341358). American Journal of Speech-Language Pathology, 27(3S), 11111123. This includes the impact on functional communication in key school situations and on quality of life (Beilby et al., 2012b; Yaruss et al., 2012). Engaging parents in treatment helps to achieve carryover in the home environment and helps with treatment across languages (Shenker, 2013). Similarities - Typical and Atypical Pneumonia 5. Individuals may experience the impact of fluency disorders in social and emotional, academic, and vocational domains. For example, some children from bilingual or multicultural backgrounds may experience stuttering onset or a temporary increase in stuttering as result of being in new and unfamiliar situations, learning a new language, or being exposed to mixed linguistic input (Shenker, 2013). https://doi.org/10.1016/0094-730X(86)90028-8, St. Louis, K. O., & Hinzman, A. R. (1988). Characteristics of Typical Disfluency and Stuttering Differentiating typical disfluencies and stuttering is a critical piece of assessment, particularly for preschool children. American Journal of Speech-Language Pathology, 16(1), 6568. One example of a treatment approach that incorporates desensitization is Avoidance Reduction Therapy for Stuttering (Sisskin, 2018). The clinical applications of Acceptance and Commitment Therapy with clients who stutter. 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). This results in less effective social interactions. Prevalence of stuttering in African American preschool children. See ASHAs resource on person- and family-centered care. (2018). 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). Often, there are pivotal points during treatment that indicate progress (T. K. Anderson & Felsenfeld, 2003; Plexico et al., 2005). Treatment approaches for preschool children who stutter include the following. Therefore, when conducting an assessment with an adult, it is crucial to understand. Assessment of the impact of stuttering or clutteringincluding assessment of the emotional, cognitive, and attitudinal impact of disfluency. Symptoms have been observed in individuals with autism spectrum disorder as well as in neurotypical individuals. Remaining informed of research in the area of fluency disorders and advancing the knowledge base of the nature of the disability, screening, diagnosis, prognostic indicators, assessment, treatment, and service delivery for individuals with fluency disorders. Communication attitudes in children who stutter: A meta-analytic review. Universitetsforlaget. Cluttering: A synergistic framework. Journal of Fluency Disorders, 46, 114. Without proper intervention, children who exhibit signs of early stuttering are more at risk for continued stuttering. American Journal of Speech-Language Pathology, 27(3S), 11241138. However, there is no evidence to support the idea that stuttering is caused by, or more prevalent in, bilingual or multilingual speakers or that exposure to a second language increases the risk for developing stuttering (Byrd, 2018). https://doi.org/10.1016/S0094-730X(96)00024-1, Murphy, B., Quesal, R. W., & Gulker, H. (2007). sex of childboys are at higher risk for persistence of stuttering than girls (Craig et al., 2002; Yairi & Ambrose, 2013); family history of persistent stuttering (Kraft & Yairi, 2011); time duration of greater than 612 months since onset or no improvement over several months (Yairi & Ambrose, 2005); age of onsetchildren who start stuttering at age 3 years or later (Yairi & Ambrose, 2005); and. Fluency: A review of developmental and remedial practices. Stuttering and bilingualism: A review. They are likely to use interjections, repeat phrases, and revise what they are saying. (2019). Journal of Fluency Disorders, 38(1), 1429. van Zaalen, Y., & Reichel, I. K. (2014). Gupta, S., Yashodharakumar, G. Y., & Vasudha, H. H. (2016). https://doi.org/10.1044/gics4.2.57, Van Zaalen, Y., & Reichel, I. (2011). However during treatment and forming a new, more congruent identity, clients may progress through some of the stages of grief (e.g., 1. Assessment of other communication dimensions, including speech sound production, receptive and expressive language, pragmatic language, voice, hearing, and oralmotor function/structure. Strategies aimed at altering the timing of pausing are used to increase the likelihood of fluent speech production and to improve overall communication skills (e.g., intelligibility, message clarity). (2013). 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. Acquired neurogenic and psychogenic stuttering are not covered. See the Treatment section of the Fluency Disorders Evidence Map for pertinent scientific evidence, expert opinion, and client/caregiver perspective. Managing cluttering: A comprehensive guidebook of activities. Person- and family-centered practice is a collaborative approach that fosters an alliance-style partnership among individuals, families, and clinicians. Journal of Fluency Disorders, 36(4), 290295. Journal of Speech, Language, and Hearing Research, 45(6), 10971105. Allyn & Bacon. Journal of Educational Psychology, 95(1), 321. Reduced perfusion in Brocas area in developmental stuttering. https://doi.org/10.1037/0022-0663.95.1.3, Langevin, M., Bortnick, K., Hammer, T., & Wiebe, E. (1998). Psychology Press. Prevalence of stuttering in primary school children in Cairo-Egypt. Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse (CLD) Populations, 20(1), 1523. (2011). having flexibility based on individual needs and desired outcomes (Amster & Klein, 2018). In D. Ward & K. Scaler Scott (Eds. Psychology Press. Preus, A. ), The Cambridge handbook of communication disorders (pp. It is important for clinicians to verify online sites and virtual support groups recommended to clients and their families. Real-time analysis or analysis based on an audiovisual recorded speech sample demonstrating representative disfluencies beyond the clinic setting. (2013). Journal of Fluency Disorders, 38(2), 6687. The prevalence rate of stuttering in African American children (25 years of age) was estimated to be 2.52%, but was not reported to not be significantly different from that reported for European American children in the same age group between 2- to 5-year-old African American children and European American children (Proctor et al., 2008). The term overt stuttering is used when core speech behaviors are present. These simulations and applications of strategies might be most likened to cancellation and pull-out techniques used in stuttering. https://doi.org/10.1055/s-0034-1382151, Chang, S.-E., Garnett, E. O., Etchell, A., & Chow, H. M. (2019). Journal of Fluency Disorders, 63, 105746. https://doi.org/10.1016/j.jfludis.2020.105746, Boyle, M. P., Milewski, K. M., & Beita-Ell, C. (2018). The presence of at least 1 disabling developmental condition was 5.5 times higher in CWS [children who stutter] when compared to children who do not stutter (Briley & Ellis, 2018, p. 2895). Impact of stuttering severity on adolescents domain-specific and general self-esteem through cognitive and emotional mediating processes. https://doi.org/10.1111/1460-6984.12051, Fuse, A., & Lanham, E. A. Seminars in Speech and Language, 24(1), 2126. https://doi.org/10.1044/2019_PERS-SIG4-2019-0024, Boyle, M. P., & Gabel, R. (2020). Defining cluttering: The lowest common denominator. 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). Differences in fluency across languages may be due to the social context in which the language is used (Foote, 2013), as well as the proficiency of each language spoken. ET MondayFriday, Site Help | AZ Topic Index | Privacy Statement | Terms of Use
Journal of Fluency Disorders, 22(3), 219236. 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). Consistent with treatment approaches for children and adolescents, treatment for adults needs to be individualized, dynamic, and multidimensional. Such individuals may benefit from treatment strategies that focus on improving speech efficiency by reducing word avoidance and increasing spontaneity in communication. Signs and symptoms. Journal of Speech, Language, and Hearing Research, 61(5), 12381250. Moments of stuttering or disfluency may be difficult to distinguish from typical disfluency or reduced language proficiency, especially for a person unfamiliar with the language (Shenker, 2011). Partners may be sources of support for treatment of stuttering (Beilby et al., 2013). In addition, clinicians need to avoid using religious or highly familiar texts that individuals may know by rote. Evidence-based practice for school-age stuttering: Balancing existing research with clinical practice. Some families may decide to send children to live with relatives or ask children not to speak in public (Shenker, 2013). excessive coarticulation resulting in the collapsing and/or deletion of syllables and/or word endings; excessive disfluencies, which are usually of the more nonstuttering type (e.g., excessive revisions and/or use of filler words, such as um); pauses in places typically not expected syntactically; unusual prosody (often due to the atypical placement of pauses rather than a pedantic speaking style, as observed in many with autism spectrum disorder). https://doi.org/10.1016/j.jfludis.2006.12.003. Nurturing a resilient mindset in school-aged children who stutter. Without proper intervention, children who exhibit signs of early stuttering are more at risk for continued stuttering. other developmental disorders (Briley & Ellis, 2018). Wampold, B. E. (2001). Building clinical relationships with teenagers who stutter. Counseling helps an individual, a family member, or a caregiver of a person of any age who stutters move from the current scenario to a preferred scenario through an agreed-upon action plan (Egan, 2013). https://doi.org/10.1016/j.cub.2016.02.068, Beilby, J. M., & Byrnes, M. L. (2012). Scaler Scott, K. (2013). Journal of Speech, Language, and Hearing Research, 36(5), 906917. Psychology Press. https://doi.org/10.1016/j.jfludis.2017.09.004, Cassar, M. C., & Neilson, M. D. (1997). (2016b). The person exhibits negative reactions (e.g., affective, behavioral, or cognitive reactions) to their disfluency. There are limited data on the age of onset of cluttering; however, the age of onset of cluttering appears to be similar to that of stuttering (Howell & Davis, 2011). Children and adolescents with fluency disorders may qualify for accommodations whether or not they have an active individualized education program (IEP). Integrated treatment focused on parental involvement, self-regulation, and fluency may also be beneficial (Druker et al., 2019). Clinicians can help clients progress to active stages through building self-efficacy. Experiences with stuttering can affect an individuals employment, job satisfaction, personal and romantic relationships, and overall quality of life (Beilby et al., 2013; Blood & Blood, 2016). Counseling allows the clinician who works with those who stutter or clutter to practice within the ICF framework by targeting all aspects of the disordernot just the surface behaviors. (2015). The ASHA Leader, 11(10), 621. have a sense of belonging and experience less stigma. https://doi.org/10.1016/j.jfludis.2012.12.001, Beilby, J. M., Byrnes, M. L., & Yaruss, J. S. (2012a). 187214). Treatment for fluency disorders helps the individual make changes that will facilitate communication in a variety of settings. Adults who stutter may be dealing with years of shame or stigma (Boyle, 2013a), and they can experience elevated levels of negative mood states (e.g., interpersonal sensitivity and depressed mood) when compared to adults who do not stutter (Tran et al., 2011). Singular. the diagnosis of a fluency disorder (stuttering, cluttering, or both); a differential diagnosis between fluency disorders and reading disorders, language disorders, and/or speech sound disorders; descriptions of the characteristics and severity of the fluency disorder; judgments on the degree of impact the fluency disorder has on verbal communication and quality of life; a determination if the person will benefit from treatment; a determination of adverse educational, social, and vocational impact; parent or family counseling to determine optimal responses to the childs speech and stuttering; and.