Working with toddlers who stutter can be a major gray area for early intervention SLPs. Is the child going through a typical phase of language development, or is she truly showing disfluent behaviors? Do we intervene, or do we wait and see if she grows out of it? Parents often want concrete answers, but sometimes we just don’t have them when it comes to stuttering. However, new research may help us differentiate between stuttering-like behaviors and typical disfluencies in toddlers, specifically by observing “stalls” vs. “revisions.”
Revisions are replacements of a speaker’s word choice in a sentence with an alternative. For instance:
“(He) She wants to get ice cream.”
“(I gotta…) You gotta get pizza”
In these examples, the speaker initially uses one pronoun, but then revises the subject of the sentence to another.
Rispoli (2018) studied revisions in toddler’s language samples as they relate to grammatical development, such as Mean Length of Utterance (MLU) and Number of Different Words (NDW). He found that revisions were positively related to MLU and NDW, as well as increased lexical diversity. Theoretically, this makes sense because in order for a revision to occur, the toddler must have other options with which to replace the word.
Stalls are repetitions or pauses that occur after the speaker has begun to speak. For instance:
“I-I-I-I-I-I-I go to bed”
“You---------you want a drink?”
Previous research by the same author indicated that stalls are not related to measures of grammatical development.
How does this relate to the potential stutterer, you might ask? Well, since the use of revisions are actually positively related to grammatical development, they are not indicative of a fluency disorder. In fact, revisions increase with language development in both stutterers and non-stutterers at the same rate! You might even take revisions as a signal that your language therapy is working. Stalls, on the other hand, may be indicative of a fluency disorder, as they do occur more often in true stutterers than in typically-developing toddlers. And while intervening with toddlers who stutter might continue to be debatable, you may be able to reassure a worried parent that revisions, are in fact normal for a toddler.
Rispoli, M. (2018). Changing the Subject: The Place of Revisions in Grammatical Development. Journal of Speech, Language, and Hearing Research. Advance online publication. doi:10.1044/2017_JSLHR-L-17-0216.