Which scenario would raise concern about a preschooler's language development?

Which scenario would raise concern about a preschooler's language development?

• A. Repeats simple phrases at 32 months
• B. Stutters when excited or tired at 42 months
• C. Has a vocabulary of 10 words at 12 months
• D. Pronounces words that are understandable at 36 months

Answer: (B)

Fluency disruptions in early childhood are a red flag when they persist or appear beyond the typical age window for normal disfluencies. By preschool age, most children’s speech becomes more fluent, and when stuttering emerges, especially in situations of excitement or fatigue, it suggests the potential for developmental stuttering rather than routine language growth. This pattern matters because stuttering that continues or worsens beyond the toddler years can indicate a risk for persistent fluency disorder. Early identification allows timely evaluation by a speech-language pathologist, who can assess severity, rule out other speech-language issues, and discuss management options. If there are additional risk factors—such as a family history of stuttering or accompanying articulation or language delays—that would heighten concern and reinforce the need for assessment. In contrast, repeating simple phrases at around the late toddler period is a common stage as children imitate speech; a vocabulary of about ten words at one year is within range for many children; and good intelligibility at three years aligns with expected development. These scenarios are generally reassuring, not concerning.

Fluency disruptions in early childhood are a red flag when they persist or appear beyond the typical age window for normal disfluencies. By preschool age, most children’s speech becomes more fluent, and when stuttering emerges, especially in situations of excitement or fatigue, it suggests the potential for developmental stuttering rather than routine language growth.

This pattern matters because stuttering that continues or worsens beyond the toddler years can indicate a risk for persistent fluency disorder. Early identification allows timely evaluation by a speech-language pathologist, who can assess severity, rule out other speech-language issues, and discuss management options. If there are additional risk factors—such as a family history of stuttering or accompanying articulation or language delays—that would heighten concern and reinforce the need for assessment.

In contrast, repeating simple phrases at around the late toddler period is a common stage as children imitate speech; a vocabulary of about ten words at one year is within range for many children; and good intelligibility at three years aligns with expected development. These scenarios are generally reassuring, not concerning.