Stuttering is a speech disorder marked by disruptions in the normal flow of speech. These disruptions, referred to as disfluencies, often include the following:
- Sound repetitions (“b-b-b-boy”)
- Prolongation of speech sounds, syllables or words (“Mmmmay I?”)
- Use of fillers (“um”, “like”)
- Laryngeal blocks (difficulty initiating sound)
Stuttering events may be accompanied by secondary physical behaviors including eye blinks, nasal flaring, tremors of the lips and/or jaw and tension in the head, neck and shoulders. A person with stuttering might also try to hide disfluencies by avoiding words, changing words in sentences (circumlocution), pretending to “forget” what they wanted to say, avoiding situations or choosing not to speak. Stuttering generally begins in childhood (between 2 ½ and 4 years of age), and although studies indicate that genetics play a role in the disorder, its exact cause remains unknown. While pre-schoolers often demonstrate little awareness of their disfluencies, older children become increasingly aware of their stuttering and people’s reactions to it. For both children and adults, speech fluency may vary greatly from day to day or week to week. Fluency might also be better or worse during specific activities or in different environments.
A stuttering evaluation is performed by a speech-language pathologist. It involves calculating the number and types of disfluencies a person has in a variety of situations (e.g. spontaneous speech sample, oral reading), assessment of oral-motor and language skills (if necessary) and determining the client’s attitude towards stuttering and its impact on his or her daily life. This information is then analyzed to determine the presence or absence of a fluency disorder and its severity.
Treatment for pre-schoolers is different than treatment for older children and adults. Approximately 75% of pre-schoolers stop stuttering without direct treatment several months following onset. Therefore, SLPs often recommend the family monitor the child’s speech over a period of time with occasional monitoring by the speech pathologist. If treatment is recommended, however, it may include:
- Training parents to provide their children with feedback about their speech fluency
- Having parents and the speech-language pathologist model smooth speech
Treatment for older children and adults focuses on changing speech behaviors and emotions/attitudes towards speaking and communication. Goals might include:
- Decreasing frequency of stuttering
- Reducing tension during stuttering events
- Identifying and decreasing word avoidance and/or avoidance of “triggering” situations
- Examining and becoming aware of thoughts and feelings about stuttering
- Maximizing effective communication
The amount of stuttering therapy and length of treatment depends the severity of the disorder, the client’s personal goals, and his or her ability to participate in the program. These factors are all discussed at the time of the evaluation in order to determine the best course of action.