Question
I have a fifth grade student who I am serving for fluency as well as articulation. His disfluencies now occur only at the end of his sentences/phrases/thoughts, when he is pausing before beginning his next statement. He repeats on the final syllable or
Answer
The fluency behaviors you describe are highly unusual for a child with a developmental stuttering problem. Repetitions typically occur on the initial syllables (Silverman, 2004). This doesn't mean that what your child is doing is not stuttering or another kind of fluency problem. There are a few descriptions of children and adults in the literature with final sound repetition and final syllable repetition (LeBrun & Van Borsel, 1990 and Stansfield, 1995) to mention two of the more recent. In the reported case studies most individuals presented with final sound repetition as opposed to syllable repetition. Also, the majority of cases that were reported also had accompanying phonological errors or learning disabilities.
With your case it would be interesting to know more about the history of the child's fluency problem. What other kinds of stuttering behaviors did he display when you first started working with him? What did you do to help him resolve these other behaviors? Additional questions pertain to the child's articulation problems. What is the severity his articulation problem? How well has he been doing at resolving his articulation issues? From your question, it doesn't sound like you believe there is any relationship between the child's fluency and articulation problem. How is the child's language development? Could these final syllable/word repetition behaviors be language-related disfluencies, i.e., language formulation issues? If so, your treatment strategies might focus more on language/discourse development.
Regarding treating the fluency problem you describe, it sounds as though you are on the right track. Increasing the child's awareness of what he's doing using audio playback is an effective first step. Perhaps you can get him to the point to where he is aware of the behavior as he is doing it. Then, you could focus on having him make changes in what he's doing as he is doing it. I hope this feedback helps. Please feel free to ask more questions regarding this child.
References:
LeBrun, Y. and Van Borsel, J., (1990). Final sound repetitions. Journal of Fluency Disorders, 15, 2, 107-114.
Siverman, F. (2004). Stuttering and other fluency disorders (3rd Ed.). Long Grove, IL: Waveland Press.
Stansfield, J. (1995). Word-final disfluencies in adults with learning difficulties. Journal of Fluency Disorders, 20, 1, 1-10.
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.
