Fluency Disorders

A fluency disorder affects the natural flow, rhythm, and timing of speech. People with fluency disorders may know exactly what they want to say but have difficulty producing speech smoothly and easily. Fluency disorders can impact communication, participation in daily activities, confidence, and social interactions.

What Causes Fluency Disorders?

There is no single cause of a fluency disorder. Research suggests that fluency disorders result from a combination of factors, including:

Genetics

Stuttering often runs in families.
Children with a family history of stuttering may have an increased likelihood of developing a fluency disorder.

Developmental Factors

Many children experience periods of disfluency while language skills are rapidly developing.
Most children outgrow these disfluencies, but some continue to stutter.

Neurological Factors

Differences in how the brain plans and coordinates speech movements may contribute to stuttering.
Research suggests that speech and language processing networks function differently in people who stutter.

Environmental Influences

Environmental factors do not cause stuttering but may affect its severity.
Stress, fatigue, excitement, and communication demands can increase disfluencies.

Primary Behaviors

Primary behaviors are the actual moments of stuttering that interrupt speech flow.

Repetitions

Repeating sounds, syllables, or words:

"B-b-b-ball"
"Can-can-can I go?"

Prolongations

Stretching out a sound:

"Ssssssometimes"

Blocks

A temporary inability to produce a sound despite trying:

The mouth is positioned to speak, but no sound comes out.

Understanding Stuttering...

Secondary Behaviors

Secondary behaviors develop as reactions to stuttering and are attempts to push through or avoid a stutter.

Avoidance Behaviors

Avoidance behaviors occur when a person attempts to prevent a stutter before it happens.

Escape Behaviors

Escape behaviors occur during a moment of stuttering and are attempts to get out of the stutter.

Secondary Behavior Examples include:

Eye blinking
Facial tension
Head movements
Foot tapping
Jaw movements
Looking away during speech
Increased physical tension

These behaviors are not the cause of stuttering but often develop over time as a person tries to manage moments of disfluency.

Avoidance Behavior Examples include:

Avoiding certain words
Changing words mid-sentence
Avoiding speaking situations
Letting others speak for them
Limiting participation in class or conversations
Avoiding phone calls or introductions

Avoidance behaviors can sometimes have a greater impact on communication than the stuttering itself.

Escape Behavior Examples include:

Eye blinking during a block
Head nodding
Adding extra sounds ("uh," "um")
Physical movements to force speech out
Rapid speech bursts after a block

What is Cluttering?

Cluttering is a fluency disorder characterized by a rapid and/or irregular speaking rate that can make speech difficult to understand.

Unlike stuttering, individuals who clutter may not always be aware that their speech is difficult for listeners to follow.

Common Characteristics of Cluttering

Speaking too quickly
Irregular speech rate
Frequent revisions or restarts
Omitting sounds or syllables
Disorganized language formulation
Reduced speech clarity
Difficulty organizing thoughts while speaking

Example a child may say: "IwenttothestoreandthenIgotandthenwe..." instead of speaking with natural pauses and organization.

Strategies for Home

Model Slow, Relaxed Speech

Use a calm speaking rate.
Pause naturally between phrases.
Focus on communication rather than speed.

Give Your Child Time to Talk

Allow them to finish their thoughts.
Avoid interrupting or finishing sentences.

Listen Patiently

Maintain eye contact.
Show interest in the message rather than how it is said.

Reduce Communication Pressure

Ask fewer rapid-fire questions.
Create opportunities for relaxed conversation.

Encourage Confidence

Celebrate ideas and participation.
Reinforce strengths beyond speech.
Help children learn that everyone communicates differently.
Encourage them to ask for extra time when needed.

Establish Daily Connection Time

Spend a few minutes each day in one-on-one conversation.
Follow your child's interests and let them lead the discussion.

When Should Families Seek Help?

Consider consulting a speech-language pathologist if:

Stuttering persists longer than 6–12 months.
Stuttering increases in frequency or severity.
Physical tension or struggle behaviors are present.
The child expresses frustration about speaking.
Communication difficulties affect participation at school, home, or in social situations.

Early intervention can be highly effective!!!

Resources for Parents

ASHA ResourcesAmerican Speech-Language Hearing Association (ASHA)

ASHA: Stuttering, Cluttering, and Fluency Disorders

ASHA Practice Portal – Fluency Disorders

ASHA Fluency Disorders Practice Portal

ASHA: Cluttering

ASHA Cluttering Information

YouTube Resources

Stuttering Foundation

The Stuttering Foundation YouTube Channel

Friends: The National Association of Young People Who Stutter

Friends Who Stutter YouTube Channel

Practical Strategies for Parents