We all have times when we do not speak smoothly. We may add “uh” or “you know” to what we say. Or, we may say a sound or word more than once. These are called disfluencies.

People who stutter may have more disfluencies and different types of disfluencies. They may repeat parts of words (repetitions), stretch a sound out for a long time (prolongations), or have a hard time getting a word out (blocks).

Stuttering is more than just disfluencies. Stuttering also may include tension and negative feelings about talking. It may get in the way of how you talk to others. You may want to hide your stuttering. So, you may avoid certain words or situations. For example, you may not want to talk on the phone if that makes you stutter more.

Stuttering can change from day to day. You may have times when you are fluent and times when you stutter more. Stress or excitement can lead to more stuttering.

Signs and Symptoms of Stuttering

The following typical disfluencies happen to many of us and are not stuttering:
Adding a sound or word, called an interjection – “I um need to go home.”
Repeating whole words – “Well well, I don’t agree with you.”
Repeating phrases – “He is–he is 4 years old.”
Changing the words in a sentence, called revision – “I had–I lost my tooth.”
Not finishing a thought – “His name is . . . I can’t remember.”
When children are learning a lot of words or new speech sounds, you may notice some of these typical disfluencies. This is normal.
The following types of disfluencies happen when someone stutters:
Part-word repetitions – “I w-w-w-want a drink.”
One-syllable word repetitions – “Go-go-go away.”
Prolonged sounds – “Ssssssssam is nice.”
Blocks or stops – “I want a (pause) cookie.”

You may also notice other behaviors like head nodding or eye blinking. Sometimes people who stutter use these behaviors to stop or keep from stuttering. They may also avoid using certain words or use different words to keep from stuttering.

Feelings and attitudes can affect stuttering. For example, frustration or tension can cause more disfluencies. Being excited or feeling rushed can also increase disfluencies. A person who stutters may also stutter more if others tease them or bring attention to their speech. Stuttering may cause a person to be embarrassed and make them feel nervous about talking.

People with autism have challenges with communication and social skills. They often find it hard to have conversations and may not pick up on social cues. Some people with autism may not talk at all, and others may talk very well. But all will have some challenges making friends and communicating socially.

People with autism also have some type of restricted interest or repetitive behaviors. They may focus on one topic, like cars or a television show, or they may be attached to a certain object or activity. A person with autism may not like changes in their schedule or changes in the way they do something.

Autism can range on a spectrum from mild to severe, depending on how much these challenges affect everyday life.

Signs and Symptoms of Autism

You can often observe signs and symptoms of autism in very young children. But sometimes they are not very noticeable, and they might not be recognized until school age or even adulthood. Signs and symptoms may change as the person gets older, but there will always be challenges with communication, social skills, and behaviors.

Communication

Communication includes understanding, talking, reading, and writing. A person with autism may have challenges
understanding and using gestures like pointing or waving;
understanding and using words;
following directions;
learning to read or write—some children with autism read early but do not understand what they read (called hyperlexia); and
having conversations.

A person with autism may
lose early words;
be hard to understand;
repeat words or phrases they just heard or that they heard days or weeks earlier (echolalia);
use a robotic or singsong speaking voice;
talk very little or not at all; and
use challenging behaviors instead of words or gestures to communicate what they want.

Social Skills

A person with autism may have challenges relating to others. It might seem like they are not interested in others or in making friends.
It may be hard for a person with autism to
share attention with someone else and focus on the same object or event;
join in play with others and share toys;
respond when others invite them to play or talk;
understand how others feel;
take turns in play or in conversation; and
make and keep friends.

Behaviors

A person with autism may
repeat certain behaviors including hand or body movements;
cry, laugh, or become angry for unknown reasons;
have trouble changing from one activity to the next;
get upset by certain sounds, smells, or textures;
like only a few foods;
choose foods based on look or texture; and
be interested in only a few objects or topics.

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is a lifelong brain disorder that makes it hard for a person to pay attention. Some people with ADHD have trouble sitting still or controlling their behavior.

Causes of ADHD
The exact cause of ADHD is unknown. The most likely cause is genetics. Many children with ADHD have a family history of the disorder.

Signs of ADHD
A person with ADHD may show some of the following signs:

Inattention

• Has trouble concentrating
• Starts thinking about other things
• Has problems staying focused on tasks
• Does not seem to listen
• Does better on some tasks than others
• Has problems planning, organizing, and finishing tasks on time
• Has problems learning new things

Hyperactivity

• Seems unable to sit still
• Is restless and fidgety
• May bounce from one activity to the next
• Often tries to do more than one thing at once

Impulsivity

• May act before thinking
• Has problems waiting her turn, such as when playing a game