RCSLT overview on dysfluency

Dysfluent speech is the disruption of the forward flow and timing of speech by repetition of sounds, syllables or words, sound prolongation and/or blocking on sounds, silent or audible, (Bloodstein & Bernstein Ratner 2008).  These differ from breaks in fluency typically experienced, such as hesitations, pauses to process ideation or production, as they may involve significant tension and struggle. 

Disruptions may be accompanied by secondary behaviours (facial grimaces, head/body movements), physical tension, negative reactions, avoidance of sounds, words or situations or decreased overall communication (Coleman, 2013). Disorders of fluency comprise developmental stammering in children, young adults and adults; acquired/late onset stammering; atypical fluency disorders; and cluttering.

Terminology

Dysfluency, stammering and stuttering are interchangeable terms. Typically in a professional context, person-first terminology is used, e.g. child who stammers. However, some clients prefer to refer to themselves as ‘stammerers’ and there are recent initiatives to reject person-first language. If in doubt, therapists are advised to seek the opinion and preferences of each individual client.

Key points:

  • Speech and language therapists (SLTs) play a unique role in identification and assessment of children and adults with fluency disorders which affect their communication. Their unique skills allow the diagnose the specific fluency disorder, the associated consequences as well as retained communication abilities.

  • Difficulties with communication are a predominant feature in reducing access to education, have a significant impact on the quality of life including employment, peer relationships and social integration. Speech and language therapists assess the impact of the disorder on the individual.

  • Improved communication has an impact on literacy, social skills, peer relationships, employment opportunities, self-confidence and behaviour.

  • Early referral is advocated and associated with better outcomes in young children. However, fluency disorders may not become apparent until later in life, and access to services should be available at any point. 

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