Alleviating Prolongations

Question

Answer

There are many different ways and means to treating a school-age child who stutters. I suspect that if you posed this question to a dozen speech-language pathologists you might get a dozen or more different answers! There are a few questions that if answered, may provide more information in helping determine how to work with this child. How long has the child been stuttering? She may already have developed a perspective towards talking that runs contrary to a child who doesn't stutter, i.e., she may anticipate stuttering and as a result avoid certain words or may substitute words. If so, this belief and corresponding behavior may need to be addressed. How long has she been in therapy? Has it been successful or unsuccessful? Again, with a longer history of therapy, good or bad, she may have developed certain beliefs regarding therapy, about the purpose of talking (i.e., to communicate vs. to not stutter), towards what it is she needs to do to communicate effectively, or about herself as a communicator that may require exploring.

Some might answer your question by indicating a need to teach the child how to modify her stutters in a way that would make her stuttering easier, i.e., stuttering modification. Others might answer by suggesting you focus on increasing her fluent moments of speaking, thus eliminating her prolongations, i.e., fluency shaping. Still others' responses might reflect a combination of stuttering modification and fluency shaping principles. Yaruss & Quesal, 2001) have suggested using a balanced approach to treatment goals, meaning including a focus on attitudinal and cognitive issues in addition to behavioral issues. I would suggest that you consider your options; I've included several references that I think may prove very useful to you in making a determination as to what kind of therapy you want to provide this young woman. In addition to these paper references, you might want to go to the following websites: www.stuttersfa.org, www.stutteringcenter.org and the stuttering homepage. Each of these sites provides a plethora of information regarding therapy and therapy methods.

Whatever procedure or method you elect to use with this child, I would suggest that in addition to focusing on reducing her stuttering behaviors that you: help her to establish a sense of control when she talks, many of the fear-based responses to stuttering such as avoiding talking or avoiding specific words, etc. decrease as a person feels she has options and can make effective changes in the way she talks; provide her with information related to stuttering, the aforementioned websites have excellent information for children who stutter; provide information related to what she does when she talks (i.e., the processes involved in talking) and what she does when she stutters; and help her to develop an attitude of talking to talk, not talking to not stutter (Williams, 1979).

Guitar, B. (1998). Stuttering: An integrated approach to its nature and treatment (2nd Ed.). Baltimore, MD: Williams and Wilkens.

Manning, W. (2001). Clinical decision making in fluency disorders (2nd Ed.). San Diego: Singular.

Shapiro, D. (1999). Stuttering intervention: A collaborative journey to fluency freedom. Austin, TX: Pro-Ed.

Starkweather, C.W. and Givens-Ackerman, J. (1997). Stuttering. Austin, TX: Pro-Ed.

Williams, D. (1979). A perspective on approaches to stuttering therapy, In Gregory, H. (Ed.), Controversies about stuttering therapy. Baltimore: University Park Press.

Yaruss, J.S. & Quesal, R.W. (2001). The many faces of stuttering: Identifying appropriate treatment goals. ASHA Leader, 6 (21), 4-5.

Language, Speech, and Hearing Services in Schools, (1995), 26, 2. This entire issue is devoted to fluency intervention with children.

Charlie Osborne is a clinical assistant professor at the University of Wisconsin - Stevens Point. He has worked with children and adults who stutter for approximately 20 years. His email address is cosborne@uwsp.edu.