https://doi.org/10.1044/2018_AJSLP-17-0097, Kraft, S. J., & Yairi, E. (2011). Such strategies include simulating a fast rate of speech and applying pausing and/or simulating overarticulated speech and applying increased emphasis to increase intelligibility. This course presents the most up-to-date evidence regarding the identification and management of atypical disfluency. Genetic bases of stuttering: The state of the art, 2011. 9099). Individuals who stutter may report fear or anxiety about speaking and frustration or embarrassment with the time and effort required to speak (Ezrati-Vinacour et al., 2001). advertising through a classroom presentation with the guidance of the SLP or classroom teacher in the case of school-age children (W. P. Murphy et al., 2007b). Repetitive negative thinking, temperament, and adverse impact in adults who stutter. Stuttering may influence an individuals perception of their career possibilities and professional limitations (Klein & Hood, 2004). They have long-held beliefs about stuttering that positively or negatively affect self-perceptions about their communication skills and their motivation for change (Daniels, 2007). Lower levels of overt stuttering do not directly relate to lower levels of psychological, emotional, social, or functional impacts experienced by the individual (Lucey et al., 2019; Tichenor & Yaruss, 2019a, 2020). 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. It applies protections to ensure that programs and employment environments are accessible and to provide aids and services necessary for effective communication in these settings. The Stuttering Foundation We provide free online resources, services and support to those who stutter and their families, as well as support for research into the causes of stuttering. reducing secondary behaviors and minimizing avoidances. Assisting children who stutter in dealing with teasing and bullying. This approach to care incorporates individual and family preferences, priorities, and desired outcomes in the selection of treatment goals and treatment methods. The Lidcombe Program of early stuttering intervention: A clinicians guide. See ASHAs Practice Portal pages on Counseling For Professional Service Delivery and Cultural Responsiveness for more information related to counseling. https://doi.org/10.1044/2018_AJSLP-ODC11-17-0183, Blood, G. W., & Blood, I. M. (2004). Stuttering: Research and therapy. https://doi.org/10.1080/2050571X.2016.1253533. Journal of Speech, Language, and Hearing Research, 60(11), 30973109. Treatment for fluency disorders helps the individual make changes that will facilitate communication in a variety of settings. However, these disfluencies are typical and not indicative of a disorder (Shenker, 2013). 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). https://doi.org/10.1016/j.jfludis.2011.04.005, Boyle, M. P. (2013a). Board Certified Specialists in Fluency are individuals who hold ASHA certification and have demonstrated advanced knowledge and clinical expertise in diagnosing and treating individuals with fluency disorders. Plural. Seminars in Speech and Language, 35(2), 114131. https://doi.org/10.1044/2017_JSLHR-S-16-0371, Leech, K. A., Bernstein Ratner, N., Brown, B., & Weber, C. M. (2019). Contemporary Issues in Communication Science and Disorders, 31(Spring), 6979. (2011). 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). www.asha.org/policy/. Behavioural and Cognitive Psychotherapy, 23(4), 325325. Differences between children and adults should also be considered when interpreting data from neurological studies. These strategies help individuals learn about the speech mechanism and how it operates during both fluent and disfluent speech so they can modify it. https://doi.org/10.1177/152574018200600106. Seminars in Speech and Language, 23(3), 181186. Estimates report that 1.5% of school-age children who are hard of hearing also stutter, which is similar to the estimates of older elementary students who stutter (Arenas et al., 2017). 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/10.1044/2018_JSLHR-S-17-0378, Byrd, C. T. (2018). Counseling parents of children who stutter. American Journal of Speech-Language Pathology, 26(4), 11051119. Journal of Speech, Language, and Hearing Research, 56(5), 15171529. Course: #10096 Level: Intermediate 1 Hour 2233 Reviews. https://doi.org/10.1044/jshd.4901.53, Mnsson, H. (2000). For stuttering, the assessment will identify risk factors associated with stuttering, the severity of stuttering, and the presence of other speech and language concerns. The SLP can use audio- or videoconferencing to augment this type of treatment. SLPs may want to relate personal experiences when asking clients to share such vulnerable information. Stuttering and work life: An interpretative phenomenological analysis. Determination of individual strengths and coping strategies. Emotional reactivity, regulation and childhood stuttering: A behavioral and electrophysiological study. discussing the rationale for treatment decisions, and. (2019). Advocating for individuals with fluency disorders and their families at the local, state, and national levels. https://doi.org/10.1037/0022-0663.95.1.3, Langevin, M., Bortnick, K., Hammer, T., & Wiebe, E. (1998). deletion and/or collapsing of syllables (e.g., I wanwatevision). increased social communication participation (Manning & DiLollo, 2018). Given these potential issues, determining dosage often comes down to the professional opinion of the SLP and the needs of the individual. The skilled helper: A problem-management and opportunity-development approach to helping. ), Cluttering: A handbook of research, intervention and education (pp. 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). Merrill. increasing acceptance and openness with stuttering. https://doi.org/10.1093/brain/awt275, Chang, S.-E., Zhu, D. C., Choo, A. L., & Angstadt, M. (2015). Onslow, M., Packman, A., & Harrison, E. Cluttering: A synergistic framework. The assignments begin in supportive, low-fear situations and slowly evolve to more challenging situations and settings as the individual demonstrates the ability to accept or tolerate potential negative reactions. International Journal of Speech-Language Pathology, 17(4), 367372. Some persons who stutter report psychosocial benefits, including personal and relationship benefits and positive perspectives about stuttering and life. https://doi.org/10.1016/j.jfludis.2013.08.003, Jones, R. M., Choi, D., Conture, E., & Walden, T. (2014). https://doi.org/10.1016/S0094-730X(02)00162-6, Singer, C. M., Hessling, A., Kelly, E. M., Singer, L., & Jones, R. M. (2020). ), More than fluency: The social, emotional, and cognitive dimensions of stuttering (pp. Seminars in Speech and Language, 28(4), 312322. Finding the good in the challenge: Benefit finding among adults who stutter. practice treatment targets with more listeners. Children with language difficulties at the sentence, narrative, or conversational discourse level may exhibit increased speech disfluencies. They also can benefit from groups and intensive programs (Fry et al., 2014). Depression & Anxiety, 27(7), 687692. Pediatrics, 132(3), 460467. Screening of communication when a fluency disorder is suspected and as part of a comprehensive speech-language evaluation. Psychology Press. Appropriate roles for SLPs include the following: As indicated in the ASHA Code of Ethics (ASHA, 2016a), SLPs who serve this population should be specifically educated and appropriately trained to do so. Differing perspectives on what to do with a stuttering preschooler and why. https://doi.org/10.1371/journal.pone.0133758, Desai, J., Huo, Y., Wang, Z., Bansal, R., Williams, S. C., Lythgoe, D., Zelaya, F. O., & Peterson, B. S. (2016). However, these compensations may compound the negative experience of stuttering over time. Self-efficacy is a positive belief in ones own ability to successfully accomplish a set goal that is task dependent, which comes from (a) past experiences of mastery, (b) vicarious experiences, (c) verbal persuasion, and (d) emotional/physical states (Boyle, 2013a, 2013b, 2015; Boyle et al., 2018; Carter et al., 2017). (1982). They may hesitate when speaking, use fillers ("like" or "uh"), or repeat a word or phrase. Journal of Fluency Disorders, 62, 105725. https://doi.org/10.1016/j.jfludis.2019.105725, Plexico, L. W., Manning, W. H., & DiLollo, A. To facilitate generalization of skills, the clinician can help the individual use a variety of therapeutic activities outside of the treatment room, such as. Childhood stuttering: Incidence and development. Daly, D. A. Singular. Van Riper, C. (1973). Differential treatment of stuttering in the early stages of development. Speech modification (including fluency shaping) strategies (Bothe, 2002; Guitar, 1982, 2019) include a variety of techniques aimed at making changes to the timing and tension of speech production or altering the timing of pauses between syllables and words. Consistent with treatment approaches for children and adolescents, treatment for adults needs to be individualized, dynamic, and multidimensional. Atypical disfluency has been documented through case studies and has been described as final part-word repetition or "rhyme repetition". What we know for now IN BRIEF. using fillers (e.g., like, um, uh, you know); avoiding sounds or words (e.g., substituting words, inserting unnecessary words, circumlocution); and. https://doi.org/10.1044/1058-0360(2002/005), Bothe, A. K. (2002). These symptoms come suddenly and do need hospitalization. ), Cluttering: A handbook of research, intervention and education (pp. 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 treatment goals consistent with the ICF framework. Allyn & Bacon. Roberts, P., & Shenker, R. (2007). https://doi.org/10.1016/j.jcomdis.2019.04.003, Menzies, R. G., Onslow, M., Packman, A., & OBrian, S. (2009). https://doi.org/10.1044/ffd22.1.34, Beilby, J. M., Byrnes, M. L., Meagher, E. L., & Yaruss, J. S. (2013). if monitoring or treatment (direct or indirect) is recommended.