Fluency shaping with young stutterers. Parent perceptions of an integrated stuttering treatment and behavioral self-regulation program for early developmental stuttering. The perils of oral-reading fluency assessments for children who stutter led a group of SLPs to investigate the issue and call on colleagues to change their school districts policies. https://doi.org/10.1016/j.jfludis.2017.09.001, Byrd, C. T., & Donaher, J. Journal of Fluency Disorders, 27(4), 289304. In L. Cummings (Ed. seizure disorders (Briley & Ellis, 2018). It can also be challenging to assess the reading fluency of bilingual students who stutter. https://doi.org/10.1016/j.jfludis.2015.08.001, Han, T.-U., Park, J., Domingues, C. F., Moretti-Ferreira, D., Paris, E., Sainz, E., Gutierrez, J., & Drayna, D. (2014). When determining eligibility for speech and language services through the public school system, SLPs need to document the adverse educational impact of the disability using a combination of standardized test scores when available and a portfolio-based assessment (Coleman & Yaruss, 2014; Ribbler, 2006). https://doi.org/10.1055/s-2003-37447, Thordardottir, E. (2006). When developing treatment goals, the clinician takes a holistic approach and considers the extent to which stuttering affects the individuals entire communication experience. Current Biology, 26(8), 10091018. 187214). Cognitive behavior therapy and mindfulness training in the treatment of adults who stutter. Skip to main content. Journal of Speech, Language, and Hearing Research, 62(8), 26912702. Mild stuttering, on the other hand, tends to appear more regularly. https://doi.org/10.1044/1092-4388(2008/046, Millard, S. K., Zebrowski, P., & Kelman, E. (2018). Assessment and treatment of stuttering in bilingual speakers. Available 8:30 a.m.5:00 p.m. This perceived rapid rateand the resulting breakdown in speech clarityis thought to be because speakers with cluttering speak at a rate that is too fast for their systems to handle (Myers, 1992; St. Louis et al., 2007; Ward, 2006). Overheard: Bilingual and disfluent: A unique treatment challenge. Children who stutter typically know how to read (decode) the printed form of words, but they may not be able to speak the printed form fluently. Our primary goals were to identify patterns in overt features of WFDs and to extend our understanding of this clinical profile by focusing on aspects of . Clinicians need to be observant of indicators, such as stuttering avoidance or social isolation, that clients/patients/students may be internalizing negative stereotypes about stuttering (Boyle, 2013a). (2017). https://doi.org/10.1016/j.jcomdis.2014.02.001, Jones, M., Onslow, M., Packman, A., Williams, S., Ormond, T., Schwarz, I., & Gebski, V. (2005). The great psychotherapy debate: Models, methods, and findings. Differential treatment of stuttering in the early stages of development. https://doi.org/10.1044/1058-0360(2003/070), Arenas, R. M., Walker, E. A., & Oleson, J. J. Universitetsforlaget. However, the clinician needs to consider the impact of disfluency on communication and quality of life as a whole. The person is experiencing negative reactions from others (e.g., peers, classmates, coworkers, family members). Mis- and overidentification of stuttering in bilingual speakers may occur due to typical disfluencies observed in development, code switching, and wording changes to maintain the grammatical integrity of the dominant language. using indirect prompts rather than direct questions, recasting/rephrasing to model fluent speech or techniques (Millard et al., 2008; Yaruss et al., 2006), and. https://doi.org/10.1044/1058-0360(2003/088), Bricker-Katz, G., Lincoln, M., & Cumming, S. (2013). Prentice-Hall. (2013). The goals of treatment may be (a) to eliminate, greatly reduce, or help the child manage their stuttering and (b) to help them not develop negative emotional reactions related to their stuttering (H. S. Arnold et al., 2011; Yaruss et al., 2006). The ASHA Leader, 11(10), 621. Plural. ), Current issues in stuttering research and practice (pp. Journal of Speech, Language, and Hearing Research, 56(5), 15171529. Allyn & Bacon. (2017). Adults who stutter also may experience job discrimination and occupational stereotyping, including an earnings gap, especially for females (Gerlach et al., 2018). Children who stutter also may be at risk for experiencing bullying (Blood & Blood, 2004; Davis et al., 2002; Langevin et al., 1998). by ; 2022 June 3; barbara "brigid" meier; 0 . Scope of Practice in Speech-Language Pathology, Counseling For Professional Service Delivery, interprofessional education/interprofessional practice [IPE/IPP], American Board of Fluency and Fluency Disorders, assessment tools, techniques, and data sources, assessment of fluency disorders in the context of the WHO ICF framework, assessment procedures: parallel with CPT codes, characteristics of typical disfluency and stuttering, Collaborating With Interpreters, Transliterators, and Translators, ASHAs Ad Hoc Committee on Reading Fluency For School-Age Children Who Stutter, Speech Sound Disorders: Articulation and Phonology, treatment goals for fluency disorders in the context of the WHO ICF framework, What To Ask When Evaluating Any Procedure, Product, or Program, Counseling For Professional Service Deliver, Cognitive Distortions and Fluency Examples, Characteristics of Typical Disfluency and Stuttering, Early Identification of Speech, Language, and Hearing Disorders, How Can You Tell if Childhood Stuttering is the Real Deal, Assessment of Fluency Disorders In the Context of the WHO ICF Framework, Treatment Goals For Fluency Disorders in the Context of the WHO ICF Framework, Assessment Procedures: Parallel With CPT Codes, Private Health Plans: Tips and strategies for ensuring that speech and hearing services are covered, FRIENDS: The National Association of Young People Who Stutter, International Cluttering Association (ICA), SAY: The Stuttering Association for the Young, https://doi.org/10.1371/journal.pone.0133758, https://doi.org/10.1044/2020_PERSP-20-00014, https://doi.org/10.1016/j.jfludis.2019.105713, https://doi.org/10.1044/2018_AJSLP-17-0097, https://doi.org/10.1044/2017_JSLHR-S-16-0371, https://doi.org/10.1044/1092-4388(2008/046, https://doi.org/10.1044/2018_AJSLP-ODC11-17-0199, https://doi.org/10.1044/1058-0360(2011/09-0102, https://doi.org/10.1044/1092-4388(2008/07-0057, www.asha.org/practice-portal/clinical-topics/fluency-disorders/, Connect with your colleagues in the ASHA Community, repetitions of sounds, syllables, and monosyllabic words (e.g., Look at the, prolongations of consonants when it isnt for emphasis (e.g., . The skilled helper: A problem-management and opportunity-development approach to helping. Code of ethics [Ethics]. Trichon, M., & Raj, E. X. Plural. St. Louis, K. O., Myers, F., Bakker, K., & Raphael, L. (2007). Setting refers to the location of treatment (e.g., home, community-based [including work settings], school environments, clinic room). Prevalence of stuttering in African American preschool children. Crystal Cooper, Diane L. Eger, and Nancy Creaghead served as monitoring vice presidents. When distress does not become depression: Emotion context sensitivity and adjustment to bereavement. Most individuals who stutter demonstrate both observable disfluency and negative life impact (Beilby et al., 2012b; Ribbler, 2006; Tichenor & Yaruss, 2019a; Yaruss et al., 2012). In F. L. Myers & K. O. St. Louis (Eds. Journal of Fluency Disorders, 62, 105762. https://doi.org/10.1016/j.jfludis.2019.105726. Not all of these approaches are appropriate for the treatment of cluttering (see Cluttering Treatment below). Communication Disorders Quarterly, 6(1), 5059. Goals that focus on minimizing negative reactions to stuttering and difficulties communicating in various speaking situations may help the individual reduce the effort used to hide or avoid their disfluencies and communicate with more ease. Psychology Press. Yaruss, J. S., & Pelczarski, K. M. (2007). Symptoms have been observed in individuals with autism spectrum disorder as well as in neurotypical individuals. Covert stuttering: Investigation of the paradigm shift from covertly stuttering to overtly stuttering. Prevalence of anxiety disorders among children who stutter. What is Typical Pneumonia? ), More than fluency: The social, emotional, and cognitive dimensions of stuttering (pp. https://doi.org/10.1044/persp1.SIG4.55, Byrd, C. T., Croft, R., Gkalitsiou, Z., & Hampton, E. (2017). Stuttering and cluttering: Frameworks for understanding and treatment. For example, some children from bilingual or multicultural backgrounds may experience stuttering onset or a temporary increase in stuttering as result of being in new and unfamiliar situations, learning a new language, or being exposed to mixed linguistic input (Shenker, 2013). 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). https://doi.org/10.1016/S0094-730X(01)00098-5. Journal of Fluency Disorders, 13(5), 357373. https://doi.org/10.1044/ffd16.1.15. Counseling parents of children who stutter. (n.d.). Overall, the lifetime prevalence of stuttering was estimated to be 0.72% (Craig et al., 2002). ), Cluttering: Research, intervention and education (pp. Pro-Ed. Yaruss, J. S., Quesal, R. W., & Reeves, L. (2007). 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). Al-Jazi, A. Motivational interviewing: Helping people change. Content Disclaimer: The Practice Portal, ASHA policy documents, and guidelines contain information for use in all settings; however, members must consider all applicable local, state and federal requirements when applying the information in their specific work setting. Journal of Fluency Disorders, 35(4), 333354. However, several likely gene mutations have been linked to stuttering (Frigerio-Domingues & Drayna, 2017). https://doi.org/10.1055/s-0034-1382151, Chang, S.-E., Garnett, E. O., Etchell, A., & Chow, H. M. (2019). Differing perspectives on what to do with a stuttering preschooler and why. Trichon, M., & Tetnowski, J. https://doi.org/10.1044/2019_AJSLP-19-00077, Tran, Y., Blumgart, E., & Craig, A. Clinicians can help clients progress to active stages through building self-efficacy. (2003). Word-finding problems can also result in an increase in typical disfluencies that are similar to those observed in cluttering. Their description details the characteristics of each stage, along with treatment goals and processes appropriate for each stage. The clinical applications of Acceptance and Commitment Therapy with clients who stutter. Cluttering: A synergistic framework. 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). American Journal of Speech-Language Pathology, 27(3S), 12351243. "Atypical" disfluencies include: sound repetitions ("s-s-s-so"); syllable repetitions ("be-be-be-be-because"); prolongations ("Aaaaaaaaaaaaand"); and Treatment may include strategies to reduce negative reactions to stuttering in the individual and others (Yaruss et al., 2012). - Speech & Language Parent Support - SPSD 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. American Journal of Speech-Language Pathology, 27(3S), 11111123. autism spectrum disorder (Briley & Ellis, 2018). Fluency Disorders - ASHA Journal of Fluency Disorders, 34(4), 368381. typical vs atypical disfluencies asha They may hesitate when speaking, use fillers (like or uh), or repeat a word or phrase. Cluttering can co-occur with other disorders, including. See also ASHAs resources titled Person-Centered Focus on Function: Preschool Stuttering [PDF], Person-Centered Focus on Function: School-Age Stuttering [PDF], and Person-Centered Focus on Function: Adult Stuttering [PDF] for examples of assessment data consistent with the ICF framework. Fluency disorders can interfere with play, school, work, or social interactions (Yaruss & Quesal, 2004). Clinical characteristics associated with stuttering persistence: A meta-analysis. 15). Language abilities of children who stutter: A meta-analytical review. Preliminary evidence that growth in productive language differentiates childhood stuttering persistence and recovery. Journal of Fluency Disorders, 32(2), 121138. Cluttering and stuttering do not need to occur in all situations or even a majority of the time to be diagnosable disorders. Support (both giving and receiving) can be valuable for improving attitudes, boosting self-confidence, and reducing feelings of isolation (Yaruss et al., 2007). Search Evidence Maps - American Speech-Language-Hearing Association (1986). 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. American Journal of Speech-Language Pathology, 27(2), 721736. Typical vs. Atypical Disfluencies: What Are the Differences? The effects of self-disclosure and non-self-disclosure of stuttering on listeners perceptions of a person who stutters. 341358). Atypical Disfluency: What Is It and What Can I Do About It? ), Cluttering: Research, intervention and education (pp. Journal of Fluency Disorders, 36(1), 1726. In B. J. Amster & E. R. Klein (Eds. Egan, G. (2013). A meta-analysis did find differences in the receptive vocabulary, expressive vocabulary, and mean length of utterance between children who stutter and children who do not stutter, with children who stutter generally performing relatively weaker (Ntourou et al., 2011). When speakers are able to participate in decisions about treatment goals and select goals they consider important, they may be more motivated to take part in therapy (Finn, 2003; Snsterud et al., 2019). Journal of Communication Disorders, 58, 4357. Enhancing treatment for school-age children who stutter: II. Multicultural issues in school settings. Consultation with family members, educators, and other professionals regarding fluency variability (when disfluencies are noticed most and least) and the impact of disfluency. These are called typical disfluencies or nonfluencies. Journal of Fluency Disorders, 38(2), 206221. Seminars in Speech and Language, 35(2), 114131. Studies in tachyphemia: III. Treatment approaches for preschool children who stutter include the following. 6396). Signs and symptoms. Journal of Fluency Disorders, 38(1), 1429. However, as they learn to reduce reactivity (see below), they develop greater comfort while speaking, they assume more positive attitudes about their ability to communicate, and they are better able to accept and manage moments of disfluency as they occur. reducing secondary behaviors and minimizing avoidances. Scope of practice in speech-language pathology [Scope of practice]. provide and receive support from others who share the experience of stuttering. BOBapp What are typical vs. atypical disfluencies in speech? https://doi.org/10.1037/a0020113, Coleman, C., & Yaruss, J. S. (2014). Course: #10096 Level: Intermediate 1 Hour 2233 Reviews. Characteristics of Typical Disfluency and Stuttering - ASHA Nurturing a resilient mindset in school-aged children who stutter. Treatment outcomes for bilingual children who stutter do not appear to be different from those of monolingual children who stutter (Shenker, 2011). 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. 255279). Characteristics of Typical Disfluency and Stuttering Differentiating typical disfluencies and stuttering is a critical piece of assessment, particularly for preschool children. Prentice-Hall. SLPs also need to discuss with persons who stutter and their families how to evaluate the veracity and trustworthiness of sites claiming to cure stuttering that they may find on their own. https://doi.org/10.1044/2018_AJSLP-ODC11-17-0192, Tichenor, S. E., & Yaruss, J. S. (2019a). Below is a list of approaches commonly used with school-age children, adolescents, and adults who stutter. https://doi.org/10.1044/jshr.2804.495, Iverach, L., Jones, M., McLellan, L. F., Lyneham, H. J., Menzies, R. G., Onslow, M., & Rapee, R. M. (2016). This relationship is recognized as one of the common factors that account for the effectiveness of counseling (common factors theory; Wampold, 2001). https://doi.org/10.1044/gics4.2.57, Van Zaalen, Y., & Reichel, I. https://doi.org/10.1016/j.jfludis.2011.06.001. Disfluencies noted in bilingual children and adults are similar to those found for monolingual speakers (Shenker, 2013). Pediatrics, 144(4), Article e20190811. The International Journal of Indian Psychology, 3(3), 7887. Oral reading may not be a valid measure of reading fluency for children who stutter, as fluency breakdowns will slow reading rate. https://doi.org/10.1016/S0094-730X(99)00023-6, McGill, M., Siegel, J., Nguyen, D., & Rodriguez, S. (2018). For an accurate evaluation, it is ideal to collect samples of speech across various situations and tasks, both inside and outside the clinical setting (Yaruss, 1997). a sense of loss of control/cognitive dissociations; negative thoughts/feelings about oneself and ones communication abilities; rumination on perceived communication failures; a decreased sense of self-worth (report feeling less than human); avoidance of words/sounds, speaking, and social interactions; perceived judgment of communication by others (e.g., being mocked, laughed at, made fun of, pitied, talked over/for, ignored, or hung-up on); perceived negative effects on social/romantic relationships; and. https://doi.org/10.1044/2017_LSHSS-17-0089, Carter, A., Breen, L., Yaruss, J. S., & Beilby, J. Typical and Atypical Symptoms of Acute Coronary Syndrome: Time to Journal of Fluency Disorders, 49, 1328. "I-I-I-I- want the ball") Seminars in Speech and Language, 28(4), 312322. Although cluttering and stuttering can co-occur, there are some important distinctions between the two (see Scaler Scott, 2010). Arnold, H. S., Conture, E. G., Key, A. P., & Walden, T. (2011). educates the individual who stutters and their family members about stuttering and communication and. Definitions of communication disorders and variations [Relevant paper]. Person- and family-centered practice is a collaborative approach that fosters an alliance-style partnership among individuals, families, and clinicians. Multicultural identification and treatment of stuttering: A continuing need for research. Despite these challenges, some of the therapy that applies to adults can be just as effective with teens/adolescents. As indicated in the ASHA Code of Ethics (ASHA, 2016a), SLPs are obligated to provide culturally and linguistically appropriate services, regardless of the clinicians personal culture, practice setting, or caseload demographics. Estimates of incidence and prevalence vary due to a number of factors, including disparities in the sample populations (e.g., age), how stuttering was defined, and how stuttering was identified (e.g., parent report, direct observation). Thieme. (2001). The role of self-help/mutual aid in addressing the needs of individuals who stutter. Resilience has been examined in the stuttering literature as one factor that may protect people from the adverse effects of chronic stuttering (Craig et al., 2011; Freud & Amir, 2020). Journal of Fluency Disorders, 38(2), 6687. Bargaining, 5. Both procedures help the client decrease the sense of loss of control experienced during moments of stuttering by demonstrating their ability to stop and modify moments of stuttering, anxiety, and other emotional reactivity. Temperament in adults who stutter and its association with stuttering frequency and quality-of-life impacts. In D. Ward & K. Scaler Scott (Eds. Journal of Fluency Disorders, 63, 105746. https://doi.org/10.1016/j.jfludis.2020.105746, Boyle, M. P., Milewski, K. M., & Beita-Ell, C. (2018). https://doi.org/10.1016/j.jfludis.2004.12.001, Plexico, L. W., Manning, W. H., & DiLollo, A. Multilingual children who stutter: Clinical issues. Journal of Communication Disorders, 80, 8191. Journal of Fluency Disorders, 50, 7284. Treatment for fluency disorders is highly individualized and based on a thorough assessment of speech fluency, language factors, emotional/attitudinal components, and life impact (Byrd & Donaher, 2018). Scientific Reports, 7(1), 118. Scaler Scott, K., & St. Louis, K. O. Lyn Goldberg and Michelle Ferketic served as ex officios. 147171). https://doi.org/10.1044/ffd17.2.4, Murphy, W. P., Yaruss, J. S., & Quesal, R. W. (2007a). Finding the good in the challenge: Benefit finding among adults who stutter. Stuttering Therapy Resources. Starkweather, C. W. (1987). Scaler Scott, K. (2013). St. Louis, K. O., & Schulte, K. (2011). 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.
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