Over the years, a few Mom friends have come to me about their toddler's or preschooler's stuttering. The question is always: Should I worry? Then recently, a mom in a local Facebook group posted about this exact topic. There were many comments from other parents that had experienced the same thing and their child did eventually stop stuttering. Inspired by this post, I wanted to create a resource for those worried parents.
First, lets review what stuttering is. Stuttering is anything that disrupts the fluency in ones speech (stuttering is also namely called dysfluency). There are many types of these dyfluent events. They are:
Phrase repetitions and interjections/fillers are part of normal dysfluency, meaning that this occurs in the general population without a stuttering disorder. Think about it, how many times as you are responding to your children while thinking about something else did you, uh, uh, uh stutter while you shifted your attention to what they were talking about. It happens ALL THE TIME. The other types of dysfluencies are not considered part of normal dysfluency and are "atypical."
Now, lets get to the facts about young children and stuttering. Once a child starts to string multiple words together, approximately 8.5% of them will start to have periods of dysfluency (Reilly et al., 2009). They include all of the types of dysfluencies mentioned above. However, in approximately 70-80% of children the the atypical stuttering events eventually do disappear without formal intervention (Yairi & Seery, 2011). Even for those children whose stuttering is severe initially. For the children whose stuttering does not disappear, research has shown that there are certain factors that elevate the risk that the stuttering events will continue and become a stuttering disorder. Factors that contribute to an this risk include:
The problem is, however, even without all the risk factors a child's stuttering can become a stuttering disorder OR a child who has all the risk factors can stop. There is no guarantee. That's why it is so important to see a Speech-Language Pathologist to evaluate these risk factors and follow up with them periodically to evaluate the need to start therapy. For example, if a child's stuttering is increasing over time or they are showing negative behaviors towards their stuttering, it may be beneficial to begin treatment. A therapist familiar developmental stuttering will know what to look for and know what the best plan of action is for your child. Every child, their risk factors, stuttering behaviors and the effects of those on the child are unique. If you would like to get your child evaluated, please contact us.
For tips on how to talk with your child that is stuttering, head on over to the Stuttering Foundation. There is a wealth of information for parents on this site.
Nippold, M. A. (2018). Stuttering in Preschool Children: Direct Versus Indirect Treatment. Lang Speech Hear Serv Sch, 49(1), 4-12. doi: 10.1044/2017_LSHSS-17-0066.
Reilly, S., Onslow, M., Packman, A., Wake, M., Bavin, E. L., Prior, M., . . . Ukoumunne, O. C. (2009). Predicting stuttering onset by the age of 3 years: A prospective, community cohort study. Pediatrics, 123(1), 270–277.
Yairi, E., & Seery, C. H. (2011). Stuttering: Foundations and clinical applications. Upper Saddle River, NJ: Pearson Education.
***This post is not meant to diagnose any child. Please see a qualified Speech-Language Pathologist***
Here is all the information you need to find the therapy services in Anne Arundel County and surrounding areas. Take a look at the options below and decide which is best.
1. THROUGH YOUR LOCAL SCHOOL SYSTEM
Here in Maryland, early intervention, child find and school age services are delivered for free through your local public school system and are county based. What that means is that whatever county you live in will be your servicing county. Early Intervention, also called Infants and Toddlers (I & T), is birth through 3; Child Find services are for children 3-5 years of age; and School age are children in Kindergarten though 12th grade. With services provided by the school system, the child's difficulties must be educationally impacting the child and their criteria for services is more stringent than qualifying for private therapy (see below). This may mean that a child with a mild impairment and/or one that is not educationally impacting them may not receive services. Please see this article for more information on this topic. The time line from referral for an evaluation until therapy begins is typically months as timelines/procedures are different for services through the public school system. Use this document as a guideline for the process in the state of Maryland. The school system team of educators/evaluators may also decide that a different tier of intervention, also called Response to Intervention, is implemented prior to initiating an evaluation to see if your child does or does not respond to these less intensive intervention measures, thus providing more or less support for an educational impact. Referral for services can be initiated by your child's current public school teacher. However, if your child is not currently enrolled in the public school system (i.e., infant/toddler, preschooler or a child that attends a private school) or if your child's teacher has not initiated a referral, a parent can initiate the process.
If, after the evaluation, your child is determined to have a disability with educational impact, services are delivered to meet your child's needs. For Early Intervention, services are typically held at home with the provider coming to you in your home or community. However, some districts have language enrichment classes much like a preschool program where your services can be delivered. With Child Find services, your child may be serviced at their daycare, home school or within their school day if they attend a county-provided preschool program. School aged children are serviced in their home school. If your child attends a private school, some services may be available at your child's school (must be within the county where you live) where a county-provided therapist comes to your child's school. You may also be given the option to receive services at your child's "home school." Each county has different programs and each child's needs are different so there is no uniformity to where and how services are delivered. Make sure to ask specific questions on how, when and where your child's services will be provided.
Contacts for Anne Arundel County and surrounding counties are listed blow:
2. PRIVATE SPEECH-LANGUAGE SERVICES
Another option for pursuing speech-language services is through private practices. Here at Strides Speech Therapy we fall under this option. Private practices may or may not be in network with your insurance company. We are in-network with some select commercial/state plans. However, if you use our services as an out-of-network provider, we can provide you with a "Superbill" that contains all applicable diagnosis and treatment codes for you to submit to your insurance company for reimbursement. If you choose to use an in-network provider with a company we do not participate with, we are happy to refer you to other practices that accept your insurance company. Keep in mind that insurance plans very greatly and some plans do not cover developmental services or only cover limited amounts of service. Please see this resource by the American Speech-Language Hearing Association (ASHA) regarding insurance plans and speech-language benefits. You may also reach out to us for guidance on contacting your insurance company and important questions to ask. If paying privately for services, there are options aside from "out of pocket" for acquiring the financial resources to do so.
3. LOCAL UNIVERSITY CLINICS
Maryland residents are lucky enough to have 3 local universities that provide Speech-Language Services at their clinics. Run by undergraduate and graduate students and supervised by licensed and certified Speech-Language Pathologists, these clinics are located on Campus. The programs are listed below.