11. Fluency and fluency disorders

Disfluency

disruption in the forward flow of speech (can be normal or abnormal)

Fluency disorder

Abnormal disfluencies

(i.e. stuttering, cluttering)

Normal disfluencies

• whole word (my, my)

• whole phrase (i want, i want)

• interjections (umm)

Atypical disfluencies

• Sound prolongations (sssssssally)

• unfilled pause/block (i want [block] ice cream)

• part word/syllable repetition (my i-i-i-ice cream)

• incomplete/broken phrases; frequent interjections

3 types of stuttering

1. childhood onset stuttering (most common)

2. psychogenic stuttering (associated psych disorder)

3. neurogenic stuttering (nervous system damage)

Stuttering

a disruption in the forward flow of speech, can take any forms and may be accompanied by

• physical tension and secondary behaviors

• negative thoughts/emotions

• decreased communication skills

• involuntary breakdowns affect all communication

  • e.g. respiration, phonation, articulation

Cluttering

fluency disorder; irregular speaking rate, excessive normal disfluencies, and excessive repetitions

• may result in decreased speech intelligibility

• may occur with and without stuttering

• co occurs with:

  • language and articulation disorders

  • attention problems and other disorders

Stuttering etiology

unknown cause, multiple systems play a role (i.e. genetic, environmental, abnormal phonation system, etc.)

Young children stuttering treatment

parent education

• reduce rate, use prompts rather than direct questions, reduce time pressures, and increase recasting and rephrasing,

indirect strategies

• changes made to the environment, not the child’s speech (indirectly)

direct strategies

• more direct and specific activities to change and help reduce the stutter

Older children stuttering treatment

parent education

strategies

• quality and quantity

stuttering modification

• changing the way one stutters; modifying the stutter (quality)

  • identification, desensitization, modification, and stabilization

speech modification

• changing the way one speaks; modifying speech (quantity)

overall communication and speech therapy