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Developmental Fluency VS Fluency Disorder

Written by Keely Hutton, M.S.Ed., Reg. CASLPO, Bright Spot Speech-Language Pathologist


If you read our last blog post, you learned a bit about what stuttering is and what it is like to be a person who stutters (if you haven’t read it, you can check it out here). But fluency is a big topic, so let’s break it down further. How do we know if we should be concerned about a child’s “stutter”, or if their disfluencies warrant a visit to a speech-language pathologist?



Developmental Disfluencies

If you are a parent, you’re probably familiar with the disfluencies that SLPs refer to as developmental. These disfluencies are considered a normal part of development and tend to occur in young children because their brains are still working on developing and organizing language. Developmental disfluencies include:

  • Whole or part word repetitions (e.g. my my my dog)

  • Phrase repetitions (e.g. I want I want I want to go to grandma’s)

  • Revisions (e.g. we went to the- daddy picked me up at the park)

  • Filler words (e.g. uh, um)

  • Fewer than 10 disfluencies per 100 words (Guitar, 2014)

In addition to these disfluencies, young children who are disfluent due to ongoing language development do not typically have any awareness of their disfluency. As a result, they are not typically frustrated by their disluencies, and their disfluencies are not usually accompanied by the tension or struggle behaviours we see in older children or adults who stutter.

Research tells us that 70-80% of children who stutter will spontaneously recover (Neumann et al., 2019)… and we do not know why this happens. Often, if a child is exhibiting only the developmental disfluencies listed above, there is less cause for concern, as it is more likely that they will spontaneously recover as their language develops.

Persistent Stuttering

If your child is producing atypical disfluencies (i.e. sound repetitions, blocks, and sound prolongations), producing disfluencies more frequently than 10 per 100 words, or showing frustration when they are disfluent, it might be wise to visit a SLP for an initial assessment. A SLP will be able to differentiate between typical developmental disfluencies and persistent stuttering, and provide recommendations based on what they see.

Some children around the preschool age might be “borderline”, meaning they have some of the indicators of persistent stuttering mixed with some typical disfluencies. In that case, a SLP will consider additional factors, including the gender of the child (girls are more likely to recover spontaneously than boys [Bloodstein, 1995]) and genetic predisposition (a family history of stuttering will decrease the likelihood of spontaneous recovery), and discuss treatment options with the family.

Stuttering Myths…

1. People who stutter are shy and stutter because they are nervous

TRUTH: People who stutter might become more disfluent when they are nervous, or might be nervous because of their disfluencies. But nervousness and shyness do not cause someone to stutter.


2. People who stutter are less intelligent

TRUTH: Stuttering has NO IMPACT on intelligence. People who stutter are no different than people who do not stutter, and there are many accomplished, well-known people who stutter.

3. Stuttering is a habit that people can break

TRUTH: We know that motor speech, language, and genetic factors likely contribute to a person’s stutter; stuttering is not just a bad habit.


4. Stuttering can be “cured”

TRUTH: There is no “cure” for stuttering. Goals of therapy for stuttering may including learning to speak in a manner that encourages relaxed and fluent speech.


5. Stuttering is caused by bad parenting

TRUTH: Someone who stutters was predisposed to do so. Stuttering was not caused by a parent. It is helpful to reduce demands in the child’s environment, and parents can facilitate this.

Strategies at home…

In all cases, if your child produces any disfluencies ⚠️ don’t panic! ⚠️ Here are a few strategies to use at home with your child to encourage fluency:

  1. Do your best not to react if your child produces a disfluency; maintain eye contact, and show them that you are listening by nodding and smiling

  2. Be a fluent speech model - slow down your rate when speaking with your child, and use “gentle speech” with deliberate pauses

  3. Reduce speaking demands - avoid questioning your child during conversation, and give them lots of time to speak. Do your best not to interrupt or fill in their words.

  4. Use Speech Time - find a specific time during the day to give your child your full attention, and use the strategies listed above while communicating with them.

Whether or not your child stutters, they can still be effective communicators! We want to foster positive speaking experiences, so that they enjoy speaking and communicating, regardless of whether or not they stutter.

References:

Bloodstein, O., & Ratner, N. B. (2007). A handbook on stuttering (6th edition). Cengage Learning.


Guitar, B. (2014). Stuttering: An integrated approach to its nature and treatment (4th edition). Lippincott Williams & Wilkins: Baltimore, Maryland.


Neumann, K., et al. (2019). "Spontaneous" late recovery from stuttering: Dimensions of reported techniques and causal attributions. Journal of Communication Disorders, 81. https://doi.org/10.1016/j.jcomdis.2019.105915

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