CDIS 730: Unit 1Fluency, Disfluency, and Stuttering

Agenda Discuss how fluency is defined Fluency as a continuous variable Types of stuttering

More typical versus less typical disfluencies Core versus secondary behaviors

The “iceberg analogy” of stuttering Practice identifying types of stuttering

The five dimensions of fluent speech Continuity or smoothness Rate of speech Rhythmic structure of speech Information load Physical and mental effort

Continuity Listeners perceive speech as being more

fluent than it really is. The average duration of continuous

utterances without pausing is not very large.

The frequency of pauses increases as the speech act becomes more complex.

Rate of speech A measurement of speed, such as syllables per

minute (SPM), or words per minute (WPM). People naturally talk as fast as they can. Coarticulation helps us to talk with about 250-

360 SPM (between approximately 160-230 WPM) without excess effort.

The rate of speech is not constant. SPM or WPM measures do not necessarily provide much information for clinicians and researchers.

Rhythmic structure of speech Speech rhythm consists of:

Segmental: the grouping of consonants and vowels (sound segments) into syllables. The time it takes to utter the individual segments in a syllable.

Suprasegmental: the grouping of syllables and linguistic stresses into phrases; the time extending over phrases.

Information load Vowels are longer in words that convey

more information. Syntactic structure is one of the main

causes for changes in information load. The beginning of a sentence or a clause

contains a high amount of information. Consonant duration varies with

information load and is affected by phonetic environment and positioning in the word.

Information load (cont.) Speech rate changes at word, clause,

and sentence boundaries We adjust speech to maintain a more or

less constant rate of information flow: Slow down when information load is high at

syntactic boundaries Speed up when information load is low

Effort Fluent speech appears to be effortless:

Mentally requires little thought, and the speaker concentrates on the content rather than the process of the utterance

Physically requires little muscular exertion According to Starkweather (1987), effort

may be the primary dimension of fluency with the timing variables being secondary.

Key fluency concepts Fluency is a multidimensional behavior Fluency is not dichotomous with stuttering It is on a continuum:

FLUENCY DISFLUENCY STUTTERED SPEECH

When smooth flowing streams of sounds are produced in an effortless, timely manner, the speaker is judged to be fluent.

Speech disfluencies May occur in all speakers, whether PWS

or people who don’t stutter (PWDS) Depending on severity, frequency, and

other variables, disfluencies may be more or less typical of fluent speakers

There are many ways to classify disfluencies, but there are few real differences between the labels used by various researchers.

Broad types of disfluencies Interjections Whole word repetitions Phrase repetitions Revisions Incomplete phrases Part-word repetitions Prolonged sounds Broken words (or blocks)

MORE TYPICAL DISFLUENCIES

Also known as “between word” or “normal” disfluencies

Interjections Also known as “fillers” Consist of “um,” “uh,” “like,” “you know”

or any other meaningless word or phrase that is inserted before or in the middle of an utterance

For PWDS and PWS, may be habitual, an indicator of uncertainty, or a sign that the speaker needs more time to complete his or her thoughts

For PWS, may also be a sign of avoidance or fear and may be a way to postpone a moment of stuttering

Whole word repetitions One of more repetitions of the same word. E.g., “Can we go go to the bookstore after

class?” Occur naturally for both PWS and PWDS When only one easy repetition is present,

the listener probably perceives the speaker as fluent.

Exception: monosyllabic whole word repetitions, e.g., I-I-I-I want the ball” are less typical and may be more representative of stuttering.

Phrase repetitions Similar to whole word repetitions in that

they occur for both PWDS and PWS E.g., “If you want, if you want I can take

notes for you while you’re gone.” Again, sounds pretty natural to listeners.

Revisions Typically occur at the word or phrase

level. E.g., “Kelly and me—Kelly and I can

meet you at 7:00. Is generally due to some issue with

content or grammar of one’s speech—the speaker realizes he or she has made an error and corrects him or herself accordingly.

LESS TYPICAL DISFLUENCIES

Also known as “within word” or “less typical” disfluencies

Monosyllabic one word repetitions In general, repetitions of whole words

are considered more typical disfluencies. Monosyllabic words are essentially just a

single sound, and so their repetition is less typical for PWDS.

Young children, including those who will have stuttering issues, often have these repetitions, e.g., “It was a-a-a-a- bear!”

Part-word repetitions Repetitions of sounds/syllables E.g., “C-c-can I get a r-ride later?” The stuttering will be perceived as more

severe depending on the tenseness of the speaker, the number of repetitions, and the rate of the repetitions.

Occur more frequently on consonants

Prolongations Are audible extensions of a sound. E.g., “S---ara is my best friend.” Do not typically occur with much

regularity in the speech of PWDS Are most common on fricative sounds,

e.g., /f/, /s/, “sh”

Blocks Are tense, silent prolongations of a

sound. E.g., “I a----sked you to take out the

trash.” May also be called “a tense pause” or

“inaudible prolongation” Are the most severe in terms of the

types of stuttered or less typical disfluencies.

Also note Unlike PWDS, PWS may have a lot of tension

in their speech mechanism which is apparent to listeners.

PWS may experience a great deal of fear in every day speaking situations, as compared to PWDS, who may experience only occasional speech anxiety.

Fear of public speaking can lead everyone to want to avoid speaking, but PWS may have a general fear of speaking which may cause them to avoid many speaking/social situations.

A representation of more typical to less typical disfluencies

Pseudostuttering Practice! You will rotate partners over the course

of the next 15 minutes. I will call out the type of disfluency, and

you and your partner will have a brief conversation in which you both incorporate that type of disfluency into your speech.

Give it your all!

Core Stuttering Applies to the most basic characteristics

of stuttering: A disruption in fluency of verbal expression Characterized by involuntary, audible, or

silent repetitions or prolongations of sounds, syllables, and words

These disruptions occur frequently or are marked in character

The disruptions are not readily controllable

Secondary Stuttering May or may not co-occur with core

behaviors Are often nonverbal Includes escape behaviors that have been

learned over time to try to resume fluent speech when “stuck”

Include postponement/avoidance behaviors in response to anticipated stuttering Word substitutions, circumlocution, withdrawal

The stuttering cycle Very mild or almost unnoticeable

stuttering can result in a small emotional reaction

The emotional reaction can cause the stuttering to become more frequent or more severe, with an according escalation in negative emotions.

PWS are unique, so this cycle won’t fit everyone, but there are commonalities among the experiences of PWS.

Stuttering and accompanying emotions

The Iceberg Analogy Developed by Joseph Sheehan The core behaviors of stuttering are the

most noticed. What is “beneath the surface” may never be apparent to listeners.

Because emotional reactions of PWS to their stuttering can impact stuttering severity, therapists must be prepared to address both overt and more covert aspects of stuttering.