The person is having difficulty communicating messages in an efficient, effective manner. See ASHAs Practice Portal pages on Bilingual Service Delivery and Collaborating With Interpreters, Transliterators, and Translators. Client perceptions of effective and ineffective therapeutic alliances during treatment for stuttering. See ASHAs resource on assessment tools, techniques, and data sources. Journal of Fluency Disorders, 38(4), 342355. See ASHAs resource on person- and family-centered care. In D. Ward & K. Scaler Scott (Eds. However, their disfluencies are not likely to involve prolongations, blocks, physical tension, or secondary behaviors that are more typical for children who stutter (Boscolo et al., 2002). The role of self-help/mutual aid in addressing the needs of individuals who stutter. Language, Speech, and Hearing Services in Schools, 49(1), 13. https://doi.org/10.1055/s-0034-1382151, Chang, S.-E., Garnett, E. O., Etchell, A., & Chow, H. M. (2019). Preliminary evidence that growth in productive language differentiates childhood stuttering persistence and recovery. The utility of stuttering support organization conventions for young people who stutter. Journal of Educational Psychology, 95(1), 321. Technology has been incorporated into the delivery of services for fluency, including the use of telepractice to deliver face-to-face services remotely. For example, individuals who clutter may not be aware of communication breakdowns and, therefore, do not attempt to repair them. ), Controversies about stuttering therapy (pp. Folia Phoniatrica et Logopaedica, 69, 180189. Myers, F. L. (1992). Counseling persons with communication disorders and their families. For example, cluttering symptoms may decrease during a formal speech evaluationdue to increased self-monitoringbut increase in more comfortable situations where the person is less likely to self-monitor. (Eds.). It is not appropriate to determine a standard score if the norming sample of the assessment is not representative of the individual being assessed. by ; 2022 June 3; barbara "brigid" meier; 0 . For a child with normal disfluencies, a "wait and see" approach is much more acceptable than for a child with early stuttering. For example, counseling an individual to accept or tolerate embarrassment can facilitate desensitization. Children and adolescents with fluency disorders may qualify for accommodations whether or not they have an active individualized education program (IEP). Communication Disorders Quarterly, 6(1), 5059. Stuttering: Research and therapy. Other observable, secondary or concomitant, stuttering behaviors can include body movements (e.g., head nodding, leg tapping, fist clenching), facial grimaces (e.g., eye blinking, jaw tightening), and distracting sounds (e.g., throat clearing). Posted at 23:22h . Bilingual children who stutter typically do so in both languages (Nwokah, 1988; Van Borsel et al., 2001). When a student stutters: Identifying the adverse educational impact. (2014). https://doi.org/10.1073/pnas.1901480116, Harasym, J., Langevin, M., & Kully, D. (2015). Treatment may include strategies to reduce negative reactions to stuttering in the individual and others (Yaruss et al., 2012). https://doi.org/10.1044/gics4.2.57, Van Zaalen, Y., & Reichel, I. Cultural diversity should also be considered in the discussion of stuttering, as it can have an impact on assessment and treatment of stuttering. Typical vs Atypical Pneumonia in Tabular Form 6. https://doi.org/10.1044/leader.FTR1.11102006.6, Tichenor, S. E., Leslie, P., Shaiman, S., & Yaruss, J. S. (2017). When a bilingual SLP is not available, using an interpreter is a viable option. The creative process in avoidance reduction therapy for stuttering. Identifying subgroups of stutterers (No. https://doi.org/10.1002/hbm.23487, Dignazio, L. E., Kenny, M. M., Raj, E. X., & Pelkey, K. D. (2020). The ASHA Leader, 11(10), 621. Childhood stuttering: Incidence and development. The term overt stuttering is used when core speech behaviors are present. Limited research is available that identifies the causes of cluttering. Journal of Fluency Disorders, 53, 2640. Dosage depends largely on the nature of the treatment (e.g., direct, indirect), age group, and the task level (e.g., learning basic skills requires more clinic room practice than does generalization). Journal of Fluency Disorders, 49, 1328. Management of childhood stuttering. Desensitization strategies are strategies that help speakers systematically desensitize themselves to their fears about speaking and stuttering by facing those fears in structured, supportive environments. Pro-Ed. 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. Seminars in Speech and Language, 24(1), 2126. attention-deficit/hyperactivity disorder (Donaher & Richels, 2012; Lee et al., 2017). Prevalence of cluttering in two European countries: A pilot study. In B. J. Amster & E. R. Klein (Eds. School Psychology Review, 30(1), 135141. 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. In J. C. Norcross & M. R. Goldfried (Eds. Self-efficacy is a positive belief in ones own ability to successfully accomplish a set goal that is task dependent, which comes from (a) past experiences of mastery, (b) vicarious experiences, (c) verbal persuasion, and (d) emotional/physical states (Boyle, 2013a, 2013b, 2015; Boyle et al., 2018; Carter et al., 2017). 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/10.1176/appi.books.9780890425596, American Speech-Language-Hearing Association. Stuttering and cluttering: Frameworks for understanding and treatment. Journal of Communication Disorders, 44(3), 276293. Journal of Fluency Disorders, 62, 105725. https://doi.org/10.1016/j.jfludis.2019.105725, Plexico, L. W., Manning, W. H., & DiLollo, A. SLPs counseling skills should be used specifically to help speakers improve their quality of life by minimizing the burden of their communication disorder. (n.d.). It can also be challenging to assess the reading fluency of bilingual students who stutter. Teigland, A. Abou, E. M., Saleh, M., Habil, I., El Sawy, M., & El Assal, L. (2015). Other treatment approaches described below also may be incorporated as part of a comprehensive treatment approach. black quartz metaphysical properties; car accident woodbury, mn today; it severely reduces carb intake crossword clue https://doi.org/10.1016/j.jfludis.2010.07.001. (2017). It is important that parents and clinicians acknowledge and respond to a childs verbal and nonverbal reactions in a supportive manner; this helps to minimize the likelihood that the child will develop negative reactions to stuttering. Cluttering treatment: Theoretical considerations and intervention planning. The purpose of CBT is to modify current negative thoughts, emotions, and/or behaviors and replace them with positive ones through identification of thought patterns and challenging cognitive distortions in real time. www.asha.org/policy/, American Speech-Language-Hearing Association. Stuttering as defined by adults who stutter. Sociodynamic relationships between children who stutter and their non-stuttering classmates. American Journal of Speech-Language Pathology, 27(3S), 12351243. 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). One of the most widely used models of change is the transtheoretical or stages of change model (Prochaska & DiClemente, 2005). It is also not unusual for disfluencies to be apparent and then seem to go away for a period of weeks or months only to return again. https://doi.org/10.1016/S0094-730X(96)00024-1, Murphy, B., Quesal, R. W., & Gulker, H. (2007). The ability to use speech strategies; to make choices to speak and participate, regardless of the level of fluency; and to take risks is greatly reduced outside of the treatment setting when time pressure and conditioned negative feelings may trigger fear and old behaviors. Seminars in Speech and Language, 35(2), 114131. Scaler Scott, K. (2011). (2011). Psychological characteristics and perceptions of stuttering of adults who stutter with and without support group experience. Clinical decision making in fluency disorders. Atypical Disfluencies are more concerning and are an indicator that stuttering may not necessarily resolve without some type of intervention. The ultimate goal is for individuals to understand these interactions and how they can manage the disfluencies and their reactions. Stuttering Foundation: A Nonprofit Organization Helping Those Who Stutter https://doi.org/10.1044/0161-1461(2012/11-0044), Yaruss, J. S., LaSalle, L. R., & Conture, E. G. (1998). Language, Speech, and Hearing Services in Schools, 26(2), 162168. Higher incidence rates of stuttering have been reported in preschool-aged children (11.2%; Reilly et al., 2013), with prevalence estimates reported as 2.2%5.6% (Yairi & Ambrose, 2013). The impact of stuttering on adults who stutter and their partners. Indicators of positive therapeutic change may include. These strategies, like speech modification strategies, are introduced along a hierarchy of speaking situations that varies both with linguistic demands and with the stressors of the environment. Rethinking covert stuttering. 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). Similarities - Typical and Atypical Pneumonia 5. https://doi.org/10.1044/1092-4388(2008/046, Millard, S. K., Zebrowski, P., & Kelman, E. (2018). https://doi.org/10.1080/2050571X.2016.1253533. Bargaining, 5. Setting refers to the location of treatment (e.g., home, community-based [including work settings], school environments, clinic room). The SLP can use audio- or videoconferencing to augment this type of treatment. Journal of Fluency Disorders, 50, 7284. Seminars in Speech and Language, 39(4), 324332. Sisskin, V. (2018). gain insights from others who may be further along in treatment, have opportunities to gain self-confidence from mentoring others, and. Breakdowns in fluency and clarity can result from. Recommending related services when necessary for management and treatment in different settings (e.g., classroom, work, community). It discusses types of atypical dysfluency as well as application of current findings to assessment and treatment, including treatment strategies. However during treatment and forming a new, more congruent identity, clients may progress through some of the stages of grief (e.g., 1. ), Cluttering: A handbook of research, intervention and education (pp. Crystal ball gazing: Research and clinical work in fluency disorders in 2026. What is Typical Pneumonia? The neurological underpinnings of cluttering: Some initial findings. Journal of Fluency Disorders, 31(2), 90115. Skip to main content. Self-efficacy and quality of life in adults who stutter. Journal of Speech, Language, and Hearing Research, 63(9), 29953018. 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). Retrieved month, day, year, from www.asha.org/practice-portal/clinical-topics/fluency-disorders/. Journal of Fluency Disorders, 40, 3543. https://doi.org/10.1044/jshr.3103.377, Weber-Fox, C., Wray, A. H., & Arnold, H. (2013). This list is not exhaustive, and not all factors need to be present for a referral to an SLP (e.g., Guitar, 2019; Yaruss et al., 1998). Stuttering can co-occur with other disorders (Briley & Ellis, 2018), such as. Increasing fluency may not be a goal for an adult or may be only one aspect of a comprehensive and multidimensional approach (Amster & Klein, 2018). Cengage Learning. https://doi.org/10.1016/j.jfludis.2013.06.002, Nwokah, E. E. (1988). Some adults lack communication confidence as a result of negative self-perceptions about their stuttering (Beilby et al., 2012a) or due to repeated exposure to people holding stereotypes about stuttering, which, in turn, may create self-stigmatization (Boyle, 2013a). Genetic approaches to understanding the causes of stuttering. 341358). Ward, D., & Scaler Scott, K. (2011). However, there is no evidence to support the idea that stuttering is caused by, or more prevalent in, bilingual or multilingual speakers or that exposure to a second language increases the risk for developing stuttering (Byrd, 2018). Psychology Press. For school-age children and adolescents, initiation of treatment depends, in large part, on their motivation, which, in turn, is dependent on factors such as their perceived needs, the degree of adverse impact they experience, and their previous treatment experiences. Psychosocial support for adults who stutter: Exploring the role of online communities. (2019). Stuttering More than 70 million people around the world struggle with stuttering, according to The Stuttering Foundation. Bulletin of the Center for Special Needs Education Research and Practice, 13, 19. "Atypical" disfluencies include: sound repetitions ("s-s-s-so"); syllable repetitions ("be-be-be-be-because"); prolongations ("Aaaaaaaaaaaaand"); and https://doi.org/10.1002/da.20657, Bonanno, G. A., & Mancini, A. D. (2008). If treatment is warranted, it is necessary to determine the timing for intervention and to set out a plan for parent education and counseling. There are several indicators of positive therapeutic change. Changing adolescent attitudes toward stuttering. recognize physical concomitant behaviors, locate the point of physical tension and struggle during moments of disfluency, and. Drayna, D. (2011). https://doi.org/10.1044/0161-1461(2006/014), Yaruss, J. S., Coleman, C. E., & Quesal, R. W. (2012). Cluttering and Down syndrome. Journal of Fluency Disorders, 38(4), 311324. B., & Al-Khamra, R. (2015). Without proper intervention, children who exhibit signs of early stuttering are more at risk for continued stuttering. School-age stuttering therapy: A practical guide. Journal of Fluency Disorders, 26(3), 179206. For example, individuals with attention-deficit/hyperactivity disorder, autism spectrum disorder, intellectual disability, learning disability, or seizures have higher odds of stuttering. All speakers are disfluent at times. For example, stuttering has been associated with higher levels of social anxiety in adults who stutter (Blumgart et al., 2010), and this can lead to fear and avoidance of social interaction (see Craig & Tran, 2006, for a review research on this topic). Onslow, M., Packman, A., & Harrison, E. International Classification of Functioning, Disability and Health. These include when the individual who stutters. https://doi.org/10.1016/S0094-730X(97)00009-0, Yaruss, J. S. (2007). These are called typical disfluencies or nonfluencies. Their skills are developing in this area. https://doi.org/10.1016/j.jfludis.2013.03.001, Coifman, K. G., & Bonanno, G. A. Fluency Disorders (Practice Portal). Additionally, the affective, behavioral, and cognitive features of stuttering are important components of the assessment (Vanryckeghem & Kawai, 2015). attention-deficit/hyperactivity disorder (Alm, 2011). https://doi.org/10.1371/journal.pone.0133758, Desai, J., Huo, Y., Wang, Z., Bansal, R., Williams, S. C., Lythgoe, D., Zelaya, F. O., & Peterson, B. S. (2016). For a discussion of a process for selecting evidence-based approaches based on individual needs, see Yaruss and Pelczarski (2007). Reducing negative reactions through desensitization and cognitive restructuring. (2011). SIG 16 Perspectives on School-Based Issues, 15(2), 7580. See ASHAs Practice Portal pages on Counseling For Professional Service Delivery and Cultural Responsiveness for more information related to counseling. Cumulative incidence estimates of stuttering in children range from 5% to 8% (Mnsson, 2000; Yairi & Ambrose, 2013). Contemporary Issues in Communication Science and Disorders, 25(Spring), 820.
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