Fluency/Stuttering Disorders

What is a Fluency/Stuttering Disorder?

Fluency is the aspect of speech production that refers to continuity, smoothness, rate, and effort.

Stuttering, the most common fluency disorder, is an interruption in the flow of speaking characterized by repetitions (sounds, syllables, words, phrases), sound prolongations, blocks of airflow or voicing during speech, interjections, and revisions, which may affect the rate and rhythm of speech.

The National Stuttering Association characterizes secondary behaviors as learned reactions to the core behaviors (stated above) and are categorized as “avoidance behaviors”. They may include hesitations, interjections of sounds, syllables, or words; word revisions or complete changes in words; or motor movements associated with stuttering (such as eye blinking, loss of eye contact, extraneous movements, to name a few).

Cluttering, another fluency disorder, is characterized by a perceived rapid and/or irregular speech rate, which results in breakdowns in speech clarity and/or fluency.

How do I know if my child has a fluency disorder?

Primary stuttering behaviors include:

Whole-word repetitions (i.e. “Why-why-why did he go there?”)

Part-word or sound/syllable repetitions

Prolongations of sounds (i.e. “llllike this”)

Audible or silent blocking (filled or unfilled pauses in speech)

Words produced with an excess of physical tension or struggle

Interjections (i.e. “umm”, “uh”, “like”)

Secondary characteristic that may impact overall communication include:

Distracting sounds (throat clearing, insertion of unintended sound)

Facial grimaces (eye blinking, jaw tightening)

Head movements (head nodding)

Movements of the extremities (leg tapping, fist clenching)

Sound or word avoidances (word substitution, insertion of unnecessary words, circumlocution)

Reduced verbal output due to speaking avoidance

Avoidance of social situations

Fillers to mask moments of stuttering

Cluttering behaviors include:

Rapid and/or irregular speech rate

Excessive coarticulation resulting in the collapsing and/or deletion of syllables and/or word endings

Excessive disfluencies, which are usually of the more non-stuttering type (e.g., excessive revisions and/or use of filler words, such as “um”)

Pauses in places typically not expected syntactically

Unusual prosody (often due to the atypical placement of pauses rather than a “pedantic” speaking style, as observed in many with ASD)