Dysfluency/Stuttering

Dysfluency, or stuttering, is a speech disorder in which the flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words or phrases, and involuntary silent pauses or blocks in which the person speaking is unable to produce sounds. These breaks in the flow of speech differ in number and severity from those of normally fluent individuals. Stuttering events may be accompanied by secondary physical behaviors including eye blinks, nasal flaring, tremors of the lips and/or jaw and tension in the head, neck and shoulders. Dysfluency generally begins in childhood, and its exact cause remains unknown.

Some examples of stuttering include:

• "W- W- W- Where are you going?" (sound repetition)
• "SSSSave me a seat." (sound prolongation)
• "I'll meet you - um um you know like - around six o'clock." (interjections)

Risk Factors

Many specialists consider the following risk factors for a fluency disorder:

• a family history of stuttering
• stuttering that has continued for 6 months or longer
• presence of other speech or language disorders
• strong fears or concerns about stuttering on the part of the child or the family

Causes

The exact cause of dysfluency is unknown. Recent studies suggest that genetics plays a role in the disorder. It is thought that many, if not most, individuals who stutter inherit traits that put them at risk to develop stuttering. For many, certain life events are thought to "trigger" fluency difficulty.

Listeners' responses to stuttering (e.g., teasing) can aggravate fluency difficulties as well. Those who have encountered unfavorable reactions from listeners may develop emotional responses to stuttering that hinder speech production further. Examples of these emotions include shame, embarrassment, and anxiety.

Developmental Dysfluency

Developmental dysfluency is common in toddlers and preschool-aged children and may coincide with the development of grammar skills. Between the ages of 2 and 5 years, children's vocabulary expands rapidly and they learn many of the grammatical rules of language. It is not uncommon for young children to experience a phase of dysfluency as he/she starts trying to produce longer, more complex sentences. For the majority of these young children, the problem generally resolves on its own as the child becomes a more competent and skilled communicator.

Treatment for Stuttering

Most treatment programs for people who stutter are "behavioral." They are designed to teach the person specific skills or behaviors that lead to improved oral communication. For instance, many SLPs teach people who stutter to control and/or monitor the rate at which they speak. In addition, people may learn to start saying words in a slightly slower and less physically tense manner. They may also learn to control or monitor their breathing. When learning to control speech rate, people often begin by practicing smooth, fluent speech at rates that are much slower than typical speech, using short phrases and sentences. Over time, people learn to produce smooth speech at faster rates, in longer sentences, and in more challenging situations until speech sounds both fluent and natural. "Follow-up" or "maintenance" sessions are often necessary after completion of formal intervention to prevent relapse.