No Need to Worry About Young Stutterers

Stuttering preschoolers showed slightly better language skills than non stuttering children

(RxWiki News) If a young child begins to stutter while speaking, parents may worry the child will suffer setbacks in language or social development. But the opposite may be true.

A recent study found that children who began stuttering before age 4 had just as good outcomes as non-stuttering children a year or so later.

Actually, stuttering children had slightly better language and nonverbal thinking skills.

Only a small number of children who began stuttering had stopped on their own within a year.

But more time to study these children may provide more information on how many "recover" on their own.

"Be patient with your stuttering child."

The study, led by Sheena Reilly, PhD, of Murdoch Children's Research Institute in Australia, looked at how common stuttering was among preschoolers and how those children fared with it.

The researchers followed 1,619 children from when they were 8 months old until they were 4 years old.

Over that time, 11.2 percent of the children began stuttering by age 4.

Stuttering occurs when a child has trouble getting words out or repeats them. The authors offered three examples:

  • Repeat words or syllables over and over (e.g., “can—can—can—I go")
  • Make long, prolonged sounds (e.g., “caaaaaaaaaaaaaan I go”)
  • Have speech “stoppages” or “blocks” where no sounds come out

Boys and twins were a little more likely than other children to develop stuttering. In addition, children of mothers with a higher level of education tended to be more likely to begin stuttering.

However, children's language development did not appear to suffer if they stuttered. 

In fact, children who stuttered tended to have somewhat stronger language development scores and slightly better nonverbal cognition (thinking) skills than their non-stuttering peers.

The children who stuttered also had a very tiny edge on health-related quality of life.

Otherwise, there were no major differences between the stuttering and non-stuttering children, including socially and psychologically.

Only a small number of the children, 9 out of 142 (or 6.3 percent of those who stuttered), recovered from stuttering within one year of its beginning.

However, the study only followed children through age 4, so further study is needed to see how many stop stuttering on their own and without speech therapy.

"Although stuttering onset is common in preschoolers, adverse affects are not the norm in the first year after onset," the authors wrote.

They wrote that the study's findings contradict the belief that stuttering leads to poor outcomes for children socially or developmentally.

"Current best practice recommends waiting for 12 months before commencing treatment, unless the child is distressed, there is parental concern, or the child becomes reluctant to communicate," the authors wrote.

They suggested that it may even be possible to wait longer than a year for treatment.

Although speech therapy for stuttering is effective, they wrote, it can be expensive and is very intensive, typically involving 15 one-hour sessions and then another 10 one-hour follow-up sessions.

Delaying treatment for children by a year or longer has not been shown to reduce the effectiveness of the treatment if and when it is begun, they wrote.

However, some experts have expressed concerns about the limitations of the study and how it may be interpreted by parents.

"Obviously, this study is a big deal to the stuttering community," Jane Fraser, president of The Stuttering  Foundation told dailyRx. "But the headlines we are seeing can give parents a false sense that the hand’s off approach is the right approach for everyone. Unless they read the full study, their caveats are lost."

Fraser pointed out the size, scope and time period of the research must be taken into account in understanding this study.

"Through Dr. Ehud Yairi's excellent longitudinal research published in 2005, we have long known that children with higher language skills are more at risk for stuttering," Fraser said. "We also know after many years of experience that the earlier therapy is begun, the better the chances of the child's not continuing to stutter," a point the authors stated in the study.

More significant, however, is the small group of stuttering chidlren included in the study and the age they are followed to.

"The biggest problem with the data is that it stops at age 4, just when one might expect to begin to see some harmful effects from stuttering," Fraser said.

"It includes only 142 children. It is too early to interpret the findings because we do not know how many of the 142 children continued to stutter and what effects it had on them and their lives," she said. "And finally, the high cumulative incidence of 11 percent may well be because of the way the authors recruited the children."

The study was published August 26 in the journal Pediatrics. The authors declare no conflicts of interest.

The research was funded by the Australian National Health and Medical Research Council, the Australian Research Council, the Victorian government's Operational Infrastructure Support Program.

The researchers were also supported by Murdoch Childrens Research Institute, Peninsula Collaboration for Leadership in Applied Health Research and Care and the National Institute for Health Research.

This story has been updated to include the comments from The Stuttering Foundation.

Review Date: 
August 25, 2013