Tag Archives: Fluency

Treatment of Fluency Disorders

This week is National Stuttering Awareness Week and what better way for the #slpeeps to contribute, than to make it the topic of discussion for our upcoming #slpchat! Yes we are aware!

Dysfluency/stuttering and its treatment have been making the rounds across conversations all over the world with the release of the popular Academy Award winner “The King’s Speech.” We watched the more unorthodox techniques of  Lionel Logue, which poses the question “What has changed since those early days of stuttering treatment?” “What techniques are being used now to treat stuttering in preschoolers, school aged children, adolescents and adults?”

Treatment options for the various age groups vary across countries. For preschoolers indirect therapy may be used to create a fluency enhancing environment, by teaching parents to slow their rate of speech, avoid interrupting, reframe responses, and modify questions to reduce demands on the child. Other therapists may use a behavioural approach such as the Lidcombe program , which uses verbal contingencies to praise “smooth speech” and to acknowledge or correct unambiguous stuttering.

Treatment options become a bit more difficult in the school aged to adult years due to decreased neural plasticity, amongst other factors.  ASHA notes  that techniques that have the greatest efficacy for reducing the frequency of stuttering in adults and older children includes those that change the timing of speech (e.g. slowing down, stretching out sounds), or reduce physical tension during speaking (e.g. gentle onsets of speech movement).  Some other strategies that have come up in the literature are:

  •  Self-Imposed Time Outs: where a person pauses after a moment of stuttering.
  • Syllable-Timed Speech : involves speaking with minimal differentiation in linguistic stress across syllables and is achieved by saying each syllable in time to a rhythmic beat.
  • Pull outs: During the moment of stuttering, staying in the tension and sliding out by breaking down the tension in the speech mechanism, before continuing with the production of the word. Discussed here
  • Voluntary Stuttering . Discussed here

Another speech restructuring program for adolescents and adults which I (Shareka) learned about and practiced in grad school was the Camperdown program out of Australia, which presents a new way of teaching prolonged speech.

New Medical Technology has also introduced delayed auditory feedback, rate control and masking devices for stuttering treatment.

In our upcoming #slpchat on Saturday May 14th at 7pm ET, We’d like to talk about what types of treatment you use in your practice for stuttering at each age level, and what you view as effective/ineffective. Areas we also wish to look at during this time are:

  • Assessment tools in Fluency Disorders
  • When to start treatment in Preschoolers
  • The SLP role in counselling in fluency Disorders: Dealing with avoidance, anxiety and negative perspectives on stuttering.
  • Bullying and the school-aged child who stutters
  • The Acquired Neurogenic Stutter

Don’t forget to follow @Slpchat this week for some useful links to pages and articles on stuttering treatment.

We look forward to your participation this weekend! See you there! 🙂


		
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