In assessing a 4-year-old with disfluency, which characteristic is most diagnostic for distinguishing stuttering from typical development?

• A. The length of time the disfluencies have persisted
• B. The rate of speech
• C. The nature and frequency of disfluencies
• D. The child's comments to the clinician about the disfluencies

Answer: (C)

In preschoolers, telling apart typical disfluency from stuttering hinges on what the disfluencies look like and how often they occur. Normal disfluencies tend to be simple, such as whole-word repetitions, interjections, or revisions, and they don’t happen very frequently. Stuttering shows more characteristic disruptions—part-word or sound-syllable repetitions, prolongations, and blocks—and these disfluencies occur with greater frequency and effort. Because diagnosing stuttering relies on both the type of disfluency and how often it appears, this combination is the best indicator, more so than how long any single disfluency lasts, overall speech rate, or the child’s own comments about the disfluency.