Fluency

Fluency

What do you think when you hear, "fluency?"  Do you think reading fluency, reading words accurately and quickly?  Do you think fluent in a language, English, Spanish, French?  Or do you think the opposite of stuttering?  In the world of speech and language pathology, fluency is a disorder area. Stuttering isn't the only fluency disorder, but it is the most widely recognized.  Made famous by Porky Pig, Mel Tellis, and most recently, The King's Speech, stuttering has typically been portrayed in the media as a disability of the very foolish or quite evil (Think the movie, Primal Fear.)  The King's Speech was the first major production to paint a picture of the person who stutters as an intelligent, sensitive, and competent leader.  
Myths surround  both the etiology and treatment of stuttering.  From traumatic childhoods to emotionally abusive parents, causes center around a veil of mental instability.  In fact, stuttering has neurological underpinnings.  
 
Stuttering, cluttering, and childhood apraxia of speech are fluency disorders sometimes seen in the school setting. 
Stuttering
Stuttering is characterized by sound (b b b  but I love you,) word (Do do do you know where to turn?) or phrase repetitions. (I don't know where I put, where I put the keys,) or sound prolongations (e.g.: Sssssave me a seat.) Stuttering can also take on a series of interjections (e.g.: I'l meet you, you know, uhm, at, you know, ah, the restaurant at 12:00.)  Although everyone experiences these speech behaviors from time to time, people who stutter experience them more.  In more severe forms, people who stutter exhibit secondary symptoms such as eye blinks, facial grimaces, and head jerks.  The most notable difference between typical disfluencies and stuttering behaviors is that stuttering interferes with daily communication in some way.  
Cluttering
Cluttering is rarer than stuttering and is characterized by not only an unusually rapid speech but by pauses that are not semantically or syntactically appropriate, such as taking pauses in the middle of syllables.  Cluttering speech is not just rapid but is so abnormally rapid that it is difficult to make out words or phrases.  A hallmark of the difference between stuttering and cluttering is that stuttering people are very aware of their speech, while people who clutter do not recognize that anything is wrong with their speech.  They feel that the problem lies with the listener.
Childhood Apraxia of Speech
Childhood apraxia of speech is  classified as an articulation impairment.  Indeed sound errors are a characteristic of this impairment.  Childhood apraxia of speech, however, takes on abnormalities in sound coordination and prosody.   It is idiosyncratic in nature, and usually the disordered coordination and prosody interfere with intelligibility more than the sound errors.  Like stuttering and cluttering, childhood apraxia of speech has neurological causes.
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