Stuttering (Fluency Disorder)
Speech fluency refers to the natural forward flow of speech. Stuttering is characterized by an abnormally high frequency and/or duration of stoppages in the forward flow of speech. Stuttering typically begins in early childhood, however onset of stuttering can occur at anytime during life.
Recent research indicates that stuttering is likely an inherited neurophysiologic disorder. In other words, stuttering likely has a genetic component and specific genes make some individual's more susceptible to developing stuttering. People who stutter are not different from their peers in terms of personality or mental function.
Most children from age two through age six demonstrate occasional speech disfluency, usually characterized by hesitations, repetition of whole words, and repetition of phrases. Typically the signs of stuttering include:
- Repetitions of syllables in a word (primarily the first syllable - i.e., ba-ba-banana)
- Prolongation of a sound or syllable (drawing it out)
- Blocking (a pause of voice and speech or airflow while attempting to speak)
- Variation in pitch or loudness of the voice
- Struggle behaviors during speech (eye blinking, pursing of lips, head ducking, fixated facial postures)
- Abnormal breathing during speech
- Tremors (rapid movements) of the lips and jaw during speech or attempts to speak
- Avoidance or refusal to speak because of fear of stuttering
A comprehensive fluency evaluation includes obtaining a thorough history, eliciting oral speech during various activities to sample and analyze connected speech, testing articulation and language, and performing an oral-motor assessment (as needed). The patient may be videotaped for a more in-depth analysis of the stuttering behaviors.
Specific treatment depends on the severity of the disorder. Some patients with mild symptoms may only require a utilization of strategies in the home environment, whereas patients with advanced symptoms may require a more intensive clinical program designed to enhance fluency and bolster the patient's emotional well being. Research has shown that speech therapy can eliminate or reduce stuttering symptoms, and that a lack of intervention may worsen symptoms. Stuttering that persists can negatively affect one's social, academic and emotional status.