The specific strategy they select will depend on when the client catches the disfluencyin anticipation of the moment of disfluency, in the moment, or following the moment (Van Riper, 1973). Identifying subgroups of stutterers (No. 157186). Therefore, a comprehensive assessment for fluency disorders should include assessment of both overt and covert features. An examination of various aspects of auditory processing in clutterers. These feelings may come from having a positive perception about the ability to face challenges (Boyle et al., 2019). https://doi.org/10.1044/1092-4388(2008/07-0111), Prochaska, J. O., & DiClemente, C. C. (2005). https://doi.org/10.1016/S0094-730X(99)00023-6, McGill, M., Siegel, J., Nguyen, D., & Rodriguez, S. (2018). Teigland, A. Routledge. https://doi.org/10.1007/s11689-011-9090-7, Druker, K., Mazzucchelli, T., Hennessey, N., & Beilby, J. It is incumbent upon the SLP to help the individualized education program (IEP) team determine the academic and social impacts of stuttering on students in the school setting. American Journal of Speech-Language Pathology, 27(2), 721736. Journal of Fluency Disorders, 62, 105762. https://doi.org/10.1016/j.jfludis.2019.105726. For stuttering, the assessment will identify risk factors associated with stuttering, the severity of stuttering, and the presence of other speech and language concerns. 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. When a bilingual clinician is not available, using an interpreter is a viable option. Psychology Press. (2019). Journal of Speech and Hearing Disorders, 49(1), 5358. https://doi.org/10.1111/1460-6984.12051, Fuse, A., & Lanham, E. A. Reardon-Reeves, N., & Yaruss, J. S. (2013). https://doi.org/10.1016/j.jfludis.2011.04.001, Shenker, R. C. (2013). (2007). Resilience in people who stutter: Association with covert and overt characteristics of stuttering. Scaler Scott, K. (2011). Recommending related services when necessary for management and treatment in different settings (e.g., classroom, work, community). Is parentchild interaction therapy effective in reducing stuttering? Because the theory behind cluttering is that speakers are talking at a rate that is too fast for their systems to handle, techniques that help regulate speech rate, such as increased pausing, often are helpful. Perspectives on Fluency and Fluency Disorders, 22(1), 3446. BOBapp What are typical vs. atypical disfluencies in speech? Therefore, as with school-age children and adolescents, the purpose of the assessment for adults typically is not to diagnose stuttering. monosyllabic whole-word repetitions (e.g., Why-why-why did they go there?), part-word or sound/syllable repetitions (e.g., Look at the, prolongation of consonants when it isnt for emphasis (e.g., , blocking (i.e., inaudible or silent fixations or inability to initiate sounds), and. Guitar, B. Stages of change and stuttering: A preliminary view. increasing acceptance and openness with stuttering. Manning, W. H., & Quesal, R. W. (2016). (2016a). https://doi.org/10.1044/2018_AJSLP-17-0097, Kraft, S. J., & Yairi, E. (2011). Journal of Fluency Disorders, 43, 1727. Cengage Learning. Prentice-Hall. Sisskin, V. (2018). Seminars in Speech and Language, 24(1), 2126. 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. Psychology Press. Reilly, S., Onslow, M., Packman, A., Cini, E., Conway, L., Ukoumunne, O., Bavin, E., Prior, M., Eadie, P., Block, S., & Wake, M. (2013). https://doi.org/10.1017/CBO9781139108683.023. Prevalence of speech disorders in elementary school students in Jordan. These are called typical disfluencies or nonfluencies. Bulletin of the Center for Special Needs Education Research and Practice, 13, 19. Cluttering can co-occur with other disorders, including. Thieme. Word-finding problems can also result in an increase in typical disfluencies that are similar to those observed in cluttering. Journal of Fluency Disorders, 50, 5971. For example, individuals who clutter may not be aware of communication breakdowns and, therefore, do not attempt to repair them. The Neuroscientist, 25(6), 566582. ET MondayFriday, Site Help | AZ Topic Index | Privacy Statement | Terms of Use Please enable it in order to use the full functionality of our website. American Journal of Speech-Language Pathology, 27(3S), 11801194. Defining cluttering: The lowest common denominator. Perspectives on Fluency and Fluency Disorders, 16(1), 1517. Children who stutter (ages 39 years) have reduced connectivity in areas that support the timing of movement control. Journal of Fluency Disorders, 36(1), 1726. To foster generalization, assignments adhere to a hierarchy of linguistic skills and environmental stressors. typical vs atypical disfluencies asha. Fluency shaping with young stutterers. When a bilingual SLP is not available, using an interpreter is a viable option. Journal of Fluency Disorders, 58, 110. 297325). We propose that researchers and clinicians either discontinue using the terms typical and atypical or provide the reference group to which the terms apply (eg, men versus women). https://doi.org/10.1044/1058-0360.0202.65. Stuttering and labor market outcomes in the United States. Peer support for people who stutter: History, benefits, and accessibility. When a student stutters: Identifying the adverse educational impact. 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). Journal of Fluency Disorders, 38(4), 342355. 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). In fact, increased pausing alone may increase speech fluency and intelligibility for those who clutter (Scaler Scott & Ward, 2013). Speaker and observer perceptions of physical tension during stuttering. We believe it is past time to standardize the symptom assessment for MI so that proper and rapid diagnostic testing can be undertaken; however, we cannot standardize . Scheduling concerns, cost, and insurance reimbursement also are likely to be factors affecting dosage. Journal of Fluency Disorders, 62, 105724. https://doi.org/10.1016/j.jfludis.2019.105724, Gerlach, H., Totty, E., Subraminian, A., & Zebrowski, P. (2018). https://doi.org/10.1044/2017_JSLHR-S-16-0343, Snsterud, H., Feragen, K. B., Kirmess, M., Halvorsen, M. S., & Ward, D. (2019). When distress does not become depression: Emotion context sensitivity and adjustment to bereavement. https://doi.org/10.1044/1058-0360(2003/070), Arenas, R. M., Walker, E. A., & Oleson, J. J. Drayna and Kang (2011) found that gene mutations were present in close to 10% of cases of familial stuttering. https://doi.org/10.1044/cicsd_31_S_69, Blood, G. W., & Blood, I. M. (2016). Some examples of disfluencies that are more typical of a person who clutters is excessive whole word repetitions, unfinished words and interjections (such as um and well). https://doi.org/10.1016/j.jfludis.2015.08.001, Han, T.-U., Park, J., Domingues, C. F., Moretti-Ferreira, D., Paris, E., Sainz, E., Gutierrez, J., & Drayna, D. (2014). For a review of temperament, emotion, and childhood stuttering, see R. M. Jones, Choi, et al. Thieme. Acceptance and Commitment Therapy for people who stutter. 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. american journal of audiology (aja) american journal of speech-language pathology (ajslp) journal of speech, language, and hearing research (jslhr) language, speech, and hearing services in schools (lshss) perspectives of the asha special interest groups; topics; special collections When determining eligibility for speech and language services through the public school system, SLPs need to document the adverse educational impact of the disability using a combination of standardized test scores when available and a portfolio-based assessment (Coleman & Yaruss, 2014; Ribbler, 2006). 9099). Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., Danielson, M. L., Bitsko, R. H., Blumberg, S. J., Kogan, M. D., & Boyle, C. A. (2013). Referral to another helping professional should be made if a condition or situation falls outside of the SLPs scope of practice. ASHA also extends its gratitude to the following subject matter experts who were involved in the reviewand development of thispage: In addition, ASHA thanks the members of the Steering Committee of ASHAs Special Interest Division on Fluency and Fluency Disorders (Division 4) whose work preceded this content. https://doi.org/10.1037/a0020113, Coleman, C., & Yaruss, J. S. (2014). 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). In H. H. Gregory, J. H. Campbell, C. B. Gregory, & D. G. Hill (Eds. 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). Journal of Fluency Disorders, 35(4), 333354. ), Cluttering: A clinical perspective (pp. https://doi.org/10.1016/j.jfludis.2004.08.001, Kraft, S. J., Lowther, E., & Beilby, J. Some persons who stutter report psychosocial benefits, including personal and relationship benefits and positive perspectives about stuttering and life. Neural network connectivity differences in children who stutter. Pro-Ed. https://doi.org/10.1093/brain/awu400, Choi, D., Conture, E. G., Walden, T. A., Lambert, W. E., & Tumanova, V. (2013). 155192). https://doi.org/10.1016/j.jfludis.2016.10.002, Blumgart, E., Tran, Y., & Craig, A. 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). wandering womb handmaid's tale; ismackzi gta 5 mods; katherine stinney age. Building clinical relationships with teenagers who stutter. Stuttering and work life: An interpretative phenomenological analysis. Avoidance Reduction Therapy for Stuttering (ARTS). ), Handbook of psychotherapy integration (pp. The SLP works with parents and families to create an environment that facilitates fluency and that helps them develop healthy and appropriate communication attitudes (Onslow et al., 2003; Yaruss & Reardon-Reeves, 2017). 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). The dysfluencies that render concerns of Childhood Onset Stuttering are different than typical disfluencies. See ASHAs Practice Portal page on Telepractice. https://doi.org/10.1044/1058-0360.0704.62. Myers, F. L. (1992). Individuals who stutter consistently report experiencing limitations, discrimination, and glass ceilinglike effects at their jobs and within their careers (Bricker-Katz et al., 2013; Cassar & Neilson, 1997; Klein & Hood, 2004). Parents can also report if secondary behaviors are present in both languages. Some children who stutter or clutter may only experience symptoms situationally. Communication Disorders Quarterly, 6(1), 5059. (2011). It incorporates techniques such as open-ended questions, feedback, reflective listening, affirmations, and summarizing to resolve resistance or ambivalence to therapy. Seminars in Speech and Language, 39(4), 324332. For preschool children who stutter, parent and family involvement in the treatment process is essential, as is a home component (Kelman & Nicholas, 2020). For example, emotional reactivity/regulation and behavioral disinhibition may affect the childs ability to cope with disfluencies (Choi et al., 2013; Guttormsen et al., 2015; R. M. Jones, Conture, & Walden, 2014; Ntourou et al., 2013). Coexistence of stuttering and disordered phonology in young children. 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). if a child has typical disfluencies or a fluency disorder (see ASHAs resource on. American Journal of Speech-Language Pathology, 27(3S), 12351243. resilience building within the child and family (Berquez & Kelman, 2018). https://doi.org/10.1016/j.jfludis.2006.12.003. This includes the impact on functional communication in key school situations and on quality of life (Beilby et al., 2012b; Yaruss et al., 2012). https://doi.org/10.1038/s41598-017-00519-8, Chang, S.-E. (2014). See ASHAs resource on treatment goals for fluency disorders in the context of the WHO ICF framework. 2335). 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). Journal of Fluency Disorders, 32(2), 121138. Increasing the individuals awareness and self-monitoring skills helps to reduce unproductive behaviors that interfere with speech, and it may allow them to alter moments of stuttering so that they have decreased tension, are shorter, and are less disruptive to communication. https://doi.org/10.1044/cds20.1.15, Silverman, S., & Bernstein Ratner, N. (2002). See ASHAs Practice Portal resource on Transitioning Youth. Differences between children and adults should also be considered when interpreting data from neurological studies. Despite these challenges, some of the therapy that applies to adults can be just as effective with teens/adolescents. Many clinicians use an integration of approaches to achieve optimal outcomes. (2019). Children with language difficulties at the sentence, narrative, or conversational discourse level may exhibit increased speech disfluencies. Although some people with cluttering are not aware of their communication difficulties, many are aware that others have difficulty understanding them. Adults with fluency disorders have likely experienced years of treatment with varied outcomes. These should be considered during differential diagnosis but should not be the sole therapeutic strategies. https://doi.org/10.1016/j.jfludis.2017.06.001. Journal of Fluency Disorders, 49, 1328. https://doi.org/10.1159/000331073, Kuhn, M. R., & Stahl, S. A. In E. G. Conture & R. F. Curlee (Eds. 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). The ASHA Action Center welcomes questions and requests for information from members and non-members. 147171). Desensitization can help decrease word avoidance and reduce fear. Journal of Speech, Language, and Hearing Research, 56(5), 15171529. https://doi.org/10.1055/s-0034-1371755, Jones, R. M., Conture, E. G., & Walden, T. A. https://doi.org/10.1044/2017_JSLHR-S-16-0371, Leech, K. A., Bernstein Ratner, N., Brown, B., & Weber, C. M. (2019). Strategies aimed at changing the timing and tension of speech production include. Children who stutter may demonstrate decreased performance for phonological tasks such as nonword repetition (Wagovich & Anderson, 2010). Thieme. have a sense of belonging and experience less stigma. This law also applies to organizations that receive financial assistance from any federal department or agency. Palin ParentChild Interaction Therapy for early childhood stammering. https://doi.org/10.1093/med:psych/9780195165791.003.0007, Proctor, A., Yairi, E., Duff, M., & Zhang, J. Individuals are referred to a speech-language pathologist (SLP) for a comprehensive assessment when disfluencies are noted and when one or more of the factors listed below are observed along with the disfluencies. The prevalence refers to the number of individuals who are living with fluency disorders in a given time period. recognize physical concomitant behaviors, locate the point of physical tension and struggle during moments of disfluency, and. Indirect treatment focuses on counseling families about how to make changes in their own speech and how to make changes in their childs environment. EBP Briefs, 2(4), 18. In contrast, children with reading disorders are likely to have difficulty decoding the printed form, which, in turn, has a negative impact on oral reading fluency (Kuhn & Stahl, 2003). (2007) for a description of how the stages of change model can be applied to fluency therapy. increased social communication participation (Manning & DiLollo, 2018). See also ASHAs resources titled Person-Centered Focus on Function: Preschool Stuttering [PDF], Person-Centered Focus on Function: School-Age Stuttering [PDF], and Person-Centered Focus on Function: Adult Stuttering [PDF] for examples of treatment goals consistent with the ICF framework. Avoidance can lead to less talking and reduced linguistic complexity. https://doi.org/10.1176/appi.books.9780890425596, American Speech-Language-Hearing Association. 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). discussion of personal issues (e.g., prior to, or in addition to, targeting generalization of skills in a group setting). Some people who clutter tend to decrease volume at the ends of sentences or phrases and, therefore, can benefit from learning to keep a steady volume throughout their utterances. ), Cluttering: Research, intervention and education (pp. Seminars in Speech and Language, 35(2), 114131. It is not possible to determine with certainty which children will continue to stutter, but there are some factors that indicate a greater likelihood that stuttering will become chronic. Section 504 of the Rehabilitation Act of 1973 (United States Department of Labor, n.d.) protects qualified individuals from discrimination based on their disability via a 504 plan. As fear reduces, physical tension and struggle decrease, fluency is enhanced, and the individual is better able to communicate effectively. A fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm, and disfluencies (e.g., repetitions of sounds, syllables, words, and phrases; sound prolongations; and blocks), which may also be accompanied by excessive tension, speaking avoidance, struggle behaviors, and secondary mannerisms (American Speech-Language-Hearing Association [ASHA], 1993). https://doi.org/10.1044/1092-4388(2008/046, Millard, S. K., Zebrowski, P., & Kelman, E. (2018). https://doi.org/10.1016/j.jfludis.2014.12.002, Boyle, M. P., Beita-Ell, C., & Milewski, K. M. (2019). The perils of oral-reading fluency assessments for children who stutter led a group of SLPs to investigate the issue and call on colleagues to change their school districts policies. Cognitive restructuring can be combined with the desensitization strategies described above (W. P. Murphy et al., 2007a). A clinicians first responsibility when treating an individual of any age is to develop a thorough understanding of the stuttering experience and a speakers successful and unsuccessful efforts to cope with his or her communication problem (Manning & DiLollo, 2018, p. 370). Greater abnormality of cerebral blood flow in the posterior language loop, associated with processing words that we hear, correlates with more severe stuttering. Person- and family-centered practice offers a range of services, including counseling and emotional support, procuring information and resources, coordinating services, teaching specific skills to facilitate communication, and advocating for or with the individual and their family. Stuttering: Research and therapy. The treatment of stuttering. In L. Cummings (Ed. Cluttering may have an effect on pragmatic communication skills and awareness of moments of disruption (Teigland, 1996). Languages differ with regard to developmental milestones, and direct comparison of scores across languages can be misleading, even if the assessments appear similar (Thordardottir, 2006). Tourettes syndrome (see Van Borsel, 2011, for a review). https://doi.org/10.1044/2019_JSLHR-19-00138, Tichenor, S. E., & Yaruss, J. S. (2019b). https://doi.org/10.1044/leader.OV.18032013.14, Freud, D., & Amir, O. ), Controversies about stuttering therapy (pp. https://doi.org/10.1016/j.jfludis.2008.01.001. Treatment for fluency disorders helps the individual make changes that will facilitate communication in a variety of settings. Not all of these approaches are appropriate for the treatment of cluttering (see Cluttering Treatment below). https://doi.org/10.1159/000486032, Tichenor, S. E., & Yaruss, J. S. (2018). Perspectives on Fluency and Fluency Disorders, 11(1), 711. https://doi.org/10.1044/0161-1461(2012/11-0044), Yaruss, J. S., LaSalle, L. R., & Conture, E. G. (1998). Signs and symptoms of stuttering include core speech behaviors, such as. Journal of Speech, Language, and Hearing Research, 51(6), 14651479. (2016). Genetic bases of stuttering: The state of the art, 2011. The goals of treatment may be (a) to eliminate, greatly reduce, or help the child manage their stuttering and (b) to help them not develop negative emotional reactions related to their stuttering (H. S. Arnold et al., 2011; Yaruss et al., 2006). Covert stuttering. Smith, A., & Weber, C. (2017). avoidance behaviors (i.e., avoidance of sounds, words, people, or situations that involve speaking); escape behaviors, such as secondary mannerisms (e.g., eye blinking and head nodding or other movements of the extremities, body, or face); and. The young childs awareness of stuttering-like disfluency. The Present Levels of Academic Achievement and Functional Performance statements are based on objective data. Each party is equally important in the relationship, and each party respects the knowledge, skills, and experiences that the others bring to the process. Journal of Fluency Disorders, 43, 116. These individuals are said to experience covert stuttering (B. Murphy et al., 2007). 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/10.1371/journal.pone.0133758, Desai, J., Huo, Y., Wang, Z., Bansal, R., Williams, S. C., Lythgoe, D., Zelaya, F. O., & Peterson, B. S. (2016). Perspectives on Fluency and Fluency Disorders, 23(2), 5469. Perspectives of the ASHA Special Interest Groups 4:4 (615-623) 15 Aug 2019. Journal of Speech, Language, and Hearing Research, 61(12), 28952905. Children with a family history of stuttering were estimated to be 1.89 times more likely to persist in stuttering (Singer et al., 2020). Van Riper, C. (1973). It is also not unusual for disfluencies to be apparent and then seem to go away for a period of weeks or months only to return again. https://doi.org/10.1055/s-0036-1583549, Martin, R. R., Haroldson, S. K., & Triden, K. A. Perspectives on Fluency and Fluency Disorders, 4(6), 13161326. (2011). Increasing fluency may not be a goal for an adult or may be only one aspect of a comprehensive and multidimensional approach (Amster & Klein, 2018). Seminars in Speech and Language, 35(2), 6779. Although cluttering and stuttering can co-occur, there are some important distinctions between the two (see Scaler Scott, 2010). https://doi.org/10.1016/j.jfludis.2013.09.003, Ezrati-Vinacour, R., Platzky, R., & Yairi, E. (2001). Adults who stutter also may experience job discrimination and occupational stereotyping, including an earnings gap, especially for females (Gerlach et al., 2018). In R. Lees & C. Stark (Eds. In addition to being used for improving communication skills, pausing is also an effective method of rate control. (2018). 297325). https://doi.org/10.1044/0161-1461(2006/014), Yaruss, J. S., Coleman, C. E., & Quesal, R. W. (2012). The validity of reading assessment tools for children who stutter is questionable because it is difficult to differentiate the cause (decoding or stuttering) of oral reading fluency problems. 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). Yaruss, J. S., & Reardon-Reeves, N. (2017). For example, cluttering symptoms may decrease during a formal speech evaluationdue to increased self-monitoringbut increase in more comfortable situations where the person is less likely to self-monitor. Expand Search Apply; Program Guide; BOBapp(2023) . Depression & Anxiety, 27(7), 687692. Journal of Speech, Language, and Hearing Research, 62(12), 43354350. Family historyAnecdotal reports indicating the presence of cluttering in more than one family member suggest that family history may be a risk factor. Impact of stuttering severity on adolescents domain-specific and general self-esteem through cognitive and emotional mediating processes. The purpose of CBT is to modify current negative thoughts, emotions, and/or behaviors and replace them with positive ones through identification of thought patterns and challenging cognitive distortions in real time. The speech-language pathologist (SLP) uses linguistically and culturally appropriate stimuli and is sensitive to the unique values and preferences of each individual and their family to create a treatment plan (Sisskin, 2018). Enhancing treatment for school-age children who stutter: II. Clinicians can help clients progress to active stages through building self-efficacy. In fact, stuttering can affect all areas of academic competency, including academic learning, social-emotion functioning, and independent functioning (Ribbler, 2006, p. 15). Resilience and stuttering: Factors that protect people from the adversity of chronic stuttering. their reason for seeking treatment at the current time. Children and adolescents with fluency disorders may qualify for accommodations whether or not they have an active individualized education program (IEP). Clients often report successful stuttering therapy as a transformational experience progressing from avoidance to acceptance and openness, increasing self-confidence and self-efficacy (Plexico et al., 2005; Tichenor & Yaruss, 2019a). Speech, Language and Hearing, 20(3), 144153. Journal of Educational Psychology, 95(1), 321. the asha leader; journals. https://doi.org/10.1016/0094-730X(86)90028-8, St. Louis, K. O., & Hinzman, A. R. (1988). The person is having difficulty communicating messages in an efficient, effective manner. Characteristics of Typical Disfluency and Stuttering Differentiating typical disfluencies and stuttering is a critical piece of assessment, particularly for preschool children. Environmental factors and speaking demands may exacerbate disfluency and influence a persons negative reactions to stuttering. American Journal of Speech-Language Pathology, 27(3S), 11391151. 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). A comprehensive view of stuttering: Implications for assessment and treatment. Fear of speaking: Chronic anxiety and stammering. The ASHA Leader, 19(7), 4448. Journal of Fluency Disorders, 58, 94117. Self-disclosure involves communicating to others information that reveals ones identity as a person who stutters. For some people, the use of these behaviors can result in little or no observable stuttering. Treatment approaches are individualized based on the childs needs and family communication patterns. The impact of fluency disorders often extends to social and vocational aspects of the individuals life. Review of previous fluency evaluations and educational records. Early childhood stuttering and electrophysiological indices of language processing.

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