Stuttering is a communication disorder in which the flow of speech is broken by repetitions (li-li-like this), prolongations (lllllike this), or abnormal stoppages (no sound) of sounds and syllables. There may also be unusual facial and body movements associated with the effort to speak. Fluency is the flow of speech and fluent speech is smooth, forward-moving, unhesitant and effortless speech.

Like stuttering, cluttering is a fluency disorder, but the two disorders are not the same. Cluttering involves excessive breaks in the normal flow of speech that seem to result from disorganized speech planning, talking too fast or in spurts, or simply being unsure of what one wants to say. By contrast, the person who stutters typically knows exactly what he or she wants to say but is temporarily unable to say it. To make matters even more confusing, since cluttering is not well known, many who clutter are described by themselves or others as “stuttering.” Also, and equally confusing, cluttering often occurs along with stuttering.

The definition of cluttering adopted by the fluency disorders division of the American Speech-Language-Hearing Association is: Cluttering is a fluency disorder characterized by a rapid and/or irregular speaking rate, excessive disfluencies, and often other symptoms such as language or phonological errors and attention deficits.

There is no single cause of stuttering. There are several factors that likely play into the cause: genetics, child’s language skills, environmental factors and temperament. Approximately 60% of children who stutter have a family member who also stutters. Environmental factors may include: major life changes, family and sibling conflicts and unpredictable life events. Personality traits for those children who stutter might be over-sensitive or highly competitive. Parents do not cause stuttering.

Some Important Facts:

• More than 70 million people worldwide stutter, which is about 1% of the population. In the United States, that’s over 3 million Americans who stutter.
• Stuttering affects four times as many males as females.
• Approximately 5 percent of all children go through a period of stuttering that lasts six months or more. Three-quarters of those will recover by late childhood, leaving about 1% with a long-term problem.

There are many different stuttering intervention approaches that have been used with preschool-age and early school-age children.  Indirect approaches to treating stuttering involve modifying the child’s environment rather than working directly with the child (R. J. Ingham & Cordes, 1998; Richels & Conture, 2007) while direct approaches target the child’s individual speech behaviors (R. J. Ingham & Cordes, 1998; Richels & Conture, 2007).

There are two therapeutic techniques used when treating stuttering-stuttering modification and fluency shaping. Stuttering modification aims to reduce speech-related avoidance behaviors, fears, and negative attitudes (Guitar & Peters, 1980; Peters & Guitar, 1991)  The goal of stuttering modification is to modify stuttering moments by decreasing the tension so the stuttering is less severe and the fear or avoidance behaviors of stuttering are eliminated (Blomgren et al., 2005; Guitar, 1998)  Fluency shaping, on the other hand, focuses on teaching the individual to speak more fluently (Blomgren et al., 2005; Guitar, 1998).

The Lidcombe Program is a behavioral parent-directed treatment for stuttering in preschool children that was developed by the Faculty of Health Sciences at The University of Sydney and the Stuttering Unit of the Bankstown Health Service in Sydney, Australia. Using this program, the SLP teaches the parent to deliver treatment to the child and to use a 10-point Likert scale to measure the severity of the child’s stuttering in his or her everyday environment (Onslow, Packman, & Harrison, 2003; Rousseau et al., 2007).

Stuttering Resources

• National Stuttering Association
• Stuttering Foundation of America
• Lidcombe Program