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Seven Things to Know About Fluency Disorders

Feb 08th, 2019 | by Lynette LaScala
Lynette LaScala

Lynette LaScala

February 08th, 2019

1. What we most commonly know as “stuttering” is called childhood-onset fluency disorder in the medical field.

  • With multiple contributing factors, fluency disorder is a speech disorder that is characterized by sound prolongations, repetitions, and/or blockage of sounds, syllables, words, or phrases which disrupt the natural flow of speech.

2. Stuttering is common in periods of language development between 2-5 years of age.

  • Disfluent speech is experienced by everyone on occasion and is considered normal. The chart below outlines details about normal disfluencies:
Age Common Disfluencies
18 months – 3 years
  •  Repetitions of sounds, syllables, and words
  •  Especially noticeable at the beginning of sentences
3 years +
  • Repetitions of whole words and phrases more common
  • Interjections such as “like”, “uh”, “um”
  • Revising sentences or switching topics altogether mid-sentence

3. Less common disfluencies that may indicate referral to a speech language pathologist include:

  • Sound prolongations (e.g., “mmmmmommy, it’s mmmmy ball”)
  • Audible blocks and breaks in inappropriate parts of a word/sentence (e.g., “I wa–ant it”)
  • Words produced with excessive physical tension or struggle in the face, neck, torso, arms, or hands
  • Secondary physical behaviors, such as eye blinking or jaw tightening
  • Normal disfluencies at an increased frequency and persistence (e.g., a sound repetition 8 times before a word rather than 3-4 times)

4. The number of boys who stutter increase by 3-4x more than girls as children reach about 6 years of age 

(Craig, Hancock, Tran, Craig, & Peters, 2002).

  • 80-90% percent of children with diagnosable childhood-onset fluency disorder generally show persistent stuttering lasting longer than 6 months by age 6 (Maguire, Yeh, & Ito, 2012).

5. Contrary to popular belief, emotional problems and parenting style does not cause stuttering.

  • However, coping with disfluencies may cause negative emotional reactions to stuttering (Silverman & Bernstein Ratner, 2002).
  • Stuttering can cause anxiety about activities and situations that involve speaking
  • Children may avoid speaking in social situations (e.g., raising their hand in class, making friends, answering the telephone) and/or avoid certain words they may stutter on.

6. Recent findings have shown genetic and neurological factors contribute to fluency disorder. 

  • Studies have found three likely causative gene mutations linked to stuttering (Drayna & Kang, 2011).
  • Children who stutter (ages 3 to 9 years) have shown physical differences in the brain that affect speech fluency (Chang & Zhu, 2013).

7. Treatment for fluency disorder is highly individualized and requires a thorough assessment that includes speech fluency, language factors, emotional/attitudinal components, and the impact that stuttering has on an individual’s life. 

  • Therapy approaches vary based on the child’s age and understanding of stuttering. For young children, treatment may be indirectly targeted through family modifications of their own speech rate and changes in the family environment.
  • Direct treatment approaches may incorporate a number of different strategies, including:
    • Fluency Shaping: Techniques aimed at changing the timing and tension of speech production
    • Stuttering Modification: Aims to make stuttering more manageable when it occurs by employing strategies that reduce physical tension and struggle on stuttered words
    • Reducing Negative Reactions: Approaches and strategies for reducing negative emotions and reactions associated with stuttering
    • Activity and Life Participation: Aims improve an individual’s participation in speaking situations of daily life overall, typically through generalization of approaches mentioned above

About NAPA Center

At NAPA Center, we take an individualized approach to therapy because we understand that each child is unique with very specific needs. We embrace differences with an understanding that individualized programs work better. For this reason, no two therapeutic programs are alike. If your child needs our services, we will work closely with you to select the best therapies for them, creating a customized program specific to your child’s needs and your family’s goals. Let your child’s journey begin today by contacting us to learn more.

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