Speech Therapy: An Overview On Fluency Disorders And Tips On How To Deal With It
Speech Therapy: An Overview On Fluency Disorders
One of the main categories of speech problems in need for speech therapy are fluency disorders. However, there are different types of fluency disorders, even though they may all seem the same. Each type has its own cause, and defining characteristics that make them stand out from one another.
There are basically six main types of fluency disorders, while some are considered to be other conditions that are related to fluency disorders.
Normal Developmental Disfluency
Normal developmental disfluency, is a fluency disorder that is a lot of times mistaken to be stuttering. This condition occurs with children from ages 1:6- 6 years old, although the peak of the condition is considered to be 2-4 years of age.
A lot of parents may be concerned of the way their child speaks, but in reality, this is a normal condition that every child goes through. Normal developmental disfluency is a normal part of a child's development. So there is really no need to worry at all.
A child would normally get over this stage as his speech skills develop. However, a proper environment, and interaction is needed for that to happen. If a child is pressured by his parents or people around him about his speech, the higher the probability that his disfluency would become a problem in the future and could develop to stuttering.
Stuttering
Stuttering is a disorder of childhood (developmental) that is characterized by an abnormally high frequency or duration of stoppages in the forward flow of speech. Although normal developmental disfluency has its own share of stoppages, stuttering on the other hand has some extra characteristics that normal developmental disfluency doesn't have.
What makes stuttering different, from normal developmental disfluency, is that stuttering has escape behaviors, avoidance behaviors, and other secondary behaviors. These so called behaviors are also called physical concomitants. Some examples are eye blinks, head nods, jaw tremors and total body gyrations.
Neurogenic Disfluency
This kind of disfluency is a result of an identifiable neuropathology in a person that has no history of fluency problems prior to occurrence of the pathology. People who have accidents that caused brain problems, which induced their disfluency, fall into this category.
Neurogenic disfluency has similar characteristics as stuttering, including the physical behaviors like eye blinks and tremors. The thing is that, the main problem in conditions like these is not fluency at all, but the lesser control of muscles needed in speech production.
Psychogenic Disfluency
A disfluency with no found evidence of neurological dysfunction and no history of developmental stuttering. It is of sudden onset and attributed to an identifiable emotional crisis. Can be grouped into three categories namely: emotionally based, manipulative, and malingering disfluencies
An example of this kind of disfluency is when a person starts to stutter when a specific other is around. For instance, a student who is afraid of her teacher, starts to stutter every time her teacher is around but speaks fluently when around her friends and family.
Language Bases Disfluency
This is a disfluency that is attributed to the development of linguistic sophistication. The main root of the problem here would be language problems, which would require language based therapy rather than fluency-based therapy.
Mixed Fluency Failures
These are fluency failures that are characterized by overlapping causative factors. Speech pattern observed is the result of a blend of two or more factors/disfluency.
Cluttering
This is a condition that is related to fluency disorders. It is considered to be the extreme of stuttering. It is a disorder of timing and rhythm of speech where the person speaks too fast that his speech can't be comprehended. The thing is, a clutterer isn't aware that he is cluttering, while a stutterer is very much aware that he stutters.
Speech Therapy Assessment Tips For Fluency Disorders
During the assessment of an individual with suspected fluency disorder, there are some things to remember to make the assessment more comprehensive and useful. Here are some of those critical points to take note of during assessment.
Benefits Of Obtaining Both Reading and Conversation Sample
It is more beneficial to obtain both reading and conversation sample from school children and adults because this would give more reliability and credibility to the samples taken.
Since stuttering varies in different situations, a reading and conversation sample would allow the clinician to see the behaviors of the person in two different tasks. A conversational speech sample is likely to have more variability, while a reading passage would likely have less variability.
Information To Assess Motivation
Through interview, a therapist can learn a lot from his client. In fact, insight about the client's motivation could be seen by asking the following questions like "What do you believe caused you to stutter?", "Has you stuttering changed or caused you more problems recently?, "Why did you come in for help at the present time?", " Are there times or situations when you stutter more? Less? What are they?".
Benefits Of Continuing Evaluation
No individual could be understood in an hour or two; that's why continuing of evaluation is recommended. The clinician might overlook an important element at times and some times a vital clue will not be present in the samples of behavior taken from the limited time of the evaluation period.
Note The Difference When Assessing Feelings and Attitudes
Assessing a school-age child's feelings and attitudes would require the clinician to establish rapport and to get to know the child much better after some time, because the clinician's judgment is also a fair measurement in the case of school-age children.
Talking to the child and observing his behaviors would be necessary. When the clinician has known the child much better, he could administer the A-19 Scale to the child. Other methods could also be used such as "Worry Ladder" and "Hands Down" that could be found in the workbook, The School-Age Child Who Stutters: Working Effectively with Attitudes and Emotions.
For adults and adolescents assessment of feelings and attitudes are usually done by administering tools such as, the Modified Erickson Scale of Communication Attitudes, the Stutterer's Self-Rating of Reactions to Speech Situations, the Perceptions of Stuttering Inventory and the Locus of Control of Behavior Scale.
Remember The Role Of The IEP Team
An Individualized Education Program (IEP) team is appointed to a child to be the ones to consider reports by the clinician and other information. They decide if the child meets the state's eligibility standards and if the child's stuttering has a negative effect on his education.
If a child is eligible for services measurable, the IEP team sets goals and short-term objectives for the child. They also provide services needed by the child for improvement in the educational setting.
Goals Of Trial Therapy
Trial therapy for a school-age child is done to understand what approach might work and what might be difficult for him. This could increase the child's motivation and positive outlook for the treatment. In the case of adults and adolescents, trial therapy is done for 3 main reasons.
First, is to get an idea of how a client would respond to different therapy approaches. Second, is to make a differential diagnosis between developmental, neurological or psychological stuttering. Third, it gives a preview to the client of what to expect during therapy sessions, in effect it would give them motivation to go on their treatment.
Steve Cownley
http://dyslexiaandstuttering.freeiz.com/
One of the main categories of speech problems in need for speech therapy are fluency disorders. However, there are different types of fluency disorders, even though they may all seem the same. Each type has its own cause, and defining characteristics that make them stand out from one another.
There are basically six main types of fluency disorders, while some are considered to be other conditions that are related to fluency disorders.
Normal Developmental Disfluency
Normal developmental disfluency, is a fluency disorder that is a lot of times mistaken to be stuttering. This condition occurs with children from ages 1:6- 6 years old, although the peak of the condition is considered to be 2-4 years of age.
A lot of parents may be concerned of the way their child speaks, but in reality, this is a normal condition that every child goes through. Normal developmental disfluency is a normal part of a child's development. So there is really no need to worry at all.
A child would normally get over this stage as his speech skills develop. However, a proper environment, and interaction is needed for that to happen. If a child is pressured by his parents or people around him about his speech, the higher the probability that his disfluency would become a problem in the future and could develop to stuttering.
Stuttering
Stuttering is a disorder of childhood (developmental) that is characterized by an abnormally high frequency or duration of stoppages in the forward flow of speech. Although normal developmental disfluency has its own share of stoppages, stuttering on the other hand has some extra characteristics that normal developmental disfluency doesn't have.
What makes stuttering different, from normal developmental disfluency, is that stuttering has escape behaviors, avoidance behaviors, and other secondary behaviors. These so called behaviors are also called physical concomitants. Some examples are eye blinks, head nods, jaw tremors and total body gyrations.
Neurogenic Disfluency
This kind of disfluency is a result of an identifiable neuropathology in a person that has no history of fluency problems prior to occurrence of the pathology. People who have accidents that caused brain problems, which induced their disfluency, fall into this category.
Neurogenic disfluency has similar characteristics as stuttering, including the physical behaviors like eye blinks and tremors. The thing is that, the main problem in conditions like these is not fluency at all, but the lesser control of muscles needed in speech production.
Psychogenic Disfluency
A disfluency with no found evidence of neurological dysfunction and no history of developmental stuttering. It is of sudden onset and attributed to an identifiable emotional crisis. Can be grouped into three categories namely: emotionally based, manipulative, and malingering disfluencies
An example of this kind of disfluency is when a person starts to stutter when a specific other is around. For instance, a student who is afraid of her teacher, starts to stutter every time her teacher is around but speaks fluently when around her friends and family.
Language Bases Disfluency
This is a disfluency that is attributed to the development of linguistic sophistication. The main root of the problem here would be language problems, which would require language based therapy rather than fluency-based therapy.
Mixed Fluency Failures
These are fluency failures that are characterized by overlapping causative factors. Speech pattern observed is the result of a blend of two or more factors/disfluency.
Cluttering
This is a condition that is related to fluency disorders. It is considered to be the extreme of stuttering. It is a disorder of timing and rhythm of speech where the person speaks too fast that his speech can't be comprehended. The thing is, a clutterer isn't aware that he is cluttering, while a stutterer is very much aware that he stutters.
Speech Therapy Assessment Tips For Fluency Disorders
During the assessment of an individual with suspected fluency disorder, there are some things to remember to make the assessment more comprehensive and useful. Here are some of those critical points to take note of during assessment.
Benefits Of Obtaining Both Reading and Conversation Sample
It is more beneficial to obtain both reading and conversation sample from school children and adults because this would give more reliability and credibility to the samples taken.
Since stuttering varies in different situations, a reading and conversation sample would allow the clinician to see the behaviors of the person in two different tasks. A conversational speech sample is likely to have more variability, while a reading passage would likely have less variability.
Information To Assess Motivation
Through interview, a therapist can learn a lot from his client. In fact, insight about the client's motivation could be seen by asking the following questions like "What do you believe caused you to stutter?", "Has you stuttering changed or caused you more problems recently?, "Why did you come in for help at the present time?", " Are there times or situations when you stutter more? Less? What are they?".
Benefits Of Continuing Evaluation
No individual could be understood in an hour or two; that's why continuing of evaluation is recommended. The clinician might overlook an important element at times and some times a vital clue will not be present in the samples of behavior taken from the limited time of the evaluation period.
Note The Difference When Assessing Feelings and Attitudes
Assessing a school-age child's feelings and attitudes would require the clinician to establish rapport and to get to know the child much better after some time, because the clinician's judgment is also a fair measurement in the case of school-age children.
Talking to the child and observing his behaviors would be necessary. When the clinician has known the child much better, he could administer the A-19 Scale to the child. Other methods could also be used such as "Worry Ladder" and "Hands Down" that could be found in the workbook, The School-Age Child Who Stutters: Working Effectively with Attitudes and Emotions.
For adults and adolescents assessment of feelings and attitudes are usually done by administering tools such as, the Modified Erickson Scale of Communication Attitudes, the Stutterer's Self-Rating of Reactions to Speech Situations, the Perceptions of Stuttering Inventory and the Locus of Control of Behavior Scale.
Remember The Role Of The IEP Team
An Individualized Education Program (IEP) team is appointed to a child to be the ones to consider reports by the clinician and other information. They decide if the child meets the state's eligibility standards and if the child's stuttering has a negative effect on his education.
If a child is eligible for services measurable, the IEP team sets goals and short-term objectives for the child. They also provide services needed by the child for improvement in the educational setting.
Goals Of Trial Therapy
Trial therapy for a school-age child is done to understand what approach might work and what might be difficult for him. This could increase the child's motivation and positive outlook for the treatment. In the case of adults and adolescents, trial therapy is done for 3 main reasons.
First, is to get an idea of how a client would respond to different therapy approaches. Second, is to make a differential diagnosis between developmental, neurological or psychological stuttering. Third, it gives a preview to the client of what to expect during therapy sessions, in effect it would give them motivation to go on their treatment.
Steve Cownley
http://dyslexiaandstuttering.freeiz.com/