FTJ: Stuttering


Natural History of Stuttering to 4 Years of Age: A Prospective Community-Based Study

This article is available here.


Stuttering is common in young children and most seem to get better but it can be hard to reassure parents on this. They are often advised to obtain speech therapy which is time consuming and expensive.

Hot off the press, this Victorian community cohort study is very helpful I think. It suggests a cumulative incidence for stuttering of 11.2% and shows that this was mostly transient and in fact at the time of outcome the stuttering children performed slightly better in some areas of language than the non-stutterers.

In the absence of severe and disabling stuttering, current advice of reassurance plus watchful waiting for 12 months seems appropriate and in fact a longer period of observation may be fine too.



OBJECTIVES: To document the natural history of stuttering by age 4 years, including (1) cumulative incidence of onset, (2) 12-month recovery status, (3) predictors of stuttering onset and recovery, and (4) potential comorbidities. The study cohort was a prospective community-ascertained cohort (the Early Language in Victoria Study) from Melbourne, Australia, of 4-year-old children (n = 1619; recruited at age 8 months) and their mothers.

METHODS: Outcome was stuttering onset by age 4 years and recovery within 12 months of onset, defined using concurrent monthly parent and speech pathologist ratings. Potential predictors: child gender, birth weight, birth order, prematurity, and twinning; maternal mental health and education; socioeconomic status; and family history of stuttering. Potential comorbidities: preonset and concurrent temperament, language, nonverbal cognition, and health-related quality of life.

RESULTS: By age 4 years, the cumulative incidence of stuttering onset was 11.2% (95% confidence interval [CI]: 9.7% to 12.8%). Higher maternal education (P = .004), male gender (P = .02), and twinning (P = .005) predicted stuttering onset. At outcome, stuttering children had stronger language (mean [SD]: 105.0 [13.0] vs 99.6 [14.6]; mean difference 5.5, 95% CI: 3.1 to 7.8; P < .001) and nonverbal cognition (mean [SD]: 106.5 [11.4] vs 103.9 [13.7], mean difference 2.6, 95% CI: 0.4 to 4.8; P = .02) and better health-related quality of life but were otherwise similar to their nonstuttering peers. Only 9 of 142 children (6.3%; 95% CI: 2.9% to 11.7%) recovered within 12 months of onset.

CONCLUSIONS: Although stuttering onset is common in preschoolers, adverse affects are not the norm in the first year after onset. 

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Prof South is a paediatrician and intensivist based at Royal Children's Hospital, Melbourne. He regularly blogs on line Mike's webpage
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