I often hear clients ask whether now is the right time to treat their preschooler’s stuttering. There has been much media misinformation around this issue.
Parents need to know that not all children grow out of stuttering and that for those who do not grow out of it, treatment with the Lidcombe Program during the preschool years is their best treatment option.
Publicity regarding the recent article by Reilly et al., “Natural history of
stuttering to 4 years of age: A prospective community-based study”:
Response from the Australian Stuttering Research Centre Australian Stuttering Research Centre, October 2013
A recent report in the journal Pediatrics on the epidemiology of stuttering (1),
published by Australian researchers, including two from the Australian
Stuttering Research Centre, has attracted a lot of interest worldwide.
Unfortunately, much of the publicity and discussion about the article in the
press, in the social media and even in the professional literature has been
The Reilly et al. study is part of a larger community study of children in three
areas of Melbourne, Australia. Children and their parents were recruited to
the study at their universal visit to maternal and child health nurses at age 8
months. Recruitment occurred over a 6?month period. The children were then
assessed regularly by researchers to identify the natural course of language
development and to document the onset (incidence) of stuttering.
The Reilly et al. article reports the findings for those children who had started
to stutter by age 4 years. The most important finding is that many more
children started to stutter than previously thought. This is likely because
children were first assessed prior to the onset of stuttering, meaning that all
(or nearly all) children in the community who started to stutter were
The second finding is that at 4 years of age the group of children who had
started to stutter did not score lower that the rest of the children when
assessed for language development and quality of life. Again, this is likely
because the study captured all children who had started to stutter, not just
those who presented at a clinic. This is the finding that has been so widely
misrepresented. It has been reported that the authors have said that this
means that treatment for early stuttering should be withheld.
This is not the case. In their report, Reilly and colleagues endorse the
evidence?based guidelines for the Lidcombe Program about when to start
treatment (2). The Lidcombe Program was developed in Australia and is the
only treatment for stuttering in preschoolers that is supported by clinical
trials. The guidelines clearly state that (a) delaying the program for a year
after the onset of stuttering is unlikely to jeopardize a child’s responsiveness,
but (b) the program should be instigated earlier than this if “the child is
distressed, there is parental concern, or the child becomes reluctant to
communicate” (see Reilly et al., page 446).
In summary, while epidemiological studies provide information about the
incidence and course of disorders or conditions in the community, in clinical
practice the welfare of the individual is always of prime concern. A child who starts
to stutter should be assessed by a speech pathologist, who can advise on the best
course of action, taking into account the individual circumstances of the child and
(1) Reilly, S., Onslow, M., Packman, A. et al. (2013). Natural history of stuttering to
4 years of age: A prospective community?based study. Pediatrics 132, 460?467.
(2) Packman A, Onslow M, Attanasio, J. The timing of early intervention with the
Lidcombe Program. In M. Onslow, A. Packman, & E. Harrison (Eds.) The Lidcombe
Program of early stuttering intervention: A clinician’s guide (pp. 41?55). Austin, TX: