Stuttering in Toddlers: Symptoms, Causes & Ways to Help

What is Stuttering in Toddlers 

Stuttering is a specific kind of speech dysfluency that includes repetitions, prolongations, and blocks (inability to produce sound) during speech. It often begins between the ages of 2 and 5 years old and is more common in boys than girls. The medical term at this stage is developmental stuttering. (Learn about other speech disorders here).

They might get stuck on syllables, or show other signs of interrupted, non-fluent speech. The medical term for this is developmental stuttering. This post discusses how to cope with stuttering that is not part of this temporary period and thus, prolonged (Learn about other speech disorders here).

Stuttering is a specific kind of dysfluency that includes repetitions, prolongations, and blocks (inability to produce sound) during speech.

By age five, it is possible that these symptoms will diminish or disappear completely. However, it can be difficult to predict which children will outgrow developmental stuttering and those who will suffer prolonged stuttering throughout their lifetime. 

This is why early identification and intervention can be crucial for supporting toddlers who stutter and promoting their overall communication development.

A Speech-Language Pathologist can determine if there is a stuttering problem after one complete speech and language evaluation. Referrals for the evaluation are typically made by primary care physicians after concerns from family members or other caregivers.

Symptoms of Prolonged Stuttering

Certain characteristics and symptoms of stuttering can help us understand whether a child is moving through a typical “period” of dysfluency or is likely to have a true dysfluency that requires intervention. Some characteristics of a true dysfluency include:

• Stuttering begins “late” (after about 3 ½ years old).
• Stuttering occurs on final sounds in a word (e.g., “brother-er-er-er”).
• The stuttering makes it difficult for others to understand what the child is trying to say.
• Increased episodes of stuttering.
• Persistent tension or physical struggle while attempting to speak, often involving facial grimaces or body movements.
• Avoidance behaviors extend to a wide range of speaking situations, such as social interactions with known or unknown persons, new environments or stimuli, or even avoiding speech at home with family members.
• Increased frustration, embarrassment, or anxiety related to speaking difficulties, which may lead to withdrawal from communication or social isolation.
• Other speech or language problems are present.
• Co-existing disability related to learning, attention, or motor skills.
• A family history of stuttering–in combination with any of the characteristics above.

What Causes Stuttering?

In order to understand how to manage stuttering, it is important to learn more about what causes it. Your child's stutter may be caused by:

• A genetic trait that impacts members of the family.

• Disrupted motor skills: This means that the child knows exactly what they want to say, but due to a disconnect between the brain and body parts used for speech (vocal cords, tongue, lips, etc.), they are unable to remain fluent.

• Developmental setbacks: Learning delays or disorders can lead to speech disturbances.

• A hyperactive mind: If your child's brain is working faster than their mouth, then they may develop a stutter.

• Environmental Factors: Stressful or high-pressure speaking situations, as well as negative reactions from family members or peers, can exacerbate stuttering symptoms.

• Combination of Factors: Stuttering is likely influenced by a combination of genetic, neurobiological, developmental, and environmental factors, with each individual experiencing a unique interplay of these influences.

Toddler Stuttering Treatment

Following a speech and language evaluation, treatment may be indicated. In this case, your child will begin working with a Speech-Language Pathologist–preferably one who specializes in stuttering treatment–to remediate the difficulties in their speech and help improve their overall communication. There are several techniques and programs used depending on the age of the child, their overall cognitive development, and the severity and type of stuttering. Treatment for children who stutter can be classified into direct or indirect strategies.

Direct Strategies 

Direct strategies help your child change the way they speak:

• Fluency shaping: teaching the child to slow the rate of their speech, increase the length of pauses between sentences, practice turn-taking skills, learn relaxed breathing during speech, or reduce interruptions while the child is speaking.

• Stuttering modification: Identifying stuttering patterns and situations with the goal of desensitizing the child to such triggers. A psychological component to stuttering is fear that once it begins, it will increase in frequency. Reducing such fears while learning to modify speech patterns at the moment a stutter begins is the main goal. 
  

Indirect Strategies 

Indirect Strategies focus on modifications to the speaking environment:

• Exploring the child’s feelings around their stuttering behaviors.
• Identifying avoidance behaviors (a coping strategy that children use to avoid certain speaking situations in order to avoid the stutter) and helping to eliminate the use of such behaviors.
• Enrolling the family to modify speaking situations at home that cause stress and trigger stuttering, such as competing for attention with other children in the household.
• Teaching parents and family members to identify times when the child is particularly fluent, relaxed, and calling attention to the ease of their speech but also reminding them that sometimes stuttering will still happen and that it’s okay.
• Ensuring the child is not being teased by peers or other family members; teasing will increase anxiety and thus increase the fear around and incidences of stuttering.
  

Tips and Exercises to Help a Stuttering Child at Home

As a parent, there are a number of things that you can do to help your child cope with stuttering. As stated above, these strategies will mostly include indirect approaches that modify the speaking environment at home, but also include additional exercises for stuttering and activities that can encourage fluency.

Don’t blame yourself

Parents can sometimes feel responsible for their child’s stuttering and fear that difficulties because of their stuttering will interfere with their future academic, personal, or professional goals. Remaining positive about the available treatment options and strategies, and remembering that you can be a source of help to your child will, in turn, help them build confidence.

Speak with a Speech-Language Pathologist

Speak with a speech therapist who has experience working with children who stutter. They can teach you and your child useful techniques for minimizing episodes of stuttering and overcoming fears. It is important that you take an active role in therapy. A well-developed program for speech therapy at home will support your child’s success and help them master their new speech techniques.

Remain patient 

Remain patient with your child at all times. When you remain calm, your child will mirror this behavior and be more willing to continue to communicate with you. Remember, each child's journey is different, so stay supportive and encouraging as they build confidence in their speech.

Allow your child to speak

Plan several quiet minutes each day to simply listen to your child speak without interruptions or distractions. Remaining focused and generally interested, and not commenting on potential stuttering behaviors will help build confidence and trust.

Learn and practice simple at-home exercises, games, and strategies

Pausing: pausing is a technique that involves slowing your speech and increasing the time in between words. Sometimes a child will become blocked in their speech and place pauses in the middle of words. Modeling pausing between words or at the end of words, with practice, can help them do the same, placing the pauses in the correct position. You can start with encouraging a pause after the first word in a sentence and slowly increase to two, three, four, etc. words as they improve this skill. Pausing may also be practiced during board or card games.

Use simple, short sentences: speak to your child using simple words and short sentences that are easy for them to understand and produce.

Decrease tension in the diaphragm: using breathing techniques, especially diaphragmatic or “belly” breathing (breathing from deep in the belly and not the chest), can help reduce tension and anxiety in speaking situations. An example of how to teach your child diaphragmatic breathing can be found here.

Oral motor exercises: these include exercises that help a child recognize which parts of their mouth are used for speech and how. Increased awareness and practicing control of speech structures can help a child better control their fluency. Simple exercises include drinking through a straw, blowing bubbles, smacking the lips together, opening and closing the jaw, tongue movements (sticking the tongue out or touching the roof of the mouth), or blowing a feather or other light object across a surface.

Explore programs

There are many programs available to help children who stutter. One of the oldest comes from an ancient Greek named Demosthenes who suffered from a stutter. Demosthenes found that he could improve his fluency by speaking over the roar of the Mediterranean Sea. This is now what we call masking noise. Masking noise, auditory feedback, delayed auditory feedback, and frequency shifts in one’s perception of their own speech can improve parts of the brain that connect our auditory and motor systems, leading to increased fluency. Consider a program such as the one used with Forbrain. This product is proven to help children familiarize themselves with their own speech patterns while increasing awareness, decreasing misarticulations, and improving confidence in speaking situations.

Research

For parents of toddlers who stutter, thorough research is key. Explore trusted sources online, academic journals, and professional organizations to understand the causes, symptoms, and treatment options. Familiarize yourself with all things stuttering-related. Read information and current evidence-based practices used in therapy. There are plenty of readily-available resources online. A good place to start is stutteringhelp.org., where you'll find easy-to-access information and valuable insights into this speech disorder.  Learning all you can empowers you to advocate for your child effectively and work with professionals to support their speech development. 

Support your child

Become actively involved with speech therapy for your toddler. Speak to their teacher about their childhood stuttering and be attentive to their performance. This will allow you the ability to advocate for your child and ensure an optimal learning environment.

 

Final Words

Coping with a stutter is a challenge for your child, and unfortunately, there is no magic cure. By becoming actively involved in their therapy and education, you can help them manage their challenges. By providing them with your love, support, and patience, your child will gradually become a more confident, effective speaker.

FAQs on Stuttering in Toddlers

When should I worry about my toddler stuttering?

Early intervention is key. Risks of chronic stuttering in children include: having a family member who stutters, being male, difficulty understanding your child because of a stutter, stuttering that last more than 6 months or appears to be getting worse, an obvious fear or avoidance of speaking situations or feelings of anxiety, frustration, or hopelessness when trying to communicate. If your child is experiencing any of these, it’s time to consult your healthcare provider.

Why is my 2-year-old stuttering all of a sudden?

Developmental stuttering typically begins around the age of 2-3 ½ years. It’s not uncommon for a child to develop stuttering behaviors around this age, and in most cases the stuttering will improve with time, or disappear completely. At this age, it’s important to observe the stuttering behaviors to assess whether or not a professional should be consulted. 

Is stuttering a form of ADHD?

Stuttering is not a form of ADHD but has the potential to co-occur with ADHD or other speech and language disorders. Many factors can contribute to the co-occurrence of stuttering and other speech, language, or learning delays and disorders. If you think your child is also suffering from another form of speech or language difficulty, discuss it with your healthcare professional or Speech-Language Pathologist as soon as possible. 

How is cluttering different from stuttering?

While stuttering primarily affects the fluency of speech, cluttering presents as a rapid rate of speech and other dysfluencies atypical of stuttering. These include whole-word repetitions, higher incidence of interjections (such as “um” or “well”), dropping of syllables, and a lack of awareness of their difficulties. People who stutter tend to be hyper-aware of their difficulties. The two diagnoses can appear similar at first, but require differentiation in order to create appropriate therapy goals. It is also more likely that a person who clutters has co-existing disorders such as Auditory Processing Disorder, Learning Disability or poor handwriting (dysgraphia).

Is stuttering anxiety based?

The source of stuttering is not always obvious. In toddlers, we see that stuttering appears spontaneously with genetic or developmental bases and is most likely a result of rapid speech and language development. Anxiety can become a problem for people who stutter, but stuttering is not caused by anxiety itself. There does exist an acquired and rare type of stuttering called psychogenic stuttering that occurs in adults as a result of severe emotional trauma or who have a history of mental illness. 

References 

American Speech-Language-Hearing Association. (n.d.). Stuttering. https://www.asha.org/public/speech/disorders/stuttering/#professional

Brignell, A., Krahe, M., Downes, M., Kefalianos, E., Reilly, S., & Morgan, A. (2021). Interventions for children and adolescents who stutter: A systematic review, meta-analysis, and evidence map. Journal of fluency disorders, 70, 105843. https://doi.org/10.1016/j.jfludis.2021.105843

Guitar, B. (2006). Stuttering: an integrated approach to its nature and treatment. 3rd ed. Baltimore: Lippincott Williams & Wilkins

Johnson, G., Onslow, M., Horton, S., & Kefalianos, E. (2023). Psychosocial features of stuttering for school-age children: A systematic review. International journal of language & communication disorders, 58(5), 1829–1845. https://doi.org/10.1111/1460-6984.12887

Leimen Edwards, B. (2013, août 20). Distinguishing cluttering from stuttering. ASHA Wire. Retrieved February 15, 2024 from https://leader.pubs.asha.org/do/10.1044/distinguishing-cluttering-from-stuttering/full/

Shenker, R. C., & Santayana, G. (2018). What Are the Options for the Treatment of Stuttering in Preschool Children?. Seminars in speech and language, 39(4), 313–323. https://doi.org/10.1055/s-0038-1667160

Stanford Medicine Children’s Health. (n.d.). Stuttering in Children. Retrieved February 15, 2024 from https://www.stanfordchildrens.org/en/topic/default?id=stuttering-90-P02290