Teigland, A. Journal of Communication Disorders, 80, 8191. Stuttering modification strategies, originated by Van Riper (1973), have four stages: (1) identification, (2) desensitization, (3) modification, and (4) generalization and aim to reduce associated physical tension and struggle by helping individuals. Without proper intervention, children who exhibit signs of early stuttering are more at risk for continued stuttering. the impact of communication impairments on, Relevant case history (as appropriate for age), including. (2018). Individuals with disfluencies are seen in all of the typical speech-language pathology service settings, including private practices, university clinics, hospitals, and schools. Clinicians need to be mindful of different beliefs and the stress imposed on the individual and family during treatment. Individuals may exhibit pure cluttering or cluttering with stuttering (van Zaalen-Opt Hof et al., 2009). In E. Conture & R. F. Curlee (Eds. Research updates in neuroimaging studies of children who stutter. Young children may or may not verbalize their reactions to stuttering. Allyn & Bacon. See an article by ASHAs Ad Hoc Committee on Reading Fluency For School-Age Children Who Stutter (ASHA, 2014). https://doi.org/10.1192/apt.12.1.63, Craig, A., & Tran, Y. Shock, 2. Differential treatment of stuttering in the early stages of development. Trichon, M., & Raj, E. X. Speaker and observer perceptions of physical tension during stuttering. The speakers measured speech rate is not always greater than average, but the listener perceives it as rapid. American Journal of Speech-Language Pathology, 27(3S), 11111123. Plural. For students who stutter, the impact goes beyond the communication domain. It incorporates techniques such as open-ended questions, feedback, reflective listening, affirmations, and summarizing to resolve resistance or ambivalence to therapy. practice monitoring each others speech and secondary behaviors. Adolescents also may be particularly susceptible to peer pressure and bullying at this time. Often referred to as advertising in the stuttering community, self-disclosure can involve. 6396). Introduction: The importance of the social, emotional, and cognitive dimensions of stuttering. Greater abnormality of cerebral blood flow in the posterior language loop, associated with processing words that we hear, correlates with more severe stuttering. People with fluency disorders also frequently experience psychological, emotional, social, and functional impacts as a result of their communication disorder (Tichenor & Yaruss, 2019a). attention-deficit/hyperactivity disorder (Alm, 2011). 1997- American Speech-Language-Hearing Association. Awareness and identification helps speakers better understand communication, speech, and stuttering along with their attitudes, beliefs, and behaviors. https://doi.org/10.1037/0022-0663.95.1.3, Langevin, M., Bortnick, K., Hammer, T., & Wiebe, E. (1998). (2019). In addition, clinicians need to avoid using religious or highly familiar texts that individuals may know by rote. Arnold, H. S., Conture, E. G., Key, A. P., & Walden, T. (2011). Prevalence of anxiety disorders among children who stutter. Folia Phoniatrica et Logopaedica, 19. You do not have JavaScript Enabled on this browser. (1982). Speech-language pathologists (SLPs) play a central role in the screening, assessment, diagnosis, and treatment of fluency disorders. Drayna, D. (2011). Areas of the brain that were studied and the technologies used to conduct the research (e.g., PET, MEG, MRI, fMRI, NIRS, DCS) also varied widely. Journal of Fluency Disorders, 43, 116. Typical Disfluencies vs. Stuttering in Children. Impact of stuttering severity on adolescents domain-specific and general self-esteem through cognitive and emotional mediating processes. https://doi.org/10.3109/17549507.2015.1010583, Adriaensens, S., Beyers, W., & Struyf, E. (2015). Bray, M. A., Kehle, T. J., Lawless, K., & Theodore, L. (2003). The human capacity to thrive in the face of potential trauma. Effective counseling is important for encouraging individuals with a fluency disorder to share information in the affective, cognitive, and social domains. Journal of Fluency Disorders, 36(2), 110121. Speech modification approaches to stuttering treatment in schools. In H. Gregory (Ed. (2007) for a description of how the stages of change model can be applied to fluency therapy. 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. Clinical utility of self-disclosure for adults who stutter: Apologetic versus informative statements.
typical vs atypical disfluencies asha - reflectionsgallery.ae The treatment of stuttering. https://doi.org/10.1044/2019_PERS-SIG4-2019-0024, Boyle, M. P., & Gabel, R. (2020). Children who stutter also may be at risk for experiencing bullying (Blood & Blood, 2004; Davis et al., 2002; Langevin et al., 1998). 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). Brain, 136(12), 37093726. Aphasia. Acceptance and Commitment Therapy for adults who stutter: Psychosocial adjustment and speech fluency. This list of resources is not exhaustive, and the inclusion of any specific resource does not imply endorsement from ASHA. https://doi.org/10.1055/s-0036-1583549, Martin, R. R., Haroldson, S. K., & Triden, K. A. (2008). https://doi.org/10.1016/j.jfludis.2011.04.002, Foote, G. (2013). They are likely to use interjections, repeat phrases, and revise what they are saying. Language, Speech, and Hearing Services in Schools, 26(2), 162168. Individuals may experience stuttering in different ways with siblings, their spouse, or other family members. Journal of Fluency Disorders, 46, 114. slower rates of language development (Leech et al., 2017, 2019) or co-occurring speech and language impairment (Ntourou et al., 2011; Yaruss et al., 1998). The SLP can use audio- or videoconferencing to augment this type of treatment. Children and adults who stutter also frequently experience psychological, emotional, social, and functional consequences from their stuttering, including social anxiety, a sense of loss of control, and negative thoughts or feelings about themselves or about communication (Boyle, 2015; Craig & Tran, 2014; Iverach et al., 2016; Iverach & Rapee, 2014). excessive coarticulation resulting in the collapsing and/or deletion of syllables and/or word endings; excessive disfluencies, which are usually of the more nonstuttering type (e.g., excessive revisions and/or use of filler words, such as um); pauses in places typically not expected syntactically; unusual prosody (often due to the atypical placement of pauses rather than a pedantic speaking style, as observed in many with autism spectrum disorder). ), Current issues in stuttering research and practice (pp.
Early Childhood Stuttering: Is it Stuttering or Typical Disfluency? - @ASHA (2001). Genetic contributions to stuttering: The current evidence. Overall, these indicators demonstrate progression from avoidance and negative impact to acceptance, openness, and increased socialization (V. M. Sheehan & Sisskin, 2001). Psychosocial support for adults who stutter: Exploring the role of online communities. Stuttering in relation to lexical diversity, syntactic complexity, and utterance length. https://doi.org/10.1038/s41598-017-00519-8, Chang, S.-E. (2014). Journal of Paediatrics and Child Health, 49(2), E112E115. Scheduling concerns, cost, and insurance reimbursement also are likely to be factors affecting dosage. Emotional reactivity and regulation in preschool-age children who stutter. Timing refers to the initiation of treatment relative to the diagnosis. See ASHAs resource on person- and family-centered care. Reeves, L. (2006). Guilford Press. the asha leader; journals. 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. Perspectives on Fluency and Fluency Disorders, 1(4), 5569. Technology has been incorporated into the delivery of services for fluency, including the use of telepractice to deliver face-to-face services remotely. Individuals learn to identify the thoughts underlying their negative attitudes and emotional reactions and examine the link between these thoughts, attitudes, and emotional reactions and their speech. Rehabilitation Act of 1973, Section 504. Communication attitudes in children who stutter: A meta-analytic review. Thieme.
What is the Difference Between Typical and Atypical Pneumonia Consistent with the World Health Organizations (WHO) International Classification of Functioning, Disability and Health (ICF) framework (ASHA, 2016a; Coleman & Yaruss, 2014; Vanryckeghem & Kawai, 2015; WHO, 2001; Yaruss, 2007; Yaruss & Quesal, 2004, 2006), a comprehensive fluency assessment is conducted to identify and describe. 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. In B. J. Amster & E. R. Klein (Eds. Desensitization can help decrease word avoidance and reduce fear. Palin ParentChild Interaction therapy: The bigger picture. https://doi.org/10.1044/cds20.1.15, Silverman, S., & Bernstein Ratner, N. (2002). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1016/j.jfludis.2016.09.005, Gerlach, H., Hollister, J., Caggiano, L., & Zebrowski, P. M. (2019). 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). Manning, W. H., & Quesal, R. W. (2016). International Journal of Speech-Language Pathology, 17(4), 367372. Environmental factors and speaking demands may exacerbate disfluency and influence a persons negative reactions to stuttering. Journal of Fluency Disorders, 34(3), 187200. Parent involvement may be a beneficial approach for addressing fluency issues in a bilingual child. Reducing negative reactions through desensitization and cognitive restructuring. Genetic factors and therapy outcomes in persistent developmental stuttering. discussion of personal issues (e.g., prior to, or in addition to, targeting generalization of skills in a group setting). (2013).
The speech-language pathologist (SLP) uses linguistically and culturally appropriate stimuli and is sensitive to the unique values and preferences of each individual and their family to create a treatment plan (Sisskin, 2018). ), More than fluency: The social, emotional, and cognitive dimensions of stuttering (pp. Wampold, B. E. (2001). B. facilitates conversations between the individual and their family about the experience of stuttering, the individuals communication expectations, their life goals, and how to holistically support communication (see, e.g., Berquez & Kelman, 2018; Millard et al., 2018; Rocha et al., 2019). Perspectives on Fluency and Fluency Disorders, 22(2), 5162. Journal of Fluency Disorders, 37(4), 242252. Clinicians and parents also look for reactions, such as avoidance of words or speaking situations, increased physical tension or secondary behaviors, reduced utterance length, or slight changes in pitch or loudness during stuttering episodes. A comprehensive treatment approach for preschoolers includes both parent- and child-focused strategies. have a sense of belonging and experience less stigma. Bilingual children who stutter typically do so in both languages (Nwokah, 1988; Van Borsel et al., 2001). minimizing the adverse impact of stuttering (Yaruss et al., 2012). Stuttering and reading fluency: Information for teachers [Brochure]. Journal of Speech, Language, and Hearing Research, 51(6), 14651479. The use of counseling in other areas of the speakers lifethat is, those not directly related to communicationis outside the scope of practice for SLPs (ASHA, 2016b). avoidance behaviors (i.e., avoidance of sounds, words, people, or situations that involve speaking); escape behaviors, such as secondary mannerisms (e.g., eye blinking and head nodding or other movements of the extremities, body, or face); and. Fluency and stuttering. The underlying relationship between stuttering and working memory is not fully understood but may be related to interruptions in sensorimotor timing for developmental stuttering and may involve both the basal ganglia and the prefrontal cortex (Bowers et al., 2018). There are limited data on the age of onset of cluttering; however, the age of onset of cluttering appears to be similar to that of stuttering (Howell & Davis, 2011). In contrast to adults who stutter, children who stutter did not show increases in white matter tracts in the right hemisphere (Chang et al., 2015). Peer support for people who stutter: History, benefits, and accessibility. For example, English language learners may have word-finding problems in the second language. When distress does not become depression: Emotion context sensitivity and adjustment to bereavement. Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., Danielson, M. L., Bitsko, R. H., Blumberg, S. J., Kogan, M. D., & Boyle, C. A. The ASHA Action Center welcomes questions and requests for information from members and non-members. Stuttering in animal models, such as zebra finches (Chakraborty et al., 2017) and mice (Barnes et al., 2016; Han et al., 2019), has also been investigated, including how the expression of stuttering influences social behaviors of mice (Han et al., 2019). 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. Atypical Disfluencies are more concerning and are an indicator that stuttering may not necessarily resolve without some type of intervention. their disfluencies may be accompanied by physical tension and secondary behaviors. Adjustments can include. The prevalence of speech and language disorders in French-speaking preschool children from Yaound (Cameroon). World Health Organization. https://doi.org/10.1044/2019_JSLHR-19-00137, Tichenor, S., & Yaruss, J. S. (2020). Stuttering as defined by adults who stutter. Treatment approaches that incorporate support activities also can provide venues to practice learned strategies in a safe environment and help promote generalization. The person is having difficulty communicating messages in an efficient, effective manner. Journal of Speech, Language, and Hearing Research, 61(5), 12381250. Journal of Communication Disorders, 58, 4357. Service delivery for fluency disorders encompasses, among other factors, treatment format, provider(s), dosage, timing, and setting. Communication Disorders Quarterly, 6(1), 5059. Psychological characteristics and perceptions of stuttering of adults who stutter with and without support group experience. Referring to other health care professionals when outside support is needed to facilitate treatment goals for interfering behaviors (e.g., anxiety, depression). The person is experiencing negative reactions from others (e.g., peers, classmates, coworkers, family members). Journal of Fluency Disorders, 50, 7284. Journal of Fluency Disorders, 36(3), 186193. https://doi.org/10.1016/j.jfludis.2006.12.003. Scaler Scott, K., & Ward, D. (2013). Journal of Communication Disorders, 44(3), 276293.
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