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How young is too young for treatment?

I recently read of a mother who is seeing stuttering with signs of frustration in her 2 year old daughter. She was wondering if it’s too early to seek treatment…

It is true that some children can start stuttering a very young age, but it is also true that most young children who start to stutter ultimately recover and go on to develop typically fluent speech. Determining the right time to seek treatment is a decision that must be considered carefully.

The key question that we ask at this age is not how much the child is stuttering (even if the stuttering appears to be quite severe in its presentation) but whether the child is at risk for continuing to stutter. We determine that risk by considering several factors, such as whether there is a family history of stuttering, the child's sex, how long the child has been stuttering, the child's language skills and motor skills and temperament, and other factors.

In the case of the 2-year-old described above, we can say that her young age is a factor in her favor, because a younger age of onset and a relatively short time since onset are both positive factors for recovery. Another positive factor is the fact that she's a girl, because girls are more likely to recover than boys. Still, we don't want to underestimate risk and thereby let a child fall through the cracks.

The major issue to be concerned about in this case is the fact that the child is showing signs of frustration. Once upon a time, our field thought that young children wouldn’t be aware of their stuttering. In fact, clinicians went to great lengths to try to prevent children from developing awareness of stuttering. Today, we know that some children may be acutely aware of stuttering, even at a very young age. This awareness and worry on the part of the child (and on the part of the parents) is of concern because we don’t want the child to develop the negative communication attitudes that so often plague older children, adolescents, and adults who stutter.

Therefore, we could certainly initiate treatment for a 2-year-old who has significant risk factors -- and we we may very well initiate treatment for a young child who is frustrated about stuttering even if the other risk factors are minimal! In this case, our explicit goal will be to help the child develop healthy, appropriate communication attitudes—even while we are working toward  a complete recovery from stuttering. Put another way: Even if the child will likely recover, there is still no reason for the child and parents to be worried in the meanwhile! And, if the child is at significant risk, then time spent waiting is time wasted.

Treating children at a very young age can be more difficult than treating them when they are a bit older, simply because the slightly older child may be able to engage in treatment activities more readily. Still, it is often the preferred path for increasing the likelihood of a successful outcome—that is, a child who communicates freely and easily, does not have negative attitudes about communication, and, ultimately, recovers from stuttering.

The topic of whether and when to recommend treatment for young children who stutter is covered in great detail in our book, Early Childhood Stuttering Therapy: A Practical Guide.

We also have two relevant free Practical Tips on our website. One addresses the question of “how long do we wait” before recommending therapy for a young child who stutters, and the other about helping young children develop healthy communication attitudes.

J Scott Yaruss

Written by : J Scott Yaruss

J. Scott Yaruss, PhD, is a professor of Communicative Sciences and Disorders at Michigan State University. He has published more than 70 peer-reviewed manuscripts, more than 115 other papers on stuttering, and several clinical resources, including the Overall Assessment of the Speaker's Experience of Stuttering (OASES), Early Childhood Stuttering: A Practical Guide, School-Age Stuttering Therapy: A Practical Guide, the Minimizing Bullying program, and more (all published by Stuttering Therapy Resources, Inc.).