When to be concerned about a fluency disorder

Oct. 22 is recognized as International Stuttering Awareness Day. This year’s theme of “Being Seen, Being Heard” focuses on normalizing a disorder that affects approximately three million Americans and over 70 million people worldwide. (www. stutteringhelp.org)

The 2010 Oscar-winning film “The King’s Speech” significantly expanded the general public’s interest in stuttering. Based on the true story of King George VI of England, the film focuses on the future king’s efforts to speak more fluently with the help of a speech therapist named Lionel Logue. King George VI emphatically states, “I have the right to be heard. I have a voice.” Though many advances in the understanding of stuttering and treatment methods have been made, there continues to be uncertainty surrounding what constitutes stuttering and how to best support those exhibiting symptoms.

According to the American Speech- Language-Hearing Association (ASHA), stuttering is an interruption in the flow of speaking caused by repeating sounds, syllables and words; prolonging consonant sounds; and experiencing blocks that create the inability to initiate sound. Sometimes these disfluencies lead to secondary behaviors such as negative reactions, physical tension or avoidance behaviors. Different types of stuttering exist. Neurogenic stuttering, for example, occurs after an injury to the brain caused by some sort of trauma or by a stroke. Developmental stuttering, the most prevalent type, often emerges in early childhood but can persist into adulthood and become a lifelong communication disorder.

Both adults and children experience normal disfluencies as a part of their everyday conversational speech.

We’ve all had moments when we “stumble through” a word or hear a child who repeats a word or phrase several times at the beginning of a sentence. It can be difficult for families to differentiate between what is typical and what may potentially be a disorder.

Speech-language pathologists (SLP) are trained to evaluate, diagnose and treat stuttering in all age groups. If you find yourself wondering if a stuttering disorder (also known as a fluency disorder) might be present, it is recommended that you go ahead and see a professional.

There are some basic questions for individuals and families to consider when concerned about stuttering:

• Has the stuttering lasted longer than three to six months or seemed to have gotten worse over time?

• Does it create tension when you stutter, or do you find yourself avoiding saying certain sounds, words or anything at all?

• Is there a history of stuttering in your family?

If you find yourself answering “yes” to several of these questions, then it is likely that you should contact an SLP for an evaluation. Family and close friends are often asked to be involved in the treatment process for those diagnosed with stuttering. Even if you don’t have family or friends who are affected, you will likely encounter a person who stutters in your community. People who find themselves conversing with someone who stutters can feel unsure how to react. Here are a few tips for supporting people who stutter during a conversation:

• Create space to converse. You can lessen the pressure within a conversation by speaking in an unhurried way and following the rules of turn-taking. Try to create an environment where no one feels rushed in the conversation.

• Be a good listener. This includes not interrupting and not attempting to finish the person’s sentences. It may take waiting longer than usual, but patiently waiting lets the speaker know you value what they are saying.

• Avoid offering advice. Though you may be tempted to suggest slowing down, relaxing or taking a breath, these comments are not helpful to a person who stutters and, though well-intentioned, may actually feel demeaning.

• Maintain your composure. Remain engaged in the conversation, make eye contact and keep a neutral facial expression. Most importantly, focus on the content of the message rather than how it’s being delivered.

As we prepare to observe International Stuttering Awareness Day this year, take time to consider ways in which you can better support every individual’s right to Be Seen and Be Heard. More information is available through The Stuttering Foundation at www. stutteringhelp.org. For details about services available through LSU Health Shreveport, contact Mollie E. Webb Speech and Hearing Center at 813-4200.

Elizabeth Wooden, M.A., CCC-SLP, is a clinical instructor in the Speech-Language Pathology Program at LSU Health Shreveport.