Fluency

When children are developing language it is common during the preschool period for children to develop a dysfluency (repetition or prolongation of speech sounds), which will often disappear after approximately 6 months.  In this time, children are learning and expanding their language so much, but their "articulators" (muscles/parts used in speech) or their word/sentence formulation strategies can't quite keep up.  In times of excitement, or in trying to formulate long or complex sentences, they will often stutter.  Dysfluencies can be divided into typical and non-typical types.  A "typical" dysfluency for this age group would be whole word repetition (i.e. "my my my dog is cute").  Another "typical" type is phrase repetition (i.e. "My dog my dog my dog is cute").  Yet another common dysfluency is a "revision".  This involves changing the course of the utterance after it has started (i.e. "my cat-pause-dog is cute").  A revision can occur within a word, complete or incomplete phrase.  An interjection is when a "filler" word is added such as "um", and this is common too.

Dysfluencies can also be rated as non-typical.  These are types which can raise a red flag that the child is at risk for developing a dysfluency disorder, or if the child has a dysfluency disorder (especially if the child is older in age, or the duration of dysfluency has been more than six months).  Non-typical dysfluencies include:  part word repetition (i.e. "ga ga good"), prolongation's (i.e. "wwwwwe ate ice cream" or "w(pause)e ate ice cream"), and struggle behaviors.  Struggle behaviors can include:  looking away during the dysfluency, moving all or a part of the body, facial grimace, or tension in the body (these are examples, not an exhaustive list!).

As always, follow your parental instincts!  if you suspect a fluency disorder in your child, it is wise to seek professional assistance.  Discussing it with your pediatrician and/or a knowledgeable professional may be the first course of action.  A speech/language pathologist should be able to evaluate or refer your child to another specialist for evaluation.

Having "said" that, there are strategies which can be used with young (preschool aged) children demonstrating the "typical" type of dysfluencies.  With young preschool aged children demonstrating a period of normal dysfluency with a duration of less than six months, it has been widely accepted to use "indirect" strategies to facilitate fluency.  THIS MEANS DO NOT TELL YOUR CHILD DIRECTLY TO "CHANGE", OR THAT THEIR SPEECH IS IN SOME WAY WRONG OR BAD!  Even with good intentions, telling your child to "slow down, or take a breath" can be damaging to a child's self esteem, and is generally not helpful.  Some have even felt this can have a "reverse" effect by taking a normal dysfluency and making it non-typical.  (In fact, there are many theories as to how fluency disorders develop, but that is another website).

Some other general fluency guidelines are as follows:

1. Model a slow rate of speech and appropriate loudness. (Think "Mr. Rogers"). He used a slow rate of speech with lots of pauses, and good inflection.
2. Add pauses frequently during longer utterances to allow time to process the information.
3. Be a relaxed and attentive listener. Wait until your child has completed his/her thought before responding.
4. Reduce environmental demands such as time constraints, competition among siblings for time to talk, interruptions, too much excitement.
5. Instead of giving advice, model the correct way of speaking. (i.e. child says "Lets lets lets go to the pool", parents responds "yes, lets go to the pool" in a very slow and soft voice).
6. Reduce negative influences such as being corrected, contradicted, or asking too many direct questions. (i.e. "Tell me what you did today, did you go to the zoo with daddy, and what did you see?") Giving verbal demands puts extra pressure on the child (i.e. "Sing the ABC's for Aunt Susan").
7. Try to use more commenting or indirect questioning to elicit information. Instead of "What did you see at the zoo", say "I wonder what animals live at the zoo".


Again, if the duration of dysfluency is longer than six months, the types are "non-typical", or you just suspect a dysfluency disorder, contact a physician or other qualified professional. If your child has a known dysfluency disorder, other strategies of intervention may be more appropriate. The above guidelines are for young children with normal dysfluency.

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