Fluency Disorders

Fluency

Continuity, smoothness, rate, and effort in speech production.

Disfluency

Disruption to the forward flow of speech.

Typical Disfluencies

Includes fillers and word or phrase repetition.

Atypical Disfluencies

Indicates fluency disorder.

Stuttering

Interruption to the forward flow of speaking characterized by part-word repetitions, prolongations, and blocks.

Part-word repetitions

Repetition of a portion of a word.

Prolongation

Holding a sound or syllable longer than typical.

Blocks

Inaudible fixed posture or stoppage in speech production.

Cluttering

Breakdown in speech clarity and fluency involving atypical pauses and excessive interjections.

Incidence of Stuttering in children (ages 3-17)

About 2% stutter.

Incidence of Stuttering in adults (ages 21-50)

Around 0.78% stutter.

Developmental Stuttering Onset

Symptoms typically appear between ages 2 and 5.

Genetic factors related to stuttering

If a parent stutters, their child may have a higher likelihood to stutter.

Neurophysiology factors

Includes differences in brain matter and neural network connectivity.

Primary Core Speech Behaviors

Monosyllabic whole-word repetitions, part-word repetitions, prolongation, and blocking.

Secondary Behaviors

Learned responses that occur alongside stuttering, like body movements or facial grimaces.

Avoidance Behaviors

Techniques to conceal stuttering moments.

Overt Stuttering

Displays primary and secondary stuttering behaviors visibly.

Covert Stuttering

Relies on avoidance and escape behaviors, often making stuttering less visible.

Emotional Impact of Stuttering

Can include a sense of loss of control, increased social anxiety, shame, and depression.

Neurological Factors in Cluttering

High prevalence of cluttering associated with other disorders like ASD or ADHD.

Signs of Cluttering

Excessive coarticulation, abnormal pauses, and rapid/irregular speech rate.

Case History in Assessment

Involves gathering medical history and guardian reports.

Formal Testing in Fluency Disorders

Includes tools like Stuttering Severity Instrument (SSI-4) and Overall Assessment of the Speaker’s Experience of Stuttering (OASES).

Fluency Shaping Techniques

Techniques focused on timing, tension, and pausing to improve fluency.

What are the Fluency Shaping Techniques?

Easy onset, light articulatory contact, continuous phonation, prolonged syllables, rate control, and pausing

Easy Onset Technique

Gradual initiation of voicing at the start of words.

Light Articulatory Contact

Using gentle contact for stop consonants to ease articulation.

Rate Control Technique

Involves slowing overall speech rate to improve fluency.

Stuttering Modification Techniques

Incorporates understanding and managing disfluent moments.

What are the Stutter Modification Techniques?

Preparatory Onset, Pull-out, and Cancellation

Pull-out

A technique where the speaker alters their speech during a moment of stuttering.

Cancellation Technique

A method to recover from a stutter after it occurs.

Understood Risk Factors for Stuttering

Genetics, neurophysiology, biological sex, age of onset, and duration of symptoms.

Emotionally Impacted Relationships due to Stuttering

Can involve perceived judgment and barriers in social/romantic interactions.

Disfluency Index

Measurement that includes analysis of primary and secondary speech behaviors.

Syllable Deletion in Cluttered Speech

Omitting syllables or word endings in speech.

Excessive Interjections

Use of fillers and unnecessary words during speech.

Abnormal Pauses in Cluttering

Pauses that occur in inappropriate syntactic locations.

Speaker's Mind Speed in Cluttering

The mind works faster than the body can articulate, causing issues.

Family History of Stuttering

Increased likelihood of children's speech disorders if family members stutter.

Turtle-Talk Example

A fluency shaping strategy involving syntactically appropriate pauses.

Signs of Loss of Control

An emotional impact noted in individuals who stutter.

Atypical Pauses in Cluttering

Pauses that disrupt the flow and intelligibility of speech.

Nod during Stuttering

Example of a learned secondary behavior during stuttering.

Use of Fillers

Words like 'um' or 'like' used to hide stuttering moments.

Increased Social Anxiety

A common emotional impact of living with stuttering.

Thoughts Emergence in Cluttering

Cognitive lag where thoughts come before speech is ready.