.”

Ahead, learn what stuttering is, the signs and symptoms, how it’s diagnosed, and ways to treat it.

口吃儿童的是什么?

Stuttering refers to disfluent speech production, or when the flow of speech is interrupted, explains Chiara Phan MS, CCC-SLP, a speech-language pathologist atTIRR Memorial Hermann Outpatient Adult and Pediatric Rehabilitation.

She adds, “Speech disfluencies specific to stuttering include repeating a part of a word, repeating a whole word, stretching out a sound of a word, or 'getting stuck' producing a sound of a word.”

There are three different types of stuttering. The most common one in toddlers is developmental stuttering.

“Developmental stuttering occurs during the ages of2 to 5 years,” says Phan. “It is thought to be related to a child’s speech skills trying to keep up with their language skills—the child has the idea they want to express, but is still learning how to verbalize it.” Since they are unable to verbalize the idea at the same pace at which they are thinking it, this can manifest as a stutter.

“Speech fluency is especially vulnerable in this period of significant development,” says Jacqueline Toscano, MA, CCC-SLP, a speech-language pathologist at MGH Chelsea HealthCare Center in Chelsea, MA. That’s because there are so many areas of development that come together when children speak, including articulation, language, motor, and emotional skills—and they don’t always line up perfectly.

“Developmental is also the most common form of stuttering, and about 80% of children actually stop stuttering after a period of time,” Toscano adds.

The second type is neurogenic stuttering, or a stutter that develops after a stroke, head trauma, or other type of brain injury. “Neurogenic stuttering is varied in its presentation and can include partial word repetitions, extraneous movements of the mouth, and pauses in unexpected parts of an utterance,” explains Phan.

The third and rarest type is psychogenic stuttering, or a stutter that develops after an emotional trauma. “It can be similar in presentation to developmental stuttering,” says Courtney Perrigo, MS, CCC-SLP, a speech-language pathologist at MGH Chelsea HealthCare Center in Chelsea, MA. “But we do not generally diagnose this type of stuttering in toddlers to our knowledge, as usually there are several factors influencing the development of stuttering in younger children.”

Signs and Symptoms of Stuttering

If you’ve noticed a change in your child’s speech, one of thebiggest signsthat it may be a stutter is your family history.

“There is a genetic component to stuttering,” says Karthik. “If there is a person who stutters in the family, there is a significant likelihood that someone else in that family stutters, or used to stutter as a child.” Indeed, scientists at theNational Institute on Deafness and Other Communication Disorders (NIDCD)have identified variants in four genes responsible for stuttering.

In addition to the verbal symptoms mentioned above, there are secondary behaviors that typically accompany stuttering.

Stressful situations, such as speaking in front of the class, may make a child’s stuttering more severe.

How Is Stuttering Diagnosed?

If you are concerned about your child’s speech or if you’ve noticed any of the above symptoms, the first step would be to speak with their pediatrician and/or aspeech-language pathologist(SLP). Since most stuttering in toddlers is the result of developmental lags, it often goes away on its own and a visit to the doctor is not necessary—though there is a tipping point.

Here are some of the differences to look for:

No Need to Worry	Time for an Appointment
Stutter appears before age 4	Stutter appears after age 4
Symptoms last fewer than 6 months	Symptoms last longer than 6 months
Speaking does not cause stress or frustration	Speaking causes visible stress or frustration
No family history of stuttering	Stuttering runs in the family
No other physical behaviors while speaking	Secondary physical behaviors while speaking

If you do decide to visit a specialist, they will conduct an evaluation.

“Typically, an SLP will conduct an in-depth case history to find out more about the child, including their overall development,” explains Toscano. “In addition, the child’s speech and language skills will be screened and the SLP will observe their speech fluency in various contexts. Stuttering assessment is multi-faceted as it evaluates a variety of areas, including observation of stuttering behaviors, secondary behaviors, and the child’s thoughts and feelings about their speech and stuttering.”

This evaluation will determine whether indirect or direct intervention is needed.

Treatments for Stuttering in Children

The first way to address stuttering in children is through indirect intervention with the parents or caregivers.

“For developmental stuttering, especially if the child is closer to 2 years of age, we may first attempt an indirect model where we train the parents to model slow speech. We also train the parents to ask fewer questions,” says Phan.

Other strategies parents can employ, says Perrigo, include focusing on what the child is saying instead of how they are saying it, maintaining eye contact, and giving them plenty of time to express themselves without pressuring them to rush or trying to finish their sentences.

One important note: This approach never involves an adult telling a child to speak differently.“Modeling a slower rate in your own speech is okay, but we get into murky territory if we try to tell a young child to talk more slowly since they may not be cognitively ready for that,” explains Perrigo. “Nor do we want them to associate communication with something they are doing 'wrong' and need
to change so young, if at all.”

Instead, the above strategies are meant to make them feel comfortable with speaking, even if they are stuttering. This could boost their confidence and help them work through it themselves, as opposed to telling them what to do differently.

Adirect treatment modelinvolves the SLP working with the child to teach them certain speech patterns. There are a few different strategies that SLPs will use, but they generally involve helping the child relax before speaking, regulate their breathing, and gradually progress from single-syllable words to longer words and finally to sentences.

“It can also include discussion on the child’s emotions regarding the stuttering and any physical behaviors that occur with their stuttering,” Phan adds. Since stutters often worsen in situations where the child feels anxious or tense, talking about what these situations are and how the stuttering makes them feel can help children overcome or avoid them.The result: A decrease in instances of stuttering.

Neither treatment model is more effective than the other. Instead, an SLP will determine which they think will work best based on the severity of the child’s stutter and what symptoms they are presenting.

“Ultimately, the goal of speech therapy for toddlers who stutter is to facilitate their fluency, but also to encourage them to keep talking whether they stutter or not,” Karthik adds.

A Word From Verywell

Stuttering in toddlers is not uncommon and may go away on its own. But if symptoms persist longer than 6 months as your child gets older and are accompanied by secondary physical behaviors, or if your family has a history of stuttering, you may want to reach out to a speech-language pathologist. They can work with you and/or your child to encourage healthy speech patterns and facilitate stress-free communication. If you have questions about your child specifically, contact your child's pediatrician or healthcare provider for a referral to a specialist.