Unit IX: Fluency Disorders

Fluency: the ability to speak clearly and coherently


Disfluency: any disruption in the normal flow of speech

  • Typical children have many disfluencies, but decline with age

  • Occurs in people with fluency disorders, often with higher frequency and different types


Stuttering:

  • Persistent and frequent disfluencies

  • Impacts roughly 3 million people

  • Affects all ages, but typically start between 2 and 6 years old

  • Can vary throughout the day

  • Boys are 2-3 x likelier than girls to stutter

    • As they age, boys are 3-4 x more likely


Normal Disfluencies

Word repetitions

I like that … that book.

Phrase repetitions

I want a … want a big one!

Sentence repetitions

Watch me! Watch me! Watch me!

Hesitations

He took … my juice

Interjections

We, um, got to go too.


Causes of Stuttering:

  • Developmental stuttering

    • Many theories, different levels of explanation

    • Genetic

    • Neurological features

      • Brain function: more right hemisphere activation

      • Brain structure: differences in white matter pathways

    • Psycholinguistic: difficulty coordinating retrieval of words and putting words together in sentences

  • Acquired:

    • Neurological event

    • Psychogenic


Signs and Symptoms:



Type

Example

Monosyllabic whole-word repetitions

Why-why-why did they go there?

Part-word or sound/syllable repetition

Look at the b-b-boy.

Prolongation of consonants when it isn’t for emphasis

Sssssssometimes we stay home.

Blocking

Inaudible or silent fixations or inability to initiate sound

Production of words with an excess physical tension or struggle


Physical signs of struggle during stuttering:

  • Eye blinking

  • Mouth movements

  • Facial movements

  • Body or limb movements

  • Vocalizations


Avoidance and Escape Behaviors:

  • Used to conceal stuttering

  • Can result in no observable stuttering

  • Using fillers

    • Avoiding sounds or words

    • Altering rate of speech


Variability in Fluency:

  • Many people who stutter often or sometimes speak fluently

  • Harder tasks:

    • Conversation

    • Public speaking

  • Easier tasks:

    • Reading out loud

    • Chanting

    • Singing

    • Choral reading/speaking


Stuttering Treatment:

  • Direct: train fluency directly

    • Modifying stuttering: stutter more effectively

    • Modifying speech