3.4.1 What is fluency?

The term fluency refers to the smoothness, ease, and natural flow with which a person speaks.

Fluency or flow of speech generally involves several components including:

1. Rate: The speed at which speech occurs, which should neither be too fast nor too slow for effective communication.
2. Rhythm: The natural pattern of stressed and unstressed syllables in speech, contributing to the flow of speech.
3. Pausing: The ability to use pauses appropriately to separate thoughts or phrases, aiding clarity and comprehension.
4. Articulation: The clarity and precision with which speech sounds and words are articulated.
5. Continuity: The ability to maintain a steady, uninterrupted flow of speech, without excessive hesitations or fillers (like “um” or “uh”).
6. Intonation: The variation in pitch and tone that helps convey meaning and emotion.

A person with good speech fluency can speak clearly, confidently, and in a way that is easy for others to follow.  The speech is generally effortless in nature, easy, rhythmical and evenly flowing (Gillam & Marquardt, 2016, p. 195). Conversely, speech difficulties, such as stuttering or frequent interruptions, may impact a person’s fluency of speech.  It is important to note that we all have normal dysfluencies in our speech from time to time.  We do not speak in a perfectly fluent manner all of the time.  We use, for example, false starts, hesitations, fillers, revisions and corrections, and repetitions of words and phrases.  When interruptions to the flow of speech are consistent, this is when there may be an impairment of speech fluency.

Below is an example from the movie “The King’s Speech” of how interruptions to the flow of speech (e.g. stuttering) can impact speech fluency.  For those who are unaware, this movie is about King George VI.

^{The King’s Speech Trailer by Transmission Films}

3.4.2 What is fluency disorder?

A fluency disorder is a communication disorder that affects the flow of speech. People with fluency disorders may experience disruptions in the normal smoothness or fluency of their speech, making it difficult to speak in a fluid and natural manner.  Fluency disorders can be developmental (i.e. starting in childhood), or they may emerge later in life due to neurological (e.g. stroke, brain injury) or psychological factors (e.g. anxiety).

The most common type of fluency disorder is stuttering.  Another type of fluency disorder is cluttering.  Stuttering and cluttering differ in their nature and characteristics.

Stuttering

Stuttering is the most common fluency disorder and involves frequent disruptions in the flow of speech (primary stuttering characteristics).  Other physical behaviours (secondary stuttering characteristics) may also be observable.  Often stuttering occurs on specific sounds, syllables or words, and it can affect a person’s ability to communicate efficiently and effectively, especially in stressful or high-pressure situations.

Primary stuttering characteristics

• Repetitions of sounds, syllables, or words (e.g., “I-I-I want to go”; “dino dino dino dinosaur”).
• Prolongations of sounds (e.g., “sssssssnake”).
• Blocks, where the person has difficulty starting a word or sound, often leading to a long pauses (e.g. “My name is Lau…………ra’)
• Filler/interjections to help get through blocks in speech (e.g. “um”, “ah”)
• Circumlocutions of words (e.g. “we went to the, uh the uh the place where there’s a big bridge’ [avoiding the name of the location])

Secondary stuttering characteristics or behaviours

• Eye blinking or squinting (e.g. Repeated blinking or squinting during moments of stuttering).
• Facial grimacing  (e.g. Tensing the face or making a grimace, such as wrinkling the forehead).
• Head jerking or nodding (e.g. A sudden movement of the head, sometimes as a way to “get the words out”).
• Tension in the body (e.g. Tensing or stiffening muscles, especially in the shoulders, neck, or chest).
• Speech or physical avoidance (e.g. Shifting away from eye contact, avoiding certain words or situations, or physically stepping back).
• Hand movements or gestures (e.g. Using the hands in exaggerated ways while speaking, sometimes in an attempt to force out the words).

In the video below, Australian music artist, Megan Washington, discusses her personal experiences of stuttering, as well as her interactions with speech pathologists.  See if you can observe some of the primary and secondary stuttering characteristics outlined above.

^{The thing is, I stutter: Megan Washington at TEDxSydney 2014 by TEDxTalks}

Australia is a global leader in the area of stuttering research.  The Australian Stuttering Research Centre website contains valuable information about stuttering including the onset and impacts, as well as assessment and intervention approaches for children and adults.

Cluttering

Cluttering generally is when a person uses a rapid or disorganised speech pattern which is often characterised by unclear, imprecise, slurred or poorly structured speech.  People who clutter often speech very quickly, omit syllables or words, or mix elements of words together which makes them sound jumbled.  Typically, a person who clutters will not demonstrate physical behaviours associated with their speech (unlike in stuttering).  A person who clutters may have difficulty organising their thoughts and they may be unaware of the nature of their disorganised speech pattern.