Typical vs. Atypical Disfluencies: What Are the Differences?
- Children between 18 months and 3 years old typically exhibit speech disfluencies about once every 10 sentences as they learn to talk. They repeat sounds, syllables, and words, particularly when starting sentences.
- Children older than 3 are less likely to repeat sounds or syllables. Instead, as they work to rapidly develop their speech abilities, they may use filler words and sounds, switch topics midsentence, shift the order of a sentence, or leave a thought unfinished.
Typical vs. Atypical Disfluencies
- Blinking or shutting their eyes, looking to the side, or tensing their mouths when they speak
- Avoiding speaking or pretending to forget what they were going to say
- Covering their mouth or pretending to cough or yawn to mask the disfluency
- Not using words that trigger the disfluency
- Adding filler sounds to disguise disfluencies
Types of Speech Disfluencies
- Age of onset — Atypical disfluencies often begin after age 3 1/2.
- Frequency of disfluency — Disfluencies that occur more than once per 100 words typically require treatment
- Family history — Stuttering, for example, is more common in individuals who have a family member with speech disfluency issues.
- How long the disfluency persists — Speech disfluencies that are atypical frequently last six months or longer.
- Gender — For stuttering, males are three to four times more likely to experience long-term concerns.
- Behaviors — Individuals with atypical disfluencies often exhibit negative reactions or physical responses to the issue.
Most Common Forms of Atypical Disfluency
- Repetition — “li-li-like this”
- Prolongations — “lllllike this”
- Abnormal stoppages — No sound
- Speaking rapidly
- Omitting word endings
- Deleting syllables (“probly” instead of “probably,” for example)
- Collapsing syllables (“pleece” instead of “police,” for example)
- Unusual pauses
Stuttering and Cluttering vs. Typical Disfluencies
- Adding a sound or word, called an interjection
- Repeating whole words or phrases
- Changing a sentence’s wording midway through it
- Taking pauses while thinking
Assessment and Treatment of Typical and Atypical Disfluencies
- Level of impairment — Ability to speak with efficiency, frequency of interruptions, presence of disfluency-linked behaviors, and amount of effort required for speaking
- Limitations on activity — Impact on participating in school, work, and social and at-home activities; on progressing at school; and on enjoying life
- Attitudes about the disfluency — Emotional and behavioral responses of the individual exhibiting disfluency as well as those who interact with them
Assessment of Disfluencies by Age
Speech Disfluency Assessment for Preschool Children
Speech Disfluency Assessment for School-Age Children
Speech Disfluency Assessment for Adults
Diagnosing Different Speech Impairments
Treatments for Disfluencies
Direct Treatments for Disfluencies
- Self-monitoring exercises — The individual focuses on their own speech and messages in the therapy setting, increasing their awareness of their speech patterns and building their ability to control their fluency.
- Cancellation technique — After stuttering or cluttering occurs, the speaker pauses to consider the word or phrase and then makes adjustments that make fluency easier.
- Pausing exercises — To make their communication clearer and to encourage appropriate pacing, the individual changes the timing of pauses in their speech.
Indirect Treatments for Disfluencies
- Changing the conditions that can worsen disfluencies by refraining from prompting the person to speak in front of others or correcting their speech
- Listening closely, maintaining eye contact, and ensuring people take turns speaking
- Modeling fluent speaking, using slower speech with more pauses, and talking throughout daily activities to encourage communication in an informal environment
Resources for Addressing Disfluencies and Fluency Disorders
Fluency Disorder Organizations
- American Board of Fluency and Fluency Disorders — Seeks to promote high standards of practice in the treatment of fluency disorders, providing professional certification, discussions, helpful links, and lists of certified speech-language professionals
- ASHA — Provides publications and research as well as information about events and jobs for speech-language professionals
- Friends — Supports young people who stutter as well as their families and those who treat stuttering, providing activities targeting different ages as well as events and a newsletter
- International Fluency Association (IFA) — Advances science, education, treatment, and advocacy related to stuttering and cluttering
- International Cluttering Association (ICA) — Connects speech-language professionals, researchers, and those who clutter and their families by offering conferences, a newsletter, and assessment information
- National Stuttering Association (NSA) — Supports those who stutter and their loved ones as well as speech-language professionals through local chapters, a newsletter, events, and a tool for finding specialists
- The SLP Solution — Assists speech-language pathologists through therapy guides, e-books, continuing education, and expert advice
- The Stuttering Association for the Young (SAY) — Provides camps, therapy, and creative arts programs for children age 3 to 18 who stutter
- The Stuttering Foundation — Offers articles, podcasts, and videos for people who stutter and their loved ones as well as support for research about the disorder
- StutterTalk — Hosts a podcast about stuttering and provides a newsletter and links to information about the disfluency
- Stuttering Therapy Resources — Offers therapy guides, handouts, videos, and a newsletter targeting professionals who treat stuttering
Fluency Disorder Publications
- Fluency Disorders: Stuttering, Cluttering, and Related Fluency Problems, Second Edition — Details fluency disorders as well as treatments that meet ASHA standards, focusing on the impact that fluent communication has on quality of life
- Journal of Fluency Disorders — Features research and clinical reports as well as articles that examine the latest fluency disorder treatments
- Stuttering as a Mindbody Disorder: How and Why Expressiveness and Assertiveness Promote Fluency — Examines the role that stress and tension play in stuttering
- Stuttering, Fifth Edition — Provides an overview of stuttering and how to assess and address it, including case studies and videos on treatment techniques