Journal of Fluency Disorders, 13(5), 331355. A recent U.S. study estimated that approximately 2% of children ages 317 years stutter (Zablotsky et al., 2019). social anxiety disorder (Brundage et al., 2017; Craig & Tran, 2014; Iverach et al., 2018), speech sound disorders (St. Louis & Hinzman, 1988; Wolk et al., 1993), and. Journal of Fluency Disorders, 38(3), 260274. 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). having flexibility based on individual needs and desired outcomes (Amster & Klein, 2018). The ASHA Action Center welcomes questions and requests for information from members and non-members. https://doi.org/10.1044/2019_JSLHR-19-00137, Tichenor, S., & Yaruss, J. S. (2020). American Journal of Speech-Language Pathology, 27(3S), 11111123. Typical childhood disfluencies may increase and decrease without any external influence. It is important for clinicians to verify online sites and virtual support groups recommended to clients and their families. In D. Ward & K. Scaler Scott (Eds. Self-help and mutual aid groups. Language, Speech, and Hearing Services in Schools, 43(4), 536548. Some children go through a disfluent period of speaking. https://doi.org/10.1055/s-2007-986528, Yaruss, J. S., Coleman, C., & Hammer, D. (2006). (2014). Persons who clutter can experience the same affective, behavioral, and cognitive reactions as those with stuttering, including communication avoidance, anxiety, and negative attitudes toward communication (Scaler Scott & St. Louis, 2011). The great psychotherapy debate: Models, methods, and findings. Onset may be progressive or sudden. However, several likely gene mutations have been linked to stuttering (Frigerio-Domingues & Drayna, 2017). https://doi.org/10.1159/000504221, Rollnick, S., & Miller, W. R. (1995). Psychology Press. Cluttering and autism spectrum disorders. With this approach, parents are trained to provide verbal contingencies based on whether a childs speech is fluent or stuttered (M. Jones et al., 2005; Onslow et al., 2003). (2018). 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. Journal of Fluency Disorders, 62, 105725. https://doi.org/10.1016/j.jfludis.2019.105725, Plexico, L. W., Manning, W. H., & DiLollo, A. Education, 136(2), 159168. Psychology Press. (2018). Referring to other health care professionals when outside support is needed to facilitate treatment goals for interfering behaviors (e.g., anxiety, depression). Impact of social media and quality of life of people who stutter. Although cluttering has been reported in children as young as 4 years of age, the diagnosis is more commonly made at about 8 years of age (Ward, 2006), when a childs language becomes lengthy and/or complex enough for symptoms to manifest themselves. 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). seizure disorders (Briley & Ellis, 2018). Desensitization strategies are strategies that help speakers systematically desensitize themselves to their fears about speaking and stuttering by facing those fears in structured, supportive environments. https://doi.org/10.1016/j.jfludis.2017.09.001, Byrd, C. T., & Donaher, J. For example, counseling an individual to accept or tolerate embarrassment can facilitate desensitization. https://doi.org/10.1016/j.jfludis.2013.09.001, Boyle, M. P. (2015). Individuals may experience the impact of fluency disorders in social and emotional, academic, and vocational domains. 256276). ), Cluttering: A handbook of research, intervention and education (pp. Counseling persons with communication disorders and their families. Adults with fluency disorders have likely experienced years of treatment with varied outcomes. Expand Search Apply; Program Guide; BOBapp(2023) . Genetic factors and therapy outcomes in persistent developmental stuttering. https://doi.org/10.1002/mgg3.276, Frigerio-Domingues, C. E., Gkalitsiou, Z., Zezinka, A., Sainz, E., Gutierrez, J., Byrd, C., Webster, R., & Drayna, D. (2019). Guttormsen, L. S., Kefalianos, E., & Nss, K. A. Stimulability testing (e.g., person is asked to increase pausing and/or decrease speech rate in some other way)a reduction of overall speech rate typically helps in reducing cluttering symptoms. https://doi.org/10.1016/j.jcomdis.2010.12.003. American Journal of Speech-Language Pathology, 27(3S), 11391151. typical vs atypical disfluencies asha typical vs atypical disfluencies asha. https://doi.org/10.1093/brain/awm241, Watson, J. Perspectives on Fluency and Fluency Disorders, 17(2), 49. https://doi.org/10.1055/s-2003-37447, Thordardottir, E. (2006). https://doi.org/10.1016/j.jfludis.2018.09.004, Menzies, R. G., OBrian, S., Packman, A., Jones, M., Helgadttir, F. D., & Onslow, M. (2019). Covert stuttering: Investigation of the paradigm shift from covertly stuttering to overtly stuttering. Guilford Press. Journal of Speech, Language, and Hearing Research, 36(5), 906917. practice monitoring each others speech and secondary behaviors. increasing self-confidence and self-efficacy. However, fluency shaping approaches, such as easy onset or continuous phonation, may not be appropriate for the treatment of cluttering. (2017). Journal of Fluency Disorders, 36(1), 1726. Journal of Fluency Disorders, 21(34), 201214. Stuttering-related podcasts: Audio-based self-help for people who stutter. https://doi.org/10.1016/j.jfludis.2014.01.001. Pro-Ed. Journal of Speech and Hearing Disorders, 49(1), 5358. Psychological characteristics and perceptions of stuttering of adults who stutter with and without support group experience. These should be considered during differential diagnosis but should not be the sole therapeutic strategies. In H. H. Gregory, J. H. Campbell, C. B. Gregory, & D. G. Hill (Eds. 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). Language growth predicts stuttering persistence over and above family history and treatment experience: Response to Marcotte. http://blog.asha.org/2013/09/26/how-can-you-tell-if-childhood-stuttering-is-the-real-deal/, Multisyllabic whole-word and phrase repetitions, Secondary behaviors (e.g., eye blinks, facial grimacing, changes in pitch or loudness), Avoidance behaviors (e.g., reduced verbal output or word/situational avoidances). https://doi.org/10.1044/ffd11.1.7, Shenker, R. C. (2011). American Journal of Speech-Language Pathology, 28(1), 1428. Journal of Fluency Disorders, 38(1), 1429. (2003). Genetics and neurophysiology appear to be related to the underlying causes of stuttering. https://doi.org/10.1016/j.jfludis.2004.12.001, Plexico, L. W., Manning, W. H., & DiLollo, A. Awareness and identification helps speakers better understand communication, speech, and stuttering along with their attitudes, beliefs, and behaviors. Journal of Fluency Disorders, 38(2), 206221. Studies in tachyphemia: III. Journal of Speech, Language, and Hearing Research, 62(8), 26912702. Fear of speaking: Chronic anxiety and stammering. Through a process of identifying the assumptions underlying their thoughts, they can evaluate whether those thoughts are helpful (or valid) and ultimately adopt different assumptions or thoughts. Fluency refers to continuity, smoothness, rate, and effort in speech production. In D. Ward & K. Scaler Scott (Eds. Approaches may vary by therapeutic philosophy, goals and activities, duration and intensity, and age of the individual. https://doi.org/10.1016/0094-730X(88)90003-4. ), Cluttering: A handbook of research, intervention and education (pp. Evaluating stuttering in young children: Diagnostic data. Journal of Speech, Language, and Hearing Research, 54(6), 14851496. Seminars in Speech and Language, 35(2), 6779. (2010). Multicultural identification and treatment of stuttering: A continuing need for research. Cognitive behavior therapy for adults who stutter: A tutorial for speech-language pathologists. 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). Children who stutter also may be at risk for experiencing bullying (Blood & Blood, 2004; Davis et al., 2002; Langevin et al., 1998). PLOS ONE, 10(7), Article e0133758. https://doi.org/10.1016/j.jfludis.2004.08.001, Kraft, S. J., Lowther, E., & Beilby, J. ), Stuttering and related disorders of fluency (pp. https://doi.org/10.1044/leader.FTR2.19072014.44, American Speech-Language-Hearing Association. increasing acceptance and openness with stuttering. Early childhood stuttering for clinicians by clinicians. production of words with an excess of physical tension or struggle. Direct versus indirect treatment for preschool children who stutter: The RESTART randomized trial. Summary - Typical vs Atypical Pneumonia. https://doi.org/10.1016/j.jfludis.2009.09.002, Millard, S. K., Nicholas, A., & Cook, F. M. (2008). talking about stuttering or treatment of stuttering. Peer support for people who stutter: History, benefits, and accessibility. Therefore, clinicians may want to ask open-ended questions to assess communication across specific situations (e.g., How do you participate in class? How do you talk to strangers? Please describe a situation when you ordered food from a restaurant. How did it feel?). When developing treatment goals, the clinician takes a holistic approach and considers the extent to which stuttering affects the individuals entire communication experience. It may occur only in specific situations, but it is more likely to occur in these situations, day after day. Impact of stuttering severity on adolescents domain-specific and general self-esteem through cognitive and emotional mediating processes. https://doi.org/10.1016/j.jfludis.2017.06.001. Van Borsel, J., Maes, E., & Foulon, S. (2001). American Journal of Speech-Language Pathology, 20(3), 163179. 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. See ASHAs resource on assessment tools, techniques, and data sources. Sheehan, J. G. (1970). https://doi.org/10.1044/2018_AJSLP-ODC11-17-0189, Chakraborty, M., Chen, L.-F., Fridel, E. E., Klein, M. E., Senft, R. A., Sarkar, A., & Jarvis, E. D. (2017). Bilingual clinicians who have the necessary clinical expertise to treat the individual may not always be available. You do not have JavaScript Enabled on this browser. Risk factors that may be associated with persistent stuttering include. Reading slowly may be perceived as a reading problem, even though the underlying cause is stuttering. https://doi.org/10.1044/0161-1461(2012/11-0044), Yaruss, J. S., LaSalle, L. R., & Conture, E. G. (1998). (2001). ), Current issues in stuttering research and practice (pp. See ASHAs Practice Portal pages on Counseling For Professional Service Delivery and Cultural Responsiveness for more information related to counseling. Apraxia of Speech (Adults) Apraxia of Speech (Childhood) Attention Deficit Hyperactivity Disorder (ADHD) Auditory Neuropathy Spectrum Disorder (ANSD) Augmentative and Alternative Communication (AAC) Autism. The speaker is thought to be talking at a rate that is too fast for their system to handle, resulting in breakdowns in fluency and/or intelligibility (Bakker et al., 2011). Harper & Row. These findings suggest the presence of atypical lateralization of speech and language functions near the onset of stuttering. 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. What we know for now IN BRIEF. Communication attitudes in children who stutter: A meta-analytic review. Adults who stutter also may experience job discrimination and occupational stereotyping, including an earnings gap, especially for females (Gerlach et al., 2018). 1997- American Speech-Language-Hearing Association. The cost of such avoidance can be great because of the resulting impact on the persons ability to say what they want to say, when they want to say it. I ran out of cheese and bread the other day while making sandwiches and now Im out so I need to go to the store), and/or. https://doi.org/10.1016/j.jfludis.2013.08.001, Briley, P. M., & Ellis, C. (2018). 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. Diagnostic and statistical manual of mental disorders (5th ed.). recognize physical concomitant behaviors, locate the point of physical tension and struggle during moments of disfluency, and. Drayna, D. (2011). 1-888-266-0574. Some adults lack communication confidence as a result of negative self-perceptions about their stuttering (Beilby et al., 2012a) or due to repeated exposure to people holding stereotypes about stuttering, which, in turn, may create self-stigmatization (Boyle, 2013a). A comparison of stutterers and nonstutterers affective, cognitive, and behavioral self-reports. Fluency treatment is a dynamic process; service delivery may change over time as the individuals needs change. What is Typical Pneumonia? SLPs counseling skills should be used specifically to help speakers improve their quality of life by minimizing the burden of their communication disorder. A study of the role of the FOXP2 and CNTNAP2 genes in persistent developmental stuttering. other developmental disorders (Briley & Ellis, 2018). Contemporary Issues in Communication Science and Disorders, 31(Spring), 6979. increasing the time provided for an oral reading or presentation, providing an alternative assignment to oral reading, and. Assessment and treatment of stuttering in bilingual speakers. (2005). 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). Consistent with treatment approaches for children and adolescents, treatment for adults needs to be individualized, dynamic, and multidimensional. Toward a better understanding of the process of disclosure events among people who stutter. St. Louis, K. O., Myers, F., Bakker, K., & Raphael, L. (2007). Group experiences and individual differences in stuttering. https://doi.org/10.1044/ffd17.2.4, Murphy, W. P., Yaruss, J. S., & Quesal, R. W. (2007a). Perspectives on Fluency and Fluency Disorders, 22(1), 3446. their reason for seeking treatment at the current time. Journal of Fluency Disorders, 35(3), 216234. Sisskin, V. (2018). Journal of Speech, Language, and Hearing Research, 62(12), 43354350. Roberts, P., & Shenker, R. (2007). All approaches should include a plan for generalization and maintenance of skills involved in activities of daily living. Effortful control, an aspect of temperament that supports self-regulation, may be predictive of stuttering severity and may facilitate positive change in treatment (Kraft et al., 2019). https://doi.org/10.1055/s-2002-33751, Bowers, A., Bowers, L. M., Hudock, D., & Ramsdell-Hudock, H. L. (2018). In D. Ward & K. Scaler Scott (Eds. https://doi.org/10.1016/j.jfludis.2007.02.002, Murphy, W. P., Yaruss, J. S., & Quesal, R. W. (2007b). 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. A comprehensive treatment approach for preschoolers includes both parent- and child-focused strategies. Strategies aimed at changing the timing and tension of speech production include. The person exhibits negative reactions (e.g., affective, behavioral, or cognitive reactions) to their disfluency. https://doi.org/10.1016/j.jfludis.2018.10.003, Bray, M. A., & Kehle, T. J. Resilience in people who stutter: Association with covert and overt characteristics of stuttering. Epidemiology of stuttering: 21st century advances. Stuttering as defined by adults who stutter. In fact, increased pausing alone may increase speech fluency and intelligibility for those who clutter (Scaler Scott & Ward, 2013). There are several indicators of positive therapeutic change. 297325). Journal of Fluency Disorders, 38(2), 171183. Temperamental characteristics of young children who stutter. However, a school-age child or adolescent who stutters may not report their experience accurately, possibly due to a lack of awareness or a desire to appease the clinician (Adriaensens et al., 2015; Erickson & Block, 2013). Treatment outcomes for bilingual children who stutter do not appear to be different from those of monolingual children who stutter (Shenker, 2011). University Park Press. A comprehensive assessment for persistent stuttering should include a self-assessment of the experience of stuttering. https://doi.org/10.1044/cicsd_29_S_91, Zebrowski, P. M., & Schum, R. L. (1993). Stuttering can co-occur with other disorders (Briley & Ellis, 2018), such as. (2007) for a description of how the stages of change model can be applied to fluency therapy. Children who stutter may demonstrate poorer expressive lexical skills compared to their peers (Silverman & Bernstein Ratner, 2002). In B. J. Amster & E. R. Klein (Eds. Consequently, they may speak less to avoid being disfluent, and they may avoid social situations.

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