Fluency Disorders

When people speak, it is normal to have a moment where something does not come out quickly, you use the word "uh" or occasionally repeat a sound or word. It is not normal if these disruptions prevent you from easily communicating and expressing your thoughts to others. Fluency disorders are more commonly known as stuttering or cluttering and can present differently in adulthood.

Treating a fluency speech disorder is essential to help individuals maximize their communication potential. A speech-language pathologist (SLP) can provide an evaluation, diagnose a fluency disorder, and develop a treatment plan to address behaviors that increase disfluencies. Treatment may include various techniques such as adjusting the rate of speech, using a variety of breathing techniques to adjust breath support, using self-monitoring skills, and more. With the right kind of intervention, people with fluency disorders can often improve their communication skills and express themselves with increased ease.

Fluency Disorders in Adulthood

Fluency disorders can also manifest in adulthood. Stuttering, prolongations, and other fluency difficulties in adults may be caused by a head injury, such as a traumatic brain injury or stroke, or develop from a neurodegenerative disorder. Adults may also present with stuttering after experiencing stuttering difficulties as a child and receiving treatment, only for the stuttering symptoms to return later in life.

Adults who suspect they may have a fluency disorder should speak to a speech-language pathologist to seek out an evaluation and treatment plan through speech therapy. With the proper intervention, adults can often gain more control over their speech and develop better communication skills.

The symptoms and manifestations of fluency disorders can differ depending on age. In children, the condition often presents as a frequent repetitions, sound prolongations, and pauses in speech. Whereas in adulthood, onset of fluency disorder may appear through stuttering patterns and fluency difficulties that were not present earlier in life. It's important to note that even if a person did not experience disorders as a child, they might still encounter them later in life. Early evaluation and intervention are essential for both childhood and adulthood fluency disorders so that individuals can gain control over their speech.

How Would I Distinguish It From Normal Disfluencies?

Fluency disorders such as stuttering and cluttering can be distinguished from normal disfluencies, which are common in both children and adults. Normal disfluencies may sound like hesitations between words, using filler words such as “um,” and revisions or corrections while speaking. However, these types of disfluencies typically do not cause the individual significant communication disruption or feelings of struggle. In contrast, fluency disorders disrupt communication patterns and create more difficulty for the speaker. Individuals with a fluency disorder often experience discouragement and frustration due to their inability to communicate as quickly and easily as others.

Some additional indicators of a fluency disorder include:

• Repetitions of sounds, syllables, or words
• Holding out speech sounds for a few seconds more than normal.
• "Blocks" in speech. A "block" is a moment of disfluency when a person tries to say something, but the words "get stuck" and will not come out. You may notice a grimace when seeing a block.

How Do I Prepare For A Fluency Evaluation, And What Does Therapy Look Like?

Testing and evaluation for fluency speech disorders is an important step in identifying and diagnosing communication disorders. A speech-language pathologist will administer standardized and informal assessments to better understand the client’s disordered speech patterns. The results from these tests can then be used to develop an individualized treatment plan to improve communication skills.

The speech therapist will likely collect a "language sample" in which the child or adult is asked to describe a picture, read, or tell a story about a certain event or activity. The therapist will analyze the sample and determine which strategies will be most helpful in making it easier for the person to speak clearly. In therapy, the clinician will demonstrate these strategies, and the patient will practice them during a variety of activities (ex. reading, conversation, phone calls, talking to family/friends, etc.).