Is It Normal Disfluency or Stuttering in Preschoolers?
Parents frequently call in a state of great concern when they believe their youngster might be stuttering. So the question is, how do we determine when the child is exhibiting normal disfluency or stuttering?
First, let's define our terms. Disfluency is anything that impedes the forward movement of speech. So, when you stop in mid-sentence and say "Um" or "Er" that is disfluency. Or, if you say, "I want, um, I want that", that is disfluency. Stuttering differs from disfluency in both quantity and quality.
Research indicates that preschoolers tend to be highly disfluent. They back up, repeat words and restate much of the time. In fact, one study found that in a language sample taken from a group of 3 year olds, every third word was repeated. What underlies this high degree of disfluency is the child's developing language system.
In other words, the preschool child is developing vocabulary, grammatical structures and the ability to talk about abstract ideas and events. Because these skills are not yet fully developed, there is a lack of automaticity. The child might struggle to find the word he wants to say or the structure needed (as in past tense 'ed') to fully express his idea. So, it appears that for most youngsters, disfluency is part of the developmental process.
Now, we call these "normal" disfluencies, not stuttering. So what disfluencies raise a red flag during a speech evaluation? Sound repetitions (b-b-book) or prolongations (sssssoup) are indicative of a possible fluency disorder. Part word repetitions (be-be-because) are also not typical of developmental disfluencies. Remember, we also said quality and quantity. If a child occasionally repeats or prolongs a sound, that should not be a cause for concern.
However, if you notice that your child is exhibiting speech behaviors such as repetition of sounds, prolongation of sounds in words (as mentioned above), seems "stuck" and cannot get his words out, or exhibits facial tension during speech, this behavior is a cause for concern.