Download this Risk Factor Chart
- Family history
There is now strong evidence that almost half of all children who stutter have a family member who stutters. The risk that your child is actually stuttering instead of just having normal disfluencies increases if that family member is still stuttering. There is less risk if the family member outgrew stuttering as a child.
- Age at onset
Children who begin stuttering before age 3 1/2 are more likely to outgrow stuttering; if your child begins stuttering before age 3, there is a much better chance she will outgrow it within 6 months.
- Time since onset
Between 75% and 80% of all children who begin stuttering will begin to show improvement within 12 to 24 months without speech therapy. If your child has been stuttering longer than 6 months, or if the stuttering has worsened, he may be less likely to outgrow it on his own.
- Gender
Girls are more likely than boys to outgrow stuttering. In fact, three to four boys continue to stutter for every girl who stutters. Why this difference? First, it appears that during early childhood, there are innate differences between boys' and girls' speech and language abilities. Second, during this same period, parents, family members, and others often react to boys somewhat differently than girls. Therefore, it may be that more boys stutter than girls because of basic differences in boys' speech and language abilities and differences in their interactions with others. That being said, many boys who begin stuttering will outgrow the problem. What is important for you to remember is that if your child is stuttering right now, it doesn't necessarily mean he or she will stutter the rest of his or her life.
- Other speech and language factors
A child who speaks clearly with few, if any, speech errors would be more likely to outgrow stuttering than a child whose speech errors make him difficult to understand. If your child makes frequent speech errors such as substituting one sound for another or leaving sounds out of words, or has trouble following directions, you should be more concerned. The most recent findings dispel previous reports that children who begin stuttering have, as a group, lower language skills. On the contrary, there are indications that they are well within the norms or above. Advanced language skills appear to be even more of a risk factor for children whose stuttering persists3.
These risk factors place children at higher risk for developing stuttering. If your child has any of these risk factors and is showing some or all of the warning signs mentioned previously, you should be more concerned. You may want to schedule a speech screening with a speech therapist who specializes in stuttering. The therapist will decide whether your child is stuttering, and then determine whether to wait a bit longer or begin treatment right away.
1 Longitudinal research studies by Drs. Ehud Yairi and Nicoline G. Ambrose and colleagues at the University of Illinois provide excellent new information about the development of stuttering in early childhood. Their findings are helping speech-language pathologists determine who is most likely to outgrow stuttering versus who is most likely to develop a lifelong stuttering problem. Research reports include:
Yairi, E. & Ambrose, N. (1992). A longitudinal study of stuttering in children: A preliminary report. Journal of Speech, Language, and Hearing Research, 35, 755-760.
Ambrose, N. & Yairi, E. (1999). Normative disfluency data for early childhood stuttering. Journal of Speech, Language, and Hearing Research, 42, 895-909.
Yairi, E. & Ambrose, N. (1999). Early childhood stuttering I: Persistence and recovery rates. Journal of Speech, Language, and Hearing Research, 42, 1097-1112.
2 Yairi, E. & Ambrose, N. (2005). Early Childhood Stuttering: For Clinicians by Clinicians, ProEd, Austin, TX.
3 Yairi, E. & Ambrose, N. (2005). Early Childhood Stuttering: For Clinicians by Clinicians, Chapter 7, Pro-Ed, Austin, TX.
One way to understand the development of resilience is to visualize a balance scale or seesaw. Protective experiences and coping skills on one side counterbalance significant adversity on the other. Resilience is evident when a child’s health and development tips toward positive outcomes — even when a heavy load of factors is stacked on the negative outcome side.
The single most common factor for children who develop resilience is at least one stable and committed relationship with a supportive parent, caregiver, or other adult. These relationships provide the personalized responsiveness, scaffolding, and protection that buffer children from developmental disruption. They also build key capacities—such as the ability to plan, monitor, and regulate behavior—that enable children to respond adaptively to adversity and thrive. This combination of supportive relationships, adaptive skill-building, and positive experiences is the foundation of resilience.
Children who do well in the face of serious hardship typically have a biological resistance to adversity and strong relationships with the important adults in their family and community. Resilience is the result of a combination of protective factors. Neither individual characteristics nor social environments alone are likely to ensure positive outcomes for children who experience prolonged periods of toxic stress. It is the interaction between biology and environment that builds a child’s ability to cope with adversity and overcome threats to healthy development.
Research has identified a common set of factors that predispose children to positive outcomes in the face of significant adversity. Individuals who demonstrate resilience in response to one form of adversity may not necessarily do so in response to another. Yet when these positive influences are operating effectively, they “stack the scale” with positive weight and optimize resilience across multiple contexts. These counterbalancing factors include
- facilitating supportive adult-child relationships;
- building a sense of self-efficacy and perceived control;
- providing opportunities to strengthen adaptive skills and self-regulatory capacities; and
- mobilizing sources of faith, hope, and cultural traditions.
Learning to cope with manageable threats is critical for the development of resilience. Not all stress is harmful. There are numerous opportunities in every child’s life to experience manageable stress—and with the help of supportive adults, this “positive stress” can be growth-promoting. Over time, we become better able to cope with life’s obstacles and hardships, both physically and mentally.
The capabilities that underlie resilience can be strengthened at any age. The brain and other biological systems are most adaptable early in life. Yet while their development lays the foundation for a wide range of resilient behaviors, it is never too late to build resilience. Age-appropriate, health-promoting activities can significantly improve the odds that an individual will recover from stress-inducing experiences. For example, regular physical exercise, stress-reduction practices, and programs that actively build executive function and self-regulation skills can improve the abilities of children and adults to cope with, adapt to, and even prevent adversity in their lives. Adults who strengthen these skills in themselves can better model healthy behaviors for their children, thereby improving the resilience of the next generation.
- Risk factors are "personal traits, characteristics of the environment, or conditions in the family, school, or community that are linked to youth's likelihood of engaging in delinquency and other problem behaviors.” 1
- Protective factors are "those characteristics of the child, family, and wider environment that reduce the likelihood of adversity leading to negative child outcomes and behaviors, such as delinquency and later adult offending .2
In the context of youth involved or at risk of involvement with the juvenile justice system, risk factors can be considered to be those conditions or variables associated with a higher likelihood of delinquency and/or juvenile justice system contact; protective factors are those conditions which lessen this likelihood.3
Types of Protective and Risk Factors
Risk and protective factors for child delinquency have been identified 4 across multiple domains:
- Individual
- Family
- Peers
- School, neighborhood, and community
Table 1: Examples of risk and protective factors by domain
| ● Early antisocial behavior and emotional factors such as low behavioral inhibitions ● Poor cognitive development ● | ● ● ● Willingness to please adults ● Religious and club affiliations | |
| ● Inadequate or inappropriate child rearing practices, ● ● ● ● Parental antisocial history ● ● Exposure to repeated family violence ● ● ● ● A high level of parent-child conflict ● A low level of positive parental involvement | ● Participation in shared activities between youth and family (including siblings and parents) ● Providing the forum to discuss problems and issues with parents ● Availability of economic and other resources to expose youth to multiple experiences ● The presence of a positive adult (ally) in the family to mentor and be supportive | |
| ● Spending time with peers who engage in delinquent or risky behavior ● ● Less exposure to positive social opportunities because of bullying and rejection | ● Positive and healthy friends to associate with ● Engagement in healthy and safe activities with peers during leisure time (e.g., clubs, sports, other recreation) | |
| ● Poor academic performance ● Enrollment in schools that are unsafe and fail to address the academic and social and emotional needs of children and youth ● ● Low educational aspirations ● ● Living in an impoverished neighborhood ● Social disorganization in the community in which the youth lives ● | ● Enrollment in schools that address not only the academic needs of youth but also their social and emotional needs and learning ● Schools that provide a safe environment ● A community and neighborhood that promote and foster healthy activities for youth ● Access to and participation in consistent mentoring |
It is important to note the following:
- No single risk factor leads a young person to delinquency.
- Risk factors do not operate in isolation and no single factor is responsible for explaining why an individual may experience negative outcomes like delinquency. "Violence results from a complex interplay of a variety of factors and requires nuanced, developmentally based responses tailored to the specific situation of each child.” 5
- When the risk factors a youth is exposed to cross multiple domains, the likelihood of delinquency increases at an even greater rate. 6
- Different risk factors may also be more likely to influence youth at different points in their development. For example, peer risk factors typically occur later in a youth’s development than individual and family factors.
- Because risk and protective factors are dynamic in nature, service providers and agencies should adopt ongoing assessments of these conditions. A thorough trauma-informed awareness of a person or group’s specific risk factors at the individual, familial, peer, and school/community levels will provide the most successful prevention and response intervention.
While youth may face a number of risk factors it is important to remember that everyone has strengths and is capable of being resilient: “All children and families have individual strengths that can be identified, built on, and employed” to prevent future delinquency and justice system involvement.7 In recent years, studies of juvenile delinquency and justice system involvement have increasingly examined the impact of these strengths (protective factors) on youth’s ability to overcome challenges and thrive.8
Resources
Child Abuse and Neglect Resources
This website shares resources, publications, and data sources on child abuse and neglect, including federal and non-federal resources for the public, interested community members, and practitioners.
Fact Sheet Template: Complex Trauma in Juvenile Justice-Involved Youth (PDF, 7 pages)
This fact sheet provides a detailed description of the path from complex trauma exposure to involvement in the juvenile justice system. The source also provides recommendations for judges and juvenile justice program administrators, parents and family members, and adults who supervise youth regarding how to best serve and understand justice-involved youth.
Child Abuse Training for Judicial and Court Personnel
This project trains judicial, legal, and social service professionals to improve their response in child abuse and neglect cases. It also teaches practitioners how to coordinate information and services across the juvenile justice and child welfare systems.
In Focus: Children's Advocacy Centers (PDF, 1 page)
This brief details the work of children's advocacy centers and their multidisciplinary teams of child abuse prevention and intervention professionals.
Victims of Child Abuse Act Program
This program works to improve the lives of those affected by maximizing the impact of victim services and ensuring professionals have access to effective and innovative training. OJJDP supports these initiatives under the program:
- Children's Advocacy Centers (CACs)
- Alaska and Tribal Children's Advocacy Centers Expansion
- Court Appointed Special Advocates/Guardian ad Litem (CASA/GAL)
- Child Abuse Training for Judicial and Court Personnel
Model Programs Guide: Arts-Based Programs and Therapies
This guide presents evidence-based juvenile justice and youth prevention, intervention, and reentry programs. Each program is rated either effective, promising, or no effect. Users can search the database for programs and interventions based on the age range of the child or young adult or use other search filters to find arts-based programs and therapies.
Model Programs Guide: Community-Based
This guide presents evidence-based juvenile justice and youth prevention, intervention, and reentry programs. Each program is rated either effective, promising, or no effect. Users can search programs and interventions based on the age range of the child or young adult or can use other search filters to find community-based prevention programming.
Model Programs Guide: Mentoring
This guide presents evidence-based juvenile justice and youth prevention, intervention, and reentry programs. Each program is rated either effective, promising, or no effect. Users can search the database for programs and interventions based on the age range of the child or young adult or can use other search filters to find mentoring programs.
Model Programs Guide: Parents and Families
This guide presents evidence-based juvenile justice and youth prevention, intervention, and reentry programs. Each program is rated either effective, promising, or no effect. Users can search the database for programs and interventions based on the age range of the child or young adult or can use other search filters to find parent and family-oriented programs.
Preventing Child Abuse & Neglect
This webpage features a list of resources related to child abuse prevention, protecting children from risk of abuse, and strengthening families.
Protective Factors Against Delinquency (PDF, 14 pages)
This literature review analyzes protective factors, or characteristics or conditions that may reduce the influence of risk factors causing delinquent and violent behavior, as a buffer against juvenile delinquency. Protective factors at the level of the individual, family, peer, school, and community are explored.
Tool Kit for Creating Your Own Truancy Reduction Program (PDF, 229 pages)
This toolkit provides a comprehensive analysis of the causes of truancy, the extent of the issue, evaluation measures for truancy reduction programs and barriers to accurate progress measurement, as well as best practices for managing truancy reduction among youth.
T. E. A. M., Teach, Empower, Affirm, Mentor, A Risk Reduction Mentoring Curriculum, Instructor’s Manual (PDF, 253 pages)
This curriculum manual is intended for implementation with middle school students and its aim is to address four central risk factors for delinquent behavior among this population. The curriculum takes a strengths-based approach that focuses on empowering youth and includes lessons on school engagement, peer relationships, and victimization.
References
1 Murray & Farrington, 2010
2 Vanderbilt-Adriance & Shaw, 2008; Developmental Services Group, Inc., 2013
3 Jessor, 1998
4 A study group comprised of nearly 40 experts convened by the U. S. Department of Justice Office of Juvenile Justice and Delinquency Prevention (OJJDP) identified four domains for risk and protective factors.
5 Office of Juvenile Justice and Delinquency Prevention & Centers for Disease Control and Prevention, 2016
6 Wasserman et al., 2003
7 Osher,1996, p. 186
8 Kendziora & Osher, 2004