What is developmental stuttering?
Developmental stuttering is a common speech disorder that typically begins in early childhood but can continue into adolescence and adulthood. While many children recover without treatment, early support and speech therapy can significantly improve fluency and communication confidence. With the right tools and strategies, most children who stutter lead full, expressive lives.
More information about developmental stuttering
Developmental stuttering is a disruption in the normal flow of speech. It may include repetitions of sounds, syllables or words (e.g., “ba-ba-ball”), sound prolongations (stretching out a sound) or silent blocks (pauses where no sound comes out). It commonly begins between the ages of 18 months and 6 years, often during a period of rapid language development. Stuttering can be gradual or appear suddenly. A characteristic of stuttering is that it fluctuates (comes and goes or gets better or worse). Fluctuations are a natural part of how stuttering presents, particularly in younger children.
Key points about the fluctuation of stuttering
- Stuttering often varies in frequency and severity from day to day, situation to situation and even moment to moment.
- Stuttering can be more pronounced when a child is tired, excited, stressed or under pressure to speak. It may decrease when the child is relaxed, speaking alone or in familiar settings.
- In children, especially during the early years of stuttering, it is common to see periods of improvement followed by regression (going backward or getting worse). Periods of improvement can sometimes be mistaken for recovery.
- The presence of certain people (such as strangers, authority figures or peers) can affect fluency. The child’s awareness of their own speech can also affect fluency.
According to the Stuttering Foundation of America, approximately 5 per cent of all children experience a period of stuttering. About 75 per cent of these children recover naturally, typically within a few months. The remaining 25 per cent may continue to stutter into adolescence and adulthood.
What does stuttering sound and look like?
When children are learning to talk, it is normal for their speech to sometimes have little bumps or pauses. These common speech interruptions are usually not stuttering.
Normal speech interruptions (NOT stuttering)
- Using filler words such as “um” or “uh”: “I want to um... play.”
- Changing ideas mid-sentence: “I want to—oh, I played outside yesterday.”
- Stopping one thought to start another: “I like dinosaurs… My friend has a puppy.”
Stuttering
- Repeating whole words: “I want to to to play.”
- Repeating parts of words or sounds: “I wa-wa-wa-want to play,” or “I li-li-like it.”
- Repeating whole phrases: “I want to I want to I want to play.”
- Stretching out sounds: “I waaaaant to play.”
- Getting stuck or blocked: “I want (pause) to play.”
- Adding extra sounds or noises when stuck.
- Adding too many filler words such as “um,” “oh,” or “but um-but um.”
Physical signs of struggle or tension
Sometimes, children or teens who stutter may show that they are trying hard to get the words out by:
- closing their eyes
- moving their arms, hands or legs while talking
- covering their mouth or speaking with little movement of the mouth
- having tightness or tension in their jaw, lips or tongue
- avoiding eye contact or looking away when speaking
- showing frustration or anxiety about talking
- saying, “I can’t talk,” or “help me”
What causes developmental stuttering?
The exact cause of stuttering is still not fully understood, but research shows it is usually due to a mix of different things:
- Family history: Stuttering often runs in families, so if other family members have stuttered, a child might be more likely to stutter too.
- Brain differences: Some children who stutter have differences in how their brain controls speech, which can make it harder for them to speak smoothly.
- Environment: Things like stressful speaking situations (e.g., talking in front of a group or when feeling pressured), family communication styles (e.g., talking quickly or interrupting) or changes and stress at home can sometimes make stuttering worse.
- Language development: Learning new words and longer sentences, or speaking more than one language, can make speaking more challenging. Sometimes, the brain and mouth are still figuring out how to work together smoothly, which can lead to stuttering.
Is stuttering caused by trauma, stress or emotions?
Trauma, stress or strong emotions can make stuttering worse, but they DO NOT cause it. Stuttering is mainly due to how the brain controls speech, and it sometimes runs in families. It is important to remember that stuttering is a speech difference, not a sign of emotional problems.
Does parenting style cause stuttering?
No, parenting does not cause stuttering. Stuttering is not caused by how parents talk or behave.
Is my child faking it or copying someone?
No, your child is not faking stuttering or trying to get attention. Stuttering is a neurological speech difference, not something a child copies from others.
Can you “catch” stuttering?
No, you cannot “catch” stuttering like a cold. Stuttering is not contagious.
Stuttering happens because of differences in how the brain controls speech, and it is nobody’s fault.
How is stuttering diagnosed?
A speech-language pathologist (SLP) will listen carefully to your child’s speech and look for things such as:
- how your child’s speech is interrupted and whether these interruptions show signs of stuttering
- how often and how much your child is stuttering in a variety of activities (playing with toys, books, reading, show and share, telling a story, describing a silly picture)
- how your child reacts or feels when they stutter
The assessment often looks like play and conversation, but during that time, the SLP is getting and sharing important information.
Parents will be asked about what they notice at home, for example how long the stuttering has been happening, when it is better or worse and how your child seems to feel about it.
The SLP will also pay attention to how your child pronounces words, how well they use language to share their thoughts and how well they understand what others say.
When to seek help
Many children stop stuttering without treatment, but early intervention can still be helpful in preventing long-lasting stuttering and helping your child speak more fluently. Early support also gives parents the reassurance, tools and guidance they need to make communication with their child enjoyable and successful.
Bring your child for an evaluation with an SLP if you notice any of the following:
- Your child has stuttered for six months or more.
- Your child starts stuttering in later preschool years (after age 4).
- Your child starts to stutter more.
- There is tension or struggle when your child is talking.
- Your child is frustrated and gives up talking.
- Your child begins avoiding social activities or says it is too hard to talk.
- There is a family history of stuttering.
- You are worried about your child’s stuttering.
How to seek SLP services
Children not yet in kindergarten
In Ontario, parents and caregivers can register for a preschool speech and language program using the contact information listed on the Government of Ontario website: www.ontario.ca/page/preschool-speech-and-language-program. Similar programs are available in other provinces.
School-aged children (kindergarten and up)
Speak with your child’s physician, classroom teacher or school principal to be connected with a speech-language pathologist.
Private speech-language pathology services
Families seeking private (fee-for-service) support in Ontario can find a certified speech-language pathologist through the College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO) and individual and group programs at The Speech and Stuttering Institute in Toronto. For private speech-language pathology services outside of Ontario, visit www.sac-oac.ca/for-the-public.
Speech therapy and intervention
Once your child is connected with a speech-language pathologist, they will receive effective, evidence-based therapy to help them manage or overcome stuttering.
Types of therapy
The following are the types of therapy that may be available to your child or teen through speech-language pathology services.
- Indirect therapy for younger children: Focuses on the communication environment, often involving parent training.
- Parent/caregiver involvement is an important part of the therapy process. Parents and caregivers can help reinforce strategies at home and support the child’s progress between sessions. Engaged parents and caregivers can also gain valuable tools and confidence to foster their child’s communication skills in everyday life. For tips to help your child at home, visit www.stutteringhelp.org/7-tips-talking-your-child.
- Direct therapy for older children and teens: Teaches specific strategies to help older children and teens speak more fluently, stop avoiding speaking due to stuttering and build confidence.
- School-age children are typically seen for speech therapy sessions once a week. Sessions typically last 45 to 60 minutes and may be provided individually or in a group setting. In some cases, particularly for older children, an intensive treatment program may be recommended (e.g., therapy offered several days a week or over several weeks in a row during the summer). Paired and group sessions can be especially beneficial for building overall communication skills and giving children and teens opportunities to support and learn from each other in a social, encouraging environment.
- Therapy may be virtual, in person or a hybrid model (both virtual and in person).
Parental support matters
Parents and caregivers play a vital role in supporting a child who stutters. See below for what you can do to help your child if they are stuttering:
- When your child speaks, listen patiently and maintain eye contact.
- Avoid interrupting your child or finishing their sentences.
- Create a relaxed communication environment at home.
- Do not pressure your child to speak quickly or perfectly.
- Avoid teaching and giving advice on how your child should talk. Instead, focus and comment on what your child says (the content and their feelings).
Long-term outlook
With the right support, children who stutter can thrive. Many children grow into confident communicators, whether or not stuttering persists. Modern therapy and positive communication habits can help minimize the impact of stuttering on self-esteem, academic success and social relationships.
Where and how to refer
SickKids accepts referrals for developmental stuttering from physicians under specific criteria due to SickKids’ specialized treatment approach and limited staffing resources. For more information, please visit https://www.sickkids.ca/en/care-services/for-health-care-providers/refer-patient/referral-criteria/.
Referral pathways
Children not yet in kindergarten
In Ontario, parents and caregivers can self-refer their preschool-aged child using this online referral form: https://www.ontario.ca/page/preschool-speech-and-language-program.
School-aged children (kindergarten and up)
Begin the referral process with your child’s classroom teacher or school principal. The School Board Speech-Language Pathologist (SLP) will determine if a referral for treatment in school and/or at SickKids is appropriate based on their assessment.
Private SLP support (fee for service)
Information about private SLP support in Ontario is available at the following links:
- Speech and Stuttering Institute (Toronto): https://speechandstuttering.com/
- CASLPO: https://caslpo.com/public-patients/public-register
Information about private SLP support outside of Ontario:
- Speech-Language & Audiology Canada: https://www.sac-oac.ca/for-the-public/
Further information and resources on stuttering
References
Guitar, B. (2024). Stuttering: An integrated approach to its nature and treatment (6th ed.). Wolters Kluwer.
The Stuttering Foundation. (n.d.). Stuttering facts & information. Retrieved from: https://www.stutteringhelp.org/faq
Yairi, E., & Ambrose, N.G. (2013). Epidemiology of stuttering: 21st century advances. Journal of Fluency Disorders, 38(2), 66–87. https://doi.org/10.1016/j.jfludis.2012.11.002