5 Causes Of Stuttering In Toddlers, Symptoms And Treatment

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Toddlers may sometimes encounter pauses in speech and some levels of disfluencies while speaking, which is a normal aspect of developing communication skills. However, stuttering in toddlers is a phenomenon that could cause concern among many parents. Also, stuttering may last for longer durations in some children and could hamper their social and interactive abilities. Continue reading this post as we tell you about the possible causes of a toddler’s stuttering and ways to treat the condition.

In This Article

What Is Stuttering?

Stuttering is the disfluency of speech caused by repeated use of syllables, words, and sounds (1). Since the toddler repeats words or phrases, stuttering leads to a chronic break or interruption in speech fluency.

Some subtypes of stuttering include – developmental stuttering, persistent stuttering, and acquired stuttering. Developmental stuttering is observed when a child’s brain development is not seen as expected, whereas acquired stuttering is observed when illness results in stuttering. On the other hand, persistent stuttering is a type of developmental stuttering that persists even in adulthood.

Children with stuttering or other speech problems usually experience socialization issues, such as forming and maintaining peer relationships.

Types of Stuttering

The three different types of stuttering are developmental stuttering, persistent stuttering, and acquired stuttering.

Developmental stuttering is observed when a child’s brain development is not seen as expected. This is characterized by a lag between what the child wishes to say verbally and the process of the physiological development of speech and language (2).

Acquired stuttering is observed when an illness results in a sudden onset of stuttering throughout the speech. This illness may be a mental illness that hinders thinking and reasoning or physiological, such as stroke, brain tumor, brain cancer, and brain disorder of the spoken language centers (aphasia). It includes the psychogenic and neurogenic subtypes (3) (4).
Persistent stuttering is a type of developmental stuttering that persists even in adulthood.

How Common Is Stuttering Among Toddlers?

According to the US National Institute of Health, about one in 20 children develop stuttering. The probability of stuttering is the highest between the ages two and five years. Stuttering is also more common in boys than girls.

Can Stuttering Happen Suddenly?

Yes. Stuttering can happen suddenly. A toddler, who did not stutter before, may develop it overnight (5) It can also build up gradually as a part of a language development process.

What Causes Stuttering In Toddlers?

Here are some causes and potential risk factors of stuttering in toddlers (6):

A family history: Toddlers who have family members with a stutter are at a higher risk of developing the condition. Faulty genes associated with stuttering can transmit the speech disorder across generations, which shows that stuttering has genetic predisposition.

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Brain injuries: Suffering a trauma to the brain may result in stuttering, referred to as acquired stuttering or neurogenic stuttering.

Emotional shock: Environmental factors such as shock or trauma may impair one’s emotional regulation abilities and increase the risk of stuttering in toddlers. Such a condition is called psychogenic stuttering. Family discordance or change in surroundings can also precipitate stuttering.

Neurological disorders: Problems with the nervous system can cause stuttering. An example is Tourette syndrome where a person has repeated, involuntary movements of face or other parts. According to the Centers for Disease Control and Prevention (CDC) data, in the United States, 0.3% of all children aged 3 to 17 have been diagnosed with Tourette Syndrome.

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Other speech disorders: Stuttering often co-exists with other speech, language, and communication disorders that a toddler might have.
Onset: Another stuttering risk factor is the age of onset of the stuttering in the child. Anecdotal sources suggest that children who have had an onset of stuttering before the age of 3.5 years of age are more likely to outgrow the stuttering (7).

If your toddler is positive to any of the above causes, then look out for any signs of stuttering because the first signs of stuttering can emerge between the age of 18 and 24 months (8).

What Are The Symptoms Of Stuttering?

Following are the symptoms of stuttering (9):

Repetition of phrases and sounds: Example, “I want my t-t-toys!”, “The tree has a ne-ne-nest.”

Prolongation of sounds: Example, “The tortoise walks sssslow.”

Blank moments while talking: There are going to be repeated blocks. When speaking a sentence, a toddler would pause awkwardly, because of their inability to speak comfortably further.

Collateral traits: A stuttering toddler may often twitch their lips, move their jaw awkwardly, or blink repeatedly.

Frustration and anxiety while speaking: Since the toddler is unable to communicate their feelings properly, they associate speaking with frustration and annoyance.

Anticipation: Anticipation of speaking a word can have an inhibitory effect on fluency, similar to that caused by anxiety and frustration. A study demonstrated the correlation between anticipation and stuttering. As inferred from the graph, children who stutter often feel anticipation. Therefore, a treatment that facilitates productive responses to anticipation may be beneficial in reducing its effects on stuttering.

Prevalence of anticipation and stuttering in children and teens

Source: Anticipation: Changing the Way We Think about Stuttering; New York University

Some parents may feel that the symptoms mentioned above are normal during speech development of the toddler. However, a stuttering toddler’s speech differs from a disfluent one’s.

Quick fact

Children who stutter may get breathless or nervous while talking or appear afraid to speak (17).

How To Differentiate Stuttering From Normal Disfluency?

Here is how you can distinguish stuttering from normal disfluency (7).

Normal disfluency	Stuttering
Lasts less than six months	Lasts longer than six months
Uses fillers like “um,” “eh,” and “like” to cover pause	No use of fillers while pausing
Repeats words than sounds	Repeats sounds and syllables rather than words
No wavering of the pitch of the voice	The pitch may rise with repetition of the word or sounds, and the child may have voice gaps or blocks in between.
No frustration, anxiety, or tension while talking	Toddler seems tensed and frustrated when talking
No secondary/collateral traits like blinking of the eyes and twitching of the mouth	Displays other secondary traits like twitching of eyes and mouth

If you are unable to differentiate the symptoms or suspect a problem with your toddler’s speech, consult a doctor.

When To Visit A Doctor For A Toddler’s Stuttering?

Do not wait if you suspect that your child is stuttering. Timely diagnosis and early intervention is the key to effective resolution of the issue. Depending on the toddler’s condition, a pediatrician may refer you to a pediatric speech-language pathologist. An analysis by the pathologist can help diagnose the toddler’s stuttering problem.

How Is Stuttering In Toddlers Diagnosed?

Doctor will observe the symptoms to diagnose the condition

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A speech-language therapist will use the following procedures to diagnose stuttering in toddlers (11):

Review the condition: The pathologist will conduct a multidisciplinary assessment to check for how long the condition has persisted, whether someone else in the family has the stutters, and if the child has any other speech disorders. The doctor will also consider any brain injuries that the toddler has had in the past.

Observation of symptoms: Simple speech exercises would help the pathologist observe the signs of stuttering and its intensity.

Overall speech development of the toddler: A toddler with normal disfluency can comfortably reach other speech and language milestones of their life. However, those with stuttering may not.

How Is Stuttering In Toddlers Treated?

Basic speech changes and long-term therapy are used to rectify stuttering. The treatment is a systematic approach involving a combination of therapeutic procedures and language modification and varies as per the severity of the toddler’s stuttering. The two treatment options include (9):

Speech modification: A speech-language pathologist employs counseling and behavior modification techniques to address stuttering. For instance, they train the toddler to make subtle changes in the language to minimize the chances of stuttering. These include the use of words and phrases that a toddler can say better.
Then, parents are suggested a modified communication style to best suit a stuttering toddler. Young toddlers can benefit from speech intervention and may be cured sooner.

Long-term therapy: This involves teaching the toddler to deal with triggers, using short sentences, and methods to avoid a prolonged pause in speech. Therapy sessions are often conducted in groups and work at instilling confidence in the toddlers.

The treatment is a systematic approach involving a combination of therapeutic procedures and language modification and varies as per the severity of the toddler’s stuttering. The doctor will ensure progress monitoring and provide follow-up care in order to check the efficacy of the treatment.

How Can Parents Help A Toddler Who Stutters?

Parent education can help . Here is how parents can play a crucial role in toning down the intensity of a toddler’s stutter:

Speak to the toddler calmly. Use a slow and relaxed speech to communicate with your toddler; use pauses when you talk. Use shorter sentences that seem less demanding of an answer (“So you had fun at the park!”) instead of questions (“So what did you do in the park today?”).

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Rely on facial expressions and body language. If a nod or wave of the hand can do the work, then avoid using words. It can help cut down the number of stuttering triggers for a toddler.

Have patience. When your toddler stutters, do not ask them to complete the sentence quickly or interrupt to complete the word they are struggling to pronounce. Also, do not tell the toddler to slow their speed of talking. A toddler may perceive stuttering to be wrong, which in turn could increase stress.

Do not let the toddler feel conscious about stuttering. Avoid pointing out to stutter. It can hurt the little one’s self-confidence and deter them from sharing their feelings.
Tell your toddler that stuttering should not limit them. Older toddlers may seem frustrated to communicate with their peers. Encourage them to talk to their friends more, regardless of their stutter. Helping the toddler cope with the condition every day also aids the speech therapy that they are undergoing.

In addition, help toddlers develop coping strategies to help them cope with stuttering and feel more comfortable in situations where they may feel self-conscious.

Pointing out to stutter can hamper a toddler's self-confidence

Image: Shutterstock

Quick fact

Reduced self-esteem, poor performance at school, social isolation, and limited participation in certain activities are some of the complications that may arise from stuttering in children (17).

How To Prevent Stuttering In Toddlers?

There are no prevention strategies that you can implement to prevent stuttering in toddlers since it is caused by reasons that are not entirely understood (12) Ensuring that you stay alert to the shortcomings in your toddler’s speech is the best way to help your toddler overcome it.

Frequently Asked Questions

1. At what age should a child stop stuttering?

According to Nationwide Children’s, stuttering usually begins between 18 months and five years of age. About 75 to 80% of children who stutter will stop doing so within 12 to 24 months without speech therapy (13).

2. Is stuttering considered autism in toddlers?

Children with autism can have speech issues such as stammering or stuttering (14). However, if a toddler stutters, it doesn’t necessarily mean that they are autistic. Remember, stuttering isn’t a sign of autism, and not all autistic children stutter.

3. When should I worry about my three-year-old stuttering?

According to the American Academy Of Pediatrics (AAP), “about 5% of all children are likely to be disfluent at some point in their development, usually between ages 2 ½ and 5 (15)”. Hence, a parent should not worry about their child stuttering unless they notice their child (16):

struggle to talk or have facial tension
avoid situations where they have to talk
avoid saying certain sounds or words

Stuttering in toddlers can be cured with the help of timely medical intervention, and the child will be able to overcome the condition successfully. But it is vital that you support your little one during the process and boost their confidence by helping them understand that stuttering should not limit their opportunities or their ability to do anything. There are no stated ways that could help prevent the occurrence of stuttering. However, being aware of the symptoms and consulting a speech therapist immediately in case of any shortcomings can help deal with the condition in your toddler.

Infographic: How Can Parents Help A Toddler Who Stutters?

Stuttering is a common speech disorder that affects many young children. It can be distressing for the child. This infographic sheds light on the crucial role parents can play in helping their child improve their speech and lead happy life. Read on!

how can parents help a toddler who stutters (infographic)

Get the high-quality PDF version of this infographic.

Key Pointers

Stuttering is a verbal disfluency caused by the repetitive use of syllables, phrases, and sounds.
Stuttering can be caused by brain injuries, family history, neurological problems, emotional shock, or other speech abnormalities.
Symptoms of stuttering in children include blank moments while talking, repetition of sounds and phrases, anxiety and frustration while speaking, or prolongation of sounds.
Stuttering in toddlers is treated with basic speech changes and long-term therapy, with a systematic approach tailored to severity.
If you feel your child is stuttering, consult a doctor right away.

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