Fluency and Stuttering Christy H. Collins, M.Ed., CCC-SLP

Stuttering Defined Stuttering is a speech fluency disorder characterized by disruptions in the production of speech sounds that impedes communication when the speaker produces too many of them. The disruptions of speech are also referred to as “dysfluencies”. Dysfluencies occur as repeated words, phrases, or preceded by “um” or “uh”. Onset begins during childhood and may last throughout life. A technical definition of stuttering: The inability to move forward in the forward flow of speech (Moore, 1987). Stuttering may involve getting stuck, hesitating, repeating, or tensing in some way while speaking.

Levels of Speech Fluency Stuttering Dysfluent speech: Blocks, hesitations Discoordination of jaw, lips, and tongue Poor rhythm, timing, stress, and intonation Poor breath support Secondary characteristics: Facial grimaces, inappropriate body movements Using fillers, starters, and avoidance of certain sounds Lack of eye contact

Controlled Speech Levels of Speech Fluency  Full breath  Breath and speech together  Talking in breath groups  Stretchy onset/loose contact  Regulated rate  Continuous vocal phonation  Pause often  Minimizing consonants  Maximizing vowels  Reduced loudness and effort  Block corrections  Eye contact  Body still/Hands in lap  Correct proxemics

Levels of Speech Fluency Fluent Speech Regular speech Automatic smooth speech with minimal disruptions Absence of timing, stress, intonation, or rhythm difficulties in speech Coordination of language and motor speech

Risk Factors  A family history of stuttering  Stuttering that has continued for 6 months or longer  Presence of other speech or language disorders  Strong fears or concerns about stuttering on the part of the child or the family

Stuttering Diagnosed Case history Interview Assess the number and types of speech dysfluencies produced in various situations Assess the reaction and coping methods with dysfluencies Gather information about factors that make stuttering worse A variety of other assessments (e.g., speech rate, language skills)

Stuttering Diagnosed Perceptions of Stuttering Inventory developed by Dr. Gerald Woolf. British Journal of Disorders of Communication, 1967, 2, Fluency Assessment Checklist. David A. Daly. LinguiSystems, Inc., Stuttering Prediction Instrument, Ages 3-8 (SPI). Glyndon D. Riley. Stuttering Severity Instrument for children and Adults, Third Edition (SSI-3). Glyndon D. Riley.

Tips for SLPs 1.Maximize the involvement of parents and teachers through education, modeling and direct practice. 2.Collect baseline stuttering data. It may be necessary for the parent or teacher to provide taped speech samples. 3.Require the student to exaggerate and use target speech both inside and outside the therapy setting. 4.The stutterer must practice any newly learned speech pattern conscientiously, with deliberation and awareness so that it becomes automatic. 5.Validate the aspects of the student’s “normal” speech and language such as, grammar, articulation, voice quality, “manners”, etc. so the student’s perception of his/her communication pattern is not “stuttering skewed”. Fluency is only one parameter of the speaking pattern.

Tips for SLPs 6.Set up reinforcement and rewards schedules 7.Be patient with the student who stutters. Changing fluency patterns is hard work. 8.Strive to maintain a “fluency friendly” environment. Reduce excessive noise and overstimulation. 9.Provide models of rhythmic speech even if the student is speaking well. 10.Know that you are a significant mentor for the student who stutters. Often, just knowing that there is a place to go to talk freely is gratifying for the student. The majority of some sessions may involve listening and supporting the student!

Stuttering Resources American Speech-Language Hearing Association National Stuttering Association Stuttering Home Page Chat Room University of Wisconsin Family Village Stuttering Page Stuttering Home Page Stuttering Foundation of America International Stuttering Association

References American Speech-Language Hearing Association (ASHA). Stuttering. Characteristics, causes, and treatment of stuttering. Includes information on normal dysfluencies and links to further information on stuttering KB - ASHA Web Site 27 Jun 07 Moore, S. (1987). Effects of Echoic, Short-Term and Long-Term Memory on Validity and Reliability of Self-Identification of Authentic and Simulated Stuttering. Unpublished doctoral dissertation, University of Southern California, Los Angeles. Farley, Alice Anne G., M.Ed., CCC-SLP, BRS-FD (2006). Color Me Fluent Fluency Program. Super Duper Publications.