A fluency disorder is a frequent or pervasive disruption of the normal rhythmic flow and rate of speech characterized by repetitions and prolongations in sounds, syllables, words, and phrases, as well as blocking and word avoidance or substitutions. It can also be accompanied by excessive tension, speaking avoidance, struggle behaviors.
Stuttering is the most common type of fluency disorders. According to the American Psychological Association, stuttering affects about 1% of all children. Approximately 95% of children who stutter start to do so before the age of 4 years. Some cases usually recover spontaneously by the age of 16, but more severe cases may persist into adulthood.
Stuttering has three main components:
1. Core behaviors influencing speech production
monosyllabic whole-word repetitions (you-you-you want to play?),
part-word or sound/syllable repetitions (give me the b-b-ball),
prolongation of consonants (sssssit on the chair),
silent blocking or inability to initiate sounds.
2. Secondary behaviors
They include body movements (head nodding, leg tapping), facial grimaces (eye blinking), neck and face red spots, etc. Individuals will often use fillers (like, um, uh, you know); avoid certain sounds or words (substitute words, insert unnecessary words, use circumlocution); and alter their rate of speech.
3. Feelings and attitudes
The experience that the person who stutters builds around his stuttering and society, can be characterized by a number of psychological, emotional, social, and functional reactions, such as anxiety, embarrassment, avoidance, tension and struggle, sometimes resulting in low self-esteem. Consequently, they may deliberately choose to speak less in certain social situations, or even avoid these situations.
Research in the last years allowed us to conclude that stuttering is considered multifactorial, combining genetics (genetic predisposition), neuropsychology, environmental factors (family dynamics, lifestyle, and anxiety), and lastly emotional regulation and behavioral disinhibition that may affect the child’s ability to cope with disfluencies.