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Between the ages of 30 months and 5 years your child is in the midst of a leap in her language skills, so it's natural that she should have some difficulty putting her sentences together fluently. (She stutters when her brainpower outstrips her verbal dexterity.) Her rapidly developing brain is trying to pull up the right words in the right order. In the process, she may repeat the whole word or first syllable, resulting in something that sounds like this: "Mom ... I-Mom ... I-I-want-uh-I want you-gimme dat teddy bear!"
This stumbling over words is different from a true stuttering problem (also called dysfluency), which affects only 5 percent of children and is unusual in preschoolers. If your child is truly stuttering (and not just stumbling over words occasionally), she may drag out the first sound in a word, saying "ssssoda," or repeat the sound, as in "Sh-sh-she nice!" She may also open her mouth to say something and then get stuck before any sound comes out. Along with this "blocking," you may see tension in her jaw or cheeks, or she may look away or clench her fist from the tension, blink repeatedly, grimace, or stomp her foot from the frustration of trying to get the words out.
Preschoolers (and adults, too) tend to stutter when they're upset, uncomfortable, angry, or even just plain excited. If your 3- or 4-year-old is stuttering only at these times, and the stuttering is mild, don't rush to get her evaluated. Most kids outgrow it without any intervention by age 5 or 6. If she's really struggling, however, or she hasn't improved within three to six months, talk to her pediatrician, or, if she's in preschool, with her teacher. Her school may be able to refer you to an early speech and language intervention program (usually coordinated through the county or public school system) that will provide free speech and language screening. Or her doctor can refer you to a speech-language pathologist for an evaluation.
For years, it was thought that preschoolers were too young to begin formal speech therapy for stuttering — that it would only make them self-conscious. Most practitioners now feel, though, that a child with a severe stutter (usually measured in the number of repeated or prolonged sounds and blocks) can benefit from early intervention. If exercises are presented as fun games, even a preschooler can learn strategies to reduce the frequency and severity of stuttering episodes.
You can also take steps at home to help a child who stutters. Whether your preschooler is simply going through a normal dysfluent stage or exhibiting a true stutter, the way in which you respond is important. Keep your voice soft and relaxed, your speech slow — think Mr. Rogers. If you are a rapid staccato talker, try to slow down so your child doesn't feel the need to respond in a similar manner. Don't tell her to slow down, though — just speak slowly and she'll follow your lead. Maintain eye contact, smile, and be patient. If you turn away and act hurried, your preschooler will feel pressure to "get it out" and this will only make her stuttering worse. Allow your child to express her frustration or embarrassment. She may say: "I can't say it. It won't come out." Acknowledge her feelings by saying: "I understand how frustrating that must be." If you look frustrated, your preschooler will pick up on this and be even more self-conscious. There is no need at this point to let her know her stuttering is frustrating or worrisome for you.
For more information and resources, call the Stuttering Foundation of America at (800) 992-9392.