Typical vs. Atypical Disfluencies: What Are the Differences?

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Fluency in speech refers to how smoothly someone forms sounds, words, and phrases when communicating. Maintaining a high level of fluency is crucial to conveying one’s thoughts and needs clearly when speaking. That makes speech fluency an important part of social and professional interactions.

However, sometimes people have disfluencies, or nonfluencies, in their speech, such as adding pauses, sounds, or words, or repeating themselves. These disfluencies are common, particularly for young children who are mastering language.

Persistent problems with fluency, however, can indicate a fluency disorder.

Understanding what are typical vs. atypical disfluencies is an important step in tackling communication problems before they lead to negative outcomes that can range from learning difficulties to social anxiety disorders.

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These infrequent interruptions in fluency, known as typical disfluencies, can include adding or repeating words or fillers such as “like” or “uh.” They also can include prolonged sounds or blocks in which the individual seemingly cannot speak.

Young children commonly exhibit speech disfluencies, with the most prevalent symptoms shifting according to age.

Most children can easily use language by age 5. Typical disfluencies can continue to occur at any time, however, particularly for children who are experiencing feelings such as fatigue, excitement, or unhappiness, or if they are rushed. These disfluencies may occur regularly for days or weeks and then decrease or disappear, returning later.

Typical disfluencies generally are not a cause for concern and don’t signal a need for an intervention from a speech-language pathologist, a professional who treats communication and swallowing problems.

When disfluencies include frequent interruptions that cause a person’s speech to have an abnormal rate and rhythm, or they’re accompanied by certain behaviors, they are atypical disfluencies. When these disfluencies have a significant impact on how the individual interacts with others, it can represent a fluency disorder.

People with atypical disfluencies may react through behaviors such as:

Unlike typical disfluencies, atypical disfluencies generally require assistance, such as therapy from a speech-language pathologist, to correct them.

Without early intervention, those with atypical disfluencies in their speech can find school, work, and social activities difficult. Children who do not receive treatment may find making friends challenging. They may experience bullying, struggle with learning, and suffer from anxiety issues.

To help ensure they are taking the appropriate course of action related to their loved one’s speech disfluency, individuals should explore resources about fluency disorders and learn about the types of speech disfluency.

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As speech-language pathologists evaluate individuals who have speech disfluencies, they consider a variety of factors to determine whether they are typical or atypical disfluencies.

The American Speech-Language-Hearing Association (ASHA) and the Eyas Landing clinic note some characteristics that can indicate an atypical speech disfluency:

Brain changes are believed to be a contributing factor in atypical disfluency, according to research — including that referenced in a 2022 Frontiers in Human Neuroscience article about stuttering.

There are two predominant types of atypical disfluencies: stuttering and cluttering. Following are descriptions of each of these forms of disfluency.

More than 70 million people around the world struggle with stuttering, according to The Stuttering Foundation.

People with this type of atypical disfluency, also called stammering, have speech that’s broken by repetitions, prolongations, or abnormal silence. The Stuttering Foundation provides the following examples for these interruptions:

Unusual facial and body movements often accompany this speech disfluency.

People with the atypical disfluency known as cluttering rarely recognize that they have the condition. Instead, others often report that they can’t understand the speaker. Cluttering is commonly described as talking too fast, or someone’s brain going faster than their mouth.

Cluttering is believed to be less prevalent than stuttering.

Symptoms of cluttering in speech include:

About a third of people who clutter also stutter, according to Speech IRL speech therapy. But the conditions are different in their speech characteristics and other symptoms.

Unlike stuttering, those who clutter rarely exhibit behaviors and movements associated with their condition, for example, and they often aren’t aware of the disfluency. Additionally, cluttering typically appears later than stuttering, with most cases occurring in those age 8 or older.

The characteristics of stuttering and cluttering differ from those that represent typical disfluencies. Following are some disfluencies that are typical and usually don’t point to a speech disorder:

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When speech-language pathologists assess and treat speech disfluencies, they begin by considering some key factors related to the issue. As they evaluate the individual’s health history and listen to them speak, they note the following issues:

Specific issues related to the language an individual speaks as well as an individual’s family communication preferences also are important factors for speech-language pathologists to consider as they assess people with disfluencies.

Speech disfluency assessments also may include an oral mechanism exam, which focuses on how an individual’s tongue, jaw, throat, teeth, tonsils, and top of the mouth work during speech.

Speech-language pathologists consider specific sets of issues depending on the age of the individuals who are exhibiting speech disfluencies. When it comes to typical vs. atypical disfluencies, the areas of focus change according to whether the person is a preschool-age child, a school-age child, or an adult.

For preschool children, assessment of speech fluency concerns focuses on whether the disfluency is typical or atypical and whether the issue warrants treatment. Speech-language pathologists work with families to develop plans for treatment and reevaluation.

For speech disfluency concerns in school-age children, the most important concern is the impact of the issue on the individual’s interactions — and life.

Speech-language pathologists typically start by asking these children and adolescents to assess themselves. Because older children might have learned to mask their disfluencies, speech-language professionals may pose open-ended questions to get honest answers about how the child is participating in class, ordering food in a restaurant, or taking part in other types of interactions.

Adults with speech disfluencies often have exhibited the issue for a long time. As with older children, the main goal of assessment is to determine the extent of the impact the disfluency has had on the individual’s life.

By determining the depth of the individual’s concern about the issue, speech-language pathologists can gauge that person’s willingness to make changes to address it as well as the potential benefits for doing so.

In addition to evaluating whether a disfluency is typical or atypical, speech-language pathologists also must determine whether the concern is a speech disfluency at all.

The issue could instead be related to a reading disorder, challenges in learning a new language, or a different type of disorder. Movements that could be tied to stuttering, for example, might instead be the result of apraxia, a disease that causes an inability to control or coordinate one’s movements.

There’s no cure for disfluency disorders. But speech-language pathologists can use exercises and other techniques to help the individual decrease the number of speech interruptions, limit disfluency-related behaviors and movements, and lessen the stress and other negative feelings associated with the issue.

Speech-language pathologists address disfluencies through direct and indirect techniques.

Direct techniques for treating speech disfluencies focus on the individual making changes to their own speech and attitudes. Following are some commonly used direct approaches to treating speech disfluencies:

Indirect treatments call on the individual’s loved ones to make changes to facilitate speech improvements for the person struggling with a disfluency disorder. Among the steps that families can take to help someone manage a disfluency disorder are:

Families should work closely with speech-language pathologists to support efforts to decrease the rate of disfluencies and facilitate treatment plans.

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A variety of organizations and publications provide valuable information to help people identify typical vs. typical disfluencies, learn about types of disfluencies, and find support. Following are resources to help individuals, families, and speech-language pathologists take prompt action to address these disorders.

Many groups offer support to individuals with fluency disorders and to the family members and speech-language professionals who assist them. These groups provide resources such as assessment tools, articles, training materials, and therapy kits. They include:

Books and professional journals can provide speech-language pathologists and students — as well as individuals with fluency disorders and their families — with in-depth information about disfluencies, assessments, and treatments. Following are some publications about fluency disorders:

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While occasional disfluencies in speech are common, especially for young children, certain patterns in speech and behavior can indicate a fluency disorder. Because these disorders can have serious implications for individuals’ quality of life, promptly determining whether they are typical or atypical disfluencies is critical.

Connecting with resources that educate and support individuals with disfluencies — as well as their families and speech-language pathologists — can help put those with fluency disorders on a path to effective communication, successful learning, and positive family and social interactions.

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