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PHYSICIAN’S CHECKLIST FOR REFERRAL |
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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 |
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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. |
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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.” |
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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. |
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Child reaction: |
None apparent |
Some show little concern, some will be frustrated and embarrassed. |
Most are embarrassed and some are also fearful of speaking. |
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Parent reaction: |
None to a great deal |
Most concerned, but concern may be minimal. |
All have some degree of concern. |
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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.