Stuttering is an intra/interpersonal speech and language disturbance which involves high awareness and low tolerance on the part of the person who stutters and his/her listeners. Stuttering involves one or more of the following speech disrupters: tension, struggle, tremors, repetitions, prolongations, pitch tension, irregular voice stopping and breathing, and associated behavioral tension. This list is not meant to be exhaustive since each person who stutters exhibits unique characteristics in his/her attempt to not stutter.
Propositionality is also an important variable in the disruption of the forward flow of speech. Propositionality is present in the environment as well as a part of the linguistic, semantic, and neuromuscular components of speaking. As propositionality increases so does stuttering.
A negative psyche is fostered by any of the variables previously cited. This low self-esteem becomes integrated into the personality of the person who stutters and, in part, can include other "behavioral disfluencies". Avoidance for speech and other personal contact are additional psychological components.
Care should be taken not to confuse stuttering with disfluency, dysfluency, and/or cluttering.
ASSESSMENT OF STUTTERING: DANGER SIGNS
The presence of at least two of the following are significant diagnostic indicators: (1) reports of stuttering from any source; (2) duration of stuttering beyond a 6 week period; (3) stuttering beyond the age of 5; (4) other disabilities including attention deficit disorders, learning deficits, language and/or speech deficits, discoordination and balance difficulties, neurogenic disorders, and genetic risk factors. The following should be observed and/or evaluated in a stressful environment: (5) avoidant speech and/or inhibited personal interaction; (6) associated tension and/or struggle; (7) disrhythmic stuttering; (8) phonatory stopping and/or disruption; (9) a minimum of 2 part and/or whole word repetitions; (10) prolongations of at least 1/2 second and occurring on 5% of a speech sample; (11) evidence of high awareness and low tolerance.
A sense of confidence, consistency, and competency by the child are in evidence in stressful environments and are supported by direct observation. Additionally, the following are important indicators: (1) favorable reports from persons in the environment; (2) well developed self-help skills; (3) increased confidence in speaking; (4) an improved concept of self; (5) stutter free speech; (6) less than 1% stuttering with an absence of the speech related danger signs; (7) improved speech and language skills; (8) maintenance of improved speaking skills over a 6 month period; (9) a significant increase in talking time and spontaneity; (10) increased tolerance and lowered awareness; (11) managed residual stuttering; (12) reduction or possibly elimination of other disabilities.