As children learn language during the pre-school and elementary years, their thoughts may outpace their developing speech and language skills, and a period of normal developmental dysfluency can result.  Dysfluencies may include frequent interjections ('uhm', 'uh'), uneven flow of speech (stopping, starting, reformulating), word and sound repetitions, prolongation of sounds, etc.  Teachers and parents should allow children who are dysfluent plenty of time to express themselves, and show them that what they have to say is valued by listening in a relaxed, attentive manner.  By modelling patience and relaxation, teachers and parents can encourage children to relax and give themselves the time they need to express themselves.  Avoid labeling the child as a stutterer, speaking for the child, correcting the child's manner of speech, or rushing the child.  When appropriate, reassure the child that he/she has so many ideas, that he/she needs to be patient and allow time to express the thoughts.  There may be several periods of developmental dysfluency, but in most cases it gradually decreases as the child's language skills increase. 

Fluency of speech becomes a concern when dysfluency is consistent and severe enough to interfere with communication (a child is often difficult to understand) and/or when it persists beyond the normal developmental range.  It may also be a cause for concern  1)  if a child is frequently frustrated by dysfluency when he/she attempts to communicate,  2)  if the child avoids speaking or avoids certain sounds or words because he/she is afraid of dysfluency,  3) if the child frequently blocks airflow (breath-holding), or  4)  if the dysfluency is often accompanied by additional behaviors such as tics, finger-snaps, tapping etc. which the child seems to use to help 'get started'.  If there is a concern about fluency that my result in a referral for a special education speech/language assessment (if classroom interventions are not successful), you will need documented evidence of the nature, frequency and length of the classroom interventions tried.  It is recommended that teachers discuss the concern with parents before trying preferrals interventions.

If the child's fluency improves when prereferral interventions are implemented for four to six weeks, continue to implement the interventions.  If concerns about fluency persist because there is no improvement or improvement is minimal, the next step is a referral for fluency assessment.

Prepared by S. Penner 11/1/93