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Stuttering alarms and disturbs parents. They are often at a loss as to what to do. Ignore? Get speech therapy? Wait for the child to outgrow it?

Stuttering is a communication disorder characterized by disruption of the smooth rhythm and flow of speech. Stutterers may repeat sounds or syllables, prolong sounds, or actually exhibit a blockage of speech — unable to utter any sounds without great effort.

All young children stutter occasionally, especially around age 3 or 4, when they are expanding their language skills and developing the ability to use complex sentences and make up stories. One professor of mine described this normal disfluency seen in nearly all preschoolers as, “A case of the brain moving faster than the tongue, but the tongue will catch up.” Generally, such children do not seem to be aware of having any trouble speaking and the disfluency improves and goes away. No treatment is needed except patience and understanding on the part of the parents.

Most children have lost their developmental disfluencies and have fluent speech by the time they enter school. And although all of us pepper our speech with fillers like “you know” and “uh” and often repeat words, most people have a smooth speech pattern.

However, stuttering can persist. Chronic stuttering affects nearly 3 million people, is found in males 4 times more frequently than in females, and there is a tendency for stuttering to run in families. Although stuttering is somewhat more frequent in children with cerebral palsy or mental retardation, in most instances stuttering is an isolated problem in a thoroughly normal child. Stuttering in school-age children and adults has great variability ranging from occasional annoyance to a profound problem that interferes with school and job performance as well as self-esteem and quality of life.

There is some controversy about classification but it is useful to divide stuttering children into three groups:

1) Those with NORMAL DISFLUENCY have a developmental problem and will outgrow it.

2) MILD STUTTERERS are at low risk of becoming chronic stutterers.

3) Those with SEVERE STUTTERING have a high risk of becoming chronic stutterers.

The problem is that these three stuttering entities overlap somewhat. Further, calling undue attention to the stuttering can make things worse because environmental factors play a big role in stuttering. Children whose parents place high demands on them to perform or to shine academically, athletically or socially may stutter. (Do this child’s parents place too much value on his “brilliance?”) Also, stress can greatly exacerbate stuttering symptoms.

My philosophy in practice was to use the experts to help me make a diagnosis and to use these experts early. In other words if a child exhibits stuttering beyond that of normal developmental disfluency I always refer to a speech-language pathologist.

Although sometimes even the experts cannot classify every child or decide which ones will outgrow or adapt to their stuttering, speech-language pathologists are very good at working with the parents and parents are key to helping the stuttering child.

Important recommendations for parents of a stuttering child include:

Model slower, relaxed, simpler speech. Talk in a relaxed style yourself and increase pauses rather than asking the child to talk slower.

Do not criticize or correct the child’s speech or “fill in the word.”

Discourage interruptions — let everybody including the children have an un-pressured turn.

Slow down the pace of family life as much as possible. Find time for “hanging out” and doing nothing together instead of programming every moment.

Give the child individual attention including plenty of nonverbal activities like coloring together.

“Niche-pick” for the child’s strengths and competencies instead of nit-picking.

Don’t alarm the child about the stuttering or seem worried about it because anxiety makes stuttering worse. Treat going to a speech-language therapist as a fun thing; avoid gloom and doom when talking about stuttering.

See that the child gets enough sleep.

Minimize family conflicts. Often when a child has a problem, fights between parents escalate because both parents are upset.

Call the Stuttering Foundation of America at 1-800-992-9392 for further information.