Fluency Disorders

Speakers are considered ‘fluent’ if there is a natural and easy flow and rhythm to their speech. Fluency disorders are evidenced by behaviors that interfere with the production of speech sounds that are sequenced to create smoothly connected words. The best known fluency disorder is stuttering, which is a disruption in the forward flow of speech that may be accompanied by physical tension in the speech musculature (throat), additional non-speech behaviors (such as eye blinks or facial tension), avoidance or abandonment of communication attempts, and/or negative reactions on the part of the speaker. Dysfluent behaviors such as repeating whole words (“Mommy, mommy, mommy”) or phrases (“Can I, Can I”) or using interjections (“um”, “uh”, “like”, “you know”) are found in virtually all speakers.  These can be less normal if the number is excessive; however, these behaviors alone are not typically cause for concern.  Disruptions in the forward flow of speech that may be considered stuttering behaviors include the following:

• Repetitions:  repeating a sound or syllable, or a combination of the two types (e.g., “li-li-li-like this”)
• Prolongations: holding onto a sound for an extended period of time (e.g., “lllike this”)
• Blocks: no sound is produced then a “burst” of tension or air is released and the sound is started (e.g., “—-like this”)

Fluency disorders typically begin during childhood and, for some individuals, persists throughout life. At this time there is no known cure for stuttering, but management through fluency enhancing strategies and/or stuttering modification techniques, usually along with cognitive behavioral training and counseling of clients and families, are options.

Services may include evaluation and treatment for individuals and small groups. Treatment for younger children is likely to include a combination of indirect (family-focused) approaches, along with direct (child-focused) treatment. For older children, adolescents and adults, the goals shift to successful management of stuttering behaviors using specific strategies in tandem with counseling components. The primary objective for any age is to develop the speaker’s ability to be as fluent as possible while maintaining a positive attitude toward speaking and focusing on the ability to communicate effectively.

The Speech-Language Institute offers assessment and treatment of fluency disorders in children, adolescents, and adults. Professors with expertise in fluency impairments work with graduate student clinicians to assess and remediate communication disorders associated with stuttering.