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Sally's mother and father were concerned because Sally, age 3, was beginning to avoid speaking. The problem had begun several months earlier when Sally was repeating parts of words, like, "Ca-ca-ca-can I ha-ha-ha-have some?" Then a few weeks ago she had difficulty getting started making the first sound of a word. She would open her mouth, quite wide at times, but nothing would come out. Once she asked her mom, "Why can't I talk?"
Sally's speech and language development had been normal. She began using single words at an early age 9 months and was speaking in 2 3 word sentences by 13 months. She talked fluently and enjoyed the family's fast-paced conversations and word games.
When Sally's father discussed her speech with Sally's pediatrician, she referred Sally to a speech-language pathologist in private practice who was known to have expertise in stuttering. Once-a-week treatment sessions consisted of parent counseling and play-oriented interactions between Sally and her speech clinician. Over a period of six months the clinician's model of a relaxed, accepting style of interacting, combined with Sally's parents' changes in the intensity of speech and language stimulation at home, eliminated Sally's avoidance of speaking and her inability to get sounds started. She continued to show a slightly greater than normal amount of word repetition and phrase repetition for several more years and gradually developed normal speech.