Ingham, R. J., & Onslow, M. (1985). Journal of Fluency Disorders, 36(2), 122129. Journal of Speech, Language, and Hearing Research, 31(3), 377385. Menu. having flexibility based on individual needs and desired outcomes (Amster & Klein, 2018). Journal of Fluency Disorders, 46, 114. Estimates of incidence and prevalence vary due to a number of factors, including disparities in the sample populations (e.g., age), how stuttering was defined, and how stuttering was identified (e.g., parent report, direct observation). Our primary goals were to identify patterns in overt features of WFDs and to extend our understanding of this clinical profile by focusing on aspects of . Differentially diagnosing fluency disorders from disfluencies stemming from language encoding difficulties such as language delay or second language learning. Reeves, L. (2006). One of the most widely used models of change is the transtheoretical or stages of change model (Prochaska & DiClemente, 2005). typical vs atypical disfluencies asha. Assessment of awareness in young children of disfluencies and difficulty in speaking. ET MondayFriday, Site Help | AZ Topic Index | Privacy Statement | Terms of Use The impact of fluency disorders often extends to social and vocational aspects of the individuals life. Resiliencethe ability to adjust and cope in the face of adversitycan help lessen the negative impact (e.g., Coifman & Bonanno, 2010). Individuals and families may have a wide range of beliefs about the best way to treat fluency disorders, ranging from medical and therapeutic intervention to prayer. Operant approaches operate within a framework of stuttering as a learned behavior (for a discussion, see Conture, 2001; de Sonneville-Koedoot et al., 2015, p. 334; Onslow & Yaruss, 2007). Empirical research on whether bilingual individuals who stutter are more disfluent in one language than the other is sparse and based on small case studies (Tellis & Tellis, 2003), but many bilingual individuals who stutter report this to be the case (Nwokah, 1988). Not all of these approaches are appropriate for the treatment of cluttering (see Cluttering Treatment below). Individuals may experience the impact of fluency disorders in social and emotional, academic, and vocational domains. In K. O. Lewis (Ed. (1996). 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). https://doi.org/10.1016/S0021-9924(03)00052-2, Yaruss, J. S., & Quesal, R. W. (2006). Overall, these indicators demonstrate progression from avoidance and negative impact to acceptance, openness, and increased socialization (V. M. Sheehan & Sisskin, 2001). https://doi.org/10.1044/2019_JSLHR-19-00137, Tichenor, S., & Yaruss, J. S. (2020). A comprehensive treatment approach for school-age children, adolescents, and adults includes multiple goals and considers the age of the individual and their unique needs (e.g., communication in the classroom, in the community, or at work). The clinician (a) considers the degree to which the individuals disfluent behaviors and overall communication are influenced by a coexisting disorder (e.g., other speech or language disorders, Down syndrome, autism spectrum disorder, attention-deficit/hyperactivity disorder) and (b) determines how treatment might be adjusted accordingly. However, a preliminary prevalence study estimated the rate of cluttering to be between 1.1% and 1.2% of school-age children (Van Zaalen & Reichel, 2017). https://doi.org/10.1016/S0094-730X(96)00024-1, Murphy, B., Quesal, R. W., & Gulker, H. (2007). Fluency treatment can occur at any point after the diagnosis. Fluency and stuttering. Cluttering: A handbook of research, intervention and education. Estimates have reported the male-to-female ratio of individuals who stutter to be as large as 4:1; however, more recent studies in preschool children suggest that a younger age of onset has smaller ratios in gender differences (Yairi & Ambrose, 2013). However, several likely gene mutations have been linked to stuttering (Frigerio-Domingues & Drayna, 2017). Real-time analysis or analysis based on an audiovisual recorded speech sample demonstrating representative disfluencies beyond the clinic setting. Onset may be progressive or sudden. Direct treatment approaches can also target resilience and effort control in the child and family (Caughter & Crofts, 2018; Druker et al., 2019; Kraft et al., 2019). Rather, the purpose is to determine the extent and impact of the fluency disorder on the individual, the potential benefit from treatment, and the individuals desire and willingness to change. For example, individuals with attention-deficit/hyperactivity disorder, autism spectrum disorder, intellectual disability, learning disability, or seizures have higher odds of stuttering. Randomised controlled trial of the Lidcombe programme of early stuttering intervention. Direct treatment approaches may include speech modification (e.g., reduced rate of speech, prolonged syllables) and stuttering modification strategies (e.g., modifying a stuttered word, pulling out of a stuttered word) to reduce disfluency rate, physical tension, and secondary behaviors (Hill, 2003). There are two predominant types of atypical disfluencies: stuttering and cluttering. Technology has been incorporated into the delivery of services for fluency, including the use of telepractice to deliver face-to-face services remotely. As children who stutter get older, they may become adept at word and situational avoidances that result in a low frequency of overt stuttering. Molt, L. F. (1996). Psychology Press. ), Current issues in stuttering research and practice (pp. Language, Speech, and Hearing Services in Schools, 48(4), 234248. Aphasia. 2335). An examination of various aspects of auditory processing in clutterers. Journal of Fluency Disorders, 32(2), 139162. Stuttering in school-age children: A comprehensive approach to treatment. The ability to use speech strategies; to make choices to speak and participate, regardless of the level of fluency; and to take risks is greatly reduced outside of the treatment setting when time pressure and conditioned negative feelings may trigger fear and old behaviors. Sociodynamic relationships between children who stutter and their non-stuttering classmates. Al-Jazi, A. However, their disfluencies are not likely to involve prolongations, blocks, physical tension, or secondary behaviors that are more typical for children who stutter (Boscolo et al., 2002). Communication Disorders Quarterly, 39(2), 335345. Education, 136(2), 159168. https://doi.org/10.1016/j.jfludis.2004.08.001, Kraft, S. J., Lowther, E., & Beilby, J. https://doi.org/10.1016/j.jfludis.2018.08.006, Boyle, M. P. (2011). ), Cluttering: Research, intervention and education (pp. Cluttering may have an effect on pragmatic communication skills and awareness of moments of disruption (Teigland, 1996). https://doi.org/10.1044/2020_PERSP-20-00014. if monitoring or treatment (direct or indirect) is recommended. In addition to stuttering-like disfluencies and other typical disfluencies, the children with ASD also produced atypical disfluencies, which usually are not observed in children with typically developing speech or developmental stuttering. Introduction: The importance of the social, emotional, and cognitive dimensions of stuttering. ACT is a holistic, person-centered approach that allows individuals to alter the relationships they have with their emotions and thoughts. Assessment of speech fluency (e.g., frequency, type, and duration of disfluencies), speech rate, speech intelligibility, and the presence of secondary behaviors in a variety of speaking tasks (e.g., conversational and narrative contexts). Counseling parents of children who stutter. Professional awareness of cluttering. Guilford Press. For an accurate evaluation, it is ideal to collect samples of speech across various situations and tasks, both inside and outside the clinical setting (Yaruss, 1997). Clinical implications of situational variability in preschool children who stutter. The person exhibits negative reactions (e.g., affective, behavioral, or cognitive reactions) to their disfluency. Human Brain Mapping, 38(4), 18651874. (1986). https://doi.org/10.1037/0022-0663.95.1.3, Langevin, M., Bortnick, K., Hammer, T., & Wiebe, E. (1998). Genetics and neurophysiology appear to be related to the underlying causes of stuttering. https://doi.org/10.1044/2018_AJSLP-ODC11-17-0190. However, even when children show little observable disfluency, they may still need treatment because of the negative impact of stuttering or cluttering on their lives. Stuttering and reading fluency: Information for teachers [Brochure]. (1988). (2014). https://doi.org/10.1016/j.jfludis.2018.10.003, Bray, M. A., & Kehle, T. J. ), More than fluency: The social, emotional, and cognitive dimensions of stuttering (pp. Such individuals may benefit from treatment strategies that focus on improving speech efficiency by reducing word avoidance and increasing spontaneity in communication. Long-term consequences of childhood bullying in adults who stutter: Social anxiety, fear of negative evaluation, self-esteem, and satisfaction with life. Systems that govern self-regulation may underlie cluttering; qualitative interviews with those who clutter suggest that thoughts emerge before they are ready (Scaler Scott & St. Louis, 2011). https://doi.org/10.1016/j.jfludis.2006.02.002. Journal of Speech, Language, and Hearing Research, 62(12), 43564369. Emotional problems and parenting style do not cause stuttering. Journal of Fluency Disorders, 44, 3245. Journal of Fluency Disorders, 58, 94117. Journal of Fluency Disorders, 36(3), 186193. https://doi.org/10.1044/persp2.SIG17.42, Vanryckeghem, M., & Kawai, M. (2015). Assessment of other communication dimensions, including speech sound production, receptive and expressive language, pragmatic language, voice, hearing, and oralmotor function/structure. Journal of Communication Disorders, 80, 1117. 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). Scheduling concerns, cost, and insurance reimbursement also are likely to be factors affecting dosage. There is not enough epidemiological research to state specific risk factors for cluttering. Studies in tachyphemia: III. 1-888-266-0574. Typical Disfluencies vs. Stuttering in Children. minimizing the adverse impact of stuttering (Yaruss et al., 2012). In D. Ward & K. Scaler Scott (Eds. https://doi.org/10.1016/j.jfludis.2010.04.003, Wagovich, S., & Hall, N. (2017). Measurement and modification of speech naturalness during stuttering therapy. https://doi.org/10.1016/j.jfludis.2013.03.001, Coifman, K. G., & Bonanno, G. A. Seminars in Speech and Language, 39(4), 324332. https://doi.org/10.1016/j.jfludis.2009.09.002, Millard, S. K., Nicholas, A., & Cook, F. M. (2008). 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). White matter neuroanatomical differences in young children who stutter. https://doi.org/10.1044/leader.FTR1.11102006.6, Tichenor, S. E., Leslie, P., Shaiman, S., & Yaruss, J. S. (2017). Studies of cluttering: Perceptions of cluttering by speech-language pathologists and educators. Coworkers may have negative attitudes toward individuals who stutter, and the individual may feel excluded because of this. Experts in the field of cluttering have consistently estimated that approximately one third of children and adults who stutter also present with at least some components of cluttering (Daly, 1986; Preus, 1981; Ward, 2006). ), Cluttering: Research, intervention and education (pp. Journal of Fluency Disorders, 50, 7284. Following are descriptions of each of these forms of disfluency. Journal of Fluency Disorders, 36(2), 110121. Children who stutter (ages 39 years) have reduced connectivity in areas that support the timing of movement control. The model describes the following stages of behavioral change: See Manning and DiLollo (2018) and Floyd et al. frequency of exposure to all languages used by the child and their proficiency (comprehension and production) in each language; family history of stuttering or cluttering; description of disfluency and rating of severity; age of onset of disfluency and patterns of disfluency since onset (e.g., continuous or variable); previous fluency treatment and treatment outcomes; exploration of parental reactions to the childs moments of disfluency or speaking frustration; and. The person exhibits physical tension or secondary behaviors (e.g., eye blinking, head nodding) associated with the disfluency. Posted at 23:22h . Journal of Speech, Language, and Hearing Research, 46(5), 12211233. Consequently, they may speak less to avoid being disfluent, and they may avoid social situations. A phenomenological analysis of the moment of stuttering. Perspectives on Global Issues in Communication Sciences and Related Disorders, 4(2), 5762. See What To Ask When Evaluating Any Procedure, Product, or Program. Educating families about local support organizations for people who stutter and their families. Assessment and treatment of stuttering in bilingual speakers. Journal of Speech, Language, and Hearing Research, 51(3), 636650. ET MondayFriday, Site Help | AZ Topic Index | Privacy Statement | Terms of Use When being spontaneous and saying all they want to say, individuals may exhibit more surface-level stuttering. Changing adolescent attitudes toward stuttering. https://doi.org/10.1055/s-2008-1064082, Caughter, S., & Crofts, V. (2018). Stuttering and cluttering: Frameworks for understanding and treatment. Stuttering and work life: An interpretative phenomenological analysis. Individuals who stutter are more likely to be self-aware about their disfluencies and communication, and they may exhibit more physical tension, secondary behaviors, and negative reactions to communication. Word-finding problems can also result in an increase in typical disfluencies that are similar to those observed in cluttering. Bullying in adolescents who stutter: Communicative competence and self-esteem. In D. Ward & K. Scaler Scott (Eds. Individuals who clutter may exhibit more errors related to reduced speech intelligibility secondary to rapid rate of speech. ), Stuttering and related disorders of fluency (pp. Clinical characteristics associated with stuttering persistence: A meta-analysis. Journal of Fluency Disorders, 58, 110. resilience building within the child and family (Berquez & Kelman, 2018). Genetic factors and therapy outcomes in persistent developmental stuttering. It is important for clinicians to verify online sites and virtual support groups recommended to clients and their families. These modifications are used regardless of whether a particular word is expected to be produced fluently. American Journal of Speech-Language Pathology, 16(1), 6568. Parents can also learn about how to help their child generalize skills from the treatment room to different settings and with different people. https://doi.org/10.1044/2018_AJSLP-ODC11-17-0199. Scaler Scott, K. (2011). their reason for seeking treatment at the current time. B. Psychology Press. Potential neurological underpinnings of cluttering include dysregulation of the anterior cingulate cortex and the supplementary motor area (Alm, 2011) as well as increased activity in the basal ganglia and premotor cortex (Ward et al., 2015). Advocating for individuals with fluency disorders and their families at the local, state, and national levels. Numerous treatment approaches and strategies have been developed in an attempt to help speakers reduce the negative reactions associated with stuttering (e.g., W. P. Murphy et al., 2007a). Provider refers to the person providing treatment (e.g., SLP, trained volunteer, family member, or caregiver). Treating preschool children who stutter: Description and preliminary evaluation of a family-focused treatment approach. The purpose of the screening is to identify individuals who require further speech-language assessment. Contemporary Issues in Communication Science and Disorders, 25(Spring), 820. Client perceptions of effective and ineffective therapeutic alliances during treatment for stuttering. ), Cluttering: A clinical perspective (pp. The professional roles and activities in speech-language pathology include clinical/educational services (diagnosis, assessment, planning, and treatment); prevention and advocacy; and education, administration, and research. https://doi.org/10.1044/cicsd_25_S_8, Leech, K. A., Bernstein Ratner, N., Brown, B., & Weber, C. M. (2017). Improvements in fluency may generalize spontaneously from a treated language to an untreated language in bilingual speakers (Roberts & Shenker, 2007). https://doi.org/10.1016/j.jfludis.2004.12.001, Plexico, L. W., Manning, W. H., & DiLollo, A.