Fluency refers to the flow of speech. Speech is evaluated in terms of its continuity, rhythm, rate, and effort. Two fluency disorders are stuttering and cluttering.
Stuttering (also referred to as Stammering)
Stuttering is a communication disorder that typically begins in the preschool years between the ages of 2 and 6 when language reaches a level of sophistication that allows children to engage in more meaningful communication. It is recognized by speech behaviours such as multiple repetition of words (he-he-he-he-he) or part of words (bu-bu-bu-because or o-o-only), speech sound prolongation (“lllllook” or “whaaaat’), and blocks (getting stuck). Secondary behaviours involving the body, such as eye blinks, head thrusts, or arm movement, can accompany stuttering. While there are commonalities, stuttering can look and sound different across individuals.
Persistent stuttering left untreated continues to develop as children grow up and become adults. Before long, social anxiety begins to take hold and gives rise to nervousness and fear whenever the need to speak or the possibility of stuttering arises. Speaking gradually becomes an embarrassing, humiliating experience to be avoided.
No two people who stutter are exactly alike or experience stuttering in exactly the same way. For some, stuttering is easier to deal with than it is for others. In general, most people would rather not stutter. The journey to improvement and recovery will also be different for each affected person.
For most of us the word “cluttered” brings to mind a desk, closet or purse brimful of items that need to be sorted and organized in a manageable way. This descriptive word has also been used to represent a style of speaking that comes across as cluttered. Features of cluttering include: random bursts of rapid speech that is difficult to understand, unusual speech rhythm, decreasing loudness and clarity, and discourse that is disorganized and marked by inappropriate pauses, unfinished words and sentences, revisions, and interjections or pause fillers such as “uh, um, well, like, you know. Although cluttering and stuttering often occur together, it is important to identify them separately so treatment can be planned accordingly. Persons who clutter are often unaware that their speech is difficult for others to understand even though they are regularly asked to repeat themselves or sense that listeners don’t understand them, or don’t seem to enjoy talking with them. Cluttering has been identified in individuals with Down syndrome, Tourette syndrome, autism, attention deficit disorders and learning disabilities.
Who does it affect?
Stuttering is found in children as young as 2 years old, in school-aged children, in adolescents and adults of all ages. It affects 1% of adults and approximately 4% of the total population. It is more common in males than females. There is little information available on cluttering which often goes unidentified.
What is the impact?
Stuttering can have serious consequences. As the disorder progresses, negative thoughts and emotions become part of the stuttering experience, leading the person to “hold back” and affecting personal engagement in school, at work, in the community, with family and friends. Stuttering erodes self-confidence and affects self-esteem. Stuttering and cluttering can bring about feelings of frustration, isolation, and exclusion.
Can anything be done?
Absolutely. Stuttering is more easily treated in young children – early assessment and intervention is highly recommended. The disorder increases in complexity as children grow into teenagers and adults and treatment is adjusted accordingly. While there is no known cure, improvement is possible at any age.
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