Treatment of the Borderline Stutterer

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Treatment of the Borderline Stutterer

• Integrated Approach

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Characteristics of the Borderline Stutterer

• More than 10 disfluencies per 100 words
• More than 2 units per repetition
• More repetitions and prolongations than revisions
  or incomplete phrases
• Disfluencies are loose and relaxed
• Little or no reaction to disfluencies

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Indirect Treatment

• Assess family interaction patterns and intervene
  where appropriate
• High rate of speech
• Lack of pauses between speakers turns
• Interruptions
• Frequent questions
• Frequent critical/corrective comments
• Inadequate listening
• Complex vocabulary use
• Advanced levels of syntax

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Quantifying interaction patterns

• Rates of speech above 220 SPM
• Less than 1 second between speaking turns
• More than 10 of childs utterances are
  interrupted
• More than 25 of parents utterances are
  questions
• More than 50 of parents utterances are
  critical/corrective
• Moe than 50 of parents utterances are unrelated
  to previous comment by child

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Indirect Treatment Session 1

• Model one or two of the behaviors you want the
  family to change
• Observe family members interacting with child
• Provide feedback on the targeted behaviors. Use
  dense positive reinforcement (51 ratio over
  corrective comments)
• Encourage daily one-on-one time with child

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Subsequent Indirect Sessions

• 6 to 8 weeks of intervention
• Gradual changes in interaction styles
• Positive reinforcement of parents efforts
• On-again, off-again fluency development

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Direct TreatmentMild Borderline

• Follow Lidcombe Approach

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Direct Treatment of Moderate-Severe Borderline
Stutterer

• Model easy stuttering vs. hard stuttering
• Have child catch you on hard stutters
• Play at stuttering (PAWS)
• Intentional slow, easy stuttering
• Ask the child to change his hard stutters into
  easy stutters

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Stuttering Foundation of America

• Booklets
• If Your Child Stutters A Guide for Parents
• Stuttering and Your Child Questions and Answers
• Videotapes
• Stuttering and the Preschool Child Help for
  Families

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Other Clinicians

• Richard Curlee
• Edward Conture
• Lois Nelson
• Fosnot and Woodford
• Stocker http//www.mnsu.edu/comdis/kuster/journal/
  osborne2/Meg.Sabrina.Nancy.ppt

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Study Questions

• 1, 2, 6