Fluency in Speech and Fluency in Reading

My son has a fluency disorder on top of his expressive language and childhood apraxia of speech (CAS). Many people have asked me if he seems to be more disfluent when he is nervous or anxious. The answer is no. He is disfluent all the time. He is disfluent in his speech when he is watching TV totally relaxed as well as when he is excited. The only time he is not is when he is saying something familiar or something controlled, which means in speech therapy he is rarely disfluent. They are working on particular things and he knows what he needs to say, but the minute you ask him about his day or something novel he breaks down. He inappropriately adds a schwa (‘uh’ sound like if you were to say puh-lay instead of play), he repeats words over and over again until he can find the word he wants to say and usually his sentences don’t make much sense. You have to pick out bits and pieces in order to put it all together.

I have heard a period of dysfluency can be typical of children with apraxia, but not many really know how to treat it because it doesn’t seem to last long and doesn’t require treatment. For my son it has been going on for quite a while.  We have had it addressed in therapy.  We found a specialist in apraxia who knew how to address the fluency. I was cautious not to get someone who would treat it as stuttering since that requires a certain type of treatment and he had none of the classic signs of stuttering. He was just plain disfluent in his speech. His fluency is (from what I have seen) directly related to his expressive language disorder mixed with his apraxia. It is very difficult for him to find the words he needs and often looks for an easier alternative word which stalls his entire sentence and makes him more unintelligible while he is trying to find that next word.

Anyway, I know what you are thinking. What does this have to do with fluency in reading? Well tonight I realized that he reads the way he speaks. He wants to show his animation, his passion, his knowledge BUT he can’t physically read that fast because he is only 6 and doesn’t have the skill base. He still has to decode the words and say them out loud. When he was reading tonight, it sounded EXACTLY how it does when he wants to tell someone a story and can’t quite get it out. There is a disconnect between how he wants to say something and his ability to access those words. There was a disconnect between his wanting to show how much passion he can put into a story and his actual ability to read. It may not be interesting to you, but it was incredibly interesting to me.

All of this time I have been trying to make people understand that his disfluency is not out of anxiety in a situation, but out of not being able to adequately convey the message in the way he would like to because he doesn’t have a solid foundation yet to be able to access the words he needs due to his combination of having an expressive language disorder and childhood apraxia of speech. Will this come in time? I have NO doubt. Is it painful to watch in the meantime? Absolutely, but like reading we need to practice fluency in speech. We need to know those words so well that they come naturally. He’s just not at that point yet, but with continued language and speech therapy I know that he will get there.