Stuttering in Children: Passing Phase or Time for a Speech Therapist?

“Ma-ma-mummy, I-I-I want...” Your 3-year-old, who used to talk without difficulty, suddenly starts tripping over words. Sometimes the word will not come out at all, they get frustrated, you wait. Stuttering (called stammering in the UK) worries parents a lot, and advice from relatives (“tell him to breathe”, “it will pass”) often adds to the confusion.

Two things need telling apart: the normal hesitations of a child learning to talk very fast, and stuttering that is setting in. Here is how to recognise them, and when to see a speech therapist.

Normal hesitations or stuttering: how to tell the difference?

Between 2 and 4 years, many children hesitate. They have more ideas than words, and their mouth struggles to keep up with their thoughts. Repeating a whole word without effort (“I want, I want the ball”) or saying “um” often is common and is not stuttering, notes Le Quotidien du médecin.

Stuttering, for its part, shows through more marked signs, described by the NHS:

Stuttering can fluctuate: days without, then days with. It often gets worse when the child is excited, tired or in a hurry to speak.

At what age does stuttering appear, and why?

Developmental stuttering is the most common kind. It generally begins between 2 and 6 years, most often between 3 and 5, according to the specialists interviewed by Le Figaro. The NHS estimates that about one young child in twelve goes through a phase of stuttering.

Its exact causes remain unknown. What we do know is that:

• parents do not cause it, the NHS insists;
• heredity matters: about two people in three who stutter have an affected parent;
• boys are three to four times more affected than girls;
• small differences in how the brain areas devoted to speech work play a role.

Stress or a significant event do not create stuttering on their own, but they can make it more visible in a child who is predisposed.

Does it pass by itself?

Often, yes. According to the NHS, about two children in three who stutter end up speaking fluently. But nobody can predict, at the start, which child will recover alone.

That is why we do not wait indefinitely. Speech therapists agree on one point: therapy is more effective in the young child, and it is easier to make stuttering disappear before age 6. To follow language as a whole, our milestones on first words and language from 0 to 3 years can complete the picture.

When to see a speech therapist

A speech therapist interviewed by Allodocteurs advises asking for an opinion from the start of symptoms, from a speech therapist trained in stuttering, even at 3. The first appointment often serves to assess the risks and guide the parents.

See someone without delay if:

• there are blocks, stretched sounds, tension in the face or body;
• your child avoids speaking, changes their words, gets angry or cries because of their speech;
• a parent or relative stutters or has stuttered;
• the stuttering appears after 5, or comes with a language delay.

In Morocco, the paediatrician can refer you to a speech therapist. Ask them explicitly whether they have experience with childhood stuttering: therapy relies heavily on parent coaching, meaning sessions where you are shown how to speak and react at home. Some speech therapists use the Lidcombe method, which aims to make the child's speech more fluent, according to Le Figaro.

Attitudes that help at home

How you react does not cause the stuttering, but it can ease it. The NHS emphasises an environment where your child feels relaxed and confident to speak.

1. Give them time. Wait calmly for them to finish, looking at them, without finishing their sentences for them.
2. Slow down yourself. Speak a little more slowly, with pauses: they will imitate this rhythm far better than an instruction.
3. Avoid instructions such as “breathe”, “start again”, “speak softly”: they raise the pressure.
4. Respond to the content, to what they are telling you, not to the way they say it.
5. Set aside a calm moment each day, a few minutes one-to-one, without screens or siblings cutting in.
6. Do not correct them in public and protect them from teasing, including from cousins or grandparents.

To help them build confidence more broadly, our article on children's self-confidence offers ideas that also work outside of speech.

Stuttering and bilingualism: should a language be dropped?

Bilingualism does not create stuttering in a child who is not predisposed. But studies do not all say the same thing, and it is honest to say so.

• A British study published in 2008 in Archives of Disease in Childhood found more children bilingual from birth among the children who stutter seen in clinics, and fewer spontaneous recoveries among them. Its authors themselves stress that this is an association, observed in a small group coming from specialist clinics, not proof of cause.
• Speech therapists remind us that bilingualism does not cause language disorders, and that it is better to speak to your child in the language you are most at ease in.

In practice, in Morocco, where many children grow up between darija, Arabic, Amazigh and French, do not give up a language on your own initiative. If your child stutters, discuss your family situation with the speech therapist, who will adapt their advice. Our article on the multilingual child in Morocco explains what is normal in bilingual development. And to place your child at their age, see our milestones for the 3-year-old and the 4-year-old.