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There are several types of non-typical fluency disorders including:
Fluency disorders arising from Neurological Trauma and Disease:
Fluency disorders in neurological trauma and disease have been given many lables including, acquired stuttering, cortical
stuttering, and neurogenic stuttering. They have been documented to be transient or persistent, and an independent speech
disorder or a symptom of a neurological disease. Fluency disorders in neurological trauma and disease are rare in comparison to
developmental stuttering, which affects about 5% of preschool children. Such disorders are characterized by:
- Dysfluencies are produced on both function and content words.
- Onset may be delayed following a stroke or other trauma. Most fluency disorders develop within one month
following the onset.
- Individual may seem frustrated but does not appear anxious about the dysfluencies.
- Repetitions, prolongations, and blocks are not restricted to initial syllables.
- Secondary behaviors such as facial grimacing, eye blinking, or fist clenching are rarely associated with the moments
of dysfluency.
- Fluency does not improve with repeated readings of a passage.
- Fluency disorders occur in relation to a clear precipitating event.
- Auditory masking does not result in improved speech.
- A majority of cases of acquired fluency disorders result from damage to the dominant hemisphere.
- Acquired fluency disorders appear to be higher in left hemisphere disorders than right hemisphere disorders.
- Dysfluencies continue during singing.
Psychogenic Fluency Disorders:
Psychogenic fluency disorders are those that originate in the mind or mental activity of the brain such as thought and
reasoning. Psychogenic stuttering occasionally occurs in individuals who have some types of mental illness or individuals who
have experienced severe mental stress or anguish. These disorders are characterized by:
- Rapid and possitive response to one or two sessions of behavioral treatment.
- Individual evidences struggle behaviors and other signs of axiety.
- Individual evidences situational specific moments of dysfluency.
- Presence of unusual grammatical formations and bizarre speech such as multiple repetitions of nearly all phonemes
with concurrent head bobbing, facial grimaces, and tremor-like arm movements.
- Caused by reaction to emotional trauma.
- Onset is sudden.
- Repetitions of initial or stresses syllables.
- Individual's speech is not affected by choral reading, white noise or signing.
- Automatic or over-learned responses continue to be dysfluent.
- Individual does not appear to be concerned with dysfluencies
- Does not avoid words or situations
Pharmacological Reactions:
Examining how some drugs or neuropharmacological agents may cause, rather than cure, stuttering (known as drug-induced stuttering)
may be just as important a perspective for exploring drugs and stuttering. Some drugs induce a dysfluency pattern that
reflects difficulty in retrieving the words to use. Once the words are retrieved, speaking goes forward with little or no
difficulty in producing the utterance. Neuropharmacological agents that induce stuttering come from a variety of drug classes.
They include members of the neuroleptics, the tricyclic antidepressants (TCAs), antihistamines and bronchodialators,
tranquilizers, and the selective serotonin reuptake inhibitor (SSRIs) type of antidepressants. Characteristics include:
- Sudden onset
- Dysfluencies improve with altered medication
- Often drugs that affect the basal ganglia affect fluency
- Individual will present little or no concern about dysfluencies
- Individual's speech does not change with altered speech tasks or environment
- Individual does not respond to behavioral therapy
Developmental Stuttering:
In developmental stuttering, the speaker knows what words he/she wishes to convey, but is unable to easily initiate the act
of speaking or produce the words without repetitions or prolongations of the sounds. This type of stuttering is felt to occur
when a child's speech and language abilities are unable to meet his or her verbal demands. Stuttering happens when the child
searches for the correct word. Developmental stuttering is usually outgrown.
Stuttering is a speech disorder in which the normal flow of speech is disrupted by frequent repetitions or prolongations of
speech sounds, syllables or words or by an individual's inability to start a word. The speech disruptions may be accompanied
by rapid eye blinks, tremors of the lips and/or jaw or other struggle behaviors of the face or upper body that a person who
stutters may use in an attempt to speak. Certain situations, such as speaking before a group of people or talking on the
telephone, tend to make stuttering more severe, whereas other situations, such as singing or speaking alone, often improve
fluency. Stuttering may also be referred to as stammering, especially in England, and by a broader term, disfluent speech.
Stuttering is different from two additional speech fluency disorders, cluttering, characterized by a rapid, irregular
speech and spasmodic dysphonia, a voice disorder.
- Individual evidence anxiety and fear of speaking situations
- Individual uses secondary behaviors such as facial grimacing, eye blinking, etc... during moments of
stuttering
- Fluency improves with repeated readings of a passage
- Severity of moments of stuttering may change depending on the environment and speaking task
- Onset of stuttering usually occurs between the ages of 2 -5.
- Auditory masking usually results in improved fluency
- Singing usually results in improved fluency
- Individual uses escape and avoidance behaviors
- There is no evidence of etiological factors determining stuttering
Cluttering:
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. Cluttering is accompanied by any of the following:
- Confusing, disorganized language or conversational skills.
- Limited awareness of his or her fluency and rate problems.
- Temporary improvement when asked to "slow down" or "pay attention" to speech (or when being tape recorded).
- Mispronunciation or slurrring of speech sounds or deleting non-stressed syllables in longer words (e.g., "ferchly"
for "fortunately").
- Speech that is difficult to understand.
- Several blood relatives who stutter or clutter.
- Social or vocational problems resulting from cluttering symptoms.
- Learning disability not related to reduced intelligence.
- Sloppy handwriting.
li>Distractibility, hyperactivity, or a limited attention span.
- Auditory perceptual difficulties.
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