Pre-School Stuttering

It is common for a child aged 2-6 to experience a period of disfluency. Some patterns of disfluency need only to be monitored by the parents. "More typical" disfluencies are those present in the speech of all speakers, and may resolve without intervention. These should be loose and effortless. (Of course, early intervention strategies for parents can increase the odds of the child "outgrowing" the period of disfluency.) "Less typical," or at-risk patterns, are indicative of disfluencies involved with stuttering.

Direct Therapy for Young Children: Overview

We offer you a unique, highly effective direct approach that aims to resolve stuttering in children age 3-6. Realize that the symptoms of stuttering (i.e., tight lips, eyes blinking, facial grimaces, tense repetitions, avoidance etc.) are a sign that your child is trying to stop herself from stuttering. This struggle and force response is age appropriate. Recall when young children yank stuff out of a drawer or tug on a "pull toy" wrapped around a chair leg -- their motto is "when stuck, use force."

Secondary symptoms- such as eye blinking, facial contortions, and running out of air- are manifestations of the physical force and struggle. When children apply this forceful, panic-like reaction to tension in their speech anatomy (i.e., lips or voice box) the symptoms can escalate quickly. In an effort to prevent such uncomfortable force some preschool children will begin word changing, whispering, character voices, and inserting unnecessary sounds(i.e., "uh uh uh uh"). When you think about it, this is evidence they are trying to solve it themselves. Attempted solutions by the child can become very problematic.

The best window of opportunity to resolve stuttering is when it is only a behavior. That is, before emotions, cognitions (limiting thoughts), and the identity of a stutterer is established. Teasing, mocking, stern verbal corrections, and internal struggle all lead to more frustration, more tension, and more symptoms. The process begins with a comprehensive speech and language evaluation. It is important to confirm that a child who is stuttering is within normal limits for articulation, oral-motor skills, hearing, and language. In-depth video analysis of fluency is performed. Parental education and training begins the first visit.

The therapy process involves parents learning hands-on strategies to facilitate fluency at home. After demonstrating successful use of these strategies in the clinic, parents begin the direct approach at home. We tailor a program specific to your child and work together with parents toward common goals. The program is loaded with positive reinforcement as the child learns more fluent speech patterns. Most children age 3-6 graduate out of the clinic in 10-12 sessions.

Many parents ask: "will my child outgrow this?" Most children age 2-6 experience a period of normally disfluent speech. Some studies indicate that up to 75% of young children will resolve on their own. Many pediatricians give a blanket response of: "Don't worry he'll outgrow it." Worldwide 1-2% of the adolescent and adult population stutters. That is about 60 million people.

The odds of outgrowing it after age seven are very slim. That is because children develop the emotions and avoidance behaviors as a result of their awareness and dislike of stuttering. As you educate yourself about the progressive nature of stuttering you must decide whether help from a specialist is desired.

Many parents share: "I heard you're not suppose to say or do anything when a child stutters…it will only make it worse." This information comes from the misinformed, or the practitioner who lacks the knowledge and/or experience required to deliver direct therapy. Where passive help -- such as modeling slow speech and reducing time pressure and demands on the child -- will assist a majority of children through the stage of normal disfluency (less typical), there is a category of children who are at high risk for progressing into a life-long stuttering problem. A skilled practitioner of direct therapy can deliver treatment that will preserve the self-image of the child and rapidly develop new speech patterns.

The F.A.S.T. Fluency Program™ was designed by Tim Mackesey in 1997, and has been improving every week since. F.A.S.T. is an acronym for Family And SLP Treatment. It is a team approach. It is personalized to address the unique needs of your child. More than 200 children have graduated from this program with stuttering resolved. F.A.S.T. Fluency will prove to be at the cutting edge of fluency treatment for years to come.

Answer These Questions:

1. Has your child been exhibiting "less typical" disfluencies for 2 or more months?
If so, a chronic pattern may be developing. An assessment can help with diagnosis and early intervention strategies. Therapy may or may not be indicated.

2. Is your child aware of his disfluencies? This can be because a listener, including yourself, has offered advice or commented on it. Or, is he exhibiting physical signs of struggle (i.e., eye blinks, facial grimaces, movement of extremities, etc.)
Awareness is a watershed area dividing low-risk and high risk. This is because many children begin trying to prevent stuttering, either from frustration related to the physical struggle to talk, or because listeners are correcting them when they do stutter.

3. Has your child expressed concern to you? Have his siblings, relatives, teacher/day care, or friends inquired?
If the child himself is expressing concern, he needs help from a stuttering specialist.

If others are making inquiries, the behavior is noticeable enough that he is at risk for teasing and developing an identity of a stutterer.

4. Are you as a parent concerned and don’t want to take chances? Would you be more comfortable with an expert opinion and early intervention strategies?
An ounce of prevention can be worth a pound of cure. Age 3-6 offers a critical time window to resolve stuttering.


5. Have you witnessed any signs of avoiding speaking? This could be overt, such as the child who aborts an attempt at speaking due to frustration. Or covert, such as changing words when they fear stuttering.
Avoidance is advanced awareness and requires immediate intervention. When you think about it, a child who is avoiding is trying to prevent stuttering.
Interjections such as "uh uh," "but," or "and," that immediately precede stutters can also be an avoidance habit. These indicate the child is aware of a stutter and using a "filler" or "starter" strategy.



A "yes" answer on any of these five questions suggests that an assessment by a stuttering specialist is indicated. Family-centered early intervention can be very effective in helping you and your child.
In early intervention, we desire to resolve the stuttering before it progresses into a life-long speech impediment. Let us help you solve this problem.