Comments

Treatment suggestions for atypical stuttering — 3 Comments

  1. Hi Sumi,
    Thanks for your email. I am wondering if this student might be helped by natural pausing. I try to focus on pausing rather than breathing as I find whenever I focus on breathing, kids get very confused and apply the strategy inappropriately. In stuttering blocks, it sounds to the listener like the child is running out of air, thus the inclination is to tell someone to take a breath. However, stuttering can be counter intuitive, and in reality a breath in is counterproductive. But when we pause naturally in speaking, our breathing takes care of itself. So I wonder about increased focus on pausing, which would also help for language planning as well. If he tends to block after a pause, he can use a preparatory set to get started with his next phrase.

    His disfluencies sound like they may fit in the “atypical” category, and often (though not always) we find that children with atypical disfluency are less aware and/or impacted by the disfluency. I would always want to leave the door open for the child to talk about stuttering, but if he doesn’t have negative attitudes or feelings right now, I would just monitor it. You can consider connecting him with support networks like those offered by the National Stuttering Association (www.westutter.org), if he is open to it. But if he doesn’t see much impact, that’s good. The support resource may not be as meaningful for him now, but something to have in the background in case that changes.

    Finally, the nasal emissions to me needs investigation. I did work with a student who was pushing so hard against her stuttering that nasal emissions resulted. This was a student who was very negatively impacted by her stuttering and needed support. She was working so hard to fight her stuttering that she needed more work on densensitization….not sure if this is the case here given the other things you say. But if the nasal emission occurs in speech at other times than stuttering, then this may be a separate issue that needs investigation by a craniofacial team.

    Hope that helps a little with some areas to further investigate/try.

  2. Have you tried identification? I had 3 different adolescent PWS that had mid-word disfluencies and inhalations. They were somewhat aware of what they were doing but generally were not bothered. Stuttering had minimal impact on their life or attitudes about communication. All 3 also had pragmatic deficits, two of which had a diagnosis of Aspergers Syndrome.

    2 of the 3 made dramatic and lasting improvements with identification of stuttering moments. They knew they had disfluencies but really did not know when, how often, or what they sounded like. We did videos of others, videos of self, and identification in the moment. We also used some continuous phonation to help move through their utterances smoothly.

    I am not sure if this seems suitable for your client. Best of luck to you!
    Tricia 🙂

  3. To scalerscott and Tricia Hedinger,

    Your comments and suggestions are wonderfully helpful and has got the cogs turning! Though the family/student is eager to discontinue services, with your suggestions in mind, there are few more things I think I can do.

    I am thankful for this community and support 🙂