A study of the role of the FOXP2 and CNTNAP2 genes in persistent developmental stuttering. Treatment approaches for adults should take into consideration career and workplace factors. Language, Speech, and Hearing Services in Schools, 48(4), 234248. These symptoms come suddenly and do need hospitalization. Ingham, R. J., & Onslow, M. (1985). (2015). https://doi.org/10.1016/j.jfludis.2011.06.001. American Journal of Speech-Language Pathology, 26(4), 11051119. other developmental disorders (Briley & Ellis, 2018). Amster, B. J., & Klein, E. R. (2018). 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. Technology has been incorporated into the delivery of services for fluency, including the use of telepractice to deliver face-to-face services remotely. 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. https://doi.org/10.1044/2019_JSLHR-S-18-0318, Lucey, J., Evans, D., & Maxfield, N. D. (2019). For example, an individual might elect to self-disclose in a workplace and educate coworkers about fluency disorders via a group presentation followed by a question-and-answer period. More recently, CBT and mindfulness have been applied to stuttering therapy and may support that CBT+mindfulness is more beneficial to clients who stutter than CBT alone (Gupta et al., 2016; Harley, 2018). https://doi.org/10.1111/1469-7610.00093, de Sonneville-Koedoot, C., Stolk, E., Rietveld, T., & Franken, M. C. (2015). Psychology Press. All speakers are disfluent at times. Avoidance can lead to less talking and reduced linguistic complexity. american journal of audiology (aja) american journal of speech-language pathology (ajslp) journal of speech, language, and hearing research (jslhr) language, speech, and hearing services in schools (lshss) perspectives of the asha special interest groups; topics; special collections Journal of Speech, Language, and Hearing Research, 54(6), 14851496. 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). Format refers to the manner in which a client receives treatmentindividually, as part of a group, or both. Clinical decision making in fluency disorders. 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. The SLP can use audio- or videoconferencing to augment this type of treatment. Journal of Speech, Language, and Hearing Research, 62(5), 13711372. Overheard: Bilingual and disfluent: A unique treatment challenge. https://doi.org/10.1044/2018_AJSLP-17-0097, Kraft, S. J., & Yairi, E. (2011). ), Handbook of psychotherapy integration (pp. The human capacity to thrive in the face of potential trauma. 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). In this way, positive reinforcement is used to increase or strengthen the response of fluency (the desired behavior). https://doi.org/10.1016/j.jfludis.2009.09.002, Millard, S. K., Nicholas, A., & Cook, F. M. (2008). Children with normal disfluencies have emergent fluency. Journal of Fluency Disorders, 21(34), 201214. A study of pragmatic skills of clutterers and normal speakers. Possible genetic factors in cluttering. is more open and willing to disclose and talk about their stuttering; experiences reduced impact from stuttering; generalizes attitudes, beliefs, and behaviors across contexts; reports feeling more authentic and enjoying social conversations; and. When a bilingual SLP is not available, using an interpreter is a viable option. Identifying subgroups of stutterers (No. They may hesitate when speaking, use fillers (like or uh), or repeat a word or phrase. Counseling parents of children who stutter. 6396). https://doi.org/10.1044/2017_AJSLP-16-0079, Davis, S., Howell, P., & Cooke, F. (2002). Parents of bilingual children easily can be trained to provide perceptual ratings of fluency in any language spoken by the child (Shenker, 2013). https://doi.org/10.1542/peds.2012-3067, Ribbler, N. (2006). 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). 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). talking about stuttering or treatment of stuttering. being more comfortable and open with stuttering and pseudostuttering; reporting experiencing decreased anxiety while communicating; reporting less adverse psychological, emotional, social, and functional impacts; reporting enjoying social communication, including with strangers; and. 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). Content for ASHAs Fluency Disorders Practice Portal pagewas developed through a comprehensive process that includes multiple rounds of subject matter expert input and review. However, sensitive temperament (individual behavioral characteristics or reactions) and emotion are commonly seen as traits associated with stuttering in young children. Preliminary evidence that growth in productive language differentiates childhood stuttering persistence and recovery. https://doi.org/10.1159/000331073, Kuhn, M. R., & Stahl, S. A. Summary - Typical vs Atypical Pneumonia. We often use the term "emergent" to describe skills that are developing, but have not fully emerged. https://doi.org/10.1044/cicsd_29_S_91, Zebrowski, P. M., & Schum, R. L. (1993). One example of a treatment approach that incorporates desensitization is Avoidance Reduction Therapy for Stuttering (Sisskin, 2018). ), Controversies about stuttering therapy (pp. Intrajudge and interjudge reliability of the Stuttering Severity InstrumentFourth Edition. Cluttering and Down syndrome. A range of studies support a genetic predisposition for stuttering, but no definitive findings have been made regarding which transmission model, chromosomes, genes, or sex factors are involved in the expression of stuttering in the population at large (Kraft & Yairi, 2011, p. 34). attention-deficit/hyperactivity disorder (Donaher & Richels, 2012; Lee et al., 2017). Journal of Fluency Disorders, 22(3), 219236. https://doi.org/10.1055/s-0034-1371755, Jones, R. M., Conture, E. G., & Walden, T. A. Perspectives on Global Issues in Communication Sciences and Related Disorders, 4(2), 5762. the individuals lived experiences with stuttering, the perceived impact of these experiences with stuttering, and. It is incumbent upon the SLP to help the individualized education program (IEP) team determine the academic and social impacts of stuttering on students in the school setting. Clinicians may provide education about the speech systems and processes (e.g., respiratory system, phonatory, articulation/resonance, and nonverbal features) and that communication includes both verbal and nonverbal aspects, pragmatics, senderreceiver dynamics, and interpersonal relational features, which may be a target in treatment. Cluttering may have an effect on pragmatic communication skills and awareness of moments of disruption (Teigland, 1996). Parents can also report if secondary behaviors are present in both languages. https://doi.org/10.1016/S0021-9924(03)00052-2, Yaruss, J. S., & Quesal, R. W. (2006). Drayna, D., & Kang, C. (2011). Bray, M. A., Kehle, T. J., Lawless, K., & Theodore, L. (2003). (2019). https://doi.org/10.1016/j.jfludis.2015.08.001, Han, T.-U., Park, J., Domingues, C. F., Moretti-Ferreira, D., Paris, E., Sainz, E., Gutierrez, J., & Drayna, D. (2014). A comprehensive fluency assessment typically includes the following: See ASHAs resource on assessment procedures: parallel with CPT codes for a breakdown of pre-evaluation, intra-service, and post-service procedures. https://doi.org/10.1044/1058-0360(2011/09-0102), Ntourou, K., Conture, E. G., & Walden, T. A. 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). Allyn & Bacon. The effects of self-disclosure on the communicative interaction between a person who stutters and a normally fluent speaker. Counseling begins with active listening and continues with microskills (Egan, 2013) that emphasize attending, showing empathy, demonstrating shared interest in the individual/family, and working to build trust. Some children who stutter or clutter may only experience symptoms situationally. In B. J. Amster & E. R. Klein (Eds. What is Typical Pneumonia? Both procedures help the client decrease the sense of loss of control experienced during moments of stuttering by demonstrating their ability to stop and modify moments of stuttering, anxiety, and other emotional reactivity. These modifications are used to facilitate speech fluency and may include. Plural. Mancinelli, J. M. (2019). https://doi.org/10.1044/1092-4388(2003/095), Anderson, T. K., & Felsenfeld, S. (2003). The purpose of the screening is to identify individuals who require further speech-language assessment. In contrast to adults who stutter, children who stutter did not show increases in white matter tracts in the right hemisphere (Chang et al., 2015). 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., . https://doi.org/10.1016/S0094-730X(97)00009-0, Yaruss, J. S. (2007). World Health Organization. Some families may decide to send children to live with relatives or ask children not to speak in public (Shenker, 2013). https://doi.org/10.1044/ffd23.2.54, Plexico, L. W., Hamilton, M. B., Hawkins, H., & Erath, S. (2019). Journal of Speech, Language, and Hearing Research, 61(5), 12381250. (2009). 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. (2019). https://doi.org/10.1016/j.jfludis.2014.12.002, Boyle, M. P., Beita-Ell, C., & Milewski, K. M. (2019). Mindfulness training in stuttering therapy: A tutorial for speech-language pathologists. https://doi.org/10.1044/jshr.2804.495, Iverach, L., Jones, M., McLellan, L. F., Lyneham, H. J., Menzies, R. G., Onslow, M., & Rapee, R. M. (2016). practice treatment targets with more listeners. Genetic contributions to stuttering: The current evidence. PLOS ONE, 10(7), Article e0133758. https://doi.org/10.1016/S0094-730X(96)00024-1, Murphy, B., Quesal, R. W., & Gulker, H. (2007). Perspectives of the ASHA Special Interest Groups 4:4 (615-623) 15 Aug 2019. Donaher, J., & Richels, C. (2012). Proceedings of the National Academy of Sciences of the United States of America, 116(35), 1751517524. Treatment for adolescents who stutter poses a particular challenge because of the issues related to this developmental stage. https://doi.org/10.1016/j.jcomdis.2019.04.003, Menzies, R. G., Onslow, M., Packman, A., & OBrian, S. (2009). Assessment of other communication dimensions, including speech sound production, receptive and expressive language, pragmatic language, voice, hearing, and oralmotor function/structure. https://doi.org/10.1044/0161-1461(2006/014), Yaruss, J. S., Coleman, C. E., & Quesal, R. W. (2012). ASHA also extends its gratitude to the following subject matter experts who were involved in the reviewand development of thispage: In addition, ASHA thanks the members of the Steering Committee of ASHAs Special Interest Division on Fluency and Fluency Disorders (Division 4) whose work preceded this content. Journal of Speech, Language, and Hearing Research, 44(2), 368380. Reading slowly may be perceived as a reading problem, even though the underlying cause is stuttering. To facilitate generalization of skills, the clinician can help the individual use a variety of therapeutic activities outside of the treatment room, such as. However, increased mean length of utterance, more diverse vocabulary, and greater syntactic complexity have also been noted (Wagovich & Hall, 2017). (n.d.). An increase in observable disfluent behaviors may occur as the individual communicates more freely. 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. Enhancing treatment for school-age children who stutter: II. Journal of Speech, Language, and Hearing Research, 63(9), 29953018. Smith, A., & Weber, C. (2017).
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