What Causes Stuttering in Children?
September 6, 2020
American Institute for Stuttering
Understanding what causes a child's stuttering can be a perplexing and distressing problem for many parents and caregivers. Witnessing a child struggle with a stutter can lead to confusion, concern, and a deep desire to help. Generalist speech language pathologists aren't always equipped to offer guidance.
As a result, parents often grapple with misconceptions and conflicting advice and are left unsure how best to support their child's communication needs. And the concern is not just about the developmental stuttering: the child's overall well-being, self-esteem, and social interactions are all affected.
In this article, you’ll learn the most common causes of a child's stuttering; how genetics, environment, and development can affect this speech disorder; and ways to help children thrive verbally and emotionally.
Stuttering—also known as childhood-onset fluency disorder—is characterized by momentary, involuntary disruptions to the forward flow of speech. These often take the form of sound repetitions ("c-c-c-car"); prolongations, where a sound is stretched and elongated ("heeeeeee-lp"); or silent blocks, where no sound emerges at all ("--").
These disruptions happen unexpectedly and can last from mere moments to several seconds each. But they should be considered only stuttering symptoms.
While all speakers have some occasional disfluencies such as producing interjections, or reformulating what we are saying mid-word, these do not qualify as stuttering. Unlike those with normal disfluency, children who stutter experience a marked feeling of loss of control—and uniquely anticipate and try to avoid moments of stuttered speech.
Those who stutter often experience negative emotions and thoughts related to their difficulty. In addition, they may limit their participation in certain activities and make important life decisions based on their speech fluency.
Without proper therapy and support, people who stutter can suffer devastating emotional consequences such as shame, fear, embarrassment, anger, depression, and helplessness. That often translates to difficulties in social, educational, and employment settings.
Many children (and adults) who stutter are bullied and taunted. Stuttering can, in fact, come to govern every aspect of a person’s life.
Researchers suspect that 5-8% of all children stutter.
Stuttering typically has its origins in childhood. Approximately 95% of children who stutter start to do so before the age of 4 years, and the average age of onset is approximately 33 months. When a child stutters, onset may be progressive or sudden. Some children go through a disfluent period of speaking. It is also not unusual for disfluencies to be apparent and then seem to go away for a period of weeks or months only to return again. Approximately 88%–91% of these children will recover spontaneously with or without intervention (Yairi & Ambrose, 2013).
It is not possible to determine with certainty which children will continue to stutter, but there are some factors that indicate a greater likelihood that stuttering will persist.
Risk factors that may be associated with persistent stuttering include:
For those children who continue to stutter, specialized speech therapy can help minimize avoidance and physical struggle, and help the child maintain confidence and participation in social and academic settings.
Generally speaking there are three type of stuttering in children: developmental stuttering, neurogenic stuttering, and psychogenic stuttering.
The most common form of stuttering. This type of stuttering occurs in young children, emerging during the preschool years when children are still learning speech sounds and language skills.
The causes of developmental stuttering are thought to be multifactorial. Genetics appear to play a major role, and children who stutter have been shown to exhibit marked differences in both brain structure and function. Increasingly, it is thought that children's stuttering is simply a naturally occurring variation in speech timing that some children are born with.
And while the child's environment can make talking easier or more difficult, parenting style does not cause stuttering.
A subtype of acquired stuttering in which disfluencies are associated with acquired brain damage in a person who did not stutter before brain damage.
The neurological event itself is usually a head trauma or a disease that leads to disturbances in the normal functioning of the brain. Neurogenic stuttering can occur at any age as a result of neurological impairment. Additionally, there are reports of the onset of neurogenic stuttering in childhood in literature.
There are known cases of three-year-old children whose neurogenic stuttering occurred due to damage caused by rotavirus, encephalitis, or trauma, as well as ninety-three-year-olds where neurogenic stuttering occurred as a result of stroke, neurodegenerative disease, and traumatic brain injury. However, the highest incidence of neurogenic stuttering is in adults. (Junuzovic-Zunic et al, 2021)
A broad category of speech fluency problems that may arise following a psychological disturbance or emotionally traumatic event. This type of stuttering usually begins abruptly, with no association of a history of developmental stuttering or neuropathology.
We have strong evidence to suggest that stuttering is inherited.
Studies have illuminated genetic factors, showing that when a child has a first-degree relative (e.g., a parent or a sibling) who stutters, the child has a much higher likelihood of stuttering themselves. This likelihood grows even higher when that first-degree relative is a twin (Kraft & Yairi, 2011).
Children with a family history of stuttering are estimated to be 1.89 times more likely to see their stuttering persist into adulthood (Singer et al., 2020).
Environmental factors do not cause stuttering. But certain speaking and interaction styles that a child is exposed to—a fast-paced conversational environment, frequent interruptions, perfectionism and criticism—can increase demands placed on a child's speech, which can exacerbate disfluency and influence a person’s negative reactions to stuttering.
Language abilities and differences in cognitive development can also contribute to the severity of a child's stutter.
Slower rates of language development (Leech et al., 2017, 2019) or co-occurring speech and language issues (Ntourou et al., 2011; Yaruss et al., 1998) are associated with stuttering, and are often cited as indicators that stuttering might persist into adulthood.
Stuttering can co-occur with other childhood disorders (Briley & Ellis, 2018), such as:
Emotional factors do not cause stuttering. However, sensitive temperament (individual behavioral characteristics or reactions) and emotional characteristics are commonly seen as traits associated with stuttering in young children.
For example, emotional reactivity/regulation and behavioral disinhibition may affect the child’s ability to cope with disfluencies (Choi et al., 2013; Guttormsen et al., 2015; R. M. Jones, Conture, & Walden, 2014; Ntourou et al., 2013).
It is quite common for children who stutter to exhibit other speech difficulties.
A nationwide survey in 2003 found that, of 2,628 children who stutter, 62% had other co-occurring speech disorders or language disorders (Blood et al, 2003).
Articulation disorders (33.5%) and phonology disorders (12.7%) were the most frequently reported co-occurring speech disorders. Only 34.3% of the children who stuttered had co-occurring non-speech-language disorders.
Of those children with co-occurring non-speech-language disorders, learning disabilities (15.2%), literacy disorders (8.2%), and attention deficit disorders (ADD) (5.9%) were the most frequently reported.
As is the case with children who don't stutter, early intervention is recommended when co-occuring speech issues are present.
If your child is stuttering, even during pre-school years, a speech therapist or speech language pathologist can help.
Speech therapy should not take as its focus the elimination of the stutter, or perfectly fluent speech, as attempts to suppress or avoid stuttering often drive an increase in struggle and distress. Instead, a trained stuttering specialist can coach parents in reducing stressors in the environment, allowing for maximum speaking comfort while simultaneously boosting the child's effective communication skills and confidence, so that they can say what they want to say, whether they stutter or not.
Maladaptive coping strategies and physical secondaries can be identified early and reduced.
While many therapies focus primarily on physical management techniques, AIS takes a holistic approach to treatment that addresses the physical, emotional, and cognitive aspects of stuttering. Treatment frequency, goals, and activities are individualized according to the unique needs of each person and his or her family.
Early treatment for young children involves educating the family, helping them to modify environmental factors that contribute to stuttering and to provide an environment that is conducive to effective, free-flowing communication. Negative feelings are also addressed.
For children that are more aware of their stuttering, we work to promote feelings of confidence communicating, help the child navigate feelings about stuttering, and work on speaking with less tension and struggle.
Services may include one-on-one therapy in person or online, group therapy, specialty workshops, and support groups. AIS therapists work on:
Therapists work with children individually as well as with their parents. They teach parents to communicate effectively with their child about stuttering and to help the child utilize key strategies.
Although there are 3 million people who stutter in the US, there are less than 150 specialists to treat them in the entire country. Because of this, vast parts of the country have absolutely no support, and this hits particularly hard in rural settings and for underserved populations.
In fact, over 50% of the services that AIS provides are for underserved children and adults, and over half of AIS’s clients receive full or partial scholarships.
At the American Institute for Stuttering (AIS), we understand the unique challenges children with stuttering face and believe every child deserves the chance to thrive.
Led by one of the country’s leading Ph.D.’s in fluency disorders, Dr. Heather Grossman, our highly specialized stuttering therapists have empowered hundreds of kids with the tools and therapy they need to live confidently. We’ve seen firsthand the positive outcomes that specialized stuttering therapy can bring.
With a wealth of experience and a deep understanding of the complexities of stuttering, we are committed to offering the most effective therapy possible, based on the latest research, and providing an inclusive environment where children can explore and improve their communication skills.
At AIS, speech therapy goes beyond tools and techniques; it empowers each child to speak confidently and live fearlessly. Get started on your child's journey with the help of a speech language pathologist at AIS.
Call us today at (212) 633-6400 or contact us online to learn more about our affordable stuttering therapy services for kids.
Stuttering is a complex speech disorder that can have various underlying causes, including gentics, neurological factors, developmental issues, and even emotional trauma.
By recognizing the early signs of stuttering in children and seeking professional help from a speech-language pathologist at AIS, parents and caregivers can play a vital role in helping their young child live confidently.
At AIS, we encourage parents, caregivers, and educators to embrace the journey, understanding that children who stutter can speak freely and live fearlessly with the right support.
Remember, stuttering is not just a speech issue; it's part of a child's unique path, and with the right guidance, they can navigate it successfully.
