Fluency and Stuttering: A Brief Overview

First, what is stuttering? 

Stuttering is a multi-dimensional fluency disorder that disrupts the natural flow of speech. The exact causes of stuttering are unknown and the range of severity is wide, with characteristics varying from person to person. Stuttering can essentially be broken down into three major components: core behaviors, secondary behaviors, and negative feelings/attitudes.  

Core Behaviors

The core behaviors of stuttering consist of the observable, uncontrollable disfluencies that a person makes when speaking. These include repetitions, prolongations, and blocks. Repetitions involve repeating a sound, syllable, or single syllable word (ex: “I want to p-p-p-play” or “I wa-wa-want to play” or “I want-want-want to play”). Prolongations involve holding out a sound for an extended time (ex: “I waaaaaaaant to play”). Blocks are silent and occur when a sound gets “stuck” or cannot be initiated, like an unwanted, tense pause (ex: “I w-------ant to play”).  

Secondary Behaviors

Secondary behaviors may develop as children get older and become more aware of their own stuttering. They also tend to increase with severity. These behaviors can be physical, including eye blinking, tics, lip tremors, facial tremors, jerking of the head, breathing movements, or fist clenching. A person may also demonstrate avoidance or escape behaviors to prevent stuttering in fear of certain sounds, words, speaking partners, or situations.  

Negative Feelings and Attitudes

If stuttering persists into adolescence and adulthood, a person may begin to associate past negative experiences with speaking and consequently develop negative reactions toward stuttering and communication. This can include feelings of fear, shame, guilt, embarrassment, and frustration. It is just as important to address the inner, personal aspects of stuttering as it is to acknowledge the outer, surface aspects.  

Indirect Techniques for Childhood Stuttering

Usually, in early childhood, we mainly see the core behaviors or disfluencies of stuttering. Indirect therapy methods may be used by parents at home to help reduce the occurrence of stuttering. This includes asking fewer questions, using a slower rate of speech, and increasing pause time during conversation. These methods aim to reduce communicative stress during conversation, which in turn will indirectly target your child’s fluency.  

Ideas for at Home

Join your child in play with his or her favorite toys (e.g., racetrack, stuffed animals, etc.). Try not to ask too many questions or speak too quickly, and give your child plenty of time to respond to you so he or she doesn’t feel rushed to communicate. The mood should be relaxed and positive for communication. You may self-monitor your own rate of speech, pause time, and amount of questions asked by making a tally mark each time you ask a question or notice yourself speaking in a hurried manner.  

I think my child may be stuttering. What should I do?

Mild disfluencies in very young children may be normal and occur at times when they are learning language. However, if you notice your child has been exhibiting the behaviors described above for more than three months, or if the disfluencies appear to be more than just mild, you should seek the help of a speech-language pathologist right away. Treatment approaches vary depending on age, severity, impact, and emotional components that may be involved. A speech-language pathologist will be able to complete an evaluation and develop an individualized treatment program that is appropriate for your child. Treatment options are available to older children, adolescents, and adults as well! 

-Ashley Cochran, M.S. CCC-SLP

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