Fluency

Fluency disorders include stuttering and cluttering. They impact the ability to produce continual, even speech with minimal effort at an appropriate rate.

Stuttering is the most common fluency disorder.

While everybody has occasional typical dysfluencies, known as interjections or fillers (“um”, “like”, etc.), stuttering as a fluency disorder presents differently. Stuttering typically involves effort or tension by the speaker, and dysfluencies may consist of:

• Repetitions and revisions of anything ranging from sounds to entire phrases
• Prolongation of sounds
• Blocking (silent or filled pauses while the speaker attempts to produce the sound)
• Interjection of words

Behaviors secondary to stuttering also often occur, such as twitching and shaking of the face or body. Stuttering typically has underlying emotional roots as well. Because of these emotional ties, individuals who stutter may exhibit avoidance behaviors such as:

• Using words and sounds to fill space during or in anticipation of a stuttering moment
• Circumlocution of problematic words
• Avoidance of speaking situations
• Talking in a different voice (many people who stutter do not do so when using an unnatural voice or prosody)
• Avoidance of situations in which extreme emotions are exhibited (e.g., stressful or exciting situations), which may increase dysfluencies

Stuttering typically begins in childhood, and while some children outgrow their dysfluencies, others do not. Stuttering may have academic and professional impacts, as well as affect social interactions and emotional health.

Cluttering involves a rapid, uneven speech rate, in which parts of words are deleted. This results in a running together of words with irregular pauses, often making the speaker difficult to understand. Additionally, minimal self-monitoring is present, and frequent revision dysfluencies and fillers are seen in their speech.

If a fluency disorder is suspected, a speech-language pathologist at Language & Learning will consult with and interview the client as well as any other relevant family members or professionals. Because dysfluencies are often highly dependent upon the speaking situation, the clinician will also assess the client through observation of dyfluencies in a variety of communicative situations. Additionally, it is important to examine the accompanying emotional components and reactions, as well as secondary behaviors.

Treatment of fluency disorders depends upon each individual client’s profile. Stuttering treatment may involve any combination of:

• Counseling (desensitization, cognitive modification, disclosure practice, exploration of support avenues)
• Generalization activities
• Exploration of accommodations
• Reduction of avoidance behaviors
• Speech production/mechanism education
• Speech modification (i.e., fluency shaping) techniques
• Stuttering modification techniques.

Generally, fluency shaping techniques are used to avoid stuttering moments (e.g., easy onset, light articulatory contact), while stuttering modification techniques require the client to identify and modify stuttering moments (e.g., pull-out, cancellation). Treatment for cluttering, while also highly dependent upon the individual, might involve increasing self-awareness/monitoring and implementing compensatory strategies (e.g., over-emphasis of problematic words/parts, over-articulation, increased pausing).