Stuttering and Fluency Disorders
Stuttering—Fluency Disorders
Chapter 12
Outline
•
I. Introduction and Basic Definitions
•
II. Stuttering Defined
•
III. Evaluating Children with Fluency Disorders
•
IV. Treatment for Children who Stutter
•
V. Treatment for Teens and Adults
Information about cluttering is not on the
exam:
•
Bottom of page 291-all of 292
You don’t have to know…
•
Any theories about the etiology of stuttering on pages 290-291
Kids Talk About Stuttering**
•
https://www.youtube.com/watch?v=2Jk3AtlfWKQ
I. INTRODUCTION AND BASIC DEFINITIONS**
•
The terms stuttering and disfluency are both used
•
My mom stuttered and so did my sister Crystal as well as my
husband Mike and son Mark
•
Today, we encourage people to be comfortable with stuttering and
not try to avoid it
My personal philosophy:
Youtube:
•
https://www.youtube.com/watch?v=zZ4XNEDSKWY
•
Steve’s Powerful and Personal Response to Stuttering
Typical disfluency
Risk Factors for Persistent Stuttering**
•
All little kids have typical disfluencies
•
Family history is a big red flag
•
Time duration of 6-12 months since onset of stuttering or no
improvement over several months
•
Starting to stutter at 3 and ½ or later
•
Co-occurring speech and/or language disorders
•
Child aware of/distressed by disfluencies
Other Facts**
•
90% of children who stutter begin to stutter between 2-6 years
of age
•
The male-female ratio is 4:1
•
Stuttering is especially associated with hemispheric asymmetry,
including increased activity in motor centers in the
nondominant (usually the right) hemisphere
When some children are learning another
language:
Other disorders can occur along with stuttering:
Causes of stuttering are multifactorial**
•
Genetics
•
Environment
•
Neurophysiology—brain differences
Barry Guitar describes the path:**
•
Child is born with genetic predisposition to stutter
•
At around 3 years old, mild normal disfluencies occur
•
If people criticize, bully, or shame the child, the normal disfluencies
can worsen into stuttering
II. STUTTERING DEFINED
•
A. Introduction
B. Audible Overt Behaviors
C. Visible Overt/Secondary Behaviors**
•
Head jerks
•
Blinking quickly
•
Tapping the foot
•
(my husband) pounding the hand or fist
•
Losing eye contact
•
Fist clenches
D. Covert Reactions—Feelings and Thoughts
Stuttering often gets worse when people:**
•
Say their own name
•
Speak with authority figures
•
Speak on the phone
•
Speak in public
III. EVALUATING CHILDREN WTH FLUENCY DISORDERS**
•
Is the child stuttering or are they at risk for stuttering?
•
Does the child have any other communicative risk factors? (e.g.,
language disorder)
•
Is therapy warranted?
•
What therapy approach would be most beneficial?
The most important thing…
Interviewing children**
•
With young children: “Is talking easy
or hard for you?”
•
With older children and teens, ask
what situations make stuttering
worse
•
What has helped you and what
hasn’t?
A major goal is:**
•
Understand how the client feels about their stuttering
•
They might not be bothered by it
•
They might be very self conscious and fearful
We want to:
One mom I worked with claimed that her son
stuttered**
•
But the teacher never heard it, and neither did we
•
It wasn’t till she brought her phone in and had us listen to a recording
from home
•
We were shocked—Mom was right!
We record the number and types of
disfluency**
•
For example, a common technique is to count the % of disfluencies
in a 100-word sample
•
Does the child have mostly prolongations? Blocks? Repetitions?
How severe is the stuttering? 5 types
:**
•
1. Normal disfluency—less than 10% disfluencies in 100 words,
mostly relaxed word and phrase repetitions—child not aware
•
2. Borderline stuttering—more than 10 disfluencies of various
types per 100 words—loose and relaxed
•
3. Beginning stuttering—tension, hurry, rapid and abrupt
repetitions, prolongations, phonatory arrest (word catches in their
throat)—child is aware and frustrated—may have secondary
mannerisms
IV. TREATMENT FOR CHILDREN WHO
STUTTER**
•
A. Primary Prevention
•
We as SLPs help eliminate or diminish the onset and development
of stuttering
•
Usually this involves modifying conditions in the home and school
We can teach parents, teachers, siblings, and others in the
child’s life to:
B. Direct Therapy for Children**
•
Be warm, accepting, calm, and easygoing
•
Build the child’s confidence
•
I do like published fluency programs, esp. those that involve
GILCU—gradually increased length and complexity of utterance
Stuttering modification…**
•
Focuses more on improvement of overall communication than on
fluent speech
•
Person who stutters must recognize and confront their fears,
avoidance behaviors, and struggles—this is more important than
being fluent
•
Goals: spontaneous fluency, controlled fluency, or acceptable
stuttering
Fluency shaping:
V. TREATMENT FOR TEENS AND ADULTS**
•
Both internal and external motivation are important
•
Often, the person will want therapy because they feel like their
stuttering is holding them back from job opportunities
•
We need to directly interview them, paying careful attention to
what situations are causing distress/anxiety
•
Of course, we are evaluating what behaviors they are exhibiting—
repetitions? Blocks? Prolongations?
I worked with Jon, a teenager**
•
Who was afraid to ask girls out because he was
afraid they would make fun of him
Four aspects of treatment:
Outline
•
I. Developmental Disabilities
•
II. Autism Spectrum Disorder
•
III. Additional Considerations for Individuals with Autism Spectrum
Disorder and Developmental Disabilities
Reflection
•
There are points of view today about stuttering. POV #1: We should
leave people who stutter alone. The world needs to accommodate
them. POV #2: The world needs to be more accommodating—true!
But we should see what our clients want and focus on giving them
choices of behaviors to select if they want to be fluent in certain
situations.
•
Write 3-4 sentences on which POV you support and why.
Explore the nuances of stuttering and fluency disorders, from definitions to evaluation and treatment approaches for children, teens, and adults. Discover insights on cluttering, typical disfluency, risk factors, and other key facts related to stuttering. Gain personal perspectives, watch informative videos, and learn about important aspects of managing stuttering effectively.
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Presentation Transcript
StutteringFluency Disorders Chapter 12
Outline I. Introduction and Basic Definitions II. Stuttering Defined III. Evaluating Children with Fluency Disorders IV. Treatment for Children who Stutter V. Treatment for Teens and Adults
Information about cluttering is not on the exam: Bottom of page 291-all of 292
You dont have to know Any theories about the etiology of stuttering on pages 290-291
Kids Talk About Stuttering** https://www.youtube.com/watch?v=2Jk3AtlfWKQ
I. INTRODUCTION AND BASIC DEFINITIONS** The terms stuttering and disfluency are both used My mom stuttered and so did my sister Crystal as well as my husband Mike and son Mark Today, we encourage people to be comfortable with stuttering and not try to avoid it
Youtube: https://www.youtube.com/watch?v=zZ4XNEDSKWY Steve s Powerful and Personal Response to Stuttering
Risk Factors for Persistent Stuttering** All little kids have typical disfluencies Family history is a big red flag Time duration of 6-12 months since onset of stuttering or no improvement over several months Starting to stutter at 3 and or later Co-occurring speech and/or language disorders Child aware of/distressed by disfluencies
Other Facts** 90% of children who stutter begin to stutter between 2-6 years of age The male-female ratio is 4:1 Stuttering is especially associated with hemispheric asymmetry, including increased activity in motor centers in the nondominant (usually the right) hemisphere
When some children are learning another language:
Causes of stuttering are multifactorial** Genetics Environment Neurophysiology brain differences
Barry Guitar describes the path:** Child is born with genetic predisposition to stutter At around 3 years old, mild normal disfluencies occur If people criticize, bully, or shame the child, the normal disfluencies can worsen into stuttering
II. STUTTERING DEFINED A. Introduction
C. Visible Overt/Secondary Behaviors** Head jerks Blinking quickly Tapping the foot (my husband) pounding the hand or fist Losing eye contact Fist clenches
Stuttering often gets worse when people:** Say their own name Speak with authority figures Speak on the phone Speak in public
III. EVALUATING CHILDREN WTH FLUENCY DISORDERS** Is the child stuttering or are they at risk for stuttering? Does the child have any other communicative risk factors? (e.g., language disorder) Is therapy warranted? What therapy approach would be most beneficial?
Interviewing children** With young children: Is talking easy or hard for you? With older children and teens, ask what situations make stuttering worse What has helped you and what hasn t?
A major goal is:** Understand how the client feels about their stuttering They might not be bothered by it They might be very self conscious and fearful
One mom I worked with claimed that her son stuttered** But the teacher never heard it, and neither did we It wasn t till she brought her phone in and had us listen to a recording from home We were shocked Mom was right!
We record the number and types of disfluency** For example, a common technique is to count the % of disfluencies in a 100-word sample Does the child have mostly prolongations? Blocks? Repetitions?
How severe is the stuttering? 5 types:** 1. Normal disfluency less than 10% disfluencies in 100 words, mostly relaxed word and phrase repetitions child not aware 2. Borderline stuttering more than 10 disfluencies of various types per 100 words loose and relaxed 3. Beginning stuttering tension, hurry, rapid and abrupt repetitions, prolongations, phonatory arrest (word catches in their throat) child is aware and frustrated may have secondary mannerisms
IV. TREATMENT FOR CHILDREN WHO STUTTER** A. Primary Prevention We as SLPs help eliminate or diminish the onset and development of stuttering Usually this involves modifying conditions in the home and school
We can teach parents, teachers, siblings, and others in the child s life to:
B. Direct Therapy for Children** Be warm, accepting, calm, and easygoing Build the child s confidence I do like published fluency programs, esp. those that involve GILCU gradually increased length and complexity of utterance
Stuttering modification** Focuses more on improvement of overall communication than on fluent speech Person who stutters must recognize and confront their fears, avoidance behaviors, and struggles this is more important than being fluent Goals: spontaneous fluency, controlled fluency, or acceptable stuttering
V. TREATMENT FOR TEENS AND ADULTS** Both internal and external motivation are important Often, the person will want therapy because they feel like their stuttering is holding them back from job opportunities We need to directly interview them, paying careful attention to what situations are causing distress/anxiety Of course, we are evaluating what behaviors they are exhibiting repetitions? Blocks? Prolongations?
I worked with Jon, a teenager** Who was afraid to ask girls out because he was afraid they would make fun of him
Outline I. Developmental Disabilities II. Autism Spectrum Disorder III. Additional Considerations for Individuals with Autism Spectrum Disorder and Developmental Disabilities
Reflection There are points of view today about stuttering. POV #1: We should leave people who stutter alone. The world needs to accommodate them. POV #2: The world needs to be more accommodating true! But we should see what our clients want and focus on giving them choices of behaviors to select if they want to be fluent in certain situations. Write 3-4 sentences on which POV you support and why.
