DEFINITIONS

Fluency

By beginning with a definition of fluency rather than stut­ tering, l am pointing out how many elements must be maintained in the flow of speec h if a spea ker is to be consid­ ered fluent. lt is an impressive balancing act; little wonder that everyone slips and stumbles from time to time when they talk.

Fluency is hard to define. In fact, most researchers have focused on its opposite, disfluency. (I use the term disflu­ ency to apply both to stuttering and to normal hesitations, making it easier to refer to hesitations that could be either normal or abnormal.) One of the ea rly fluency researchers, Freida Goldman-Eisler, showed that normal speech is filled with hesitations (Goldman-Eisler, 1968). Other researchers have acknowledged this and expanded the study of fluent speech by contrast ing it with disfluent speech. Dalton and Hardcastle (1977), . Inclusion of intonation and stress in this list may seem unusual. It could be said that speakers who reduce stut­ tering by using a monotone are not really fluent. We would

argue that it is not their fluency but the “naturalness” of their speech that is affected. Nonetheless, both will be of interest to the clinician who works to help clients with all aspects of their communication.

Starkweather (1980, 1987) suggested that many of the variables that determine fluency reflect temporal aspects of speech production. These include such variables as pauses, rhythm, intonation, stress, and rate that are controlled by when and how fast we move our speech structures. So, our temporal control of the movements of these structures deter­ mines our fluency. Starkweather also noted that the rate of information flow, not just sound flow, is an importan t aspect of fluency. Thus, a speaker who speaks without hesitations but has difficu lty conveying information in a timely and orderly fash ion might not be considered a fluent speaker.

In his description of fluency, Starkweather (1987) also included the effort with which a speaker speaks. By effort, he means both the mental and physical work a speaker exerts when speaking. This is difficult to measu re, but it may turn out that listeners can make such judgments reliably. Moreover, mental and physical effort may reflect imp or tant components of what it feels like to be a person who stutters.

In essence, fluenc y can be thought of simply as the effort­ less flow of speech. Thus, a speaker who is judged to be “flu­ ent” appears to use little effort when speaking. However, the components of such apparently effortless speech floware hard to pin down. As researchers analyze fluency more carefully, they may find that the appearance of excess effort may give rise to judgments that a person is stuttering. However, other elements, such as unusual rhythm or slow rate of information flow, may result in judgments that a person is not a fluent speaker, but is not a stutterer either. I will discuss aspects of fluency again when] relate some of the elements of fluency, such as rate and naturalness, to various therapy approaches.

Stuttering

General Description

Stuttering appears at first to be complex and mysterious, but much of it is based on htunan nature and can  be eas­ ily understood if you think about your own experiences. In some ways, it is like a problem you might have wit h your car. Imagin e you had a car that would suddenly stop when you  were driving in traffic (Fig. 1.2). Sometimes it would sputter and jerk when you pulled away from a stop sign. Other times, it would drop into neutral, and the engine would race, but the wheels wouldn’t turn. Still other times, the brakes would jam by themselves and wouldn’t release until you stomped repeat­edly on the pedal.

Compare this with what the “core” of stuttering behav­ ior is: Stuttering is characterized by an abnormally high fre­ quency and/or duration of stoppages in  the forward  flow  of speech. These stoppages usually take the form of (a) repetitions of sounds, syllables, or one-syllable words, (b) prolongations of sounds, or (c) “!blockages” or “blocks” of airflow or voicing in speech.

Return ing to the car analogy : After youa repeatedly had problems with your car; you would probably develop some cop­ ing strategies to get it goingagain. You might, if it sputtered and jerked, push harder on the gas pedal to try to make it speed up. Sim ilarly, speakers who are stutte ring usually react to their repetitions, prolongations, or blocks by trying to force words out or by using extra sounds, words, or movements in their effo rts to become “unstuck” or to avoid getting stuck.

If your cars problem persisted for several days or longer, you would  probably  develop some  bad  feelings about it. The first time it happened, you would be surprised.

 as it hap­pened more and more, surprise would give way to frustration. if your car frequently  quit  in the middle of  traffic  and other

drivers nearly hit you and started honking, you  would begin to anticipate problems and become afraid they would happen whenever you drove the car.

The child who begins to stutter goes through many of the same feelings- sur p1·ise, frustration,  embarrassment, and fear. These feelings- in combination with the difficulty the child has in speaking- may cause the stutterer to limit himself in school, social situations, and at work. This might be similar to your responses to a troublesome car. After your car quit on you in traffic many times, youcl probably leave it in the garage and walk, or you’d just stay home.

Another aspect of any description of stuttering involves specifying what it is not. For example, an important distinc­ tion must be made between the stuttering behaviors just described and normal hesitations. Children whose speech and language are developing normally often display rep­ etitions, revisions, and pauses-which are not stuttering. Neither are the brief repetitions, revisions, and pauses in the speech of most nonstuttering adults when they are in a hurry or uncertain. 

A distinction should also be made between stuttering and certain other fluency disorders. Disfluency resulting from cerebral damage or disease or psychological trauma differ from stuttering that begins in childhood. In addition, stuttering differs from cluttering, which is another fluency disorder involvingrapid, garbled speech that . These disorders may be treated somewhat differently, although some of the techniques that clinicians use with stuttering are also useful with other fluency disor­ ders.

 

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