Fluency Disorder

Fluency

flow of speech during communication

Difference between fluent and disfluent speech

fluent = smooth, effortless, automatic

disfluent = disrupts rate, rhythm, smoothness

Rate

how fast you talk

Rhythm

prosody, noticing how a person talks

Normal disfluencies

do not affect communication

Types of normal disfluencies (see slide 4 in ppt for examples)

word repetition

phrase repetition

sentence repetitions

hesitations

interjections (uhm)

What are fluency disorders marked by?

struggle and tension

high frequency

duration of stoppages

Two types of fluency disorders

stuttering

cluttering

Two parts of stuttering

core behaviors: repetitions, prolongations, blocks

secondary behaviors: responses to core bx (overcome stuttering moment but do not fix stuttering overall)

Developmental stuttering

early onset without struggle or tension

early recovery before 5 or 6

Types of repetition (see slide 9 in ppt for examples)

repeat sound, syllable, word, phrase

Prolongations

stretching a sound in a word (ex: wwwwwait, waaaait)

Blocks

stopping or getting stuck before or during production of sound

Types of secondary behaviors

escape behaviors, avoidance behaviors, negative feelings and attitudes

Escape behaviors

physical: nodding, squinting eyes, hitting side of leg

Avoidance behaviors

avoiding words, sounds, speaking, situations

Two causes of stuttering

predisposing and precipitating factors

Predisposing factors

make person susceptible to stuttering

-genetic factors

-gender (males more likely than females)

-differences in brain morphology/neural physiology

Precipitating factors

developmental and environmental factors that make stuttering worse

-age (onset 2.5-5 years old)

-stress

-self-awareness/temperament

Acquired stuttering

caused by illness, trauma, or accident affecting brain

Difference between neurogenic stuttering and psychogenic stuttering

neurogenic stuttering: caused by brain injuries

psychogenic: caused by psychological trauma

Cluttering

rapid/unusual rates of speech (ROS) --> disfluencies, frequent pauses in speech, blending of sounds in words

Difference between cluttering and stuttering

cluttering has fewer repetitions but more errors and no struggle, tension, or avoidance

Core behaviors of cluttering

10 or more disfluencies in 100 syllables

Secondary behaviors of cluttering

escape behaviors (physical)

avoidance behaviors (circumlocution)

Differences between normal disfluency and stuttering

Normal disfluency: disfluencies come and go after 3, unaware of disfluencies

Stuttering: disfluencies persist, aware of disfluencies (struggle and tension)

Early intervention for children who stutter

-reduces stuttering

-treatments can be direct or indirect

Direct treatment

involves fluency shaping and stuttering modification

Fluency shaping

-slow rate of speech

-easy onset

-light articulatory movements

Indirect treatment

involves parent training

Environmental modification

reduce demands/stress

Operant training models

-positive input (said that really smoothly)

-prompt fluent speech (grocery store)

-prompt self correction (say it again)

People don't stutter when they...

sing, whisper, speak/read in chorus, don't hear their own voice