dysfluency

Dysfluency refers to disruptions in the smooth flow of speech. It includes repetitions of sounds or syllables, prolongations of sounds, blocks where speech is momentarily blocked, as well as interjections, revisions, and filled pauses such as um or uh. While many children experience disfluencies during language development, dysfluency is typically distinguished by its persistence, frequency, and impact on communication or daily functioning.

Stuttering, often described as stammering in some regions, is the best-known form of dysfluency and is characterized by repetitions, prolongations, and blocked speech that may be accompanied by physical tension or secondary behaviors. Cluttering involves rapid, disorganized speech with abnormal rhythm and often poor articulation. Other disfluencies include hesitations, revisions, and frequent use of fillers even when fluent speech is possible.

Causes arise from a combination of genetic, neurophysiological, linguistic, and environmental factors. Most cases begin in childhood, with onset commonly before adolescence. A family history of stuttering or other speech-language disorders increases risk. Acquired dysfluency can follow neurological injury, disease, or certain medicines, though this is less common.

Assessment is usually conducted by a speech-language pathologist who measures the frequency and types of disfluencies, the situation in which they occur, and the degree to which they interfere with communication. The clinician also evaluates related factors such as anxiety, attitudes toward speaking, and social participation, to distinguish developmental dysfluency from other conditions.

Management is individualized and may include fluency shaping, stuttering modification, or cognitive-behavioral approaches, often combined with parent or teacher involvement for children. Early intervention improves outcomes, though some individuals experience persistent dysfluency into adulthood. Not all dysfluency requires treatment if it does not impair communication or well-being.