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Greetings everyone!  I’m back for week four of Better Hearing and Speech Month (2017). This week’s topic is “What is a Fluency Disorder?”  We all have experienced some degree of disfluency (“stuttering”) as we are conversing with others.  Let’s take a closer look at “What is a Fluency Disorder?”…

Fluency Disorder or “Stuttering” is characterized by an abnormally high frequency and/or duration of stoppages in the forward flow of speech.  Many theories have been proposed regarding the cause of stuttering, ranging from genetic and other organic explanations to learned, environmental, or linguistic accounts.

The onset of stuttering usually occurs between two and five years of age and may emerge in a sudden or severe manner.  Some researchers report that approximately 80% of children who stutter will spontaneously recover before the age of puberty.

Categories of Stuttering Behaviors

There are two main categories of characteristics that are associated with stuttering:  core behaviors and secondary behaviors.

Core behaviors are the basic manifestations that seem beyond the voluntary control of the stutterer and include the following:

*Repetitions of sounds, syllables, or whole words (i.e., c-c-cat, ba-ba-balloon and we-we-we are going)
*Prolongations of single sounds (i.e., sssssoap and fffffishing)
*Blocks of airflow/voicing during speech (inappropriate stoppage of air or voice at any level of the vocal tract)

Secondary behaviors develop over time as learned reactions to the core behaviors and are categorized as escape or avoidance behaviors.  Escape behaviors occur during a stuttering moment and are attempts to break out of the stutter.  Common examples of escape behaviors include head nods, eye blinks, foot taps and jaw tremors.  In the more advanced stages of stuttering, these behaviors may be accompanied by visible struggle and muscular tension.  Avoidance behaviors occur in anticipation of a stuttering moment and are attempts to refrain from stuttering at all.  Typical avoidance behaviors are circumlocutions (substitutions of less feared vocabulary words), unfilled pauses without accompanying tension and struggle within or between words and use of “um” or other interjections to postpone speaking.

Most typically developing children between two and four years of age display relatively effortless disfluencies during the normal course of language acquisition:

*Hesitations (silent pauses)
*Interjections of sounds, syllables or words (i.e., “Um, I went to school” and “Did you you know find her?”)
*Revisions/repetitions of words, phrases or sentences (i.e., “You have to touch, no, turn it” and “I have some…I want you to look at these baseball cards”)
*Normal rhythm and stress patterns
*No tension or tremors noted

It is important to differentiate between these normal disfluencies and the atypical disfluencies in the following list, which are often the early signs of stuttering:

*Three or more within-word disfluencies per 100 words (especially fragmentation of syllables)
*Disfluencies on more than 10% of syllables spoken
*Predominant use of prolongations, blocks and part-word repetitions (as opposed to interjections and whole-word or phrase repetitions)
*Presence of secondary behaviors/increased tension
*Vowel neutralization (schwa) during repetitions (i.e., “buh-buh-beat”)
*Duration of single instance of disfluency that exceeds two seconds
*Uncontrolled or abrupt changes in pitch or loudness

It is my hope that you have gained an understanding of “What is a Fluency Disorder?”  If you suspect that your child exhibits the early characteristics of stuttering, please consult with a Speech-language pathologist as soon as possible!  I thank you for reading the above information and I encourage you to come back for week five’s discussion on “What is a Voice Disorder?”

Reference:  

Roth, Froma P. and Worthington, Colleen K.  Treatment Resource Manual for Speech-Language Pathology 2nd Edition.  Albany:  Singular Thomson Learning, 2001.  Print.