Many conditions can affect speech. In order to diagnose stuttering in your child, the following conditions will need to be ruled out as the primary cause:

• Normal disfluency. This form of stuttering naturally resolves on its own, usually before puberty.
• Hearing problems. When a child does not hear well, he or she may not speak normally.
• Other sensory deficit. These problems can prevent a child from observing and practicing various aspects of speech. For example, a child with poor eyesight may have trouble recognizing body language or how words are formed.
• Speech-motor deficit. Some children have speech irregularities due to nervous system or brain development problems.

Sometimes stuttering occurs along with another condition. In these situations, a health professional will try to determine whether stuttering is the primary or secondary problem. The following are speech problems that may be confused with or occur along with stuttering:

• Cluttering. Speech is sporadic, fast, and jerky. Some slurring, irregular phrasing, pausing, or absence of syllables can also occur. The speaker usually is not aware of the problems.
  • Example of cluttering (spoken quickly and slurred): "I have muh-muh—ti-ti-time—money for a scoo ... uh ... thing you eat that's c-c-cold ... ice c-c-cream."
  • Example of developmental stuttering: "I have muh-muh-money for a scooooop of iiiiice cream."
• Tourette's disorder, characterized by additional speech problems, interjections, and physical tics.
• Spastic dysphonia. Speech has a muffled, struggling quality, as if the person is trying to talk while being strangled. Usually, this problem occurs only in people who are middle-aged.