context: Stuttering is not uncommon in children between the ages of 2 and 5. For many children, it's simply part of learning to use language and putting words together to form sentences. It may come and go, and it may last for a few weeks or for a couple of years. Most children outgrow stuttering on their own without professional intervention. But for some, stuttering can become a life-long condition that causes problems in school and in functioning as an adult. As a parent, you can't help being concerned when you suddenly notice your tot has begun to stutter. Is there something you can do to help him get over this hurdle? When is stuttering normal and when should you ask your doctor for help? Here is information you can use to guide your actions and decisions if your child starts to stutter. Stuttering, sometimes called stammering or dysfluency, is a disruption in the normal patterns of speech. It can take many forms. For example, someone who stutters might repeat a sound or a syllable, especially at the beginning of the word, such as "li- li- like." It can also manifest as a prolongation of a sound such as "ssssssee." Sometimes stuttering involves the complete stoppage of speech or the omission of a sound. Or it can be the repeated interruption of speech with sounds such as "uh" or "um." Anyone can stutter at any age. But it's most common among children who are learning to form words into sentences. And boys are more likely than girls to stutter. Normal language dysfluency often starts between the ages of 18 and 24 months and tends to come and go up to the age of 5. About one out of every five children at some point has a dysfluency that seems severe enough to cause parents concern. And about one out of every 20 children will develop stuttering that lasts for more than six months. The fact that stuttering at times seems severe or that it continues for more than six months does not necessarily mean that stuttering is going to be a lifelong problem. Knowing what to look for and knowing how to respond to your child's stuttering will go a long way toward preventing that from happening. It isn't always possible to tell when a child's stuttering will develop into a more serious problem that continues into the school years. But there are signs to look for that indicate stuttering may be a problem: You may notice tension and a struggle with facial muscles. You may also notice the voice rising in pitch with repetitions. In more severe cases of stuttering, a child may demonstrate considerable effort and tension in trying to speak. More severe cases are often marked by attempts to avoid stuttering by changing words or using extra sounds to start talking. Sometimes, a child will try to avoid situations where he or she needs to talk. Experts point to four factors that contribute to stuttering: A family history of stuttering. There is disagreement as to whether stuttering is genetic, because specific genes have not been identified. But close to 60% of all stutterers have someone in the family who also stutters or stuttered. Child development. Children who have other language and speech problems are more likely to stutter than children who don't. Neurophysiology. In some children who stutter, language is processed in different parts of the brain than it is for children who don't stutter. This may also interfere with the interaction between the brain and the muscles that control speech. Family dynamics. Some children's stuttering has been attributed to high family expectations and a fast-paced lifestyle. It was commonly believed that stuttering was often the result of either physical or emotional trauma. Although there are some instances of stuttering following such traumas, they are rare and usually connected with physical trauma or illness later in life. There is little evidence to support the idea that children stutter as a result of emotional upheaval. Talk with your doctor if you are concerned about your child's development, including stuttering. Your doctor may refer you to a specialist known as a speech-language pathologist ( SLP) who can evaluate your child and determine whether or not there is a risk of a long-term problem. In most cases involving children, treatment primarily focuses on training and working with the parents to develop techniques to help the child cope with and get beyond his or her stuttering. There is no "cure" for stuttering, and no drug has been approved to treat stuttering. Sometimes the SLP will work directly with the child to develop individual behavioral techniques that can help the child learn not to stutter. The actual therapy may vary from child to child depending on the child's particular circumstances. For children who have a severe problem with stuttering, early evaluation and intervention is very helpful. Signs to look for that suggest you should have your child evaluated include: Stuttering that becomes more frequent and gets worse with time Stuttering that is accompanied by body or facial movements Speech that is especially difficult or strained Avoiding situations that require talking Vocal tension that results in rising pitch while talking Stuttering that continues after a child has turned 5 years old There are a lot of things you and other family members can do to help a child who stutters get beyond his or her problems with speaking: Create opportunities for talking that are relaxed, fun, and enjoyable. Find times to engage your child in conversations without distractions of TV or other interruptions. For instance, you can make it a habit to involve him in family conversations at dinner each day. Don't be critical of your child's speech or insist on precise or correct speech. Don't put pressure on your child to entertain or interact verbally with other people when stuttering becomes a problem. Encourage activities that don't involve a lot of verbal interaction. Listen attentively to what your child is saying, maintaining normal eye contact without displaying signs of impatience or frustration. Avoid reacting negatively when your child stutters, correcting his speech, or completing his sentences. It's important for the child to understand that people can communicate effectively even when they do stutter. Although phrases such as " Stop and take a deep breath" or " Slow down" may be meant to help your child, they can actually make him more self-conscious and should not be used. Model a slow, relaxed way of speaking to help your child slow down his own speech. Don't be afraid to talk with your child about stuttering. If he asks questions or expresses concern, listen and answer in ways that will help him understand that disruptions in speech are normal and that everyone experiences them to some degree. To find out more about stuttering and how to help your child, call the Stuttering Foundation of America at 1-800-992-9392.