When a person has a fluency disorder it means the person has trouble speaking in a fluid, or flowing, way. The person may say the whole word or parts of the word more than once, or pause awkwardly between words. This is known as stuttering. The person may speak fast and jam words together, or say "uh" often. This is called cluttering.
These changes in speech sounds are called "disfluencies." Many people have a few disfluencies in their speech. But people with a fluency disorder have many disfluencies when they talk. For them, speaking and being understood may be a daily struggle.
Signs of a fluency disorder
A fluency disorder causes problems with the flow, rhythm, and speed of speech. A person with stuttering may have speech that's interrupted or blocked, as though the person is trying to say a sound but it doesn't come out. The person may repeat part or all of a word as he or she tries to say the word. The person may drag out syllables. Or the person may talk breathlessly, or seem tense while trying to speak. A person with cluttering often speaks fast and merges some words together or cuts off parts of them. The person may sound like he or she is slurring or mumbling. And the person may stop and start speech and say "um" or "uh" often when talking.
Some people have both stuttering and cluttering. They may also have what are known as "accessory" or "secondary" behaviors. These are methods a person may use to try to avoid or cover up their disfluencies. These behaviors can include:
Not speaking, even when the person wants or needs to
Pretending to forget what the person wanted to say
Covering his or her mouth or pretending to cough or yawn to cover up stuttering
Using "filler" sounds between words to make the rate of speech sound more normal
Not using certain words that seem to cause stuttering
Rearranging words in sentences
Children with fluency disorders also may develop beliefs that can hinder them later on. For example, a child who stutters may decide that speaking is difficult by nature. Fear, anxiety, anger, and shame involving speaking are also common.
What causes a fluency disorder?
The exact causes of fluency disorders are not known. It may be genetic and run in families. It can occur at the same time as another speech disorder. The signs of a fluency disorder can be made worse by emotions such as stress or anxiety.
Diagnosing and treating fluency disorders
Experts feel it is important to assess and address speech disorders early. Children who struggle with speech can find school and community activities challenging or painful because they are not able to communicate their thoughts. They might even have problems developing friendships.
A fluency disorder can be diagnosed by a speech-language pathologist (SLP). An SLP will ask about the person's medical history, listen to them speak. The SLP may do an oral-mechanism exam and testing of speech-language skills.
Once a person is diagnosed, an SLP can use exercises and strategies to help the person speak more fluently. A fluency disorder is not something that can be "cured." But an SLP uses different kinds of methods to help a person with fluency disorder manage speech day to day. These methods can reduce the number of disfluencies in a person's daily speaking.
An SLP can help the person lower his or her own stress around moments of fluency problems. The SLP will work on changing negative feelings, thoughts, and beliefs around the person's speech. He or she will help the person reduce the use of accessory behaviors. The person will learn strategies such as speaking in shorter sentences, and learning how to control his or her breathing and the rate at which the person speaks. An SLP will often talk with family, caregivers, and teachers about the disorder and how to help.
If someone you know has a fluency disorder:
Be patient and supportive. As frustrating as it is for you to try to understand someone with a fluency disorder, it can be much more frustrating for that person. Be as patient as you can while the person works on his or her speech.
Be kind. Making fun of a child (or an adult) with a fluency disorder may take away the person's desire to communicate.
Join a support group. Many fluency disorders, such as stuttering, have support groups. Spending time with other families coping with fluency disorders can be helpful.
- MMI board-certified, academically-affiliated clinician
- Turley, Ray, BSN, MSN