Dysfluencies

Dysfluencies are interruptions or deviations from the smooth, continuous flow of speech. They occur in all speakers and can be considered normal in everyday conversation, especially under cognitive load or time pressure. In clinical and research contexts, dysfluencies describe a range of phenomena that disrupt fluency, including hesitations, repetitions, prolongations, revisions, false starts, interjections, and repairs.

Common categories include repetitions (repeating a sound, syllable, or word), prolongations (stretching a sound), blocks (temporarily no vocalization), interjections and filled pauses (um, uh), and revisions or repairs (restarting or correcting what was said). Interjections and false starts are often present in normal speech when mild. It is important to distinguish normal d ysfluencies from fluency disorders such as stuttering, cluttering, or acquired apraxia of speech. Core dysfluencies refer to momentary disruptions in the flow of speech, whereas secondary behaviors (facial tension, blinking, avoidance) may accompany persistent issues.

Developmental versus acquired dysfluencies are distinguished in clinical practice. Developmental disfluencies are common in young children as speech and language develop and typically lessen over time. If disfluency persists beyond early childhood or significantly interferes with communication, evaluation for a fluency disorder may be warranted. Acquired dysfluencies can follow neurological injuries, strokes, brain injuries, or certain medications and reflect changes in speech planning or production.

Assessment and management focus on frequency, types, duration, and impact on communication. Treatments may include fluency shaping and stuttering modification approaches, plus strategies to reduce avoidance and support effective communication. Education for caregivers and environmental adjustments can also help. When dysfluencies are influenced by psychological factors, counseling or cognitive-behavioral therapy may be appropriate. The goal is to improve overall communication effectiveness while recognizing that some pauses and disruptions are a normal part of speech.