Stuttering is an interruption of the normal flow of speech, which takes on many different patterns. Commonly, it involves either saying a string of repeated sounds or making abnormal pauses during speech. In early childhood, stuttering is sometimes part of normal speech development. In fact, about 5% of all young children go through a brief period of stuttering when they are learning to talk. Stuttering typically is first noticed between the ages of 2 and 5. It usually goes away on its own within a matter of months. In a small number of children (around 1%), stuttering continues and may get worse. Boys are more likely to stutter than girls.
In addition, normal problems with fluency tend to come and go, or happen only at certain times (such as when a child is tired or excited), but true stuttering is present most of the time. Once a child begins to stutter, he or she may feel embarrassed, self-conscious or anxious when asked to speak. The child may find it hard to socialize with friends and also may intentionally avoid situations where talking is expected, such as telephone calls, classroom discussions and school plays.
In 2005, we estimated pneumococcal disease caused 136,000 deaths (46,000-253,000) comprising 10% of deaths in Indian children aged 1-59 months. The death rate for pneumococci was 106 per 100,000 (36-197), and more than two thirds of pneumococcal deaths were pneumonia-relate. Across regions, pneumococcal mortality ranged from 51-141 deaths per 100,000 1-59 months children and was highest in the Central and Eastern regions >50% of pneumococcal deaths occurred in four states with reported low rates of antibiotic use3: Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh.