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Practical Thoughts Blog

How long do we wait?

How long do we wait?

Happy 2018!

I’m just sitting here watching some more snow fall while I archive my emails from 2017. The biggest folder in my mailbox is the one where I keep all of the questions that I receive from clinicians and families about stuttering. I am often struck by just how much uncertainty there is about stuttering, and I am pleased when I can offer some words of comfort or guidance to people who aren’t sure what to do to help a child who stutters.

One of the most common questions I get is, “How long should we wait before recommending therapy for a young child who stutters?”

Certainly, there is no single answer to this question. The decision about whether and when to enroll a young child in therapy can be complicated by many factors, and there has been a longstanding debate among stuttering specialists about the best course of action to take when a young child starts to stutter.

Some of my colleagues recommend waiting (or watching) to see if a child will “outgrow” stuttering before initiating therapy. This is an understandable course of action, given the high percentage of young children who do stop stuttering while they are still in the preschool years. The argument is that it is neither efficient nor necessary to provide therapy to a child who will ultimately stop stuttering on his own.

While I understand this argument, I personally take a different approach. The reason for this is that we don’t know for sure which children will recover and which children will continue to stutter. At the same time, we do know for sure that continued stuttering can have a notable negative impact on a child’s life—a negative impact that we want to minimize or prevent.

Therefore, I prefer to recommend therapy if either of the following two conditions is true:

  • The child appears to be at risk for continuing to stutter
  • The child or parents are concerned about the child’s communication abilities

Answering the question of whether or not a child is at risk involves conducting a comprehensive evaluation of the child’s speech, language, and general development. Important factors include whether there is a family history of stuttering, the length of time that the child has been stuttering, the child’s language and motor skills, and the child’s developing temperament. (Full details about how to conduct such an evaluation are covered in Early Childhood Stuttering Therapy: A Practical Guide.)

Determining whether the child and parents are concerned about stuttering involves talking with them about how stuttering affects the child’s life. (Again, the early childhood stuttering therapy guide has numerous sample dialogues showing how SLPs can talk to parents and their young children about stuttering.)

Ultimately, we do not want the child to experience negative consequences as a result of his speaking abilities, so I tend to recommend therapy more often than not, so that we can have the greatest chance of helping the child recover from stuttering. The reasoning is simple: The parents probably wouldn’t have contacted me if they hadn’t had some reason to be concerned, and I know that I can help them, and their child, to understand more about stuttering and to reduce the likelihood that the child experience problems due to stuttering.

Of course, the nature of that therapy will matter—not all children should receive the same therapy, but that is the topic for another blog entry…

Here’s to a wonderful 2018 for all! And, for a few more details about when we recommend therapy for preschool children who stutter, check out the following “Practical Tip.”

Stuttering Therapy Resources Practical Tip: How Long Should We Wait