Normal developmental disfluency and early signs of stuttering are often difficult to differentiate. Thus, diagnosis of a stuttering problem is made tentatively. It is based upon both direct observation of the child and information from parents about the child’s speech in different situations and at different times.
Between the ages of 18 months and 7 years, many children pass through stages of speech disfluency associated with their attempts to learn how to talk. Children with normal disfluencies between 18 months and 3 years will exhibit repetitions of sounds, syllables, and words, especially at the beginning of sentences. These occur usually about once in every ten sentences.
After 3 years of age, children with normal disfluencies are less likely to repeat sounds or syllables but will instead repeat whole words (I-I-I can’t) and phrases (I want…I want…I want to go). They will also commonly use fillers such as “uh” or “um” and sometimes switch topics in the middle of a sentence, revising and leaving sentences unfinished.
Normal children may be disfluent at any time but are likely to increase their disfluencies when they are tired, excited, upset, or being rushed to speak. They also may be more disfluent when they ask questions or when someone asks them questions.
Their disfluencies may increase in frequency for several days or weeks and then be hardly noticeable for weeks or months, only to return again.
Typically, children with normal disfluencies appear to be unaware of them, showing no signs of surprise or frustration. Parents’ reactions to normal disfluencies show a wider range of reactions than their children do. Most parents will not notice their child’s disfluencies or will treat them as normal.
Some parents, however, may be extremely sensitive to speech development and will become unnecessarily concerned about normal disfluencies. These overly concerned parents often benefit from referral to a speech clinician for an evaluation and continued reassurance.