A fluency disorder, which is often referred to as “stuttering”, is characterized by primary and secondary behaviors. Primary behaviors may include repetition of sounds, syllables, or whole words: prolongation of single sounds: or blocks of airflow or voicing during speech. Secondary behaviors develop over time as learned reactions to the primary behaviors and are characterized as avoidance behaviors. They may include hesitations, interjections of sounds, syllables, or words; word revisions or complete changes in words: or motor movements associated with stuttering (such as eye blinking, loss of eye contact, extraneous movements). Stuttering is often confused with a period of “normal disfluency”, which typically emerges when children are learning to combine words and speak in short sentences (18 months of age) and can continue into their early school years when they learn to read (7 years of age).

Speech-language pathologists (SLPs) rely on many factors in making a differential diagnosis, including the consideration of certain risk factors and warning signs that point to which clients would benefit from treatment. Many theories have been proposed regarding the cause of stuttering. It is probable that a combination of factors (i.e., neurological, psychological, social, and linguistic) impact the onset and development of fluency disorders. Those factors form the bases for treatment and treatment is rightfully designed to address each client’s unique needs. Some therapy approaches are indirect, where the SLP works with parents and adjustments are made in the home that facilitate fluent speech. Other therapy approaches are direct in nature, where clients may be instructed in fluency-shaping or stuttering modification techniques or a combination of the two. Finally, in case of moderate to severe stuttering, client’s feelings and attitude towards their speech are also addressed in a comprehensive therapy approach.