When you have a fluency disorder it means that you have trouble speaking in a fluid,
or flowing, way. You may say the whole word or parts of the word more than once, or
pause awkwardly between words. This is known as stuttering. You 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 if you have a fluency disorder, you will have many disfluencies
when you talk. For you, 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. If
you stutter, your speech may sound interrupted or blocked, as though you are trying
to say a sound but it doesn't come out. You may repeat part or all of a word as you
to say it. You may drag out syllables. Or you may talk breathlessly, or seem tense
while trying to speak. If you clutter, you often speak fast and merge some words together
or cut off parts of them. You may sound like you are slurring or mumbling. And you
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 methods are used to try to avoid or
cover up disfluencies. These behaviors can include:
Covering your mouth or pretending to cough or yawn to cover up stuttering
Not speaking, even when you want or need to
Not using certain words that seem to cause stuttering
Pretending to forget what you wanted to say
Rearranging words in sentences
Using "filler" sounds between words to make the rate of speech sound more normal
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 happen 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
A fluency disorder can be diagnosed by a speech-language pathologist (SLP). An SLP
will ask about your medical history and listen to you speak. The SLP may do an oral-mechanism
exam and testing of speech-language skills.
Once you are diagnosed, an SLP can use exercises and strategies to help you speak
more fluently. A fluency disorder is not something that can be cured. But an SLP uses
different kinds of methods to help you manage speech day-to-day. These methods can
reduce the number of disfluencies in your daily speaking.
An SLP can help you lower your own stress around moments of fluency problems. The
SLP will work on changing your negative feelings, thoughts, and beliefs about your
speech. He or she will help you reduce the use of accessory behaviors. You will learn
strategies such as speaking in shorter sentences, and control your breathing and the
rate of your speech. 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:
Use available resources. Public schools are required to assess children with communication disorders
and, if the child meets certain criteria, provide treatment services. If you
have a child as young as age 3 with communication problems, contact your local
public school’s office and talk to the principal about assessment options.
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 who has it. Be as patient as
you can while the person works on his or her speech.
Be kind. Making fun of a person with a fluency disorder is a form of bullying. It is destructive
and 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.