The early clonic iterations of the child between 20 and 40 months are a part of the normal speech patterns of growing children. As a rule reassurance of the parents and withdrawal of attention and concern from speech are all that is necessary. There is a group of children who start speaking late and whose familial background shows evidence of difficulty in the language area and delay in establishing a functional superiority of one side over the other. Many of these children have trouble with the enunciation of specific sounds, with vocabulary and with sentence construction. In spite of at least average intelligence these children handle speech poorly. They often show a great number of clonic iterations at an age when most children have already discarded them. Their handling of speech closely resembles the cluttering of older children and adults. Such children frequently need technical help with sounds, vocabulary and grammatical construction. Smoother production of speech and slowing up of speed will often bring about a reduction in the original iterations. The pediatrician should be aware of the fact that emotional tensions and conflicts tend to become fixed to a speech mechanism which is none too stable in these children. The cluttering child may easily turn into a stutterer. There is a larger group of children who show no familial difficulty in the language area, who talk early and quite well and who abruptly develop stuttering at some time during childhood. Some of these children display other symptoms of emotional disorder; others seem to function effectively in most areas but express their emotional conflicts principally in stuttering. These children should be referred for psychiatric help early. In older children who stutter, a careful differential diagnosis is necessary as to the relative importance of specific language and emotional factors in pathogenesis. If existing emotional difficulties seem to be the result rather than the cause of the stuttering, a more specifically technical therapy is favored; in cases where emotional factors are outstanding a psychiatric approach is to be preferred. Speech is a means of expression of the personality as well as a means of communication; severe dysfunctions in speech then may reflect a personality disorder or a disorder of interpersonal relationships or both. In the child, however, speech is also a tool which he masters as it develops. A speech difficulty in the growing child must be evaluated from both points of view.