Parent involvement may be a beneficial approach for addressing fluency issues in a bilingual child. Parent perceptions of an integrated stuttering treatment and behavioral self-regulation program for early developmental stuttering. There are two predominant types of atypical disfluencies: stuttering and cluttering. Journal of Fluency Disorders, 50, 7284. Another example is Cognitive Behavior Therapy (CBT; Menzies et al., 2019, 2009). Advocating for individuals with fluency disorders and their families at the local, state, and national levels. talking about stuttering or treatment of 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). https://doi.org/10.4324/9781351122351, Klein, J. F., & Hood, S. B. The individual who stutters becomes desensitized to their fears by performing activities (e.g., self-disclosing, going to a place where they fear speaking) using a fear hierarchy. This hierarchy represents situations or activities that range from low risk to high risk. Seminars in Speech and Language, 28(4), 312322. bringing peers into the treatment setting; planning strategies to use in the classroom, cafeteria, or playground or at work; taking outings to stores and other businesses; and. Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse (CLD) Populations, 20(1), 1523. The Journal of Child Psychology and Psychiatry, 43(7), 939947. Assessment and treatment of stuttering in bilingual speakers. For example, counseling an individual to accept or tolerate embarrassment can facilitate desensitization. Language, Speech, and Hearing Services in Schools, 48(4), 234248. Roberts, P., & Shenker, R. (2007). Consistent with a person- and family-centered approach to stuttering treatment, the SLP. Enhancing treatment for school-age children who stutter: II. The effects of self-disclosure on the communicative interaction between a person who stutters and a normally fluent speaker. Counseling allows the clinician who works with those who stutter or clutter to practice within the ICF framework by targeting all aspects of the disordernot just the surface behaviors. In D. Ward & K. Scaler Scott (Eds. Gupta, S., Yashodharakumar, G. Y., & Vasudha, H. H. (2016). Diagnostic and statistical manual of mental disorders (5th ed.). Genetic contributions to stuttering: The current evidence. Overall, the lifetime prevalence of stuttering was estimated to be 0.72% (Craig et al., 2002). Cluttering and autism spectrum disorders. https://doi.org/10.1016/j.jfludis.2010.12.003. Mild stuttering, on the other hand, tends to appear more regularly. Section 504 of the Rehabilitation Act of 1973 (United States Department of Labor, n.d.) protects qualified individuals from discrimination based on their disability via a 504 plan. Journal of Speech, Language, and Hearing Research, 31(3), 377385. 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). ), More than fluency: The social, emotional, and cognitive dimensions of stuttering (pp. Journal of Communication Disorders, 80, 8191. See the Assessment section of the Fluency Disorders Evidence Map for pertinent scientific evidence, expert opinion, and client/caregiver perspective. May 11, 2022 As a speech-language pathologist, you might often face the question of whether a young child is showing early signs of stuttering, or if those disruptions are simply typical speech disfluencies. 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. Language abilities of children who stutter: A meta-analytical review. American Journal of Speech-Language Pathology, 20(3), 163179. typical vs atypical disfluencies asha typical vs atypical disfluencies asha. https://doi.org/10.1044/ffd16.1.15. Van Borsel, J., Maes, E., & Foulon, S. (2001). https://doi.org/10.1016/j.jfludis.2013.08.001, Briley, P. M., & Ellis, C. (2018). https://doi.org/10.1044/2017_AJSLP-16-0079, Davis, S., Howell, P., & Cooke, F. (2002). Their description details the characteristics of each stage, along with treatment goals and processes appropriate for each stage. These include when the individual who stutters. Human GNPTAB stuttering mutations engineered into mice cause vocalization deficits and astrocyte pathology in the corpus callosum. Journal of Fluency Disorders, 21(34), 201214. Impact of social media and quality of life of people who stutter. https://doi.org/10.1016/j.jfludis.2013.09.003, Ezrati-Vinacour, R., Platzky, R., & Yairi, E. (2001). The young childs awareness of stuttering-like disfluency. https://doi.org/10.1016/0094-730X(88)90003-4. Evidence-based treatment and stutteringHistorical perspective. Allyn & Bacon. 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). Differential treatment of stuttering in the early stages of development. Alternative measures of reading fluencysuch as tests of silent reading fluencymay be more valid measures for children who stutter. Helping adolescents who stutter focus on fluency. Brain, 138(3), 694711. Motivational interviewing is a person-centered approach that can be useful in developing functional goals and enhancing readiness for change (Miller & Rollnick, 2013; Rollnick & Miller, 1995). For a review of temperament, emotion, and childhood stuttering, see R. M. Jones, Choi, et al. Journal of Fluency Disorders, 54, 1423. The use of counseling in other areas of the speakers lifethat is, those not directly related to communicationis outside the scope of practice for SLPs (ASHA, 2016b). 341358). Starkweather, Janice Westbrook. For some people, the use of these behaviors can result in little or no observable stuttering. However during treatment and forming a new, more congruent identity, clients may progress through some of the stages of grief (e.g., 1. The dysfluencies that render concerns of Childhood Onset Stuttering are different than typical disfluencies. Clinicians may start with the client observing videos of others who stutter (or a puppet for children) to help them identify patterns, attitudes, and beliefs about communication and stuttering. Scaler Scott, K., & St. Louis, K. O. 178196). Menu. The role of attention in therapy for children and adolescents who stutter: Cognitive behavioral therapy and mindfulness-based interventions. Some of the most commonly prescribed typical or first-generation antipsychotics include: Haldol (haloperidol) Thorazine (chlorpromazine) Loxitane (loxapine) Moban (molindone) Mellaril (thioridazine) Serentil (mesoridazine) Navane (thiothixene) Trilafon (perphenazine) On the other hand, the following are atypical or second-generation antipsychotics: Counseling helps an individual, a family member, or a caregiver of a person of any age who stutters move from the current scenario to a preferred scenario through an agreed-upon action plan (Egan, 2013). However, fluency shaping approaches, such as easy onset or continuous phonation, may not be appropriate for the treatment of cluttering. 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. Temperamental characteristics of young children who stutter. Audiovisual recordings of speech can provide useful information to supplement direct clinical observations. Stuttering and labor market outcomes in the United States. https://doi.org/10.1044/leader.OV.18032013.14, Freud, D., & Amir, O. In D. Ward & K. Scaler Scott (Eds. Cognitive restructuring is a strategy designed to help speakers change the way they think about themselves and their speaking situations. Setting refers to the location of treatment (e.g., home, community-based [including work settings], school environments, clinic room). altering the size of the group or audience. In contrast, children with reading disorders are likely to have difficulty decoding the printed form, which, in turn, has a negative impact on oral reading fluency (Kuhn & Stahl, 2003). A thematic analysis of late recovery from stuttering. Many clinicians use an integration of approaches to achieve optimal outcomes. One example of a treatment approach that incorporates desensitization is Avoidance Reduction Therapy for Stuttering (Sisskin, 2018). As is the case with any communication disorder, language differences and family/individual values and preferences are taken into consideration during assessment. Assessment of awareness in young children of disfluencies and difficulty in speaking. Individuals learn to identify the thoughts underlying their negative attitudes and emotional reactions and examine the link between these thoughts, attitudes, and emotional reactions and their speech. have a sense of belonging and experience less stigma. Plural. (2010). discussing the rationale for treatment decisions, and. Specific standardized tests can be used to rule out word-finding difficulties. Bray, M. A., Kehle, T. J., Lawless, K., & Theodore, L. (2003). Molecular Genetics & Genomic Medicine, 5(2), 95102. Such strategies include simulating a fast rate of speech and applying pausing and/or simulating overarticulated speech and applying increased emphasis to increase intelligibility. Seminars in Speech and Language, 24(1), 2126. Self-efficacy and quality of life in adults who stutter. Psychological characteristics and perceptions of stuttering of adults who stutter with and without support group experience. Fluency treatment can occur at any point after the diagnosis. Logos, 3, 8295. Pediatrics, 132(3), 460467. In E. G. Conture & R. F. Curlee (Eds. This law also applies to organizations that receive financial assistance from any federal department or agency. In fact, stuttering can affect all areas of academic competency, including academic learning, social-emotion functioning, and independent functioning (Ribbler, 2006, p. 15). Enhancing treatment for school-age children who stutter: I. American Journal of Speech-Language Pathology, 16(1), 6568. 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., .
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