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Stuttering/Fluency of Speech Disorder

What is Stuttering/Fluency of Speech Disorder?

Stuttering is a speech disorder characterized by difficulty producing easy, smooth speech. Stuttering is a “disorder of the rhythm of speech in which the individual knows precisely what he wishes to say, but at the time is unable to say it because of involuntary, repetitive prolongations or cessations of a sound.” (World Health Organization, 1977) Stuttering and cluttering (see below) are also called fluency or fluency of speech disorders.

Stuttering can occur in children, adolescents and adults. Although there may be no clear cause, stuttering appears to run in families and affects three to four times as many males as females. Stuttering usually starts in early childhood, often by the age of three years, but some children may experience a later onset. Stuttering may start gradually over days, weeks or months, or it can appear to happen suddenly, over hours or a day. Many young children (1 in 20) begin to stutter by age five years, but the problem will resolve in most of these children (75-80%) naturally and without intervention, leaving about 1% who may experience stuttering as a life-long challenge.

When someone stutters, they may repeat sounds (b-b-bye), syllables (mo-mo-mom), or words (and-and-and), prolong sounds (mmmmay) or have silent blocks when no sound comes out. You may also see secondary behaviours, which may include grimacing, blinking, body movements or muscle tension.

People who stutter are self-conscious about their stuttering and may develop negative feelings and attitudes about speaking as a result of frustration with not being able to communicate easily or if teased by others. People who stutter may avoid speaking situations and may experience anxiety about speaking. This may limit educational, occupational, or social opportunities and interactions.

Cluttering is a fluency disorder that impacts the speaker’s rate of speech (too fast or irregular) as well as the organization and intelligibility of their speech. People who are clutterers may have other problems as well with language, sound patterns, and attention.

What can professionals do to help?

Speech-language pathologists (SLPs) are the only professionals trained to assess, treat and manage stuttering. The SLP will consider several factors including when the stuttering started, how the stuttering behaviours affect communication and the person’s daily life, what situations influence stuttering, and what the person does to cope.

SLPs may recommend monitoring stuttering in a young child over a short period of time or commencing treatment, depending on how long the child has been stuttering and the impact it is having on their communication, social interaction and family. Early access to services is important in helping a child develop fluent speech.

Intervention will typically involve the child and the parents or caregivers to support fluent speech and reduce anxiety. Ideally, intervention should take place during the preschool years as this is thought to be the best time to reduce stuttering in children. However, children who receive services in elementary school will also have a good response to intervention, especially if parents are included in treatment so that they can support changes in the home.

For adolescents and adults who stutter, SLPs can help make decisions in choosing from various treatment approaches to increase a person’s control over their speech, address the accompanying attitudes, feelings and anxiety about stuttering, and reduce the overall negative impact of stuttering on the person’s life.