Dysphemy . Verbal fluency disorder in which there are no organic abnormalities and is characterized by verbal interruptions that affect the rhythm of language and the melody of speech.


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  • 1 Features
    • 1 Dysphemia, Stuttering and Sputtering
  • 2 Ratings
  • 3 Classification of the Evolutionary model
    • 1 Onset and Evolution of Dysphemia
  • 4 Incidence of Dysphemia
  • 5 Educational needs
  • 6 Sources


  • Breathing
  • Phonation
  • Joint
  • Coding of the language .

Breathing: dysphemic in the speech pattern usually present altered breathing and rhythm-related characteristics, presenting an incoordination

Inspiration is superficial and frequent, with stops.

Expiration is rapid, asynchronous with phonation. There is a prefonatory expulsion of the air that forces supplementary movements.

All these breathing characteristics do not constitute the cause of the problem, therefore the solution to the dysphemia is given by the modification of this respiratory pattern.

Phonation: excessive prefonatory laryngeal tension. Hard voice attack, with glottal strike. Alteration in the glottic closure rhythm.

Phonation is usually with residual air. Short phonation with a difficulty therefore to modulate it (keep the tone).

Breathing and phonation are rather consequences of the dysphemic speech pattern.

Articulation : these alterations, repetitions, blockages … spasms, extensions, dysfunctional pauses, crutches, stereotypes, lack of synchrony, excessive joint pressure, which makes the subject sometimes emit noises, sounds during or after the blockages.
There would also be the presence of an open mouth (to carry out additional respiratory movements), the nostrils dilate.

The dysphymic characteristics of the joint have specific determining factors (they are not the same in all situations, sounds, …)

  • More articulation problems in consonants than in vowels. Within consonants the stops.
  • Long words more problematic
  • The most significant words for him, the most important (names, …)
  • The most important point determinant: in initial position, more locks in phonemes of initial position of words

There has been talk of a “stubborn” effect, in the sense that they always block in the same places. So the dysphemic knows where he is going to get stuck, which makes him “obsessed” and get more stuck.

Coding of language : everyone has dysfluences. The dysphemic speech pattern is not only left with joint problems, but includes a series of strategies that turn speech into something really altered. The language is full of avoidance and substitution strategies. The dysphemic presents paragrammatisms, grammatisms, delayed response, circumlocution, lexical access problems (he cannot find the word).

Alteration in the time and tone of the language, embolofrasias (introduce words or filler expressions).

The speech pattern would be based on a series of determinants:

  • They improve with reading (when they read, especially in the most severe cases, in the mild or more hidden, they can get worse with reading).
  • They improve when speaking at the same time as another person (shading).
  • They speak worse with the audience, although there is an adaptation effect (this effect is quite problematic, because the subject gets used to the speech therapist and with it improves his speech but this does not indicate that he has overcome his problem).
  • The song is not usually affected.
  • With alcohol, they usually improve (by lowering the level of consciousness).
  • In dysphoric situations (euphoria or anger) they usually improve (they lose some control of speech and this is good for them, since it controls too much speech).
  • They worsen when they are tired in a low physical or mental form .
  • Having “syndrome of how much better, worse”, the better they want to do it, the worse they do it, in important situations.
  • When they speak aloud alone, they speak better. They also improve when talking in the dark, with animals, their relatives.
  • They talk worse on the phone .
  • They improve when they say a series of words that they know, or they set a rhythm for them to speak.
  • Very often they have trouble saying their name (meaningful words).

Dysphemia, stuttering and sputtering

Dysphemia: refers to a syndrome (group of disorders), which are of three types:

  • Linguistic problems or alterations.
  • Psychological disturbances (logophobia).
  • Motor disorders or traits (balbismo).

This is a problem that does not only affect language .

  • Stuttering: exclusively linguistic disturbances.

From this difference, it is why it is said that every human being who is stutterer, since he commits repetitions, blocks, etc., but they are not dysphemic (since they do not react negatively to this).

Dysphemia does not exist as a single thing. It has very variable manifestations, and each case is different. It is so different because the dysphemia is an individual speech pattern, like the one that each person has, although in the dysphemia it is altered.

  • Sputtering: is a language alteration characterized by excessive speed that affects intelligibility.
  • Taquilalia: speak quickly.
  • Tachyphemia: speaking quickly, when this becomes an alteration for the subject, when it comes to understanding it.

There has been a tendency to establish a close relationship between dysphemia and sputtering, this relationship has been established at different levels.

Tachylic parents can be a model for their children to be dysphemic. Sputtering has been spoken of as one of the traits of dysphemia (some dysphemic sputtering), even for some authors sputtering is the origin of dysphemia (Weis) (in the sense that he wants to speak faster). It can be a means of overcoming, controlling, or hiding dysphemia. Van Riper associates sputtering with temporary disorganization.


The traditional classification is descriptive and is focused on speech pathological symptoms; As with the traditional speech therapy model , this says little about the problem. It merely provides a label.

This classification differentiates between tonic (spastic or open) and clonic (closed) dysphemia.

  • Tonic Dysphemia: Phonatory muscular immobilization, followed by an explosion when the immobilization subsides. They are blockages or spasms, although these terms are also used synonymously with diffluence.
  • Clonic Dysphemia: Uncontrolled repetition of syllables or words, but they are abnormal contractions of the organs.

It has a subclassification that are mixed dysphemias ; they are called tonic-clonic and clonic-tonic. Those with more tonic components are assumed to have a worse prognosis (tonic is worse than clonic and tonic-clonic worse than clonic-tonic).

Evolutionary model classification

What it is about is to explain the changes in the speech pattern that generate a stuttering (dysphemia). It does not worry so much about symptoms and is very useful for the intervention. Four stages in stuttering are distinguished, of which only the last two are properly dysphemic.

  • Initial stuttering: All children, when learning to speak, hesitate, get stuck, and stutter. They are the hesitations of someone who is learning to speak. (more or less until three years old)
  • Developmental stuttering (3-5 years): This is what was called physiological dysphemia. It is a continuation and intensification of the initial stuttering. This happens to all children, (there is discussion about whether or not to intervene in these cases). Only about one in five of these children go on to develop dysphemia.
  • Primary dysphemia (5-6 years): These are children who already have a dysfluent pattern. It is a pattern with little marked features (there is enough continuity, there is not much break). It is a pattern with little tonicity, because in this primary dysphemia the emotional component is still low 8 there is little logophobia, they are little conscious). It is the optimal time to intervene.
  • Secondary dysphemia: It comes from a primary dysphemia, it is the case of adolescent subjects, adults who are very conscious and emotional (which causes fear of speaking), have incorporated or can incorporate associated movements, and in them the pattern is very difficult, very disjointed.

Onset and Evolution of Dysphemia

Refers to an explanation by Miguel Serra. This proposes four ideas about the onset and evolution of dysphemia.

  • Dysphemia does not differ initially in learning fluency (at the beginning, who will be stutterer does not differ).
  • In this learning of fluency, children experience difficulties, mainly in difficult transitions (eg when they have to start speaking at the beginning of the discourse and coarticulation (consonant groups)
  • Children use a series of stable strategies to solve these difficulties (the child and the environment also use strategies to solve them). Some of these strategies, which we cannot identify, for unknown reasons, progressively cause disruptions (breaks), increased repetitions, even tension and awareness of the problem.
  • Without being identified when, or because all these problems make this disruptive pattern appear fully consolidated. There are children who modify their speech looking for planning and control systems (which we all do), but for unknown reasons they generate a different solution to the problem of fluency.

Incidence of Dysphemia

When the study begins is before the age of seven, in 90% of cases.

There are three critical stages:

  • Physiological dysphemia.
  • Start of schooling
  • Start of puberty

It affects more men than women (between 75 and 80% more); This must be seen in an evolutionary sense, since up to the age of five the proportion is only 2 or 3 boys to girls. It is the school age when it is 4 or 5 boys per girl. In adulthood it is 6-11 men per woman.

This indicates the evolutionary nature of dysphemia and that women are recovering better (one girl improves in evolutionary dysphemia).

Girls are better able to solve language problems than boys, they don’t get stuck. This is especially noticeable in dysphemia. This does not say they are better on the linguistic level.

Sociocultural level: dysphemia is more frequent in developed countries. (especially in the USA). More dysphemic in ascending classes, more dysphemic in university students (this indicates that pressure influences, since we are talking about learning a skill, and pressure influences this learning). There may be stuttering without dysphemia, for example there are cases of aphasias that have stuttering, but not dysphemic.

Educational needs

Regarding the special educational needs of children with difficulties in verbal fluency, they are: the need for relaxation of the bodily muscles and of the articulatory muscles to acquire fluency in speech; need to reduce social anxiety; need to achieve coordination of respiratory behavior; need to make adequate and positive cognitive attributions (changing thoughts of the type I will fail in trying to can improve my speech); and the need to learn to slow down the emission of words and to emphasize the articulation of phonemes to achieve clarity in verbal language.

Regarding the educational response, on the part of the methodological process would be the methods:

Reflective (learning to speak analytically, self-observing while speaking).

Diverse (to distract the person’s attention on his way of speaking and to diminish the logophobia). In addition to this, in dysphemia, psychotherapy and speech therapy must be performed (intervention of body hypertonia and phonatory muscles); intervention in breathing and intervention in fluency, rhythm of verbal emission.


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