Direct treatment focuses on changing the childs speech, attitudes, and beliefs in order to manage stuttering or facilitate fluency (Yaruss et al., 2006). https://doi.org/10.1016/j.jfludis.2017.09.001, Byrd, C. T., & Donaher, J. Specific standardized tests can be used to rule out word-finding difficulties. Preschool children who stutter showed differences in event-related brain potentials used as indices of language processing. Individuals are referred to a speech-language pathologist (SLP) for a comprehensive assessment when disfluencies are noted and when one or more of the factors listed below are observed along with the disfluencies. Nurturing a resilient mindset in school-aged children who stutter. Journal of Speech, Language, and Hearing Research, 46(5), 12211233. (1984). Purpose Disfluencies associated with stuttering generally occur in the initial position of words. For example, stuttering has been associated with higher levels of social anxiety in adults who stutter (Blumgart et al., 2010), and this can lead to fear and avoidance of social interaction (see Craig & Tran, 2006, for a review research on this topic). using fillers (e.g., like, um, uh, you know); avoiding sounds or words (e.g., substituting words, inserting unnecessary words, circumlocution); and. Sex of childIt appears that the disorder is more common in males than in females; the male-to-female ratio for cluttering has been reported to range from 3:1 to 6:1 (G. E. Arnold, 1960; St. Louis & Hinzman, 1986; St. Louis & Rustin, 1996). American Journal of Speech-Language Pathology, 12(4), 425431. Clinical implications of situational variability in preschool children who stutter. https://doi.org/10.1044/leader.OV.18032013.14, Freud, D., & Amir, O. Fluency disorders do not necessarily affect test scores or subject grades. There are benefits of both individual and group treatment. Perspectives on Fluency and Fluency Disorders, 11(1), 711. https://doi.org/10.1016/j.jfludis.2011.06.001. Molt, L. F. (1996). International Journal of Speech-Language Pathology, 17(4), 367372. Seminars in Speech and Language, 18(4), 371389. These disfluencies do not appear to be symptoms of stuttering (child onset fluency disorder). have a sense of belonging and experience less stigma. The incidence of pediatric fluency disorder refers to the number of new cases identified in a specific time period. Persons who stutter may appear to have expressive language problems because of a tendency to avoid speaking or speak in a way thats unclear to the listener. American Journal of Speech-Language Pathology, 16(1), 6568. Time and expense are considerations along with attention to generalization and treatment needs following an intensive program (Cooper, 1979). https://doi.org/10.1044/1092-4388(2002/088), Craig, A., & Tran, Y.
Search Evidence Maps - American Speech-Language-Hearing Association Motivational interviewing: Helping people change. Bilingual children are assessed in both languages to determine stuttering profiles in both (Finn & Cordes, 1997). Direct versus indirect treatment for preschool children who stutter: The RESTART randomized trial. Stuttering and labor market outcomes in the United States. Journal of Fluency Disorders, 11(2), 131149. Clinicians can help clients progress to active stages through building self-efficacy. ), Cluttering: Research, intervention and education (pp. (2014). For example, counseling an individual to accept or tolerate embarrassment can facilitate desensitization. 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. https://doi.org/10.1016/j.jfludis.2013.08.003, Jones, R. M., Choi, D., Conture, E., & Walden, T. (2014). For example, individuals with attention-deficit/hyperactivity disorder, autism spectrum disorder, intellectual disability, learning disability, or seizures have higher odds of stuttering. 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. Children with persistent stuttering showed deficiencies in left gray matter volume with reduced white matter integrity in the left hemisphere. Sadness/Depression, 6. 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). Consequently, they may speak less to avoid being disfluent, and they may avoid social situations. Building trust by following the students lead, finding out what experiences may be motivating, and bringing together peers for support are treatment options to consider (Hearne et al., 2008). Technological advances and the expansion of social media outlets have increased opportunities for adults who stutter to connect, share, and gain information through the Internet (Fuse & Lanham, 2016; Raj & Daniels, 2017) and stuttering-related podcasts (Dignazio et al., 2020). Oxford University Press. 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). Resiliencethe ability to adjust and cope in the face of adversitycan help lessen the negative impact (e.g., Coifman & Bonanno, 2010). Explore how typical and atypical disfluencies differ, and find resources for guidance and support. Person- and family-centered practice is a collaborative approach that fosters an alliance-style partnership among individuals, families, and clinicians. Clinical characteristics associated with stuttering persistence: A meta-analysis. Without proper intervention, children who exhibit signs of early stuttering are more at risk for continued stuttering. Oral reading may not be a valid measure of reading fluency for children who stutter, as fluency breakdowns will slow reading rate. To facilitate generalization of skills, the clinician can help the individual use a variety of therapeutic activities outside of the treatment room, such as. This approach to care incorporates individual and family preferences, priorities, and desired outcomes in the selection of treatment goals and treatment methods. Journal of Communication Disorders, 80, 8191. Conture, E. G. (2001). Scaler Scott, K. (2013). For example, emotional reactivity/regulation and behavioral disinhibition may affect the childs ability to cope with disfluencies (Choi et al., 2013; Guttormsen et al., 2015; R. M. Jones, Conture, & Walden, 2014; Ntourou et al., 2013). www.asha.org/policy/, American Speech-Language-Hearing Association. White matter neuroanatomical differences in young children who stutter. Typical childhood disfluencies may increase and decrease without any external influence. Functional and neuroanatomical bases of developmental stuttering: Current insights. https://doi.org/10.1093/brain/awm241, Watson, J. In D. Ward & K. Scaler Scott (Eds. 187214). practice monitoring each others speech and secondary behaviors. Acceptance and Commitment Therapy for people who stutter. A fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm, and disfluencies (e.g., repetitions of sounds, syllables, words, and phrases; sound prolongations; and blocks), which may also be accompanied by excessive tension, speaking avoidance, struggle behaviors, and secondary mannerisms (American Speech-Language-Hearing Association [ASHA], 1993). Current Biology, 26(8), 10091018. Barnes, T. D., Wozniak, D. F., Gutierrez, J., Han, T. U., Drayna, D., & Holy, T. (2016). They are likely to use interjections, repeat phrases, and revise what they are saying. deletion and/or collapsing of syllables (e.g., I wanwatevision). Menu. Motivational interviewing may be used to help individuals who stutter better understand the thoughts and feelings associated with their stuttering and make positive changes to improve communication. Some children go through a disfluent period of speaking. 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). Arnold, H. S., Conture, E. G., Key, A. P., & Walden, T. (2011). The ASHA Action Center welcomes questions and requests for information from members and non-members. Fluency treatment can occur at any point after the diagnosis. Coexistence of stuttering and disordered phonology in young children. Journal of Fluency Disorders, 38(2), 206221. Journal of Fluency Disorders, 53, 2640. ), Cluttering: Research, intervention and education (pp. Reardon-Reeves, N., & Yaruss, J. S. (2013). Social anxiety disorder and stuttering: Current status and future directions. Human Brain Mapping, 38(4), 18651874. Timing refers to the initiation of treatment relative to the diagnosis. Greater abnormality of cerebral blood flow in the posterior language loop, associated with processing words that we hear, correlates with more severe stuttering. Research updates in neuroimaging studies of children who stutter. Journal of Fluency Disorders, 13(5), 357373. Guilford Press. Below is a list of approaches commonly used with school-age children, adolescents, and adults who stutter. Clinicians also should attempt to better understand how the person experiences the moments before, during, and after stuttering. Increasing the individuals awareness and self-monitoring skills helps to reduce unproductive behaviors that interfere with speech, and it may allow them to alter moments of stuttering so that they have decreased tension, are shorter, and are less disruptive to communication. Resilience in people who stutter: Association with covert and overt characteristics of stuttering. increasing self-confidence and self-efficacy. Some families may decide to send children to live with relatives or ask children not to speak in public (Shenker, 2013). This relationship is recognized as one of the common factors that account for the effectiveness of counseling (common factors theory; Wampold, 2001). Singular. Fluency Disorders (Practice Portal). Journal of Fluency Disorders, 36(2), 122129. Journal of Fluency Disorders, 30(1), 122. Treatment approaches for preschool children who stutter include the following. Journal of Fluency Disorders, 22(3), 187203. Harper & Row. Coworkers may have negative attitudes toward individuals who stutter, and the individual may feel excluded because of this. Depending on the country and methodology used, rates were estimated to range from 1.03% (Abou et al., 2015) to 1.38% (Al-Jazi & Al-Khamra, 2015), but could be as high as 8.4% (Oyono et al., 2018). Engaging parents in treatment helps to achieve carryover in the home environment and helps with treatment across languages (Shenker, 2013). Typical pneumonia is a form of community-acquired pneumonia that tends to have more serious symptoms.
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