I have been working with a student with Down's syndrome for several years. We have worked primarily on vocabulary and articulation. She is quite verbal and uses pretty good syntax and morphology. Her language and cognitive abilities are about that of a 6 or 7 year old. She is currently in 5th grade and has developed significant fluency problems this year. In the past she has had some easy repetitions of first sounds but these were infrequent and did not interfere with communication, so they were not addressed directly. However, this year she has started blocking, with what I would call severe blocks, three seconds duration with eyes closed or averted, and tension in the neck and arms. She is blocking on mouth posture for an "ah", which she inserts in places where it is not needed. (No voice, just the posture....then a forceful release of "Ah......... my brother." or "Ah......... hello." She is also diagnosed ADHD and is on medication 3 times a day for that. I am at a loss as to what to do. I am worried that she is in linguistic overload (ie: she is in inclusion for most of the day with an aide). Does anyone else think we might be asking too much of her which is causing her stress?
Answer
This definitely can be a case of linguistic overload. She may be developing language now that her motor system cannot coordinate. In terms of teaching her language, I would stay away from a lot of drill work and focus on modeling and elicitation. I wouldn't try to simplify her language use. It's a positive that her language is expanding. From a fluency standpoint, I would focus a lot on tension reduction strategies. I would teach her how to ease out of a block, use pull-outs and cancellations, and reduce the use of secondary behaviors. It might also be helpful to target negative reactions to stuttering, as these are what typically lead to increased tension and secondary behaviors.
Visit the SpeechPathology.com eLearning Library to view all of our live, recorded, and text-based courses on stuttering and a variety of other topics.
Craig E. Coleman is a Clinical Coordinator at Children's Hospital of Pittsburgh and Co-Director of the Stuttering Center of Western Pennsylvania. He received his Bachelor's and Master's degrees at the University of Pittsburgh. Craig is a Board-Recognized Specialist in Fluency Disorders. He has served on the Legislative Council of the American Speech-Language-Hearing Association. Craig is also a past president of the Pennsylvania Speech, Language, and Hearing Association.
Carole Zangari, PhD, CCC-SLP
Dr. Zangari is a faculty member in the SLP Department at Nova Southeastern University (NSU) and Executive Director of the NSU Center for Autism and Related Disabilities Satellite. She is co-author of TELL ME: AAC in the Preschool Classroom and co-edited Practically Speaking Language, Literacy, and Academic Development for Students with AAC Needs. Dr. Zangari teaches AAC courses to students at the master’s and doctoral levels, supervises in the AAC clinic, and coordinates the AAC Lab. She blogs at www.PrAACticalAAC.org.
Related Courses
1https://www.speechpathology.com/slp-ceus/course/supporting-literacy-development-through-robust-9789Supporting Literacy Development through Robust Language Intervention for Students who Use AACThis is Part 4 of the 5-part series, Applying the Science of Reading, Writing, and Oral Language for Students Who Use AAC. Improving the linguistic foundation of students who use AAC supports the development of strong literacy skills. Key intervention strategies and guidelines for robust language intervention for AAC users are discussed along with examples demonstrating their application to various language skills.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comSupporting Literacy Development through Robust Language Intervention for Students who Use AACThis is Part 4 of the 5-part series, Applying the Science of Reading, Writing, and Oral Language for Students Who Use AAC. Improving the linguistic foundation of students who use AAC supports the development of strong literacy skills. Key intervention strategies and guidelines for robust language intervention for AAC users are discussed along with examples demonstrating their application to various language skills.9789OnlinePT60M
This is Part 4 of the 5-part series, Applying the Science of Reading, Writing, and Oral Language for Students Who Use AAC. Improving the linguistic foundation of students who use AAC supports the development of strong literacy skills. Key intervention strategies and guidelines for robust language intervention for AAC users are discussed along with examples demonstrating their application to various language skills.
2https://www.speechpathology.com/slp-ceus/course/emergency-preparedness-aac-essential-roles-10065Emergency Preparedness & AAC: Essential Roles & Resources for SLPsUsers of augmentative/alternative communication (AAC) are highly vulnerable in emergency situations and may lose access to their AAC supports and devices during the process of rescue, relief, and recovery from disasters such as floods, wildfires, earthquakes, and hurricanes. This course discusses key roles for SLPs and provides information about free and low-cost resources that clinicians can use to support their clients with AAC needs as they prepare for and recover from disasters.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comEmergency Preparedness & AAC: Essential Roles & Resources for SLPsUsers of augmentative/alternative communication (AAC) are highly vulnerable in emergency situations and may lose access to their AAC supports and devices during the process of rescue, relief, and recovery from disasters such as floods, wildfires, earthquakes, and hurricanes. This course discusses key roles for SLPs and provides information about free and low-cost resources that clinicians can use to support their clients with AAC needs as they prepare for and recover from disasters.10065OnlinePT60M
Users of augmentative/alternative communication (AAC) are highly vulnerable in emergency situations and may lose access to their AAC supports and devices during the process of rescue, relief, and recovery from disasters such as floods, wildfires, earthquakes, and hurricanes. This course discusses key roles for SLPs and provides information about free and low-cost resources that clinicians can use to support their clients with AAC needs as they prepare for and recover from disasters.
3https://www.speechpathology.com/slp-ceus/course/ripple-effect-stuttering-community-based-9217The Ripple Effect of Stuttering: A Community-Based ApproachThis is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comThe Ripple Effect of Stuttering: A Community-Based ApproachThis is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)9217OnlinePT120M
This is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)
4https://www.speechpathology.com/slp-ceus/course/creating-allies-and-developing-advocacy-9223Creating Allies and Developing Advocacy Skills in Stuttering TherapyThis is Part 3 of a four-part series. This course will focus on specific strategies for involving parents/caregivers in stuttering therapy, and promoting self-advocacy skills among clients who stutter. Through the use of case studies, the speakers will problem-solve obstacles commonly faced by speech-language pathologists when addressing these important aspects of therapy. (Part 1 - Course 9278, Part 2 - Course 9286, Part 4 - Course 9304)auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comCreating Allies and Developing Advocacy Skills in Stuttering TherapyThis is Part 3 of a four-part series. This course will focus on specific strategies for involving parents/caregivers in stuttering therapy, and promoting self-advocacy skills among clients who stutter. Through the use of case studies, the speakers will problem-solve obstacles commonly faced by speech-language pathologists when addressing these important aspects of therapy. (Part 1 - Course 9278, Part 2 - Course 9286, Part 4 - Course 9304)9223OnlinePT120M
This is Part 3 of a four-part series. This course will focus on specific strategies for involving parents/caregivers in stuttering therapy, and promoting self-advocacy skills among clients who stutter. Through the use of case studies, the speakers will problem-solve obstacles commonly faced by speech-language pathologists when addressing these important aspects of therapy. (Part 1 - Course 9278, Part 2 - Course 9286, Part 4 - Course 9304)
5https://www.speechpathology.com/slp-ceus/course/best-practices-for-stuttering-assessment-9225Best Practices for Stuttering Assessment and Treatment Including the Role of Support GroupsThis course is Part 4 in a four-part series. It will provide an overview of stuttering peer support communities and the clinical importance of incorporating community experience into therapy. Current research and practical application questions will address goal writing, SLP roles and responsibilities, and common challenges connecting therapy to the community. Case studies will be shared to highlight assessment and treatment across various age ranges. (Part 1 - Course 9278, Part 2 - Course 9286, Part 3 - Course 9301)auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comBest Practices for Stuttering Assessment and Treatment Including the Role of Support GroupsThis course is Part 4 in a four-part series. It will provide an overview of stuttering peer support communities and the clinical importance of incorporating community experience into therapy. Current research and practical application questions will address goal writing, SLP roles and responsibilities, and common challenges connecting therapy to the community. Case studies will be shared to highlight assessment and treatment across various age ranges. (Part 1 - Course 9278, Part 2 - Course 9286, Part 3 - Course 9301)9225OnlinePT120M
This course is Part 4 in a four-part series. It will provide an overview of stuttering peer support communities and the clinical importance of incorporating community experience into therapy. Current research and practical application questions will address goal writing, SLP roles and responsibilities, and common challenges connecting therapy to the community. Case studies will be shared to highlight assessment and treatment across various age ranges. (Part 1 - Course 9278, Part 2 - Course 9286, Part 3 - Course 9301)
