Huntsville, AL 35801

Fluency

Fluency disorders concern rate, rhythm, and continuity of speech; stuttering and cluttering are considered fluency disorders.

What is a fluency disorder?

When you speak, it’s fairly normal to have moments where your words do not come out quickly, using filler words such as “uh,” or repeating a sound or word. However, if these disruptions in speech stop you from communicating clearly and easily, or prevent you from being able to express yourself to others, it may be worth it to be evaluated for fluency disorder.

Fluency disorders can present in childhood or adulthood, though the cause of fluency difficulties may be different depending on various factors, such as medical history, age of development, head injury, and more.

A speech-language pathologist can conduct evaluations, discuss the way fluency difficulties affect a client’s life, and develop treatment plans and form goals to decrease disfluencies. A speech therapist may also make recommendations for community support and teaching advocacy for those with fluency disorders.

Fluency disorder treatment looks different depending on the type and severity of disfluency, as well as the age or cause of moments of stuttering. Intervention may include strategies to adjust the overall rate of speech, focusing on breath support for speech, building knowledge of fluency disorders, and teaching self-monitoring skills for speech. Speech therapy is important for supporting clients with fluency difficulties.

Childhood Fluency Disorder

Fluency difficulties are somewhat common in children, especially as they’re learning to speak. Disfluencies in children can be caused by many things, including genetic, environmental, or neurological factors. Children who develop fluency difficulties, especially those with a family history of stuttering, should be seen for a speech evaluation to determine if they would benefit from speech therapy intervention.

Stuttering behaviors go beyond repetition of sounds, which is often how stuttering is represented on television. While a child with disfluencies may present with a repetition of sounds, stuttering patterns can also include repetitions of parts of words or full words, holding out sounds for too long, trouble starting speech, issues getting words out, avoiding certain sounds or words they struggle with consistently, speaking too quickly where speech becomes unintelligible, and pauses in speech. They may also exhibit some physical signs of fluency issues, such as grimacing while trying to speak, tapping their hands or feet while speaking, noisy breathing, and more.

Without intervention, fluency issues can continue into adolescence and adulthood. Fluency issues may also affect a child’s confidence in regards to communication, making them hesitant to speak, or cause them frustration when speaking. Feelings of embarrassment, frustration, nervousness, or shame surrounding disfluencies can make stuttering behaviors more severe. This can contribute to long-term difficulties regarding their speech. It’s essential for parents to be aware of the signs of fluency difficulties in children and seek assessments if they have concerns for their child’s speech.

What does fluency treatment look like for kids?

Treatment for children with fluency difficulties looks different than treatment in adults. Parents or guardians also play a bigger role in treatment, as they can help support using terms and strategies learned in speech therapy every day and in other environments, such as restaurants, school events, and more. Speech therapists often focus on strategies to increase fluency and reduce severity of moments of stuttering, but some counseling techniques may be recommended to address other aspects of fluency disorder, such as anxiety or other negative feelings regarding speaking in social situations.

Addressing speech disorders in children allows them to gain control over their own speech, participate in school activities, increase their confidence, develop better expression of speech, and participate in social and community activities.

Adult Fluency Disorders

Fluency disorders, such as stuttering and cluttering, often first develop in childhood, but they can also present in adulthood. These are considered acquired fluency difficulties, as they usually are caused by either a head injury (concussion, traumatic brain injuries, strokes, etc.) or may develop alongside a neurological or neurodegenerative disorder.

There are some adults who seek out treatment after developing stuttering difficulties as a child and receiving treatment, but experiencing that stuttering behaviors have become more frequent or difficult to manage later in life.

Speech-language pathologists can provide adults with treatment plans and intervention to allow clients to regain more control over their speech or address concerns for fluency difficulties.

“I trip over my words a lot, does that count”? How do I know if it’s a problem?”

Normal disfluencies are common in both children and adults. Some normal disfluencies include pauses between words, revisions or corrections while speaking, or using lots of filler words such as “um” or “like.” A normal disfluency typically does not cause a speaker feelings of frustration or struggle, nor does it significantly interfere with their ability to communicate.

This is unlike fluency disorders, which do often create more difficulty for the speaker, cause feelings of frustration or struggle when attempting to talk, or often disrupt their communication with others. Those with fluency disorders often communicate experiencing feelings of frustration, discouragement, or irritation due to their struggles to communicate as easily as others.

Disfluencies that are considered typical for those with fluency disorders include repetitions of sounds, syllables, and words, feeling “stuck” or unable to make sounds or “get their words out,” or holding out a sound in speech for abnormally long.

What does fluency evaluations and therapy look like?

Evaluations are essential for speech therapists to complete in order to properly diagnose communication disorders and identify which areas a client may need support in. For fluency, a speech-language pathologist will likely conduct standardized tests in order to observe a client’s speech and patterns of disfluency, as well as their own perceptions and feelings regarding their speech.

In addition to standardized assessments, a speech therapist may use other methods to gather data of a client’s speech, such as language samples. A language sample is a functional snapshot of a client’s language content and speech use; it may include the client reading aloud, describing items or pictures, retelling familiar stories, or relaying an anecdote. A speech therapist can analyze these samples to note patterns and determine which strategies would be beneficial for the client.

Results from fluency evaluations often allow therapists to set treatment plans and goals to support their clients, as well as provide results to compare to in the future to note progress. Speech therapy intervention looks different for everyone; goals differ depending on the person and their needs. Speech therapy for fluency disorders may include providing strategies to increase fluency, increasing a client’s ability to self-monitor speech, providing community resources, addressing feelings of frustration or discouragement regarding fluency issues, and practicing use of strategies in a variety of real-world situations or activities (i.e., reading, conversation, debating, phone calls, placing orders at a restaurant, introducing oneself, etc.).