Dysfluencies in the speech of adults with intellectual disabilities and reported speech difficulties.

BACKGROUND: In individuals with an intellectual disability, speech dysfluencies are more common than in the general population. In clinical practice, these fluency disorders are generally diagnosed and treated as stuttering rather than cluttering. PURPOSE: To characterise the type of dysfluencies in adults with intellectual disabilities and reported speech difficulties with an emphasis on manifestations of stuttering and cluttering, which distinction is to help optimise treatment aimed at improving fluency and intelligibility. METHOD: The dysfluencies in the spontaneous speech of 28 adults (18-40 years; 16 men) with mild and moderate intellectual disabilities (IQs 40-70), who were characterised as poorly intelligible by their caregivers, were analysed using the speech norms for typically developing adults and children. The speakers were subsequently assigned to different diagnostic categories by relating their resulting dysfluency profiles to mean articulatory rate and articulatory rate variability. RESULTS: Twenty-two (75%) of the participants showed clinically significant dysfluencies, of which 21% were classified as cluttering, 29% as cluttering-stuttering and 25% as clear cluttering at normal articulatory rate. The characteristic pattern of stuttering did not occur. CONCLUSION: The dysfluencies in the speech of adults with intellectual disabilities and poor intelligibility show patterns that are specific for this population. Together, the results suggest that in this specific group of dysfluent speakers interventions should be aimed at cluttering rather than stuttering. LEARNING OUTCOMES: The reader will be able to (1) describe patterns of dysfluencies in the speech of adults with intellectual disabilities that are specific for this group of people, (2) explain that a high rate of dysfluencies in speech is potentially a major determiner of poor intelligibility in adults with ID and (3) describe suggestions for intervention focusing on cluttering rather than stuttering in dysfluent speakers with ID.

Language planning disturbances in children who clutter or have learning disabilities.

The primary objective of this paper is to determine to what extent disturbances in the fluency of language production of children who clutter might be related to, or differ from difficulties in the same underlying processes of language formulation seen in children with learning disabilities. It is hypothesized that an increase in normal dysfluencies and sentence revisions in children who clutter reflect different neurolinguistic process to those of children with learning disabilities. To test this idea, 150 Dutch speaking children, aged 10;6 to 12;11 years, were divided in three groups (cluttering, learning difficulties and controls), and a range of speech and language variables were analysed. Results indicate differences in the underlying processes of language disturbances between children with cluttered speech and those with learning disabilities. Specifically, language production of children with learning disabilities was disturbed by problems at the conceptualizator and formulator stages of Levelt's language processing model, whilst language planning disturbances in children who clutter were considered to arise due to insufficient time to complete the editing phase of sentence structuring. These findings indicate that children who clutter can be differentiated from children with learning disabilities by both the number of main and secondary story plot elements and by the percentage of correct sentence structures.