When children start speaking around 2-3 yrs, stammering is a normal event, which gradually clears by the age of five or six. But this stammering of the child is quite 'smooth' and 'transparent'. It is not associated with the struggle, secondary behavior (blinking, nodding etc.), avoidance behavior and emotional side effects which are often seen in adolescent and adult PWS. Between 3-6 yrs, certain stressors may predispose some children to persist with 'developmental stammer', which gets overlaid with dense secondary, emotional reactions and habits. These reactions are initiated and shaped by early experiences with other children, siblings, family and teachers. The 'horror' seen on the face of a kindly teacher can be internalized by the child as a negative emotion of shame, forever linked with the act of talking.

Later, these negative emotions manifest as fear of certain words, situations and even people. These inner fears make forward flow of speech difficult. They result in 'blocks'- when the child (or adult) is not able to make any sound in spite of much struggle. PWS often fear a block as a very embarrassing event. But these blocks are completely unpredictable. So, they try to say rapidly, whatever they have to, before they get the feared 'block'. Another common reason is they
fear that they might be interrupted, which has happened with them so often as a child.

Denial is a normal psychological reaction to overwhelming stress. When we have lost a loved one, our mind refuses to believe the fact, for the first few weeks. Regarding stammering, society has a deep discomfort born out of incomprehension, something like: Perfectly normal people losing all control over themselves, something like an epileptic…

On the other hand, to most PWS in developing countries, little or no treatment is available. And lastly, this is one disorder whose variable/invisible nature makes it possible to believe that it has improved and gone away. Under these circumstances, PWS with less obvious stammer see little gain by acknowledging their problem. Obviously, if they could accept it, it would save them from considerable stress and anxiety.