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Fluency Disorder

When you have a fluency disorder it means that you have trouble speaking in a fluid, or flowing, way. You may say the whole word or parts of the word more than once, or pause awkwardly between words. This is known as stuttering. You may speak fast and jam words together, or say "uh" often. This is called cluttering.

These changes in speech sounds are called disfluencies. Many people have a few disfluencies in their speech. But if you have a fluency disorder, you will have many disfluencies when you talk. For you, speaking and being understood may be a daily struggle. 

Signs of a fluency disorder

A fluency disorder causes problems with the flow, rhythm, and speed of speech. If you stutter, your speech may sound interrupted or blocked, as though you are trying to say a sound but it doesn't come out.  You may repeat part or all of a word as you to say it. You may drag out syllables. Or you may talk breathlessly, or seem tense while trying to speak. If you clutter, you often speak fast and merge some words together or cut off parts of them. You may sound like you are slurring or mumbling. And you may stop and start speech and say "um" or "uh" often when talking.

Some people have both stuttering and cluttering. They may also have what are known as "accessory" or "secondary" behaviors. These methods are used to try to avoid or cover up disfluencies. These behaviors can include:

  • Covering your mouth or pretending to cough or yawn to cover up stuttering

  • Not speaking, even when you want or need to

  • Not using certain words that seem to cause stuttering

  • Pretending to forget what you wanted to say

  • Rearranging words in sentences

  • Using "filler" sounds between words to make the rate of speech sound more normal

Children with fluency disorders also may develop beliefs that can hinder them later on. For example, a child who stutters may decide that speaking is difficult by nature. Fear, anxiety, anger, and shame involving speaking are also common.

What causes a fluency disorder?

The exact causes of fluency disorders are not known. It may be genetic and run in families. It can happen at the same time as another speech disorder. The signs of a fluency disorder can be made worse by emotions such as stress or anxiety.

Diagnosing and treating fluency disorders

Experts feel it is important to assess and address speech disorders early. Children who struggle with speech can find school and community activities challenging or painful because they are not able to communicate their thoughts. They might even have problems developing friendships.

A fluency disorder can be diagnosed by a speech-language pathologist (SLP). An SLP will ask about your medical history and listen to you speak. The SLP may do an oral-mechanism exam and testing of speech-language skills.

Once you are diagnosed, an SLP can use exercises and strategies to help you speak more fluently. A fluency disorder is not something that can be cured. But an SLP uses different kinds of methods to help you manage speech day-to-day. These methods can reduce the number of disfluencies in your daily speaking.

An SLP can help you lower your own stress around moments of fluency problems. The SLP will work on changing your negative feelings, thoughts, and beliefs about your speech. He or she will help you reduce the use of accessory behaviors. You will learn strategies such as speaking in shorter sentences, and control your breathing and the rate of your speech. An SLP will often talk with family, caregivers, and teachers about the disorder and how to help.

If someone you know has a fluency disorder:

  • Use available resources. Public schools are required to assess children with communication disorders and, if the child meets certain criteria, provide treatment services. If you have a child as young as age 3 with communication problems, contact your local public school’s office and talk to the principal about assessment options.

  • Be patient and supportive. As frustrating as it is for you to try to understand someone with a fluency disorder, it can be much more frustrating for that person who has it. Be as patient as you can while the person works on his or her speech.

  • Be kind. Making fun of a person with a fluency disorder is a form of bullying. It is destructive and may take away the person’s desire to communicate.

  • Join a support group. Many fluency disorders, such as stuttering, have support groups. Spending time with other families coping with fluency disorders can be helpful.