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PHYSICIAN’S CHECKLIST FOR REFERRAL

 

The Child with NORMAL DISFLUENCIES

Age of Onset: 1 1/2 to 7 years of age

The Child With MILD STUTTERING

Age of Onset:1 ½ to 7 Years of age

The Child With SEVERE STUTTERING

Age of Onset: 1 1/2 to 7 years of age

Speech behavior you may see or hear:

Occasional (not more than once in ever 10 sentences), brief, (typical ½ second or shorter) repetitions of sounds, syllables or short words, e.g., li-li-like this.

Frequent (3% or more of speech), long (1/2 to 1 second) repetitions of sounds, syllables, or short words, e.g., li-li-li-like this. Occasional prolongations of sounds.

Very frequent (10% or more of speech), and often very long (1 second or longer) repetitions of sounds, syllables or short words. Frequent sound prolongations and blockages.

Other behavior you may see or here:

Occasional pauses, hesitations in speech or fillers such as “uh,” ”er,” or “um,” changing of words or thoughts.

Repetitions and prolongations begin to be associated with eyelid closing and blinking, looking to the side, and some physical tension in and around the lips.

Similar to mild stutterers only more frequent and noticeable; some rise in pitch of voice during stuttering. Extra sounds or words used as “starters.”

When problems most noticeable:

Tends to come and go when child is: tired, excited, talking about complex/new topics, asking or answering questions or talking to unresponsive listeners.

Tends to come and go in similar situations, but is more often present than absent.

Tends to be present in most speaking situations; far more consistent and non-fluctuating.

Child reaction:

None apparent

Some show little concern, some will be frustrated and embarrassed.

Most are embarrassed and some are also fearful of speaking.

Parent reaction:

None to a great deal

Most concerned, but concern may be minimal.

All have some degree of concern.

Referral decision:

Refer only if parents moderately to overly concerned.

Refer if continues for 6 to 8 weeks or if parental concern justifies it.

Refer as soon as possible.

 

Source: The Child Who Stutters:

To the Pediatrician 3rd edition, Stuttering Foundation of America Publication no. 0023, 2004.

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