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Environmental factors and speaking demands may exacerbate disfluency and influence a persons negative reactions to stuttering. Operant approaches operate within a framework of stuttering as a learned behavior (for a discussion, see Conture, 2001; de Sonneville-Koedoot et al., 2015, p. 334; Onslow & Yaruss, 2007). Overall, the lifetime prevalence of stuttering was estimated to be 0.72% (Craig et al., 2002). The ultimate goal is for individuals to understand these interactions and how they can manage the disfluencies and their reactions. Cognitive behavior therapy for adults who stutter: A tutorial for speech-language pathologists. Consultation with family members, educators, and other professionals regarding fluency variability (when disfluencies are noticed most and least) and the impact of disfluency. Psychology Press. You do not have JavaScript Enabled on this browser. Behavioral treatments that address improved speech fluency appear to be effective across a range of cultures and languages (Finn & Cordes, 1997). https://doi.org/10.1111/1469-7610.00093, de Sonneville-Koedoot, C., Stolk, E., Rietveld, T., & Franken, M. C. (2015). The attitudes of high school peers toward stuttering and toward persons who stutter can be improved through education in the form of classroom presentations about stuttering (Flynn & St. Louis, 2011). Therefore, when conducting an assessment with an adult, it is crucial to understand. Please enable it in order to use the full functionality of our website. Time pressures for verbal communication and requirements to use the telephone may lead to stress and discomfort. Bullying in adolescents who stutter: Communicative competence and self-esteem. Given that cluttering may co-occur with other disorders (e.g., autism spectrum disorder, Tourettes syndrome, and attention-deficit/hyperactivity disorder), having any of these disorders may be a risk factor; however, not all individuals with these disorders also exhibit cluttering. The dysfluencies that render concerns of Childhood Onset Stuttering are different than typical disfluencies. Members were Gordon Blood, Eugene Cooper, Hugo Gregory, John Hanley, Charles Healey, Stephen Hood, Kenneth S. Louis, Theodore Peters, C.W. Scaler Scott, K. (2010). Person- and family-centered practice is a collaborative approach that fosters an alliance-style partnership among individuals, families, and clinicians. https://doi.org/10.1044/2017_AJSLP-16-0079, Davis, S., Howell, P., & Cooke, F. (2002). Toward a better understanding of the process of disclosure events among people who stutter. Recommending related services when necessary for management and treatment in different settings (e.g., classroom, work, community). Support (both giving and receiving) can be valuable for improving attitudes, boosting self-confidence, and reducing feelings of isolation (Yaruss et al., 2007). Stuttering typically has its origins in childhood. ), Cluttering: A clinical perspective (pp. I have also noticed more atypical disfluencies, such as final part word repetitions (chair-air, bike-ike). Is parentchild interaction therapy effective in reducing stuttering? Pro-Ed. autism spectrum disorder (Briley & Ellis, 2018). Many clinicians use an integration of approaches to achieve optimal outcomes. Typical Disfluencies vs. Stuttering in Children. Adults who stutter also may experience job discrimination and occupational stereotyping, including an earnings gap, especially for females (Gerlach et al., 2018). practice treatment targets with more listeners. (2009). Speech clarity and fluency may temporarily improve when the person is asked to slow down or pay attention to their speech. (2008). (2011). https://doi.org/10.1016/j.jfludis.2014.12.003. Expand Search Apply; Program Guide; BOBapp(2023) . The ASHA Leader, 18(3), 1415. their reason for seeking treatment at the current time. Provider refers to the person providing treatment (e.g., SLP, trained volunteer, family member, or caregiver). Disclosing a fluency disorder has many benefits on both the speaker (Boyle & Gabel, 2020; Boyle et al., 2018; Mancinelli, 2019) and the listener (Byrd, Croft, et al., 2017; Byrd, McGill, et al., 2017; Ferguson et al., 2019; Healey et al., 2007). Quick: Talk fast & dont stutter! Journal of Abnormal Psychology, 119(3), 479490. Differential treatment of stuttering in the early stages of development. Arnold, G. E. (1960). Fluency disorders can interfere with play, school, work, or social interactions (Yaruss & Quesal, 2004). https://doi.org/10.1016/S0094-730X(02)00162-6, Singer, C. M., Hessling, A., Kelly, E. M., Singer, L., & Jones, R. M. (2020). May 11, 2022 As a speech-language pathologist, you might often face the question of whether a young child is showing early signs of stuttering, or if those disruptions are simply typical speech disfluencies. Seminars in Speech and Language, 39(4), 324332. However, these disfluencies are typical and not indicative of a disorder (Shenker, 2013). Children who stutter (ages 39 years) have reduced connectivity in areas that support the timing of movement control. A fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm, and disfluencies (e.g., repetitions of sounds, syllables, words, and phrases; sound prolongations; and blocks), which may also be accompanied by excessive tension, speaking avoidance, struggle behaviors, and secondary mannerisms (American Speech-Language-Hearing Association [ASHA], 1993). Fluency treatment is a dynamic process; service delivery may change over time as the individuals needs change. Acceptance and Commitment Therapy for people who stutter. The effects of self-disclosure on the communicative interaction between a person who stutters and a normally fluent speaker. https://doi.org/10.1044/jshd.4901.53, Mnsson, H. (2000). Stuttering in relation to lexical diversity, syntactic complexity, and utterance length. https://doi.org/10.1044/2018_AJSLP-ODC11-17-0189, Chakraborty, M., Chen, L.-F., Fridel, E. E., Klein, M. E., Senft, R. A., Sarkar, A., & Jarvis, E. D. (2017). Overheard: Bilingual and disfluent: A unique treatment challenge. Stuttering, the most common fluency disorder, is an interruption in the flow of speaking characterized by specific types of disfluencies, including, These disfluencies can affect the rate and rhythm of speech and may be accompanied by. Such individuals may benefit from treatment strategies that focus on improving speech efficiency by reducing word avoidance and increasing spontaneity in communication. Increased incidence of stuttering has been noted among those with a first-degree relative (e.g., parent, sibling) who stutters and an even greater likelihood if that relative is an identical twin (Kraft & Yairi, 2011). Coleman, C. (2013). Application of the ICF in fluency disorders. (2013). Daniels, D. (2007). Helping individuals who stutter become more accepting and open about their stuttering may help them have workplace conversations about it, advocate for themselves, and build support systems within the workplace (Plexico et al., 2019). These individuals are said to experience covert stuttering (B. Murphy et al., 2007). Journal of Fluency Disorders, 37(4), 242252. Characteristics of Typical Disfluency and Stuttering Differentiating typical disfluencies and stuttering is a critical piece of assessment, particularly for preschool children. Adults are likely to have been living with stuttering for a long time. Stuttering-related podcasts: Audio-based self-help for people who stutter. Sisskin, V. (2018). Palin ParentChild Interaction therapy: The bigger picture. They are likely to use interjections, repeat phrases, and revise what they are saying. Brain, 138(3), 694711. 297325). Determination of individual strengths and coping strategies. Thieme. Counseling begins with active listening and continues with microskills (Egan, 2013) that emphasize attending, showing empathy, demonstrating shared interest in the individual/family, and working to build trust. Prentice-Hall. 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/10.1016/j.jfludis.2013.03.001, Coifman, K. G., & Bonanno, G. A. Scaler Scott, K., & St. Louis, K. O. https://doi.org/10.1192/apt.12.1.63, Craig, A., & Tran, Y. https://doi.org/10.1044/2020_PERSP-20-00014. They may hesitate when speaking, use fillers ("like" or "uh"), or repeat a word or phrase. Education, 136(2), 159168. The creative process in avoidance reduction therapy for stuttering. Barnes, T. D., Wozniak, D. F., Gutierrez, J., Han, T. U., Drayna, D., & Holy, T. (2016). https://doi.org/10.1016/j.jfludis.2018.09.004, Menzies, R. G., OBrian, S., Packman, A., Jones, M., Helgadttir, F. D., & Onslow, M. (2019). Psychology Press. One study showed that children who clutter had 7.6 times more normal disfluencies compared to "atypical" disfluencies when they retold a story (van Zaalen et al., 2009). https://doi.org/10.1044/1058-0360.0202.65. Journal of Speech, Language, and Hearing Research, 62(8), 26912702. Available from http://blog.asha.org/2013/09/26/how-can-you-tell-if-childhood-stuttering-is-the-real-deal/. Explore how typical and atypical disfluencies differ, and find resources for guidance and support. Brain, 131(1), 5059. The social and communication impact of stuttering on adolescents and their families. Journal of Speech, Language, and Hearing Research, 36(5), 906917. Atypical disfluencies are generally not seen in the majority of children with developmental stuttering (child onset fluency disorder). (2018). The impact of stuttering on adults who stutter and their partners. 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. https://doi.org/10.1016/j.jfludis.2016.09.005, Gerlach, H., Hollister, J., Caggiano, L., & Zebrowski, P. M. (2019). Cognitive restructuring is a strategy designed to help speakers change the way they think about themselves and their speaking situations. It applies protections to ensure that programs and employment environments are accessible and to provide aids and services necessary for effective communication in these settings. https://doi.org/10.1044/2019_JSLHR-S-18-0225. Luterman, D. M. (2006). Cooper, E. B. Signs and symptoms of stuttering include core speech behaviors, such as. https://doi.org/10.1177/1073858418803594, Chang, S.-E., & Zhu, D. C. (2013). Developing culturally and linguistically relevant intervention plans focused on helping the individual achieve more fluent speech and self-acceptance of disfluency, providing treatment, documenting progress, and determining appropriate dismissal criteria. Stuttering and cluttering: Frameworks for understanding and treatment. Genetic factors and therapy outcomes in persistent developmental stuttering. learning disabilities (Wiig & Semel, 1984). Journal of Fluency Disorders, 58, 2234. Speech modification (including fluency shaping) strategies (Bothe, 2002; Guitar, 1982, 2019) include a variety of techniques aimed at making changes to the timing and tension of speech production or altering the timing of pauses between syllables and words. See ASHAs resource on treatment goals for fluency disorders in the context of the WHO ICF framework. American Journal of Speech-Language Pathology, 12(4), 425431. There are several indicators of positive therapeutic change. Emotional reactivity and regulation associated with fluent and stuttered utterances of preschool-age children who stutter. https://doi.org/10.1044/2018_JSLHR-L-16-0400, Palasik, S., & Hannan, J. Journal of Communication Disorders, 85, 105944. https://doi.org/10.1016/j.jcomdis.2019.105944. Journal of Fluency Disorders, 43, 116. (2003). B. Journal of Fluency Disorders, 38(2), 6687. 3. Professional awareness of cluttering. In addition, clinicians need to avoid using religious or highly familiar texts that individuals may know by rote. The influence of workplace discrimination and vigilance on job satisfaction with people who stutter. Prevalence of cluttering in two European countries: A pilot study. Social anxiety disorder in adults who stutter. (2017). Journal of Fluency Disorders, 35(4), 333354. https://doi.org/10.1044/cicsd_25_S_8, Leech, K. A., Bernstein Ratner, N., Brown, B., & Weber, C. M. (2017). These should be considered during differential diagnosis but should not be the sole therapeutic strategies. Below is a list of approaches commonly used with school-age children, adolescents, and adults who stutter. When a bilingual clinician is not available, using an interpreter is a viable option. Typical vs Atypical Pneumonia in Tabular Form 6. Bargaining, 5. Contemporary Issues in Communication Science and Disorders, 25(Spring), 820. A comprehensive view of stuttering: Implications for assessment and treatment. Treatment for adolescents who stutter poses a particular challenge because of the issues related to this developmental stage. This relationship is recognized as one of the common factors that account for the effectiveness of counseling (common factors theory; Wampold, 2001). Tallying has the client stop directly after a moment of stuttering to tally or bring awareness to it while not attempting to escape by continuing to talk. Evaluating stuttering in young children: Diagnostic data. Referring the individual to other professionals to rule out other conditions and facilitate access to comprehensive services. Clients often report successful stuttering therapy as a transformational experience progressing from avoidance to acceptance and openness, increasing self-confidence and self-efficacy (Plexico et al., 2005; Tichenor & Yaruss, 2019a). Apply Now. Thieme. Clinicians need to be familiar with various counseling principles and approaches (Luterman, 2006; Zebrowski & Schum, 1993). https://doi.org/10.1016/j.jfludis.2014.01.001. ), Stuttering and related disorders of fluency (pp. Increasing the individuals awareness and self-monitoring skills helps to reduce unproductive behaviors that interfere with speech, and it may allow them to alter moments of stuttering so that they have decreased tension, are shorter, and are less disruptive to communication. Group experiences and individual differences in stuttering. Strategies aimed at changing the timing and tension of speech production include. What we know for now IN BRIEF. https://doi.org/10.1044/cds20.1.15, Silverman, S., & Bernstein Ratner, N. (2002). Nurturing a resilient mindset in school-aged children who stutter. ), More than fluency: The social, emotional, and cognitive dimensions of stuttering (pp. Scope of practice in speech-language pathology [Scope of practice]. Stuttering and bilingualism: A review. Screening is conducted whenever a fluency disorder is suspected or as part of a comprehensive speech and language assessment. Psychology Press. Seminars in Speech and Language, 35(2), 114131. The Stuttering Foundation We provide free online resources, services and support to those who stutter and their families, as well as support for research into the causes of stuttering. Journal of Fluency Disorders, 22(3), 187203. Journal of Fluency Disorders, 38(4), 311324. This model describes stages in the process of behavioral change, and it can be used to determine an individuals readiness to make a change. 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. Clinicians may provide education about the speech systems and processes (e.g., respiratory system, phonatory, articulation/resonance, and nonverbal features) and that communication includes both verbal and nonverbal aspects, pragmatics, senderreceiver dynamics, and interpersonal relational features, which may be a target in treatment. Typical childhood disfluencies may increase and decrease without any external influence. Language, Speech, and Hearing Services in Schools, 26(2), 162168. https://doi.org/10.1016/j.jfludis.2006.12.003. Arnold, H. S., Conture, E. G., Key, A. P., & Walden, T. (2011). Cluttering, another fluency disorder, is characterized by a perceived rapid and/or irregular speech rate, atypical pauses, maze behaviors, pragmatic issues, decreased awareness of fluency problems or moments of disfluency, excessive disfluencies, collapsing or omitting syllables, and language formulation issues, which result in breakdowns in speech clarity and/or fluency (St. Louis & Schulte, 2011; van Zaalen-Opt Hof & Reichel, 2014). The cost of such avoidance can be great because of the resulting impact on the persons ability to say what they want to say, when they want to say it. Motivational interviewing is a person-centered approach that can be useful in developing functional goals and enhancing readiness for change (Miller & Rollnick, 2013; Rollnick & Miller, 1995). A descriptive study of speech, language, and hearing characteristics of school-aged stutterers.

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