Stuttering

What it is

Stuttering (childhood-onset fluency disorder) is a disruption in the normal flow of speech: repeating sounds or syllables (“b-b-ball”), prolonging sounds (“ssssoup”), or blocks where the word will not come out, sometimes with visible tension or accompanying movements. It usually begins between ages two and six as language develops rapidly.

It is not caused by anxiety, low intelligence or a character flaw, though speaking situations and stress can make it more or less noticeable. The causes involve genetics and the brain's speech-timing systems. Many famous, articulate people stutter; stuttering says nothing about what a person has to say.

How common is it

Stuttering is common in early childhood, affecting around 1 in 20 children at some point as language develops, more boys than girls. The large majority recover, often within a couple of years, so that only about 1 in 100 people stutter into adulthood. It usually begins between the ages of two and six.

How it is diagnosed

A speech and language therapist assesses the type and frequency of the disruptions, any tension or struggle, and the effect on the child, distinguishing ordinary early non-fluency from stuttering that needs help. Factors such as how long it has lasted, whether it is worsening, a family history, and the child's distress guide whether to monitor or to begin therapy.

What helps

Many young children who begin to stutter recover naturally within months to a couple of years, with or without therapy, which is why monitoring is reasonable for a while. But waiting should not be indefinite: if stuttering persists, worsens, runs in the family, or distresses the child, early speech and language therapy improves outcomes, and for preschoolers specific early programmes have good evidence.

For older children and adults, therapy focuses on techniques to ease the flow of speech and, just as importantly, on reducing the fear and avoidance that can grow around speaking. The single most useful thing the adults around a young child can do is respond to what the child says, not how fluently they say it: slow the conversational pace, give time, listen patiently, and never finish their sentences or tell them to slow down or start again, which raises the pressure that makes stuttering worse.

Stuttering in the African context

Speech and language therapists are scarce across much of the region, so many children who would benefit never reach one, and stuttering is often misread as nervousness, shyness, or slowness, none of which is true. Teasing and pressure to speak fluently can deepen the fear that makes stuttering worse. The most protective thing, available to every family for free, is to respond to what a child says rather than how fluently they say it, and to give them calm, unhurried time to speak.

Helping the child

Every adult around the child can help.

• Listen to what the child says, not how fluently they say it, and give them unhurried time.
• Try not to finish their sentences, tell them to slow down or start again, or draw attention to the stutter.
• Slow your own speaking pace a little, which helps more than any instruction to the child.
• Protect the child from teasing, and educate teachers and classmates.
• Seek a speech and language therapy assessment if it persists, worsens, or distresses the child. Our find a therapist page can help.