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Children with severe stuttering problems should be referred immediately. Children who have mild stuttering problems that have not shown marked improvement within six to eight weeks, depending on the child, should also be referred. These children should not be given direct treatment if it is not warranted, but their parents will receive support and guidance, and they will be followed carefully. Some children with mild problems may receive treatment, but it should be carefully planned so as not to make the child feel apprehensive or self-conscious about the problem. As Table 1 suggests, children with normal disfluency do not need to be referred unless the parents are so concerned that they need reassurance about the normalcy of their child's speech. They may also be followed by the speech clinician to provide additional guidance if needed.
The speech-language pathologist should have a Certificate of Clinical Competence (CCC-SP) from the American Speech-Language-Hearing Association, and should also be licensed by the state in which he or she practices. Certification requires a master's degree from an accredited university, a national examination, and a year of supervised internship. In addition, the speech-language pathologist to whom a child is referred for stuttering should be experienced with the disorder. Many hospital and university speech and language clinics will have such persons on their staff or can suggest one. Most school systems also employ speech-language pathologists.
The Stuttering Foundation of America provides referrals to qualified therapists in most areas of the country. Their toll-free telephone number is 1-800-992-9392, and their web site is www.stutteringhelp.org. They also provide books and videotapes for parents: Stuttering and The Preschool Child: Help for Families, Stuttering and Your Child: Questions and Answers, If Your Child Stutters: A Guide for Parents, and for teenagers Do You Stutter: A Guide for Teens for a nominal cost.