Speaker and observer perceptions of physical tension during stuttering. Integrated treatment focused on parental involvement, self-regulation, and fluency may also be beneficial (Druker et al., 2019). attention-deficit/hyperactivity disorder (Donaher & Richels, 2012; Lee et al., 2017). As is the case with any communication disorder, language differences and family/individual values and preferences are taken into consideration during assessment. Emotional reactivity and regulation in preschool-age children who stutter. ), Current issues in stuttering research and practice (pp. https://doi.org/10.1016/S0094-730X(02)00162-6, Singer, C. M., Hessling, A., Kelly, E. M., Singer, L., & Jones, R. M. (2020). 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). In F. L. Myers & K. O. St. Louis (Eds. Treatment for adolescents who stutter poses a particular challenge because of the issues related to this developmental stage. Effortful control, an aspect of temperament that supports self-regulation, may be predictive of stuttering severity and may facilitate positive change in treatment (Kraft et al., 2019). This includes the impact on functional communication in key school situations and on quality of life (Beilby et al., 2012b; Yaruss et al., 2012). Craig, A., Blumgart, E., & Tran, Y. Cognitive behavior therapy for adults who stutter: A tutorial for speech-language pathologists. Some adults lack communication confidence as a result of negative self-perceptions about their stuttering (Beilby et al., 2012a) or due to repeated exposure to people holding stereotypes about stuttering, which, in turn, may create self-stigmatization (Boyle, 2013a). 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). Perspectives on Fluency and Fluency Disorders, 23(2), 5469. Given that cluttering may co-occur with other disorders (e.g., autism spectrum disorder, Tourettes syndrome, and attention-deficit/hyperactivity disorder), having any of these disorders may be a risk factor; however, not all individuals with these disorders also exhibit cluttering.
Characteristics of Typical Disfluency and Stuttering 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. The relationship of self-efficacy and depression to stuttering. The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific, and credentialing association for 228,000 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology support personnel; and students. Apraxia of Speech (Adults) Apraxia of Speech (Childhood) Attention Deficit Hyperactivity Disorder (ADHD) Auditory Neuropathy Spectrum Disorder (ANSD) Augmentative and Alternative Communication (AAC) Autism. https://doi.org/10.1016/j.jfludis.2018.08.006, Boyle, M. P. (2011). Allyn & Bacon. Examples of support groups and activities include FRIENDS: The National Association of Young People Who Stutter, the National Stuttering Association, and SAY: The Stuttering Association for the Young; online groups (e.g., online chats); and social media (e.g., blogs; Reeves, 2006). Fluency treatment can occur at any point after the diagnosis. Clinicians can help clients progress to active stages through building self-efficacy. Although cluttering has been reported in children as young as 4 years of age, the diagnosis is more commonly made at about 8 years of age (Ward, 2006), when a childs language becomes lengthy and/or complex enough for symptoms to manifest themselves. Seminars in Speech and Language, 23(3), 181186. Prentice-Hall. These strategies, like speech modification strategies, are introduced along a hierarchy of speaking situations that varies both with linguistic demands and with the stressors of the environment. https://doi.org/10.1159/000331073, Kuhn, M. R., & Stahl, S. A. https://doi.org/10.1044/jshr.3103.377, Weber-Fox, C., Wray, A. H., & Arnold, H. (2013). Epidemiology of stuttering: 21st century advances. Adolescents and young adults who stutter were found to have more white matter connections in the right hemisphere as compared with normally fluent controls (Watkins et al., 2008). Characteristics of Typical Disfluency and Stuttering Differentiating typical disfluencies and stuttering is a critical piece of assessment, particularly for preschool children. (1986). Impact of stuttering severity on adolescents domain-specific and general self-esteem through cognitive and emotional mediating processes. https://doi.org/10.1016/j.jfludis.2006.02.002. Proceedings of the National Academy of Sciences of the United States of America, 116(35), 1751517524. These simulations and applications of strategies might be most likened to cancellation and pull-out techniques used in stuttering. One study showed that children who clutter had 7.6 times more normal disfluencies compared to "atypical" disfluencies when they retold a story (van Zaalen et al., 2009). Speech clarity and fluency may temporarily improve when the person is asked to slow down or pay attention to their speech. Identifying subgroups of stutterers (No. Psychology Press. For example, individuals with attention-deficit/hyperactivity disorder, autism spectrum disorder, intellectual disability, learning disability, or seizures have higher odds of stuttering. Drayna, D. (2011). 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. These are called typical disfluencies or nonfluencies. Following are descriptions of each of these forms of disfluency. The dysfluencies that render concerns of Childhood Onset Stuttering are different than typical disfluencies. Behavioral treatments that address improved speech fluency appear to be effective across a range of cultures and languages (Finn & Cordes, 1997). Thieme. Definitions of communication disorders and variations [Relevant paper]. Resiliencethe ability to adjust and cope in the face of adversitycan help lessen the negative impact (e.g., Coifman & Bonanno, 2010). Perspectives on Fluency and Fluency Disorders, 1(4), 5569. Determination of individual strengths and coping strategies. It is not appropriate to determine a standard score if the norming sample of the assessment is not representative of the individual being assessed. In addition to the challenges associated with typical adolescent experiences, treatment may not be a priority for some adolescents because of other academic and social demands, denial of a speech problem, and concern about the stigma of seeking treatment. https://doi.org/10.1044/2018_AJSLP-ODC11-17-0183, Blood, G. W., & Blood, I. M. (2004). Other treatment approaches described below also may be incorporated as part of a comprehensive treatment approach. This list is not exhaustive, and not all factors need to be present for a referral to an SLP (e.g., Guitar, 2019; Yaruss et al., 1998). 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).
Developmental Disfluency vs. Atypical Dysfluency/Stuttering: When to be NonEnglish-speaking countries reported prevalence rates similar to those reported in English-speaking countries. Journal of Fluency Disorders, 21(34), 201214. Seminars in Speech and Language, 18(4), 371389. Despite these challenges, some of the therapy that applies to adults can be just as effective with teens/adolescents.
Normal and atypical speech disfluencies - Banter Speech https://doi.org/10.1044/persp1.SIG4.55, Byrd, C. T., Croft, R., Gkalitsiou, Z., & Hampton, E. (2017). https://doi.org/10.1136/bmj.38520.451840.E0, Kelman, R., & Nicholas, A. It is important to note that there are more clinical anecdotes than data to support this statement; further research on the incidence and prevalence of cluttering is needed (Scaler Scott, 2013). Fluency disorders can interfere with play, school, work, or social interactions (Yaruss & Quesal, 2004). National Stuttering Association. There is not enough epidemiological research to state specific risk factors for cluttering. BOBapp What are typical vs. atypical disfluencies in speech? It is important to distinguish stuttering from other possible diagnoses (e.g., language formulation difficulties, cluttering, and reading disorders) and to distinguish cluttering from language-related difficulties (e.g., word finding and organization of discourse) and other disorders that have an impact on speech intelligibility (e.g., apraxia of speech and other speech sound disorders). Speech, Language and Hearing, 20(3), 144153. Identifying correlates of self-stigma in adults who stutter: Further establishing the construct validity of the Self-Stigma of Stuttering Scale (4S). The influence of workplace discrimination and vigilance on job satisfaction with people who stutter. https://doi.org/10.1016/j.cub.2016.02.068, Beilby, J. M., & Byrnes, M. L. (2012). Journal of Speech, Language, and Hearing Research, 62(12), 43354350. consultation with and referral to other professionals as needed. Stuttering More than 70 million people around the world struggle with stuttering, according to The Stuttering Foundation. Brain, 131(1), 5059. 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. Ward, D., Connally, E. L., Pliatsikas, C., Bretherton-Furness, J., & Watkins, K. E. (2015). In R. Lees & C. Stark (Eds. https://doi.org/10.1093/brain/awu400, Choi, D., Conture, E. G., Walden, T. A., Lambert, W. E., & Tumanova, V. (2013). Avoidance or escape behaviors may also be used and can temporarily conceal stuttering (Constantino et al., 2017; Douglass et al., 2019, 2018; B. Murphy et al., 2007; Starkweather, 1987; Tichenor et al., 2017; Tichenor & Yaruss, 2018, 2019a, 2019b, 2020). talking about stuttering or treatment of stuttering. https://doi.org/10.1055/s-2003-37384, Finn, P., & Cordes, A. K. (1997). On the other hand, stuttering symptoms may decrease in more comfortable situations. Prevalence of anxiety disorders among children who stutter. Self-report of self-disclosure statements for stuttering. 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. The impact of stuttering on employment opportunities and job performance. Sheehan, V. M., & Sisskin, V. (2001). 297325). Ingham, R. J., & Onslow, M. (1985). Journal of Fluency Disorders, 40, 3543. Perspectives on Fluency and Fluency Disorders, 11(1), 711. https://doi.org/10.1044/2018_AJSLP-ODC11-17-0192, Tichenor, S. E., & Yaruss, J. S. (2019a). Children who stutter may demonstrate poorer expressive lexical skills compared to their peers (Silverman & Bernstein Ratner, 2002). Lyn Goldberg and Michelle Ferketic served as ex officios.
How Can You Tell if Childhood Stuttering is the Real Deal? - @ASHA 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. This study reviews data from a school-age child with an atypical stuttering profile consisting predominantly of word-final disfluencies (WFDs). They also can benefit from groups and intensive programs (Fry et al., 2014). Roberts, P., & Shenker, R. (2007). https://doi.org/10.1016/j.jfludis.2018.10.003, Bray, M. A., & Kehle, T. J. 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). Fluency shaping with young stutterers. Clinicians also should attempt to better understand how the person experiences the moments before, during, and after stuttering. (2009).
Stuttering Foundation: A Nonprofit Organization Helping Those Who Stutter (2007) for a description of how the stages of change model can be applied to fluency therapy. An increase in observable disfluent behaviors may occur as the individual communicates more freely. Acceptance and Commitment Therapy for adults who stutter: Psychosocial adjustment and speech fluency. ), Stuttering and related disorders of fluency (pp. https://doi.org/10.1044/2017_JSLHR-S-16-0343, Snsterud, H., Feragen, K. B., Kirmess, M., Halvorsen, M. S., & Ward, D. (2019).
- Speech & Language Parent Support - SPSD if a child has typical disfluencies or a fluency disorder (see ASHAs resource on. https://doi.org/10.1016/j.jfludis.2011.04.002, Foote, G. (2013). Self-help and mutual aid groups. Sisskin, V. (2018). Treatment approaches are individualized based on the childs needs and family communication patterns. https://doi.org/10.1093/brain/awm241, Watson, J. It is not possible to determine with certainty which children will continue to stutter, but there are some factors that indicate a greater likelihood that stuttering will become chronic. Consistent with treatment approaches for children and adolescents, treatment for adults needs to be individualized, dynamic, and multidimensional. https://doi.org/10.1044/ffd22.2.51, Berquez, A., & Kelman, E. (2018). Journal of Fluency Disorders, 31(2), 90115. See ASHAs Practice Portal pages on Collaborating With Interpreters, Transliterators, and Translators and Bilingual Service Delivery. Treatment approaches for preschool children who stutter include the following. American Journal of Speech-Language Pathology, 27(3S), 11241138. Van Borsel, J. https://doi.org/10.1044/2019_AJSLP-19-00077, Tran, Y., Blumgart, E., & Craig, A. (2013). However, increased mean length of utterance, more diverse vocabulary, and greater syntactic complexity have also been noted (Wagovich & Hall, 2017). Treatment may include strategies to reduce negative reactions to stuttering in the individual and others (Yaruss et al., 2012). Approaches may vary by therapeutic philosophy, goals and activities, duration and intensity, and age of the individual. However, these disfluencies are typical and not indicative of a disorder (Shenker, 2013). Self-help and support groups for people with cluttering. increasing acceptance and openness with stuttering. Academic Press. Cognitive restructuring is a strategy designed to help speakers change the way they think about themselves and their speaking situations. https://doi.org/10.1016/j.jfludis.2004.08.001, Kraft, S. J., Lowther, E., & Beilby, J. https://doi.org/10.1044/ffd16.1.15. Coleman, C. (2013). (2008). Perspectives of the ASHA Special Interest Groups 4:4 (615-623) 15 Aug 2019. In fact, stuttering can affect all areas of academic competency, including academic learning, social-emotion functioning, and independent functioning (Ribbler, 2006, p. 15). However, sensitive temperament (individual behavioral characteristics or reactions) and emotion are commonly seen as traits associated with stuttering in young children. https://doi.org/10.1055/s-2008-1064082, Caughter, S., & Crofts, V. (2018). The professional roles and activities in speech-language pathology include clinical/educational services (diagnosis, assessment, planning, and treatment); prevention and advocacy; and education, administration, and research. In general, the earlier preschool stuttering is addressed (relative to its onset), the easier it is to manage (Onslow & OBrian, 2012). The creative process in avoidance reduction therapy for stuttering. There has been some documentation of the use of stuttering modification strategies to help those who clutter (Ward, 2006). https://doi.org/10.1016/S0094-730X(96)00023-X, Tellis, G. M., & Tellis, C. M. (2003).