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Healey, E. C., Reid, R., & Donaher, J. Engaging parents in treatment helps to achieve carryover in the home environment and helps with treatment across languages (Shenker, 2013). Some people who clutter tend to decrease volume at the ends of sentences or phrases and, therefore, can benefit from learning to keep a steady volume throughout their utterances. Ingham, R. J., & Onslow, M. (1985). Journal of Fluency Disorders, 38(4), 311324. https://doi.org/10.1016/j.jfludis.2018.08.006, Boyle, M. P. (2011). Clinical implications of situational variability in preschool children who stutter. With adults, initiation of treatment depends on the individuals previous positive or negative intervention experiences and current needs pertaining to their fluency and the impact of their fluency disorder on communication in day-to-day activities and participation in various settings (e.g., community or work). https://doi.org/10.1044/leader.FTR2.19072014.44, American Speech-Language-Hearing Association. Allyn & Bacon. https://doi.org/10.4324/9781351122351, Klein, J. F., & Hood, S. B. (2020). https://doi.org/10.1044/2018_AJSLP-ODC11-17-0199. Journal of Communication Disorders, 58, 4357. Stuttering, the most common fluency disorder, is an interruption in the flow of speaking characterized by specific types of disfluencies, including, These disfluencies can affect the rate and rhythm of speech and may be accompanied by. omission of word endings (e.g., Turn the televisoff). See ASHAs resource on assessment of fluency disorders in the context of the WHO ICF framework. Repetitive negative thinking, temperament, and adverse impact in adults who stutter. Journal of Fluency Disorders, 35(4), 333354. International Classification of Functioning, Disability and Health. Conture, E. G. (2001). Code of ethics [Ethics]. On the other hand, stuttering symptoms may decrease in more comfortable situations. Clinicians do not have to choose one approach or the other. The person exhibits physical tension or secondary behaviors (e.g., eye blinking, head nodding) associated with the disfluency. https://doi.org/10.1016/j.jfludis.2011.04.002, Foote, G. (2013). Educating other professionals about the needs of individuals with fluency disorders and the role of SLPs in screening, assessing, diagnosing, and managing fluency disorders. Prevalence of speech disorders in elementary school students in Jordan. Cambridge University Press. Word-Final Disfluencies in a School-Age Child: Beneath the Tip of the Group experiences and individual differences in stuttering. Journal of Fluency Disorders, 13(5), 357373. Stuttering Therapy Resources. Alm, P. A. Journal of Fluency Disorders, 22(3), 187203. https://doi.org/10.1044/2018_JSLHR-S-17-0353, Guitar, B. Manning, W. H., & Quesal, R. W. (2016). Journal of Fluency Disorders, 38(2), 6687. Search Evidence Maps - American Speech-Language-Hearing Association As children who stutter get older, they may become adept at word and situational avoidances that result in a low frequency of overt stuttering. The plan outlines reasonable accommodations for speaking or reading activities to help ensure a students academic success and access to the learning environment in school. The social and communication impact of stuttering on adolescents and their families. Gupta, S., Yashodharakumar, G. Y., & Vasudha, H. H. (2016). Parent perceptions of an integrated stuttering treatment and behavioral self-regulation program for early developmental stuttering. Often referred to as advertising in the stuttering community, self-disclosure can involve. SLPs counseling skills should be used specifically to help speakers improve their quality of life by minimizing the burden of their communication disorder. Overheard: Bilingual and disfluent: A unique treatment challenge. Journal of Fluency Disorders, 40, 3543. Members were Gordon Blood, Eugene Cooper, Hugo Gregory, John Hanley, Charles Healey, Stephen Hood, Kenneth S. Louis, Theodore Peters, C.W. Clinical utility of self-disclosure for adults who stutter: Apologetic versus informative statements. (2001). Other strategies for treating cluttering include overemphasizing multisyllabic words and word endings, increasing awareness of when a communication breakdown occurs (e.g., through observation of listener reactions), and increasing self-regulation of rate and clarity of speech. (2017). Functional and neuroanatomical bases of developmental stuttering: Current insights. BOBapp(2023) the impact of communication impairments on, Relevant case history (as appropriate for age), including. Clients often report successful stuttering therapy as a transformational experience progressing from avoidance to acceptance and openness, increasing self-confidence and self-efficacy (Plexico et al., 2005; Tichenor & Yaruss, 2019a). Environmental factors and speaking demands may exacerbate disfluency and influence a persons negative reactions to stuttering. Communication apprehension, loss of control, and shame may also develop as individuals experience greater difficulty with communication. 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). Indicators of positive therapeutic change may include. School Psychology Review, 30(1), 135141. Defining cluttering: The lowest common denominator. Psychology Press. In R. Lees & C. Stark (Eds. Stuttering and the International Classification of Functioning, Disability and Health (ICF): An update. Freezing is similar to tallying but has the client/clinician stop, freeze, during a moment of stuttering to perform a self-scan. https://doi.org/10.1093/brain/awu400, Choi, D., Conture, E. G., Walden, T. A., Lambert, W. E., & Tumanova, V. (2013). National Stuttering Association. Multicultural issues in school settings. Bowling Green State University Archive. Early childhood stuttering and electrophysiological indices of language processing. Contemporary Issues in Communication Science and Disorders, 29(Spring), 91100. social anxiety disorder (Brundage et al., 2017; Craig & Tran, 2014; Iverach et al., 2018), speech sound disorders (St. Louis & Hinzman, 1988; Wolk et al., 1993), and. Sheehan, V. M., & Sisskin, V. (2001). (2011). Menu. United States Department of Labor. 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. 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). 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). Screening of communication when a fluency disorder is suspected and as part of a comprehensive speech-language evaluation. For some people, the use of these behaviors can result in little or no observable stuttering. Assessment of the impact of stuttering or clutteringincluding assessment of the emotional, cognitive, and attitudinal impact of disfluency. Understanding that awareness and concern about stuttering may vary across individuals and cultures and conducting a culturally and linguistically relevant comprehensive assessment. Social anxiety disorder in adults who stutter. . It incorporates techniques such as open-ended questions, feedback, reflective listening, affirmations, and summarizing to resolve resistance or ambivalence to therapy. blocks (i.e., inaudible or silent fixation or inability to initiate sounds). Stuttering Foundation: A Nonprofit Organization Helping Those Who Stutter Treatment may include strategies to reduce negative reactions to stuttering in the individual and others (Yaruss et al., 2012). Moments of stuttering or disfluency may be difficult to distinguish from typical disfluency or reduced language proficiency, especially for a person unfamiliar with the language (Shenker, 2011). Some examples of disfluencies that are more typical of a person who clutters is excessive whole word repetitions, unfinished words and interjections (such as um and well). The incidence of pediatric fluency disorder refers to the number of new cases identified in a specific time period. 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). Pro-Ed. These brain differences have previously been observed in adults who stutter (Weber-Fox et al., 2013). https://doi.org/10.1111/1469-7610.00093, de Sonneville-Koedoot, C., Stolk, E., Rietveld, T., & Franken, M. C. (2015). https://doi.org/10.1016/j.jfludis.2011.04.005, Boyle, M. P. (2013a). In J. C. Norcross & M. R. Goldfried (Eds. Psychosocial support for adults who stutter: Exploring the role of online communities. Adults are likely to have been living with stuttering for a long time. Behavioral treatments that address improved speech fluency appear to be effective across a range of cultures and languages (Finn & Cordes, 1997). One of the core principles of ACT is mindfulness. if a child has typical disfluencies or a fluency disorder (see ASHAs resource on. if monitoring or treatment (direct or indirect) is recommended. (1979). These simulations and applications of strategies might be most likened to cancellation and pull-out techniques used in stuttering. I ran out of cheese and bread the other day while making sandwiches and now Im out so I need to go to the store), and/or. Journal of Speech, Language, and Hearing Research, 44(2), 368380. 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). Nurturing a resilient mindset in school-aged children who stutter. Risk factors that may be associated with persistent stuttering include. Guttormsen, L. S., Kefalianos, E., & Nss, K. A. One of the most widely used models of change is the transtheoretical or stages of change model (Prochaska & DiClemente, 2005). In addition to being used for improving communication skills, pausing is also an effective method of rate control. The impact of fluency disorders often extends to social and vocational aspects of the individuals life. Lyn Goldberg and Michelle Ferketic served as ex officios. Crystal Cooper, Diane L. Eger, and Nancy Creaghead served as monitoring vice presidents. In B. J. Amster & E. R. Klein (Eds. 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. https://doi.org/10.1044/persp2.SIG17.42, Vanryckeghem, M., & Kawai, M. (2015). Although cluttering and stuttering can co-occur, there are some important distinctions between the two (see Scaler Scott, 2010). Language assessment and intervention for the learning disabled. autism (see Scaler Scott, 2011, for a review), word-finding/language organization difficulties (Myers, 1992), and. Journal of Fluency Disorders, 38(2), 206221. 211230). Journal of Fluency Disorders, 36(2), 110121. 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). 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). Strategies for reducing impairment in body function have been separated into two categoriesspeech modification and stuttering modification, both of which are described below. 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. 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. Journal of Fluency Disorders, 32(2), 121138. Language intervention from a bilingual mindset. (2013). Please enable it in order to use the full functionality of our website. Journal of Speech, Language, and Hearing Research, 62(12), 43354350. The attitudes of high school peers toward stuttering and toward persons who stutter can be improved through education in the form of classroom presentations about stuttering (Flynn & St. Louis, 2011). A comprehensive treatment approach for preschoolers includes both parent- and child-focused strategies. ), Stuttering and related disorders of fluency (pp.