Any speech and language therapists here? 4.5 year old end of word 'stuttering'

[Flowersforbees]

I'm wondering whether this might warrant further investigation.

My son is 4.5, starting school in September.

He has good language and is quite mature in the way he speaks.

He will repeat whisper end of phrases after he says them E.g. it's time to go outside, followed by 'go outside' in a whisper. I think this is palilalia.

This has started to decrease but he's started to stammer / repeat the last sounds in words. Not all the time but enough for us to have noticed. For example. I think nk nk nk nk that we should ...
The word and seems to be followed by nd nd nd.

Having read about it it's not a stammer but atypical dysfluency but what I'm wondering is whether it is something to keep an eye on to see whether it passes or if it's better to catch these things early and ask for a referral to SALT. It's not affecting his life in any way at the moment, he is unaware of it.

Will also post on behaviour and development but feel that's a bit quiet over there.

My dd had word-final dysfluency at around age 5/6. It was pretty much exactly as you describe. I think she saw an SLT through the school maybe once or twice, but then it went away, maybe on its own or maybe because of the SLT.

She (now 16) still repeats herself a LOT - if she tells you about something that happened, she often basically tells you twice, but it isn't really like a speech issue. More like she doesn't think you've understood her.

To put it in context, she was eventually diagnosed with some wider issues a couple of years ago - social communication disorder, generalised anxiety disorder, some executive function issues. She's also been treated for OCD. She is on track to get 7s in her GCSEs this year, she has a part time job, and overall she is a quirky delight. 😁

My son had this at about age 6. It's slowly decreased, although he does sometimes still get a bit sort of 'stuck' in the middle of sentences and repeat him self a lot. Eg "I thought we were going to go to the park today because, well, because, well, bec-, bec- because you said we were!" It doesn't sound like a stutter or anything, he just can't quite get his thoughts organised in time for them to come out of his mouth, if that makes sense. He is now 9 and diagnosed ADHD, has some relatively minor issues at school but is generally a bright and happy (and very articulate) kid.

DS(9) does similar - repeats the last syllable in a sentence (eg "go to the park-ark-ark"). His speech was generally delayed though as well. His is related to his autism and is worse when he's tired or distracted.

SLT here. Could be worth a referral if you are concerned about it. Depending where you live theres likely quite a wait for the initial assessment anyway and it may have improved by the time you are seen and if not they can advise if therapy warranted.

Thank you for the replies, it's interesting that most of the other children who have done this have gone on to have other diagnosed conditions.

I have seen these kind of language patterns can be linked to autism. This is something that I wonder about but feel it would be very high functioning and wonder if he's just quite quirky. He's quite good socially which makes me think it can't be autism but he does love all things maths and puzzles, likes rules and is very factual. He can spot patterns, enjoys chess etc.
He speaks like a mini grown up which I find very endearing but I wonder whether it might be a bit odd for a 4 year old to say 'I'm going to take the stairs, it's much more appropriate in this situation'.

I'm a SALT and agree it might be part of a wider neurodivergence.

I've added an audio example here for if anyone is an expert (not sure it will work, never done an audio file upload). It's about 5 minutes and he's just narrating his making stuff with play sand. As I say, he doesn't do it all the time but there's a few times he does in this clip. Some of it is quiet whispering so might need a careful listen.

sndup.net/gw93/

Bumping for any evening folk

Just coming on to say my DSS did this for about a year at that age. Then one day it just stopped, like he grew out of it. No other speech or neuro issues.

I’m not an SLT but I am a developmental psychologist and specialise in language development in the early years. I have a special interest in autism partly because of my training but also because my own DC is autistic. I’ve listened to your speech sample and I do think there are several features of your sons speech that are characteristic of autism. In addition to the dysfluency you’ve already identified, I agree that he speaks like a “little professor” which is often common in autism. He also overpronounces some words, which is not a speech “problem” just a common feature of speech in autism - it’s like they’re pronouncing every syllable and sound very specifically and carefully which sounds a little odd for their age. This is particularly noticeable in your sample because it contrasts with the examples of the dysfluency so he is either over pronouncing or repeating syllables. His intonation at first listen sounds fairly typical but it is actually quite stereotyped and sounds mimicked/learnt at times rather than genuine. If he is autistic (and is good at recognising patterns) he may be a very good imitator which is exactly like my DD - her social struggles are very hard to spot because she does an excellent job of copying those around her to try to blend in.

Im not saying your son is autistic (I’m not qualified to diagnose anyway, and even if I were it would be impossible to know from such a small snapshot) but it’s something I’d really consider pursuing.

Ps. Your example of what he said about the stairs is really typical of kids with autism. My DC says similar. The other night at dinner she said “thank you mummy for this delicious meal, it’s wonderful of you to make it!” 😂

Thank you for your detailed reply bagforlifeamnesty.

I showed DH and he didn't respond and walked away so he clearly doesn't want to discuss it.

I guess we will see how he gets on as he gets older.

Sorry to hear that OP. It sounds like your DH would struggle with the idea of his son being autistic. That’s unfortunate but fairly common. This isn’t about your DH or his needs though, it’s about your son. It sounds like he’s generally getting on well and the dysfluency isn’t causing him any problems but I would still ask school/nursery for an SLT referral and go from there. If you just focus on the speech then your DH may be more willing to engage. The SLT will be trained to pick up potential autism so can make a referral later on if needed. Good luck

Both my children did this when younger, my 9 year still does occasionally, but less so now, so thunk he's beginning to grow out of it. They're both autistic.

My 12yo who has autism said yesterday "I like the practicality of plasters but not the discomfort". She sometimes appears to stutter and sometimes takes a while to find the right word - I think this is because she has a high IQ but her processing speed is slower, it's not a speech impediment as such. Definitely worth talking to someone about your son's speech though.

My 7 year old does this too. It started when he was a similar age to your son.

There is a correlation between children who have this and who also have asd/adhd, however this could just be because these children are more likely to be seen by a SALT for other issues. It doesn't seem common for children who have this type of dysluency to be aware they are doing it and for a lot of children the problem resolves by itself in time, so unless there are other issues in the child's development, there probably wouldn't seem much point referring them to speech therapy.

With my ds, I waited for a couple of years to see whether it would go away by itself and it didn't, so I referred him on for SALT. He has almost come to the end of a course of private speech therapy and is just beginning a course of NHS speech therapy. So far there had been absolutely no improvement at all, but I'm really glad I've referred him because both therapists have picked up on some minor issues I hadn't been aware of and it has led to some changes with how we do things at home and at school - everyone is more mindful now that he has trouble concentrating on tasks, he is very sensitive to sensory input and he needs loads of down time to relax over the weekend. It's also led to other referrals, so we will hopefully find out whether there is a diagnosable condition or if he just needs a little extra help to get to where the other children in his class are. Coincidentally, his older brother is currently being assessed for ASD, however I don't have any concerns about DS2 being autistic. Before all this happened, I strongly believed he was dyslexic, so it could all be linked to that I suppose.

I think your plan of waiting a little bit and seeing how he gets on at school is a good one. Both my dcs were fine in reception but really struggled with the demands of year 1, so if he does have autism it may become more obvious at that point. I have found the route to (possible) diagnosis for both of my kids has been incredibly slow, with many assessments and conversations with different hcps and teachers, so if your DH is struggling with the idea at the minute then you might find he slowly starts to accept the idea as time goes on. It's a bit of a journey for everyone tbh, and I do feel guilty when I think back to all the obvious signs that ds2 was obviously struggling with sensory overload as a toddler/preschooler and I wrote it off as a tantrum or fussiness.

They examples you give of his speech would be typical of what used to be called Asperger's syndrome but are now just part of the wider autism spectrum. I would think it highly likely to be honest given your description of him. It's perfectly possible to be social and autistic! He sounds like a lovely lad!

Thank you everyone for the additional replies.
I think we'll see how he gets on at school, it might be that there's something to investigate further.
I'll watch how he gets on over the summer holidays too and if it's still something that's happening will chat to his teacher before he starts.

If there's any changes for the worse I'll ask for a referral, whilst anticipating a long wait.

Hi
Just resurrecting this thread. How's he getting on at school? Has the speech improved?

My son (5.5yrs) has recently started doing the same and I'm worried

I’m not a SLT but I did this as a child. I’m NT but it was OCD. I had to repeat things twice to feel ‘safe’ and it embarrassed me so would mutter them quickly and quietly under my breath, often just the end of the sentence. I was diagnosed as an adult and it has been effectively treated with sertraline and therapy.