Fluency and speech rate were examined in children with epilepsy, a group known to demonstrate depressed language skills. We also sought possible functional markers of increased disfluency during speech production tasks regardless of group. Children with epilepsy had significantly more disfluencies in their narratives than their typically-developing peers, while speech rate did not differ between groups. fMRI activation in working memory regions during a covert language processing task was significantly correlated with increased disfluency in another task involving narrative speech production. Additionally, there was a significant positive correlation between disfluency frequency and laterality of activation in the cerebellum. These results support the hypothesis that children with weaker language skills demonstrate increased levels of disfluencies in their narrative speech. Findings also suggest that children with higher rates of conversational speech disfluency may activate additional language and working memory regions when processing language, possibly reflecting the need for more mid-utterance incremental processing.