Singular. A comprehensive view of stuttering: Implications for assessment and treatment. People with fluency disorders also frequently experience psychological, emotional, social, and functional impacts as a result of their communication disorder (Tichenor & Yaruss, 2019a). The Present Levels of Academic Achievement and Functional Performance statement, which serves as the baseline for the IEP, refers to other areas that are not necessarily academic and can include information about communication skills, social skills, and other activities of daily living. A phenomenological analysis of the moment of stuttering. Intervention procedures for the young stutterer. Psychology Press. Journal of Fluency Disorders, 36(3), 186193. American Journal of Speech-Language Pathology, 12(2), 243253. The coexistence of disabling conditions in children who stutter: Evidence from the National Health Interview Survey. Journal of Fluency Disorders, 38(2), 206221. However during treatment and forming a new, more congruent identity, clients may progress through some of the stages of grief (e.g., 1. Adjustments can include. 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. Advance online publication. B. Parent perceptions of an integrated stuttering treatment and behavioral self-regulation program for early developmental stuttering. Video self-modeling as a post-treatment fluency recovery strategy for adults. The goal of Avoidance Reduction Therapy for Stuttering is to decrease fear of stuttering that leads to struggle. Disfluencies are not directly targeted; however, the frequency and intensity of disfluencies decrease as struggle is reduced. Journal of Fluency Disorders, 22(3), 219236. Cluttering: A handbook of research, intervention and education. American Journal of Speech-Language Pathology, 27(3S), 12351243. https://doi.org/10.1044/1058-0360.0202.65. Differences between children and adults should also be considered when interpreting data from neurological studies. All approaches should include a plan for generalization and maintenance of skills involved in activities of daily living. 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). Therefore, clinicians may want to ask open-ended questions to assess communication across specific situations (e.g., How do you participate in class? How do you talk to strangers? Please describe a situation when you ordered food from a restaurant. How did it feel?). ), Controversies about stuttering therapy (pp. Clinical decision making in fluency disorders. School Psychology Review, 30(1), 135141. https://doi.org/10.1016/j.jfludis.2004.08.001, Kraft, S. J., Lowther, E., & Beilby, J. It is important to note that there are more clinical anecdotes than data to support this statement; further research on the incidence and prevalence of cluttering is needed (Scaler Scott, 2013). Journal of Fluency Disorders, 36(2), 122129. Individuals may experience stuttering in different ways with siblings, their spouse, or other family members. The professional roles and activities in speech-language pathology include clinical/educational services (diagnosis, assessment, planning, and treatment); prevention and advocacy; and education, administration, and research. https://doi.org/10.1016/j.jfludis.2007.02.002, Murphy, W. P., Yaruss, J. S., & Quesal, R. W. (2007b). Measurement and modification of speech naturalness during stuttering therapy. Children who stutter may demonstrate poorer expressive lexical skills compared to their peers (Silverman & Bernstein Ratner, 2002). You do not have JavaScript Enabled on this browser. ET MondayFriday, Site Help | AZ Topic Index | Privacy Statement | Terms of Use www.asha.org/policy/, American Speech-Language-Hearing Association. Daly, D. A., Simon, C. A., & Burnett-Stolnack, M. (1995). Persons who stutter may appear to have expressive language problems because of a tendency to avoid speaking or speak in a way thats unclear to the listener. Testing, and 7. 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). Scaler Scott, K., & St. Louis, K. O. Other speech or language concerns are also present. 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. The skilled helper: A problem-management and opportunity-development approach to helping. There is a family history of stuttering or cluttering. https://doi.org/10.1044/cicsd_25_S_8, Leech, K. A., Bernstein Ratner, N., Brown, B., & Weber, C. M. (2017). Technological advances and the expansion of social media outlets have increased opportunities for adults who stutter to connect, share, and gain information through the Internet (Fuse & Lanham, 2016; Raj & Daniels, 2017) and stuttering-related podcasts (Dignazio et al., 2020). University Park Press. 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). Evidence-based practice for school-age stuttering: Balancing existing research with clinical practice. http://blog.asha.org/2013/09/26/how-can-you-tell-if-childhood-stuttering-is-the-real-deal/, Multisyllabic whole-word and phrase repetitions, Secondary behaviors (e.g., eye blinks, facial grimacing, changes in pitch or loudness), Avoidance behaviors (e.g., reduced verbal output or word/situational avoidances). Journal of Speech, Language, and Hearing Research, 61(12), 28952905. is more open and willing to disclose and talk about their stuttering; experiences reduced impact from stuttering; generalizes attitudes, beliefs, and behaviors across contexts; reports feeling more authentic and enjoying social conversations; and. https://doi.org/10.3109/17549507.2015.1010583, Adriaensens, S., Beyers, W., & Struyf, E. (2015). Disclosure of stuttering and quality of life in people who stutter. American Journal of Speech-Language Pathology, 20(3), 163179. The most common atypical disfluency of concern is word-final . However, fluency shaping approaches, such as easy onset or continuous phonation, may not be appropriate for the treatment of cluttering. The great psychotherapy debate: Models, methods, and findings. Avoidance or escape behaviors may also be used and can temporarily conceal stuttering (Constantino et al., 2017; Douglass et al., 2019, 2018; B. Murphy et al., 2007; Starkweather, 1987; Tichenor et al., 2017; Tichenor & Yaruss, 2018, 2019a, 2019b, 2020). Language assessment and intervention for the learning disabled. Cambridge University Press. Genetics and neurophysiology appear to be related to the underlying causes of stuttering. Treatment approaches that incorporate support activities also can provide venues to practice learned strategies in a safe environment and help promote generalization. Reducing bullying through role-playing and self-disclosure. (2011). Douglass, J. E., Constantino, C., Alvarado, J., Verrastro, K., & Smith, K. (2019). The SLP can use audio- or videoconferencing to augment this type of treatment. See ASHAs Scope of Practice in Speech-Language Pathology (ASHA, 2016b). (2015). https://doi.org/10.1044/1092-4388(2001/030), Finn, P. (2003). (2006). Miller, W. R., & Rollnick, S. (2013). 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). 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). Teigland, A. Journal of Speech, Language, and Hearing Research, 46(5), 12211233. A preliminary comparison of speech rate, self-evaluation, and disfluency of people who speak exceptionally fast, clutter, or speak normally. Stages of change and stuttering: A preliminary view. Differentially diagnosing fluency disorders from disfluencies stemming from language encoding difficulties such as language delay or second language learning. https://doi.org/10.1055/s-2003-37447, Thordardottir, E. (2006). It may occur only in specific situations, but it is more likely to occur in these situations, day after day. B., & Al-Khamra, R. (2015). Bulletin of the Center for Special Needs Education Research and Practice, 13, 19. Part of the diagnostic process is also to distinguish between stuttering disfluencies and disfluencies that occur when learning a new language. The impact of stuttering on adults who stutter and their partners. Is parentchild interaction therapy effective in reducing stuttering? Disclosing a fluency disorder may be done a number of ways, such as verbally stating I stutter/have a speech disorder or by pseudostuttering or openly stuttering, while doing so confidently (McGill et al., 2018). https://doi.org/10.1055/s-0034-1382151, Chang, S.-E., Garnett, E. O., Etchell, A., & Chow, H. M. (2019). Stuttering is often more severe when there is increased pressure to communicate (e.g., competing for talk time, giving a report at school, talking on the telephone/during a video chat, or interviewing for a job). Stuttering and speech naturalness. ACT is a holistic, person-centered approach that allows individuals to alter the relationships they have with their emotions and thoughts. Yaruss, J. S., & Reardon-Reeves, N. (2017). Coleman, C. (2013). Specific standardized tests can be used to rule out word-finding difficulties. https://doi.org/10.1016/j.jfludis.2006.02.002. https://doi.org/10.1073/pnas.1901480116, Harasym, J., Langevin, M., & Kully, D. (2015). 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). Stuttering: Research and therapy. 211230). "I-I-I-I- want the ball") Arnold, G. E. (1960). These modifications are used regardless of whether a particular word is expected to be produced fluently. In R. Lees & C. Stark (Eds. Individuals with disfluencies are seen in all of the typical speech-language pathology service settings, including private practices, university clinics, hospitals, and schools. This list of resources is not exhaustive, and the inclusion of any specific resource does not imply endorsement from ASHA. However, increased mean length of utterance, more diverse vocabulary, and greater syntactic complexity have also been noted (Wagovich & Hall, 2017). https://doi.org/10.1136/bmj.38520.451840.E0, Kelman, R., & Nicholas, A. Crystal ball gazing: Research and clinical work in fluency disorders in 2026. For a child with normal disfluencies, a "wait and see" approach is much more acceptable than for a child with early stuttering. Indicators of positive therapeutic change may include. The interview process and work environment can be challenging for individuals who stutter. Bargaining, 5. Disfluencies noted in bilingual children and adults are similar to those found for monolingual speakers (Shenker, 2013). winery in maryland with igloos; thick peeling skin around fingernails; holiday inn st pete beach revolving restaurant; metro approved housing in norwalk ohio Menu. https://doi.org/10.1044/2020_PERSP-20-00014. Van Borsel, J., Maes, E., & Foulon, S. (2001). Therefore, when conducting an assessment with an adult, it is crucial to understand. Tellis and Tellis (2003) caution clinicians not to confuse these word-finding problems with stuttering. https://doi.org/10.1016/S0094-730X(97)00008-9, Floyd, J., Zebrowski, P. M., & Flamme, G. A. https://doi.org/10.1017/CBO9781139108683.023. Journal of Fluency Disorders, 38(2), 171183. A mutation associated with stuttering alters mouse pup ultrasonic vocalizations. The term overt stuttering is used when core speech behaviors are present. For stuttering, the assessment will identify risk factors associated with stuttering, the severity of stuttering, and the presence of other speech and language concerns. Howell, P., & Davis, S. (2011). The chart below describes some characteristics of "typical disfluency" and "stuttering" (Adapted from Coleman, 2013). These may include stuttering modification (described above) in addition to awareness, desensitization, cognitive restructuring, self-disclosure, and support. Journal of Fluency Disorders, 36(1), 1726. https://doi.org/10.1016/j.jfludis.2013.01.001. Such strategies include simulating a fast rate of speech and applying pausing and/or simulating overarticulated speech and applying increased emphasis to increase intelligibility. Effortful control, an aspect of temperament that supports self-regulation, may be predictive of stuttering severity and may facilitate positive change in treatment (Kraft et al., 2019). Developmental stuttering in children who are hard of hearing. Journal of Speech, Language, and Hearing Research, 60(9), 24832505. The Neuroscientist, 25(6), 566582. Journal of Fluency Disorders, 22(3), 187203. practice monitoring each others speech and secondary behaviors. 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. 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). their disfluencies may be accompanied by physical tension and secondary behaviors. There are several indicators of positive therapeutic change. 178196). Anger/Resistance, 4. In this way, positive reinforcement is used to increase or strengthen the response of fluency (the desired behavior). Self-report of self-disclosure statements for stuttering. 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). Chronic problems associated with illness, injury, or other traumatic events can have a negative impact on an individuals emotional health and quality of life (e.g., Bonanno & Mancini, 2008).

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