By Robyn Dean M.A., C.I./C.T.
Deaf Wellness Center
The word dysfluency refers to an individual’s lack of fluency in their preferred language. Dysfluency has two types: specific, disruptive errors and a general lack of fluency. In the first, the person is generally understandable but makes errors in their language (not errors associated with education level, like using the word “ain’t” or a misuse of grammar). In second, the person’s language is so distorted that the ability to communicate on a functional level is severely compromised. Some words used to describe forms of dysfluency include: neologism, clanging, echolalia, or perseveration, etc.
Psychiatric reasons or neurological reasons are causes of dysfluency within the hearing population. That is, dysfluency in the hearing population is due to organic brain dysfunction. However, in the Deaf population, it is not uncommon for Deaf people to be dysfluent, that is, not fluent in their preferred or their best language (that could be either English or American Sign Language, ASL), for other reasons that are associated with their exposure to language as infants and children and the use of their preferred language in educational environments. Sometimes these people are referred to as “minimally language skilled.” Deaf people who are dysfluent propose a unique challenge for service providers and interpreters. However, with interpreters in clinical service settings, there is an additional concern.
Interpreters, because of the nature of their work, seek to understand and convey meaning – English to ASL or from ASL to English. When a person is dysfluent for social or educational reasons, interpreters – hearing or Deaf interpreters – should seek to derive meaning, or to negotiate communication to the best of their ability. However, when a Deaf person is dysfluent for psychiatric or neurological reasons, deriving meaning from a message that does not inherently contain meaning – but instead contains important diagnostic information – can thwart the clinical goal. That is, the source message may be distorted (e.g., ASL) but in the target language (e.g., spoken English), it is conveyed in a fluent and understandable manner.
Most interpreters know about dysfluency within the Deaf population that originates from social and education reasons but most have no awareness that dysfluency might have other sources (pathological) and in the end, obfuscate important diagnostic information. Interpreters, both hearing and Deaf, should be educated about these other reasons for dysfluency and seek additional training on the distinguishing one from the other. Not because it is the responsibility of the interpreter to make that diagnosis – this responsibility ultimately still resides with the clinician – but so that the interpreter who has initial contact with that language can collaborate with the clinician by providing information about the communication and the nature of their struggle so that a distinction can be determined.