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.”)



According to the American Speech-Hearing Language Association (ASHA), stuttering usually starts between two and six years old. As children learn speech and language, there is a period of normal dysfluency, but it will typically last less than six months. Stuttering behaviors that last longer than this may need treatment.

There is no one cause of stuttering. 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 there 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 as well


As with any communication impairment, evaluating whether your child exhibits 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 from the parents, teachers, caregivers, extended family members, and clinical observations/assessments are integral in providing a clinical diagnosis as to whether your child is stuttering. 


There are different ways to help with stuttering. A treatment team usually includes you, your child, other family members, and your child’s teacher. Treatment will depend on any or all of the following:

  • Your child’s speech and language skills
  • Frequency of stuttering behaviors
  • Reactions of stuttering from others and how they react themselves
  • The impact of stuttering in their daily lives

For children who are 2–6 years old, treatment may focus on either of these two things:

  • Direct strategies: teaching strategies to modify or shape their stuttering
  • Indirect strategies: modifying the environment to decrease the demands of stuttering such as:
    • Allowing your child to convey their message with no interruptions
    • Not being called on in class to answer questions
    • Modeling smooth speech to your child

The community that your child is a part of will also play an integral role in reducing the adverse effects of a fluency disorder such as stuttering.

  • How family members respond when your child stutters
  • Modeling good speaking habits to help reduce stress and improve your child’s fluency
  • What to do to improve how your child feels when speaking and when they stutter

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