treating school age children who stutter

8/9/2019 Treating School Age Children Who Stutter

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Treatment Strategiesfor 5-8 Year Old

Children Who Stutter


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Since stuttering is a multifaceted

disorder, treatment strategies

must also be multifaceted

D i s a b i l i t y

R e a c t i o n s

E n i r o n m e n t a l

! n f l u e n c e s a n dO t h e r " a c t o r s

# e h a i o r a l

$ f f e c t i e

C o g n i t i e

% a n d i c a &! m & a i r m e n t' r e s u m e d

E t i o l o g y


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Recall also that

stuttering can be ery

stubborn(

Some children recoer

on their o)n* but not all+++


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Purpose

To discuss strategies for treating stuttering in 5- to 8-

year-old children

In this age range, children are transitioning from beginning

to intermediate stuttering!it is less likely that they will recover completely

"s the nature of stuttering changes, the goals and strategies

for treatment must also change

To practice techni#ues for $or%ing on both children&s

fluencyand their stuttering


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Stuttering Treatment '(er(ie$)

Preschool *hildren +orpreschool children less than 5 or ., the goal of

treatment is to improve their fluency

/elp parents and teachers pro(ide afluency-facilitating environment

/elp the child de(elop normal speech fluency

by changing the child&s speech patterns

/elp maintain healthy, appropriate attitudesto$ard

communication and spea%ing


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Stuttering Treatment '(er(ie$)

School-"ge *hildren +or school-age children, the goal of treatment

e0pands to address both fluency"12 stuttering

3or%ing on fluency: help children learn to spea% more

fluently so they stutter less often

3or%ing on stuttering: help children manage stuttering so it

does not affect communication

The goal is for children to be able to say $hat they$ant, $hen they $ant, to $hom they $ant Fluency criteria are irrelevant. Communication matters


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3or%ing on +luency

4ost techni#ues for impro(ing fluency

focus on changing timingor tension

educing Spea%ingate

Increasing Pause Time

6asier 7eginnings

Timing Tension

6asier 7eginnings,6asing In

*ancellation, Pull-

out


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*hanging Timing) Spea%ing ate

'ne of the most common techni#ues for

helpingpreschoolersspea% more fluently

is to help them slo$ their spea%ing rate

This techni#ue becomes 6SS useful

as children gro$ older

9se it sparingly and realistically

4a%e sure speech sounds natural


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*hanging Timing) ate and Pausing

:uidelines for slo$ing spea%ing rate 9se natural intonation and rhythm

2o not use choppy or robot

speech or s t r e t c h out $ords

Practice using slo$ rate before you attempt it ;get a feel for too slo$ and not slo$ enough

*an be incorporated into all acti(ities as a model

" more natural $ay of slo$ing do$n isincreasingpause time-- the length

of time bet$een $ords and phrases


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60ercise) Spea%ing ate

. e-read the passage going ?6@slo$ly

A. +inally, return to the rate you used in B=C How

does it sound now?


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eading Passage

'nce upon a time, there $as a young boy

$hose name $as DoeC Doe li%ed to play $ith

his friends in the sandbo0C 'ne day, Doe

lost his shoes in the sandbo0C /e loo%ed

and he loo%ed and he loo%ed, but he could

not find themC ater that day, Doe found out

that one of his friends had hidden his shoesas a Eo%eC Doe $as relie(ed to find his

shoes, and he had a good laugh about the

practical Eo%eC Doe $as a good sportC


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*hanging Timing "12 Tension

Easier Beginnings:educe spea%ing rate and

physical tension at the beginning of phrases

9sephrasingand pausingto gi(e multiple opportunitiesto reduce the physical tension

+ocus on naturalness throughout the phrase -- only the

beginning of the phrase is modified

e#uires lotsof practice

*an also be used $hen a spea%er %no$s he is about to

stutter easing in.


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60ercise) 6asier 7eginnings


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eading Passage

'nce upon a time FF there $as a young boy FF$hose name $as Doe FF Doe li%ed to play FF $ith his

friends FF in the sandbo0C 'ne day FF Doe lost his

shoes FF in the sandbo0C /e loo%ed FF and he

loo%ed FF and he loo%ed FF but he could not find

them FF ater that day FF Doe found out FF that one

of his friends FF had hidden his shoes FF as a Eo%e FF

Doe $as relie(ed FF to find his shoes FF and he hada good laugh FF about the practical Eo%e FF Doe $as

a good sportC


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3or%ing on Stuttering

If $e $or% on fluency, the child $ill becomemore fluent particularly in therapy.C 79T, no

fluency techni#ue is perfectCCCthe child $ill still

stutter sometimesC If children a(oid stuttering, or only use fluency

techni#ues, they $ill be in bigger trouble $hen they

do actually stutter in the real $orld

In order to more directly address stuttering, $e

also ha(e to help children become more

comfortable $ith the stuttering


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60ercise) earning about

Stuttering


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educe Tension $ith

1egati(e Practice

The tension that occurs during stuttering is a

learned reaction an attempt to not stutter.C

'(er time, it becomes automatic and in(oluntary

Therefore, children re#uire P"*TI*6 to

learn ho$ to reduce this tension

The negative practicee0ercise can help Pretend to stutter $ith lots of physical tension,

then repeated the stuttering with reduced tension

!he goal is to learn to control and modify tension


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60ercise) 1egati(e Practice


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6asy Stuttering

*hildren can also learn easy stuttering 6asy repetitions real or voluntary. that reduce the

tension in their speech musculature

This helps them learn that they can ha(e control o(er

their stuttering

?oluntary stuttering reduces children&s tendency to try to

pass themsel(es off as fluent spea%ers

The more people $ho stutter try to be fluent, the

more li%ely they are to e0perience increased stuttering

If children are comfortable $ith their their stuttering, they can

use (oluntary stuttering to release tension in the middle of a

con(ersation and pre(ent big bloc%sC


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60ercise) 6asy Stuttering

. "gain, e(aluate your affecti(e, beha(ioral,

and cogniti(e reactionsC

@ou and your students should be able to use easy

stuttering withoutany negati(e reactions

If your students still feel negati(e reactions, they need

more practice and so do you.


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3or%ing on

+luency "12 Stuttering

#ancellation:eplace stuttered speech $ith more

fluent controlled. speech

"fter stuttering, repeat the stuttered phrase using less

physically tense speech The repeated speech should not simply be repeated --

the point is to changethe tension

$ull-out:educe tension during stuttering to beable to continue spea%ing more fluently


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60ercise) *ancellation

To practice cancellation, you $ill need to use some

pseudostuttering so you ha(e some tension to modify.


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Planning Therapy

+or most children, I begin $ith strategiesdesigned to address stuttering If $e $or% on fluency, they are more li%ely to

become too fluent in the treatment room Then, $e ha(e no stuttering left to $or% on

"nd, $e ha(e trouble $ith transfer

"fter the child can modify stuttering e(ents,I introduce the fluency techni#ues I typically start $ith techni#ues for reducing

tension so $e don&t o(er-emphasiHe fluency


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Summary

"s children mo(e from beginning to intermediatestuttering, treatment strategies also need to change

to address both fluencyand stuttering

&either strategy can succeed alone, but together,

they can be very helpful for '- to (-year-old children)

Strategies for changing fluency attempt to

reduce spea%ing rate and physical tension

during fluent speech

Strategies for changing stuttering attempt

to reduce physical tension during bloc%sand impro(e children&s control o(er speech

treating school age children who stutter

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