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Jenna Cancro



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Fluency (Stuttering)

Do you know why there is a picture of James Earl Jones on the link to this 
page? He was a stutterer! Just think- one of the most famous voices in 
entertainment has dealt with dysfluent speech his whole life!

Fluency is the smoothness with which sounds, syllables, words and phrases 
are joined together during spoken language.  It also refers to the lack of 
hesitations and repetitions in speaking.

Stuttering, also know as disfluent speech, is more than just disruptions in 
the smooth flow of words.  It is also made up of emotional reactions to the 
trouble experienced in speaking.  Many of these behaviors and disfluencies 
will come and go. It is also common for children 3 to 5 years of age to 
display some disfluent speech.  However, if this dysfluency persists or 
increases over a 3 month period, you may want to talk to a pediatrician or 
request an evaluation through the school district or early intervention.  

When a child is referred for a fluency evaluation, a formal test is 
administered and a conversational speech sample is taken. During this 
sample, the therapist will be listening for the types of dysfluency that are 
present. Many forms of dysfluency are quite typical. For example, filling in 
gaps with the "filler" words, "um" or "uh," are a form of dysfluency, but 
not one that would require therapy. The state law states that the child must 
demonstrate a mild rating on a formal rating scale and be dysfluent in at 
least 5% of their words that are spoken.

Stuttering is defined on the most commonly used formal index as “repetitions 
or prolongations of sounds or syllables (including silent prolongations).” 
Rephrasing, repetition of phrases and whole words, and pausing without 
tension are not considered stuttering events.

REPITITION of a sound is exactly what it sounds like. The child might 
say "wha-wha-wha- why."

In contrast, a PROLONGATION is the extension of the initial sound of a word. 
For example, "Mommy" would become "Mmmmmmmmmommy".
A SILENT prolongation is almost like a build up of air in the child's mouth 
before they are able to say the sound. There is no sound being produced 
during this time (hence the term "silent"). Using the same example, there 
would perhaps be a slight sound as though the child were about to produce 
the "M" sound and then a pause before the word Mommy was produced.

In addition, children with more sever dysfluencies often demonstrate 
physical signs as well:
1)  TREMORS:  Occasionally you may notice that the small muscles around your 
child's mouth and jaw tremble or vibrate when he seems to get stuck on 
words.  The degree of tremor may be mild or intense.  These tremors are 
associated with difficulties in moving forward with speech when his mouth is 
held in one position with no sound coming out.  The speech/language 
pathologist will want to know how often you have noticed these tremors and 
if they appear to be lasting longer now than before.  

2)  RISE IN PITCH & LOUDNESS: As your child tries to get a word out, the 
pitch and loudness of the sound that she is prolonging may rise before 
she finishes the word.  It may slide upwards or suddently jump to a higher 
level.  In both cases, she is trying to get the stuck word unstuck.

3)  STRUGGLE & TENSION: Your child may struggle to get words out or have an 
unusual amount of tension in his lips, tongue, throat or chest when 
he tries to say certain words.  At other times he may only have a 
small amount of necessary tension on the very same words.  The degree of 
struggle may vary from being hardly noticeable to very obvious in certain 
speaking situations, and may disappear entirely for long periods of time.  
In any event, struggle and tension increase the chance that he will develop 
a persistent problem.

4)  AVOIDANCE: The struggle to speak and fear the chiild experiences in 
talking may soon lead her to try a variety of avoidances.  She may 
postpone trying a word until she is sure she can say it fluently.  You 
may notice an unusual number and length of pauses.  She may talk at times, 
substituting or inserting irrelevent words or meaningless noises until she 
is ready to say a word.  She will continue to have normal delays in speaking 
as she tries to choose words or formulate sentences but these may now become 
exaggerated.  If she does not speak even when it is clear that she knows 
what she wants to say, she is probably avoiding because of growing fears.  

These physical signs were mentiones separately, but often occur together. 
Fear reactions and avoidance are frequently accompanied by struggle and 
tension; tremors are due to excess tension. These behaviors seriously 
inhibit the flow of speeech and disturb communication. They indicate that 
your child is trying to do something about the interruptions.  He may not be 
aware that he is doing these things because they are automatic responses.  
Although some of the avoidances and tension may seem helpful to her at 
first, they are harmful in the long run because they add distracting 
elements to her speech and tend to increase her fear of words.  These 
disturbing extras eventually distress both your child and his listeners.

More information is available about stuttering and stuttering behaviors for 
both students and parents from the Stuttering Foundation.
THE STUTTERING FOUNDATION is a non-profit organization that have published 
multiple booklets, pamphlets, books to assist with learning more about 
stuttering.  See links.
     THE STUTTERING FOUNDATION
     3100 Walnut Grove Road, Suite 603
     P.O. Box 11749
     Memphis, TN   38111-0749
     800-992-9392

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Last Modified: Thursday March 16 2006
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