Sound or word repetitions occurring more than once every four sentences (5 or more times per 100 words).

Sound or word repetitions lasting 3 or more times per occasion (e.g., “I-I-I-I want to go home”).

Prolongations or stretching of sounds lasting 1/2 second or more (e.g., “Mmmmy car is gone”).

Facial grimacing or muscle tremours (e.g., quivering lip, raising eyebrows, flaring nostrils, or rapid eye blinking).

Abnormal head or jaw movements.

Wide mouth opening or tongue protrusion.

Irregular breathing patterns.

Abnormal pitch rise or loudness increase.

Avoidance of speaking situations.

Frustration with speaking (e.g, saying “I can’t talk right”, outbursts of crying, or covering mouth with hands).

Frequent “failed communication attempts”.