Which factor is most important for the SLP to consider when deciding if a 4-year-old is developmentally nonfluent or stuttering?

• A. The length of time the child has been disfluent
• B. The rate at which the child talks
• C. The nature and frequency of the child's disfluencies
• D. The child's comments to the clinician about the disfluencies

Answer: (C)

The most important factor is the nature and frequency of the disfluencies itself. In preschoolers, distinguishing normal developmental nonfluency from stuttering hinges on what the child says disfluent, how those disfluencies are built, and how often they occur. Core behaviors that suggest stuttering include part-word repetitions (like “w-w-water”), sound or syllable prolongations, and blocks where airflow stops, often accompanied by visible struggle or tension. If these types of disfluencies appear repeatedly and persist over time, that pattern points more toward stuttering than typical developmental disfluency, which usually involves simpler, more routine repetitions (often of whole words or syllables) and occurs less frequently without associated struggle. The child’s own comments about the disfluencies or the length of time they've been present can provide context but don’t define whether stuttering is present; they’re less diagnostic than the actual disfluency patterns and how often they occur.