Maintenance of improved attitudes toward stuttering. ), Current issues in stuttering research and practice (pp. If treatment is currently not warranted, the SLP educates the family about how to monitor the childs fluency to determine if and when the child should be reevaluated. EBP Briefs, 2(4), 18. https://doi.org/10.1044/1092-4388(2003/095), Anderson, T. K., & Felsenfeld, S. (2003). In addition, clinicians need to avoid using religious or highly familiar texts that individuals may know by rote. Persons who stutter may appear friendlier when they self-disclose their stuttering, and self-disclosure may help put listeners more at ease (Healey et al., 2007). Managing cluttering: A comprehensive guidebook of activities. Board Certified Specialists in Fluency are individuals who hold ASHA certification and have demonstrated advanced knowledge and clinical expertise in diagnosing and treating individuals with fluency disorders. The dysfluencies that render concerns of Childhood Onset Stuttering are different than typical disfluencies. Differential Diagnosis | Stuttering Foundation: A Nonprofit https://doi.org/10.1016/j.jfludis.2017.09.004, Cassar, M. C., & Neilson, M. D. (1997). american journal of audiology (aja) american journal of speech-language pathology (ajslp) journal of speech, language, and hearing research (jslhr) language, speech, and hearing services in schools (lshss) perspectives of the asha special interest groups; topics; special collections Treatment should consider not just the overt stuttering behavior but also the affective and cognitive reactions to stuttering. Proceedings of the National Academy of Sciences of the United States of America, 116(35), 1751517524. 115134). 7184). Some examples of disfluencies that are more typical of a person who clutters is excessive whole word repetitions, unfinished words and interjections (such as um and well). The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific, and credentialing association for 228,000 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology support personnel; and students. Roberts, P., & Shenker, R. (2007). Some examples of these are to openly discuss experiences with stuttering (from the client and the clinician with pseudostuttering or as described by previous clients who stutter) and model pseudostuttering and techniques, attitudes, and beliefs across speaking situations (Manning & Quesal, 2016; Watson, 1988). Speech clarity and fluency may temporarily improve when the person is asked to slow down or pay attention to their speech. Counseling is an integral part of the assessment and treatment of individuals who stutter or clutter. Reduced perfusion in Brocas area in developmental stuttering. (2014). Acceptance and Commitment Therapy for people who stutter. https://doi.org/10.1016/j.jfludis.2016.09.005, Gerlach, H., Hollister, J., Caggiano, L., & Zebrowski, P. M. (2019). (2010). Disfluencies noted in bilingual children and adults are similar to those found for monolingual speakers (Shenker, 2013). https://doi.org/10.1044/cicsd_25_S_8, Leech, K. A., Bernstein Ratner, N., Brown, B., & Weber, C. M. (2017). https://doi.org/10.1044/2018_AJSLP-17-0097, Kraft, S. J., & Yairi, E. (2011). van Zaalen, Y., & Reichel, I. K. (2014). Engaging parents in treatment helps to achieve carryover in the home environment and helps with treatment across languages (Shenker, 2013). discussion of personal issues (e.g., prior to, or in addition to, targeting generalization of skills in a group setting). Journal of Fluency Disorders, 58, 94117. (2014). Children with a family history of stuttering were estimated to be 1.89 times more likely to persist in stuttering (Singer et al., 2020). Specific standardized tests can be used to rule out word-finding difficulties. attention-deficit/hyperactivity disorder (Donaher & Richels, 2012; Lee et al., 2017). Anderson, J. D., Pellowski, M. W., Conture, E. G., & Kelly, E. M. (2003). A comprehensive treatment approach for preschoolers includes both parent- and child-focused strategies. https://doi.org/10.1044/2020_PERSP-20-00014. American Journal of Speech-Language Pathology, 27(3S), 11111123. (2003). Barnes, T. D., Wozniak, D. F., Gutierrez, J., Han, T. U., Drayna, D., & Holy, T. (2016). In D. Ward & K. Scaler Scott (Eds. The human capacity to thrive in the face of potential trauma. Time and expense are considerations along with attention to generalization and treatment needs following an intensive program (Cooper, 1979). American Journal of Speech-Language Pathology, 7(4), 6276. Regional cerebral blood flow is reduced in Brocas area, the region in the frontal lobes of the brain linked to speech production, and an inverse relationship was noted between the severity of stuttering and the rate of blood flow (Desai et al., 2016). These strategies help individuals learn about the speech mechanism and how it operates during both fluent and disfluent speech so they can modify it. Self-disclosure involves communicating to others information that reveals ones identity as a person who stutters. Allyn & Bacon. Stuttering Therapy Resources. Adults who stutter may be dealing with years of shame or stigma (Boyle, 2013a), and they can experience elevated levels of negative mood states (e.g., interpersonal sensitivity and depressed mood) when compared to adults who do not stutter (Tran et al., 2011). Speech, Language and Hearing, 20(3), 144153. An introduction to camps for children who stutter: What they are and how they can help. (2018). Communication Disorders Quarterly, 39(2), 335345. The model describes the following stages of behavioral change: See Manning and DiLollo (2018) and Floyd et al. Motivational interviewing may be used to help individuals who stutter better understand the thoughts and feelings associated with their stuttering and make positive changes to improve communication. In D. Ward & K. Scaler Scott (Eds. American Journal of Speech-Language Pathology, 27(3S), 11801194. typical vs atypical disfluencies asha. Motivational interviewing: Helping people change. Temperamental characteristics of young children who stutter. American Journal of Speech-Language Pathology, 28(1), 1428. Children who stutter typically know how to read (decode) the printed form of words, but they may not be able to speak the printed form fluently. Therefore, as with school-age children and adolescents, the purpose of the assessment for adults typically is not to diagnose stuttering. These modifications are used to facilitate speech fluency and may include. School Psychology Review, 30(1), 135141. Seminars in Speech and Language, 37(3), 145152. (2019). Gupta, S., Yashodharakumar, G. Y., & Vasudha, H. H. (2016). SLPs may want to relate personal experiences when asking clients to share such vulnerable information. https://doi.org/10.1016/j.jfludis.2011.06.001. Approximately 95% of children who stutter start to do so before the age of 4 years, and the average age of onset is approximately 33 months. https://doi.org/10.1016/j.jfludis.2012.11.002, Yaruss, J. S. (1997). advertising through a classroom presentation with the guidance of the SLP or classroom teacher in the case of school-age children (W. P. Murphy et al., 2007b). https://doi.org/10.1044/2019_JSLHR-S-18-0225. For example, some children from bilingual or multicultural backgrounds may experience stuttering onset or a temporary increase in stuttering as result of being in new and unfamiliar situations, learning a new language, or being exposed to mixed linguistic input (Shenker, 2013). Wampold, B. E. (2001). Freezing is similar to tallying but has the client/clinician stop, freeze, during a moment of stuttering to perform a self-scan. Overall, these indicators demonstrate progression from avoidance and negative impact to acceptance, openness, and increased socialization (V. M. Sheehan & Sisskin, 2001). ), Stuttering and related disorders of fluency (pp. In B. J. Amster & E. R. Klein (Eds. Cultural diversity should also be considered in the discussion of stuttering, as it can have an impact on assessment and treatment of stuttering. Strategies for reducing impairment in body function have been separated into two categoriesspeech modification and stuttering modification, both of which are described below. 256276). Quick: Talk fast & dont stutter! Clinicians need to understand the interaction of symptoms and the strategies that are most effective for dealing with stuttering and cluttering when they occur together. Treatment approaches for preschool children who stutter include the following. Parent involvement may be a beneficial approach for addressing fluency issues in a bilingual child. https://doi.org/10.1044/cicsd_31_S_69, Blood, G. W., & Blood, I. M. (2016). atypical pauses within sentences that are not expected syntactically (e.g., I will go to the. Hill, D. (2003). Similarities - Typical and Atypical Pneumonia 5. A study of the role of the FOXP2 and CNTNAP2 genes in persistent developmental stuttering. https://doi.org/10.1044/0161-1461(2006/014), Yaruss, J. S., Coleman, C. E., & Quesal, R. W. (2012). ), Cluttering: Research, intervention and education (pp. (2013). Prevalence of cluttering in two European countries: A pilot study. (2005). Miller, W. R., & Rollnick, S. (2013). Self-efficacy and quality of life in adults who stutter. Depression & Anxiety, 27(7), 687692. https://doi.org/10.1016/j.nbd.2014.04.019, Han, T.-U., Root, J., Reyes, L. D., Huchinson, E. B., du Hoffmann, J., Lee, W.-S., Barnes, T. D., & Drayna, D. (2019). Sisskin, V. (2018). production of words with an excess of physical tension or struggle. Acceptance and Commitment Therapy for adults who stutter: Psychosocial adjustment and speech fluency. Students who improve their attitudes toward stuttering tend to maintain these views years later (St. Louis & Flynn, 2018). https://doi.org/10.1542/peds.2007-1648, Boscolo, B., Ratner, N. B., & Rescorla, L. (2002). Psychology Press. Arnold, G. E. (1960). In J. C. Norcross & M. R. Goldfried (Eds. Trichon, M., & Tetnowski, J. Folia Phoniatrica et Logopaedica, 64(1), 3447. One example of a desensitization activity is pseudostutteringthe use of voluntary stuttering behaviorsin different, and increasingly more difficult, situations where the individual might fear the occurrence of real moments of stuttering (e.g., Reardon-Reeves & Yaruss, 2013; J. G. Sheehan, 1970). https://doi.org/10.1044/1058-0360(2003/070), Arenas, R. M., Walker, E. A., & Oleson, J. J. Atypical disfluency has been documented through case studies and has been described as final part-word repetition or "rhyme repetition". I have also noticed more atypical disfluencies, such as final part word repetitions (chair-air, bike-ike). Journal of Fluency Disorders, 36(2), 122129. Person- and family-centered practice offers a range of services, including counseling and emotional support, procuring information and resources, coordinating services, teaching specific skills to facilitate communication, and advocating for or with the individual and their family. Some children go through a disfluent period of speaking. Functional and neuroanatomical bases of developmental stuttering: Current insights. Discussions about the physical experience of anxiety and ways to reduce it and the sense of loss of control and time pressure may be of further benefit (e.g., mindfulness and grounding; Beilby et al., 2012a; Boyle, 2011; Harley, 2018). Social anxiety disorder in adults who stutter. They have long-held beliefs about stuttering that positively or negatively affect self-perceptions about their communication skills and their motivation for change (Daniels, 2007). These individuals are said to experience covert stuttering (B. Murphy et al., 2007). Human Brain Mapping, 38(4), 18651874. Language assessment and intervention for the learning disabled. https://doi.org/10.1016/j.jfludis.2010.12.003. ), Stuttering and related disorders of fluency (pp. Denial, 3. Thieme. Greater abnormality of cerebral blood flow in the posterior language loop, associated with processing words that we hear, correlates with more severe stuttering. Pro-Ed. Word-Final Disfluencies in a School-Age Child: Beneath the Tip of the Reeves, L. (2006). Recovery rates were estimated to be approximately 88%91% by Yairi and Ambrose (2013). Perspectives on Global Issues in Communication Sciences and Related Disorders, 4(2), 5762. Temperament, emotion, and childhood stuttering. It discusses types of atypical dysfluency as well as application of current findings to assessment and treatment, including treatment strategies. A comparison of stutterers and nonstutterers affective, cognitive, and behavioral self-reports. Estimates have reported the male-to-female ratio of individuals who stutter to be as large as 4:1; however, more recent studies in preschool children suggest that a younger age of onset has smaller ratios in gender differences (Yairi & Ambrose, 2013). Disfluent behavior becomes more complex as fear of speaking, anxiety, and resulting avoidance increase. Often, there are pivotal points during treatment that indicate progress (T. K. Anderson & Felsenfeld, 2003; Plexico et al., 2005). School-based SLPs and IEP teams should resist pressure to minimize the impact of stuttering on educational achievement for the purpose of disqualifying students from speech-language pathology services. Research updates in neuroimaging studies of children who stutter. Teasing/bullying experienced by children who stutter: Toward development of a questionnaire. ), More than fluency: The social, emotional, and cognitive dimensions of stuttering (pp. They also can benefit from groups and intensive programs (Fry et al., 2014). Journal of Fluency Disorders, 21(34), 201214. Journal of Speech, Language, and Hearing Research, 62(8), 26912702. Rather, the purpose is to determine the extent and impact of the fluency disorder on the individual, the potential benefit from treatment, and the individuals desire and willingness to change. Behavioral treatments that address improved speech fluency appear to be effective across a range of cultures and languages (Finn & Cordes, 1997). Below is a list of approaches commonly used with school-age children, adolescents, and adults who stutter. 4. It is not appropriate to determine a standard score if the norming sample of the assessment is not representative of the individual being assessed. Yairi, E., & Ambrose, N. (2013). typical vs atypical disfluencies asha typical vs atypical disfluencies asha. The presence of at least 1 disabling developmental condition was 5.5 times higher in CWS [children who stutter] when compared to children who do not stutter (Briley & Ellis, 2018, p. 2895). https://doi.org/10.1044/1058-0360(2011/09-0102), Ntourou, K., Conture, E. G., & Walden, T. A. Education, 136(2), 159168. Trait and social anxiety in adults with chronic stuttering: Conclusions following meta-analysis. Diagnostic and statistical manual of mental disorders (5th ed.). Journal of Fluency Disorders, 35(3), 216234. https://doi.org/10.1044/leader.FTR2.19072014.44, American Speech-Language-Hearing Association. Referring the individual to other professionals to rule out other conditions and facilitate access to comprehensive services. A comprehensive assessment for persistent stuttering should include a self-assessment of the experience of stuttering. The clinician (a) considers the degree to which the individuals disfluent behaviors and overall communication are influenced by a coexisting disorder (e.g., other speech or language disorders, Down syndrome, autism spectrum disorder, attention-deficit/hyperactivity disorder) and (b) determines how treatment might be adjusted accordingly. Evaluation of speech-related attitude by means of the KiddyCAT, CAT, and BigCAT, within a larger behavior assessment battery framework for children and adults who stutter. Individuals with disfluencies are seen in all of the typical speech-language pathology service settings, including private practices, university clinics, hospitals, and schools. Rocha, M., Yaruss, J. S., & Rato, J. R. (2019). increasing effective and efficient communication. Each party is equally important in the relationship, and each party respects the knowledge, skills, and experiences that the others bring to the process.
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