Stuttering

From the Department of Pediatrics, The University of Calgary, and the Alberta Children’s Hospital, Calgary, Alberta, Canada. Correspondence to: Alexander K.C. Leung, Alberta Children’s Hospital, 1820 Richmond Road, SW, Calgary, Alberta, Canada, T2T 5C7 Stuttering is a speech fluency disorder characterized by frequent repetitions, prolongations, hesitations , or pauses that disrupt the rhythmic flow of speech. The repetitions and prolongations may involve sounds, syllables or words. Stuttering affects approximately 5% of all preschool children and 1 % of the general population. The male to female ratio is approximately 3 to 4:1. The etiology is multifactorial. Stuttering may be due to an inappropriate response of a listener to the normal pattern of dysfluency that is observed during the early childhood years. Heredity and subtle neurophysiological dysfunction are also suggested causes. To prevent stuttering, parents should be instructed to accept dysfluent speech in early childhood. Parents should also be encouraged to change those aspects of the family environment which could be related to stuttering, to reduce the number of frustrations experienced by the child, and to build up the frustration tolerance of the child. Mild stuttering is usually a self-limited problem but severe stuttering requires treatment and counselling. The treatment plan should include tactics which will reduce or eliminate any emotional component and negative attitudes towards stuttering that are present. A referral to a speech therapist is warranted if the child is over the age of four years, has been stuttering for more than three months, shows consistent stuttering, demonstrates tension or struggle behavior when stuttering, or if the parents express significant concern.