Fluency Disorders



Fluency of speech is the ability to deliver spoken language in a smooth and effortless manner that conveys the message without any interruptions that would draw adverse attention to the speaker. There are two types of fluency disorders: stuttering and cluttering.


Stuttering of speech is the most common fluency disorder. It’s an interruption in the flow of speaking and affects the rate and rhythm in how fluent and smooth speech is delivered. Stuttering behaviors can include the following:

  • Sounds (e.g., “I want s-s-soup”)
  • Syllables (e.g., “Ba-ba-baby”)
  • Words (e.g., “He – He – He took it!”)
  • Phrases (e.g., “Can I – Can I – Can I Have”)
  • Sound prolongation (e.g., “I want ssssssome”)
  • Blocks (e.g., “I’m [pause] fine, thank you!”)

These disfluencies may be accompanied by secondary behaviors:

  • Physical tension (e.g., lips quivering, jaw clenching, eyes blinking)
  • Avoidance of certain sounds and words
  • Avoidance of speaking situations

Cluttering of speech is another fluency disorder that is characterized by rapid speech rates that result in an irregular and arrhythmical speech rate. This ultimately leads to breakdowns in speech clarity and/or fluency. Cluttering can be characterized by:

  • Deletion and/or collapsing of syllables (e.g., “I wanwatevision”) 
  • Omission of word endings (e.g., “Turn the televisoff”). 

The breakdowns in fluency are often characterized by more typical disfluencies (e.g., revisions, interjections) and/or pauses in places in sentences not expected grammatically (e.g., “I will go to the/store and buy apples.”)


Adults who continue to stutter into adulthood often have had experience receiving speech therapy as a child.

There is no one cause of stuttering, but possible causes include the following:

  • Familial: Many people who stutter have a family member who also stutters.
  • Brain differences: Some research suggests that people who stutter may have small differences in the way the brain works when speaking, which results in dysfluent speaking behaviors. 

What we do know is that these are some risk factors for stuttering:

  • Gender:  When compared to girls, boys are more likely to stutter.
  • Family recovery patterns: Children with family members who stopped stuttering are more likely to stop too.


As with any communication impairment, evaluating whether you exhibit any form of a fluency disorder requires a comprehensive evaluation from a qualified speech-language pathologist who is familiar with fluency disorders. Because stuttering can be situational and dependent on many factors, gathering information during clinical observations and assessments are integral in providing a clinical diagnosis. 



For adults, treatment may focus on the following:

  • Recognizing speaking situations that are stressful to the client
  • Identifying the severity of how stuttering is impacting their quality of life
  • Developing self-awareness of physical tension to reduce secondary stuttering behaviors that are drawing adverse attention while speaking
  • Developing confidence and self-esteem in the client’s ability to convey their thoughts and ideas
  • Teaching how to use stuttering modification and fluency shaping strategies to minimize stuttering events  

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