Atypical Disfluencies
Hello, I have a student that presents with atypical disfluencies. He repeats the final sounds of words in an echo-like fashion (volume drops with each repetition). For example, he may say, “The dog-og went down the hole to look for the boy-oy. But he was nowhere to be found-ound-ound.” We are working on awareness but would appreciate any suggestions as I have not been able to find much.
Hello! Thank you so much for asking this question of the professional panel. I do have a few more questions for you- when was the onset of this kiddo’s disfluencies (age wise, event in life wise, and was it sudden) were there any recent medication changes, how old is this kiddo now, are there any accompanying diagnoses and also, is there any tension that accompanies these word-ending disfluencies? (sorry that was kind of a lot of questions). Word-ending disfluencies can do happen, and while happening solely at the ends of words is less common, it can happen. You mentioned you are working on awareness- does the child know they are doing this and if so how does it affect their world (if it does). What does the child want from therapy (what is the child’s goals) and what did parent say at referral regarding goals? Ok- sorry that was a ton of questions but basically I need more information with this one. 🙂 In the mean time I have two studies for you to reference regarding Word-Final Disfluencies:
Van Borsel, J., Geirnaert, E., & Van Coster, R. (2005). Another case of word-final disfluencies. Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP), 57(3), 148–162. https://doi.org/10.1159/000084135
Eichorn, N., & Donnan, S. (2021). Word-Final Disfluencies in a School-Age Child: Beneath the Tip of the Iceberg. Language, speech, and hearing services in schools, 1–11. Advance online publication. https://doi.org/10.1044/2021_LSHSS-21-00005
Thanks again, and sorry this was a ton of further questions for more information, but do try to reference the two studies that I listed as this will give you good help/info/guidance.
Thanks,
Steff
Hello-
This is a really, really great question that you ask – thank you for posting it!
Since I haven’t worked with or seen your client, I am just going to provide some more general questions, suggestions, places to start with a client who may present with these types of disfluencies.
Often times, when we see atypical disfluencies in an individual – it may be suggestive of difficulties in other areas – as it may not actually be ‘stuttering’ – but is still clearly something that is impacting the individual’s overall fluency.
My recommendation before you move forward with any sort of treatment is to do additional testing in order to truly be able to gather an understanding of the client’s speech and language profile. A differential evaluation enables you to look at speech, language, pragmatics, etc. You may also want to ask questions and make referrals to additional professionals to look at things like attention and processing.
I have worked with several clients who present with atypical disfluencies and in many cases – these disfluencies seemed connected to and influenced by difficulties with language and attention. Atypical disfluencies can also be more commonly seen in individuals with autism as well. While I may have brought in some components of stuttering therapy into the clients’ treatment plan – most of my focus was on the underlying factors that were contributing to the disfluencies – at least initially.
I’ve found these short articles/discussions to be a nice starting point for thinking about what you’re observing in therapy. There are also many articles cited at the end (in the references) that may be helpful as well.
https://www.stutteringhelp.org/child-isnt-fluent-is-it-stuttering-or-something-else
https://www.stutteringhelp.org/My-client-isnt-fluent-but-is-it-stuttering
https://www.stutteringhelp.org/notstutteringbutwhat
Best of luck, and thanks again for the great question!
~Jaime