How do I know if my preschool child is stuttering? Answer these 10 simple questions to help you determine when to contact a stuttering specialist. Preschool Referral If you are human, leave this field blank. Does your child... ...have a family history of stuttering? (immediate or extended family) Make a Selection Yes No Not Sure ...stutter on more than 7% - 10% of words? Make a Selection Yes No Not Sure ...have more than 3-5 repetitions on a single word or sound? Make a Selection Yes No Not Sure ...have a rising pitch at the end of a stuttering moment? Make a Selection Yes No Not Sure ...have any tension or struggle, like they’re trying to push words out? Make a Selection Yes No Not Sure ...show any awareness or frustration when words get stuck? Make a Selection Yes No Not Sure Has your child's disfluencies stayed the same or gotten worse over the past 4 -6 weeks? Make a Selection Stayed the same Gotten worse Gotten better Not Sure Has your child been stuttering for more than 3-6 months? Make a Selection Yes No Not Sure How long has your child been stuttering? Are one or both parents concerned? Make a Selection Yes No Please rate your level of concern on a scale of 0 - 10, where 0 = Not at All concerned and 10 = Extremely concerned. Parent / Caregiver 1 Parent / Caregiver 2 I understand that the results of this questionnaire are for informational purposes only and not intended to diagnose or treat stuttering or any other speech or language disorder. * Yes Submit
