Stuttering In Toddlers And Preschoolers

Should you wait, or act now?

Many young children stop stuttering without treatment, but not all do, and nobody can tell in advance which child will. The Australian Stuttering Research Centre's advice is that a child sees a speech pathologist as soon as possible after stuttering starts, so a new stutter is a reason for an assessment, not for waiting. The signs that matter most, and what the research says about children who stop without help, are in when to worry about stuttering.

What therapy with a 2 to 5 year old looks like

Stuttering therapy with a toddler or preschooler is led by the speech pathologist in a weekly session, with a short, guided practice at home in between. Dr Lauren uses the Lidcombe Program, which was developed in Australia for children younger than 6. In the program's published treatment guide, that is a weekly consultation with parent and child together, in a clinic or by video, and a short practice session at home every day that the speech pathologist shows the parent and checks.

Person	In the weekly session	At home, between sessions
Speech pathologist	Rates the child's talking, reviews the week's ratings, demonstrates the feedback with the child, checks the practice and sets the plan for the coming week	Sets what happens at home: how long practice runs, what to praise and when to change it
Child	Plays and talks, over books and simple games	Plays and talks. Practice is meant to feel like play, not work
Parent	Sits in with the child, tells the speech pathologist how the week went and tries what she shows them	A short practice of about 15 minutes each day, done as the speech pathologist has shown, and one rating of the day's stuttering from 0 to 10

The feedback the speech pathologist shows a parent is mostly warm praise for smooth talking. Children in the Lidcombe Program are not told to change how they speak. The guide is also clear that the program is not designed for parents to use on their own: the speech pathologist's weekly session is what keeps it safe and fitted to the child.

The Australian Stuttering Research Centre lists three approaches for children under 6 that have support from randomised trials and says the strongest evidence is for the Lidcombe Program. A 2021 Cochrane review of four trials with 151 children found less stuttering after the program than on a waiting list, and rated the certainty of that evidence as very low. The goal of the program is for stuttering to resolve. Its guide tells speech pathologists to say plainly that this cannot be guaranteed.

The two stages of the program, and how a child moves from one to the next, are set out on the Lidcombe Program page. What the daily practice is like for a parent is in doing the Lidcombe Program at home. Treatment starts with a stuttering assessment.

What to do this week, before any appointment

A parent of a toddler who has just started stuttering can do these things today. None of them needs an appointment.

1. Note when it started. A speech pathologist will ask when the stuttering began and whether anyone in the family has stuttered. Write down the date and the answer while they are fresh.
2. Record a minute or two of ordinary talking. Stuttering in young children comes and goes, so a child can be fluent on the day of an assessment. A short phone recording from a day when the stuttering is present shows what you are hearing at home.
3. Listen, and let them finish. Let your child finish, answer what they said rather than how they said it, leave out "slow down" and "take a breath", and ask other adults to do the same. The reasons, and more everyday support, are in how to help a child who stutters at home.
4. Ask your doctor about a referral if you plan to claim a Medicare rebate.

These steps make talking easier for a child who stutters. They are not treatment, and they do not replace it. Parents who are asking themselves whether they caused the stutter can read what causes stuttering: parenting does not.

The year before school: stuttering at 4 or 5

A child who is stuttering at 4 or 5 has a reason to start treatment before school, and the reason is the child's experience of talking, not a deadline. Three published points sit behind that.

• Other children notice. The Australian Stuttering Research Centre recommends starting treatment as soon as possible after onset because even very young children can get negative reactions to their stuttering from other children, and says children who stutter are at risk of feeling anxious about talking from as young as 3. In one study that filmed four preschoolers who stutter at play, most responses from other children were neutral or positive, and the negative ones included interrupting, mocking, walking away and ignoring.
• Preschoolers usually know. The Centre's information sheet for pre-school teachers says children of this age are usually aware of their own stuttering, and may talk less, avoid some speaking situations and play less with other children.
• The research is strongest for this age. The Lidcombe Program was developed for children younger than 6 and most of the trials are with children of that age. The Sydney Children's Hospitals Network adds that stuttering can be harder to treat as children get older.

Treatment also takes time. The Centre says it is common for children to take several months to reach no stuttering or almost no stuttering in the Lidcombe Program, and that the time varies from child to child. Starting in the year before school gives that work room. It is not a promise that a child will start school without a stutter, and no speech pathologist can honestly make one.

What to tell kindy or childcare

Tell your child's educator about the stutter in a few plain lines. The treatment is led by the speech pathologist, so an educator is not asked to do therapy: their part is to make talking easy and to watch how other children respond. A note a parent can copy:

[Name] has started stuttering, and we are working with a speech pathologist. When [Name] gets stuck on a word, please wait and let them finish. There is no need to finish the word for them or to say "slow down". Please keep inviting [Name] into group time and conversation without pressing them to speak. If other children copy, tease or talk over [Name], please step in, and let us know. Please also tell us if you notice the stuttering change.

Those requests follow the Australian Stuttering Research Centre's one-page sheet, Information about Stuttering for Pre-school Teachers, which you can hand over with the note.

If the stutter is still there on the first day of school

A child who is still stuttering when school starts keeps going with treatment. Nothing about the first day of school ends it. The Lidcombe Program's guide says the program is also suitable for some children older than 6, and that its goals may need to be adjusted for older children.

Two things change at school. The teacher needs to know, in the same plain terms as the kindy note. And as a child gets older they take a more active part in their own therapy. What treatment looks like from the first year of school onwards is on the page about stuttering in school-aged children. For the whole picture across the ages, see stuttering in children.

Who provides the therapy

Dr Lauren Crumlish is a Certified Practising Speech Pathologist with a PhD from The University of Queensland, a 2024 Dean's Award for her thesis, and published research. She treats stuttering in children and teenagers and uses the Lidcombe Program with children under 6. Dr Lauren is a speech pathologist, not a medical doctor.

Dr Lauren works with a small number of families and has limited availability. Read more about Dr Lauren Crumlish, or apply to work with her.