As mentioned earlier, normal dysfluencies are a part of a child's speech learning process. But the old practice of 'wait and watch' is no longer recommended. The following considerations may call for an early consultation with a speech therapist.

1. Does the child have a PWS as a close relative (uncle, cousin, father, etc)?
2. The child repeats sounds more than twice, li-li-li-li-like this. Tension and struggle may be evident in the facial muscles, especially around the mouth.
3. The pitch of the voice may rise with repetitions, and occasionally the child will experience a “block”no airflow or voice for several seconds.
4. Normal dysfluencies come and go; but in this case, these are frequent and persistent.
5. If the child stutters on more than 10% of his speech, stutters with considerable effort and tension, or avoids stuttering by changing words and using extra sounds to get started, she
   or he will profit from having therapy with a specialist in stuttering. Complete blocks of speech are more common than repetitions or prolongations. Dysfluencies tend to be present in most speaking situations in such cases.