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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