All About Fluency!

What goes into coordinating fluent speech?

• Respiration- the process of using breath to create speech sounds.
• Phonation- the process by which the vocal folds produce certain sounds
• Articulation- the adjustments and movements of speech organs involved in pronouncing particular sound, taken as a whole.
• Resonation– The buzz created by the vocal folds resonates (vibrates) the air column and this in turn causes the structures above and around the larynx to vibrate/resonate as well.

If only one is “off,” there will be a breakdown in fluency.

What is Disfluency?

• Various surface interruptions that occur in on-going speech, whole word/part word repetitions, irregular rhythm, sound prolongation, cessation of speech
• “Normal nonfluencies,” occur is everyone’s speech- word finding, sentence formulation, distractions, interjections (like, um, you know)

Dimensions of normal speech fluency

• rate (appropriate timing)
• continuity (smooth connections)
• tension effort (appropriate force)

The Major Components of Stuttering:

Core Behavior-what a Person Who Stutters does WHEN they stutter

1. Repetition- When a sound, syllable, or word is repeated several times: b b b-aby or ba ba ba baby
2. Prolongation- when a sound is held for a long time or just keeps coming: baaaaaaby
3. Complete block- when the sound and airflow are completely stopped: b—–aby

Secondary Behavior– what a Person Who Stutters does BECAUSE they stutter

1. eye blinking
2. foot stomping
3. head nodding
4. face movements
5. avoid talking
6. add words
7. change what was going to be said

Feelings and attitudes about stuttering: (anxiety, nervousness, fear)

Two Approaches For Treatment

Fluency Shaping: speak more fluently, which includes factors such as: speak with a slower rate, easy onsets, airflow management, intonation and phrasing management, continuous forward moving speech

Stuttering Modification: helps the person monitor the stuttered speech more fluently (stutter more fluently)- the Moment of stuttering is changed. Some techniques include:

• Identification: understand core/avoidance behaviors understands feelings associated with stuttering learn about stuttering
• Desensitization: address emotions toward stuttering, relax, teach person who stutters to tolerate moment of stuttering and reduce anxiety
• Modification: Cancellation-finish stutter, make adjustments, and re-utter word
• Pull-outs: examine, plan, change, finish word in an easier way
• Preparatory set: before saying the word plan change, and produce the word more easily

Treatment Goals

Acceptable Fluency

• Noticeable stuttering of less severity.
• Comfort in role of communicator, despite stuttering.
• Speaker makes adjustments to maintain an acceptable level of stuttering.

Controlled Fluency

• Must monitor and adjust speech to maintain natural or normal sounding speech.
• Speaker must pay attention to how he is speaking.

Spontaneous Fluency

• Characteristic of the normal speaker.
• Effortless.
• Speaker more concerned with what is said than how it is said.

Thanks for reading! Contact one of our seven facilities if you suspect that you or a loved one may have a fluency concern. Happy Fall!

Amanda Weiner, MS CF-SLP TSSLD