What is Fluency Disorder?

With multiple contributing factors, fluency disorder is a speech disorder that is characterised by sound prolongations, repetitions, and/or blockage of sounds, syllables, words, or phrases which disrupt the natural flow of speech.

Six Things to Know About Disorders of Fluency

1. Stuttering is common in periods of language development between 2-5 years of age.

• Disfluent speech is experienced by everyone on occasion and is considered normal. The chart below outlines details about normal disfluencies:

2. Less common disfluencies that may indicate referral to a speech language pathologist include:

• Sound prolongations (e.g., “mmmmmommy, it’s mmmmy ball”)
• Audible blocks and breaks in inappropriate parts of a word/sentence (e.g., “I wa–ant it”)
• Words produced with excessive physical tension or struggle in the face, neck, torso, arms, or hands
• Secondary physical behaviors, such as eye blinking or jaw tightening
• Normal disfluencies at an increased frequency and persistence (e.g., a sound repetition 8 times before a word rather than 3-4 times)

3. The number of boys who stutter increase by 3-4x more than girls as children reach about 6 years of age 

(Craig, Hancock, Tran, Craig, & Peters, 2002).

• 80-90% percent of children with diagnosable childhood-onset fluency disorder generally show persistent stuttering lasting longer than 6 months by age 6 (Maguire, Yeh, & Ito, 2012).

4. Contrary to popular belief, emotional problems and parenting style does not cause stuttering.

• However, coping with disfluencies may cause negative emotional reactions to stuttering (Silverman & Bernstein Ratner, 2002).
• Stuttering can cause anxiety about activities and situations that involve speaking
• Children may avoid speaking in social situations (e.g., raising their hand in class, making friends, answering the telephone) and/or avoid certain words they may stutter on.

5. Recent findings have shown genetic and neurological factors contribute to fluency disorder. 

• Studies have found three likely causative gene mutations linked to stuttering (Drayna & Kang, 2011).
• Children who stutter (ages 3 to 9 years) have shown physical differences in the brain that affect speech fluency (Chang & Zhu, 2013).

6. Treatment for fluency disorder is highly individualised and requires a thorough assessment that includes speech fluency, language factors, emotional/attitudinal components, and the impact that stuttering has on an individual’s life. 

• When it comes to speech therapy for kids, therapy approaches vary based on the child’s age and understanding of stuttering. For young children, treatment may be indirectly targeted through family modifications of their own speech rate and changes in the family environment.
• Direct treatment approaches may incorporate a number of different strategies, including:
  • Fluency Shaping: Techniques aimed at changing the timing and tension of speech production
  • Stuttering Modification: Aims to make stuttering more manageable when it occurs by employing strategies that reduce physical tension and struggle on stuttered words
  • Reducing Negative Reactions: Approaches and strategies for reducing negative emotions and reactions associated with stuttering
  • Activity and Life Participation: Aims improve an individual’s participation in speaking situations of daily life overall, typically through generalisation of approaches mentioned above.

Additional Resources

Feel free to stick around — find some fun & impactful speech therapy activities and more resources in the NAPA speech therapy blog!

About NAPA Centre

At NAPA Centre, we take an individualised approach to therapy because we understand that each child is unique with very specific needs. For this reason, no two therapeutic programs are alike. In addition to hosting intensive therapy sessions worldwide, we also provide traditional speech therapy for children at our multiple clinic locations. If your child needs our services, we will work closely with you to select the best therapies for them, creating a customised program specific to your child’s needs and your family’s goals. Let your child’s journey begin today by contacting us to learn more.