The Pediatrician’s Role in Supporting Childhood Stuttering

Pediatricians play a vital role in recognizing the early signs of stuttering, guiding caregivers, and referring families to qualified speech-language pathologists. Parents often turn first to their child’s doctor for reassurance and direction, which means pediatricians are uniquely positioned to promote early intervention and reduce stigma.

The National Stuttering Association provides educational resources and professional insights to help pediatricians support children who stutter and their families with empathy, understanding, and evidence-based guidance.

What is Stuttering?

Stuttering is a natural variation in speech in which the timing and flow of spoken language include moments of repetition, prolongation, or blocking of sounds and words. These moments reflect the diversity of human communication and are not signs of reduced intelligence or poor parenting.

According to the American Speech-Language-Hearing Association (ASHA) and current research, stuttering is part of normal variation in how people produce speech.

Commonly Observed Features

Repetitions: repeating sounds, syllables, or words, for example “I I I want to go.” 

Prolongations: stretching out a sound, for example “ssssun.” 

Blocks: pauses where speech stops momentarily, often with visible or internal tension even though the speaker knows what they want to say.

These speech differences can occur more often when a person is excited, tired, feels pressure to speak quickly, or is in specific social environments.

Beyond What You Hear

Stuttering is not limited to speech sounds. It may include physical movements, emotional responses, and behavioral adaptations.

Physical aspects can include eye blinking, facial tension, or shifts in posture during speaking. 

Emotional and cognitive aspects involve thoughts and feelings about speaking that may be shaped by personal experiences and reactions from others. 

Communication behaviors such as word substitution or avoiding certain words or situations may reflect concern about how others respond to stuttering rather than the stutter itself.

Varieties of Stuttering

Although every individual’s speech is unique, stuttering can be described in several ways depending on how it begins and what causes it.

Childhood Onset Stuttering often begins between ages two and five during rapid speech and language development. 

Neurogenic Stuttering may occur following neurological changes such as a brain injury or stroke. 

Functional Stuttering is rare and can sometimes follow psychological or emotional events.

Causes of Stuttering

Stuttering is a complex neurological condition that involves multiple contributing factors. It cannot be explained by nervousness, personality, or speaking too quickly.

Developmental stuttering originates in the areas of the brain responsible for speech and language processing. Genetic, environmental, and developmental influences all interact to affect fluency. While stuttering may occur along with other speech or language differences, it is neurological rather than psychological in origin.

ADVISING CAREGIVERS

Misunderstandings about stuttering are widespread, and parents often feel responsible for their child’s speech. Pediatricians play an important role in helping parents understand that stuttering is nobody’s fault.

When speaking with caregivers, pediatricians should:

• Reassure families that stuttering is a normal variation of communication.

• Emphasize that creating a relaxed and accepting environment helps more than correction.

• Explain that an early consultation with a speech-language pathologist can support positive outcomes.

These conversations can help reduce guilt, ease anxiety, and empower families to respond to their child’s speech with confidence and support.

SPEECH THERAPY FOR CHILDREN

For Young Children

For preschoolers, speech therapy focuses on helping children and families build healthy and positive responses to moments of stuttering. Therapy supports acceptance and confidence in communication, helping children develop a sense of ease and pride in how they speak. The goal is not to eliminate stuttering but to prevent negative reactions to stuttering from the child or others, and to nurture positive attitudes about speaking.

For Older Children and Adolescents

For older children, therapy continues to address emotional and social responses to stuttering while focusing on individualized goals that promote communication confidence and self-advocacy. Effective therapy is tailored to each child’s needs and may evolve as they grow.

EARLY IDENTIFICATION

Early identification is one of the most valuable ways to improve outcomes. Pediatricians can use evidence-based tools such as the Childhood Stuttering Screening for Physicians (CSS-P) to determine whether referral to a speech-language pathologist is appropriate.

Observation alone is not enough to measure severity or determine the need for therapy. Pediatricians should consider referring when:

• Parents express concern about speech or communication frustration.

• The child shows visible struggle or physical tension when speaking.

• The child demonstrates awareness or anxiety about talking.

Discussing these factors helps families make informed choices about pursuing speech therapy early.

EARLY INTERVENTION

Up to seventy-five percent of preschoolers who stutter experience spontaneous resolution, but early identification remains essential. A wait and see approach may delay support for children who are at risk of persistent stuttering. Early referral to a speech-language pathologist can reduce the likelihood of long-term negative experiences with speaking and help children develop healthy and empowered attitudes about communication.

When and How to Refer

Speech-language pathologists certified by the American Speech-Language-Hearing Association (ASHA) are trained to diagnose and treat stuttering.

Pediatricians can refer families directly to a speech-language pathologist or connect them with national organizations like the National Stuttering Association.

To find a speech-language pathologist who specializes in childhood stuttering, click here.

How Pediatricians Can Support Families

• Recognize early signs of stuttering and take caregiver concerns seriously.

• Reassure parents that stuttering is not caused by anxiety, trauma, or parenting style.

• Refer to a qualified speech-language pathologist rather than waiting to see if stuttering resolves on its own.

• Encourage families to foster open, pressure-free communication at home.

• Share evidence-based resources from the National Stuttering Association

By providing informed, empathetic guidance, pediatricians can play a meaningful role in ensuring that children who stutter receive timely support and encouragement for confident communication.

Last Updated: October 2025

Author: National Stuttering Association Marketing & Education Team with contributions from Nicole Kulmaczewski, MS, CCC-SLP and Jacqueline Toscano, SLP.D. CCC-SLP.