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Physician's Checklist for Referral |
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The Child With Normal Disfluencies
Age of Onset: 1½ to 7 years of age |
The Child With Mild Stuttering
Age of Onset: 1½ to 7 years of age |
The Child With Severe Stuttering
Age of Onset: 1½ to 7 years of age |
| Speech behavior you may see or hear: |
Occasional (not more than once in every 10 sentences), brief, (typical ½ second or shorter) repetitions of sounds, syllables or short words, e.g., li-li-like this. |
Frequent (3% or more of speech), long (½ to 1 second) repetitions of sounds, syllables, or short words, e.g., li-li-li-like this. Occasional prolongations of sounds. |
Very frequent (10% or more of speech), and often very long (1 second or longer) repetitions of sounds, syllables or short words. Frequent sound prolongations and blockages. |
| Other behavior you may see or hear: |
Occasional pauses, hesitations in speech or fillers such as "uh," "er," or "um," changing of words or thoughts. |
Repetitions and prolongations begin to be associated with eyelid closing and blinking, looking to the side, and some physical tension in and around the lips. |
Similar to mild stutterers only more frequent and noticeable; some rise in pitch of voice during stuttering. Extra sounds or words used as "starters." |
| When problems most noticeable: |
Tends to come and go when child is: tired, excited, talking about complex/new topics, asking or answering questions or talking to unresponsive listeners. |
Tends to come and go in similar situations, but is more often present than absent. |
Tends to be present in most speaking situations; far more consistent and non-fluctuating. |
| Child reaction: |
None apparent |
Some show little concern, some will be frustrated and embarrassed. |
Most are embarrassed and some are also fearful of speaking. |
| Parent reaction: |
None to a great deal |
Most concerned, but concern may be minimal. |
All have some degree of concern. |
| Referral decision: |
Refer only if parents moderately to overly concerned. |
Refer if continues for 6 to 8 weeks or if parental concern justifies it. |
Refer as soon as possible. |