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Speech and language development from page 25

communicative intent, eye gaze, social skills, and other factors that may be related to a diagnosis of autism and is an invaluable member of the team for the medical professional providing the diagnosis. When in doubt, it is best to refer to the SLP for a comprehensive assessment to add value to other interdisciplinary findings. Speech fluency: Parents may express particular concern if they suspect that their child is stuttering. It is important to consider that all young children have certain normal disfluencies in their speech, particularly in the toddler and preschool years as they undergo periods of rapid development. Normal disfluencies are often in the form of phrase repetitions (I want…I want…); revisions (I goed...I went); and interjections (uh, um). Stutter-like disfluencies may more often take the form of repetitions of

sounds (p-p-p-puppy); syllables (bub-bub-bubble) or short words (you-you-you). It is of more concern if the child is distressed by their difficulty speaking, especially if they stop talking (oh, never mind…). If the child exhibits struggle, force, or other body movements associated with their stuttering, they should be referred to an SLP for an evaluation. The SLP

If not addressed early, challenges with language can lead to long-term impacts.

might decide to begin treatment immediately, particularly if the stuttering has been going on for a few months. Or, the SLP may decide to monitor the child for a few months to see if the stuttering subsides on its own.

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Factors that make it more likely for stuttering to persist are: being male; age of onset later in the preschool years; a family history of stuttering (persistent or resolved); and the presence of other speech and language delays. It is typical for children who stutter to go through periods of more and less fluency. It is important to realize that just because the stuttering seems

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to have gone away, it does not mean that it might not return. Treatment for stuttering is much more effective in the preschool years than it is later in life.

Conclusion As with any aspect of human development, there is a range of what is considered normal in speech and language acquisition. It is important to allow parents the opportunity to express their concerns while offering reassurance. Parents tend to be accurate reporters regarding what their child can and cannot communicate, even if their level of concern seems higher or lower than a physician’s level of concern. The American Speech-Language-Hearing Association ( offers a wide range of information for parents and professionals who are concerned with the development of children. Mark DeRuiter, PhD; Linda Hinderscheit, MA; and Marilyn Fairchild, MA, are all speech-language pathol-

ogists who work in the Department of Speech-Language-Hearing Sciences at the University of Minnesota, Twin Cities.

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