Some example of stuttering (or atypical dysfluencies) would be: Monosyllabic whole word repetitions: (e.g. practice treatment targets with more listeners. We often use the term "emergent" to describe skills that are developing, but have not fully emerged. Skip to main content. Group experiences and individual differences in stuttering. https://doi.org/10.1177/1525740117702454. discussion of personal issues (e.g., prior to, or in addition to, targeting generalization of skills in a group setting). Scaler Scott, K. (2010). For a review of temperament, emotion, and childhood stuttering, see R. M. Jones, Choi, et al. (2018). Starkweather, C. W. (1987). Journal of Speech, Language, and Hearing Research, 51(3), 636650. https://doi.org/10.1016/j.jcomdis.2014.02.001, Jones, M., Onslow, M., Packman, A., Williams, S., Ormond, T., Schwarz, I., & Gebski, V. (2005). Given these potential issues, determining dosage often comes down to the professional opinion of the SLP and the needs of the individual. The SLP can use audio- or videoconferencing to augment this type of treatment. https://doi.org/10.1044/jshr.3605.906. Cluttering and Down syndrome. The effects of self-disclosure on the communicative interaction between a person who stutters and a normally fluent speaker. https://doi.org/10.1016/j.jfludis.2013.08.001, Briley, P. M., & Ellis, C. (2018). (2007) for a description of how the stages of change model can be applied to fluency therapy. perceived communication and job barriers. Provider refers to the person providing treatment (e.g., SLP, trained volunteer, family member, or caregiver). Yairi, E., & Ambrose, N. (2005). All speakers are disfluent at times. The assignments begin in supportive, low-fear situations and slowly evolve to more challenging situations and settings as the individual demonstrates the ability to accept or tolerate potential negative reactions. https://doi.org/10.1016/j.jfludis.2018.09.004, Menzies, R. G., OBrian, S., Packman, A., Jones, M., Helgadttir, F. D., & Onslow, M. (2019). https://doi.org/10.1016/S0094-730X(96)00023-X, Tellis, G. M., & Tellis, C. M. (2003). increasing acceptance and openness with stuttering. Bowling Green State University Archive. Harper & Row. Scheduling concerns, cost, and insurance reimbursement also are likely to be factors affecting dosage. . Journal of Communication Disorders, 44(3), 276293. However, several likely gene mutations have been linked to stuttering (Frigerio-Domingues & Drayna, 2017). 1-888-266-0574. (2013). The creative process in avoidance reduction therapy for stuttering. Treatment is sensitive to cultural and linguistic factors and addresses goals within WHOs ICF framework (ASHA, 2016a; Coleman & Yaruss, 2014; WHO, 2001; Yaruss, 2007; Yaruss & Quesal, 2004, 2006). https://doi.org/10.1044/2020_JSLHR-20-00096. learning disabilities (Wiig & Semel, 1984). (2017). https://doi.org/10.1016/S0094-730X(02)00162-6, Singer, C. M., Hessling, A., Kelly, E. M., Singer, L., & Jones, R. M. (2020). Psychology Press. https://doi.org/10.1044/jshr.3103.377, Weber-Fox, C., Wray, A. H., & Arnold, H. (2013). Seminars in Speech and Language, 37(3), 145152. This law also applies to organizations that receive financial assistance from any federal department or agency. (2018). Ward, D., & Scaler Scott, K. (2011). Journal of Fluency Disorders, 54, 1423. What is Typical Pneumonia? Prevalence of stuttering in primary school children in Cairo-Egypt. 6396). In J. C. Norcross & M. R. Goldfried (Eds. A study of pragmatic skills of clutterers and normal speakers. Chronic problems associated with illness, injury, or other traumatic events can have a negative impact on an individuals emotional health and quality of life (e.g., Bonanno & Mancini, 2008). https://doi.org/10.1002/da.20657, Bonanno, G. A., & Mancini, A. D. (2008). Adults also may want to involve family members, friends, or coworkers as part of a treatment plan. The ASHA Leader, 19(7), 4448. https://doi.org/10.1044/2019_JSLHR-19-00138, Tichenor, S. E., & Yaruss, J. S. (2019b). For example, cluttering symptoms may decrease during a formal speech evaluationdue to increased self-monitoringbut increase in more comfortable situations where the person is less likely to self-monitor. Behavioral inhibition and childhood stuttering. A descriptive study of speech, language, and hearing characteristics of school-aged stutterers. Cumulative incidence estimates of stuttering in children range from 5% to 8% (Mnsson, 2000; Yairi & Ambrose, 2013). Guttormsen, L. S., Kefalianos, E., & Nss, K. A. Language, Speech, and Hearing Services in Schools, 43(4), 536548. Disfluencies noted in bilingual children and adults are similar to those found for monolingual speakers (Shenker, 2013). Fluency refers to continuity, smoothness, rate, and effort in speech production. However, a preliminary prevalence study estimated the rate of cluttering to be between 1.1% and 1.2% of school-age children (Van Zaalen & Reichel, 2017). Coexistence of stuttering and disordered phonology in young children. The clinical process for an adult involves. Cognitive behavior therapy for adults who stutter: A tutorial for speech-language pathologists. Journal of Fluency Disorders, 50, 5971. 115134). https://doi.org/10.1016/j.jfludis.2006.02.002. Children and adults who stutter also frequently experience psychological, emotional, social, and functional consequences from their stuttering, including social anxiety, a sense of loss of control, and negative thoughts or feelings about themselves or about communication (Boyle, 2015; Craig & Tran, 2014; Iverach et al., 2016; Iverach & Rapee, 2014). Journal of Fluency Disorders, 59, 120.https://doi.org/10.1016/j.jfludis.2018.11.003. 1997- American Speech-Language-Hearing Association. The prevalence of speech and language disorders in French-speaking preschool children from Yaound (Cameroon). https://doi.org/10.1016/j.jfludis.2007.02.002, Murphy, W. P., Yaruss, J. S., & Quesal, R. W. (2007b). Journal of Fluency Disorders, 50, 7284. https://doi.org/10.1044/ffd22.2.51, Berquez, A., & Kelman, E. (2018). However, as they learn to reduce reactivity (see below), they develop greater comfort while speaking, they assume more positive attitudes about their ability to communicate, and they are better able to accept and manage moments of disfluency as they occur. Some of the most commonly prescribed typical or first-generation antipsychotics include: Haldol (haloperidol) Thorazine (chlorpromazine) Loxitane (loxapine) Moban (molindone) Mellaril (thioridazine) Serentil (mesoridazine) Navane (thiothixene) Trilafon (perphenazine) On the other hand, the following are atypical or second-generation antipsychotics: A comprehensive treatment approach for school-age children, adolescents, and adults includes multiple goals and considers the age of the individual and their unique needs (e.g., communication in the classroom, in the community, or at work). https://doi.org/10.1055/s-0034-1371755, Jones, R. M., Conture, E. G., & Walden, T. A. have a sense of belonging and experience less stigma. https://doi.org/10.1073/pnas.1901480116, Harasym, J., Langevin, M., & Kully, D. (2015). American Journal of Speech-Language Pathology, 28(1), 1428. Some examples of these are to openly discuss experiences with stuttering (from the client and the clinician with pseudostuttering or as described by previous clients who stutter) and model pseudostuttering and techniques, attitudes, and beliefs across speaking situations (Manning & Quesal, 2016; Watson, 1988). Educating other professionals about the needs of individuals with fluency disorders and the role of SLPs in screening, assessing, diagnosing, and managing fluency disorders. Fluency and stuttering. Journal of Fluency Disorders, 58, 110. Purpose Disfluencies associated with stuttering generally occur in the initial position of words. Impact experienced from stuttering, or covert features of stuttering, may include. Genetic contributions to stuttering: The current evidence. Fluency of school-aged children with a history of specific expressive language impairment: An exploratory study. SIG 17 Perspectives on Global Issues in Communication Sciences and Related Disorders, 2(17), 4249. https://doi.org/10.1044/ffd11.1.7, Shenker, R. C. (2011). Psychological characteristics and perceptions of stuttering of adults who stutter with and without support group experience. Fear of speaking: Chronic anxiety and stammering. https://doi.org/10.1044/2020_PERSP-20-00014. Clinical characteristics associated with stuttering persistence: A meta-analysis. Young children may or may not verbalize their reactions to stuttering. Stuttering typically has its origins in childhood. The prevalence rate of stuttering in African American children (25 years of age) was estimated to be 2.52%, but was not reported to not be significantly different from that reported for European American children in the same age group between 2- to 5-year-old African American children and European American children (Proctor et al., 2008). Limited research is available that identifies the causes of cluttering. https://doi.org/10.1055/s-0036-1583549, Martin, R. R., Haroldson, S. K., & Triden, K. A. Diagnostic and statistical manual of mental disorders (5th ed.). See the Service Delivery section of the Fluency Disorders Evidence Map for pertinent scientific evidence, expert opinion, and client/caregiver perspective. It is not possible to determine with certainty which children will continue to stutter, but there are some factors that indicate a greater likelihood that stuttering will become chronic. Typical Disfluencies vs. Stuttering in Children. School-based SLPs and IEP teams should resist pressure to minimize the impact of stuttering on educational achievement for the purpose of disqualifying students from speech-language pathology services. The term atypical has been applied to rapid atrial tachycardias with ECG patterns differing from the typical and reverse typical flutter described above, and also to re-entrant tachycardias with circuit configuration different from the typical RA flutter circuit, even if they have an ECG pattern similar to typical flutter. omission of word endings (e.g., Turn the televisoff). Short-term intensive treatment programs have been used for some individuals to reduce disfluency and address negative attitudes. Although cluttering and stuttering can co-occur, there are some important distinctions between the two (see Scaler Scott, 2010). https://doi.org/10.1044/1092-4388(2001/030), Finn, P. (2003). The impact of stuttering on adults who stutter and their partners. https://doi.org/10.1016/j.jfludis.2006.12.003. Explore how typical and atypical disfluencies differ, and find resources for guidance and support. Genetics and neurophysiology appear to be related to the underlying causes of stuttering. Studies in tachyphemia: III. Drayna, D. (2011). https://doi.org/10.1093/brain/awu400, Choi, D., Conture, E. G., Walden, T. A., Lambert, W. E., & Tumanova, V. (2013). Mancinelli, J. M. (2019). American Journal of Speech-Language Pathology, 12(2), 243253. Section 504 of the Rehabilitation Act of 1973 also applies to individuals with disabilities in a work setting. talking about stuttering or treatment of stuttering. The impact of a stuttering disorder on Western Australian children and adolescents. Brain, 138(3), 694711. Potential risk factors for cluttering include the following: Information is varied and conflicting regarding the exact relationship between bilingualism and disfluencies (Tellis & Tellis, 2003; Van Borsel et al., 2001). The impact of stuttering on employment opportunities and job performance. Parents can also report if secondary behaviors are present in both languages. American Journal of Speech-Language Pathology, 27(3S), 11241138. social anxiety disorder (Brundage et al., 2017; Craig & Tran, 2014; Iverach et al., 2018), speech sound disorders (St. Louis & Hinzman, 1988; Wolk et al., 1993), and. However, the clinician needs to consider the impact of disfluency on communication and quality of life as a whole. excessive coarticulation resulting in the collapsing and/or deletion of syllables and/or word endings; excessive disfluencies, which are usually of the more nonstuttering type (e.g., excessive revisions and/or use of filler words, such as um); pauses in places typically not expected syntactically; unusual prosody (often due to the atypical placement of pauses rather than a pedantic speaking style, as observed in many with autism spectrum disorder). Without proper intervention, children who exhibit signs of early stuttering are more at risk for continued stuttering. Shock, 2. 157186). Reducing negative reactions through desensitization and cognitive restructuring. https://doi.org/10.1016/j.jfludis.2014.12.003. https://doi.org/10.1016/j.jfludis.2007.03.001, Flynn, T. W., & St. Louis, K. O. Early childhood stuttering and electrophysiological indices of language processing. This course presents the most up-to-date evidence regarding the identification and management of atypical disfluency. Ingham, R. J., & Onslow, M. (1985). Disclosure of stuttering and quality of life in people who stutter. Effortful control, an aspect of temperament that supports self-regulation, may be predictive of stuttering severity and may facilitate positive change in treatment (Kraft et al., 2019). https://doi.org/10.1016/j.jfludis.2004.08.001, Kraft, S. J., Lowther, E., & Beilby, J. Stuttering in school-age children: A comprehensive approach to treatment. Neurophysiological factors that are thought to contribute to stuttering include the following: These neurophysiological findings should be interpreted with caution due to the small number of subjects and the heterogeneity of the methodologies used. Journal of Fluency Disorders, 58, 94117. The validity of reading assessment tools for children who stutter is questionable because it is difficult to differentiate the cause (decoding or stuttering) of oral reading fluency problems. https://doi.org/10.1044/1058-0360.0704.62. Journal of Speech, Language, and Hearing Research, 52(1), 254263. Cluttering treatment: Theoretical considerations and intervention planning. auditory processing disorders (Molt, 1996). Prevalence of anxiety disorders among children who stutter. Setting refers to the location of treatment (e.g., home, community-based [including work settings], school environments, clinic room). Apply Now. Posted at 23:22h . Without proper intervention, children who exhibit signs of early stuttering are more at risk for continued stuttering. Stuttering and cluttering: Frameworks for understanding and treatment. Onslow, M., Packman, A., & Harrison, E. The Present Levels of Academic Achievement and Functional Performance statement, which serves as the baseline for the IEP, refers to other areas that are not necessarily academic and can include information about communication skills, social skills, and other activities of daily living. Self-help conferences for people who stutter: A qualitative investigation. Singular. Journal of Neurodevelopmental Disorders, 3(4), 374380. In N. B. Ratner & J. Tetnowski (Eds. Increasing fluency may not be a goal for an adult or may be only one aspect of a comprehensive and multidimensional approach (Amster & Klein, 2018). With adults, initiation of treatment depends on the individuals previous positive or negative intervention experiences and current needs pertaining to their fluency and the impact of their fluency disorder on communication in day-to-day activities and participation in various settings (e.g., community or work). Mindfulness training in stuttering therapy: A tutorial for speech-language pathologists. ; American Psychiatric Association, 2013). Denial, 3. When speakers are able to participate in decisions about treatment goals and select goals they consider important, they may be more motivated to take part in therapy (Finn, 2003; Snsterud et al., 2019). When a student stutters: Identifying the adverse educational impact. https://doi.org/10.1111/1460-6984.12051, Fuse, A., & Lanham, E. A. When developing treatment goals, the clinician takes a holistic approach and considers the extent to which stuttering affects the individuals entire communication experience. BOBapp What are typical vs. atypical disfluencies in speech? Douglass, J. E., Constantino, C., Alvarado, J., Verrastro, K., & Smith, K. (2019). Direct treatment approaches may include speech modification (e.g., reduced rate of speech, prolonged syllables) and stuttering modification strategies (e.g., modifying a stuttered word, pulling out of a stuttered word) to reduce disfluency rate, physical tension, and secondary behaviors (Hill, 2003). Remaining informed of research in the area of fluency disorders and advancing the knowledge base of the nature of the disability, screening, diagnosis, prognostic indicators, assessment, treatment, and service delivery for individuals with fluency disorders. Journal of Fluency Disorders, 44, 3245. Mild stuttering, on the other hand, tends to appear more regularly. Stuttering More than 70 million people around the world struggle with stuttering, according to The Stuttering Foundation. Perspectives on Fluency and Fluency Disorders, 4(6), 13161326. (2011). Epidemiology of stuttering: 21st century advances. https://doi.org/10.1044/1092-4388(2008/046, Millard, S. K., Zebrowski, P., & Kelman, E. (2018). (2010). Individuals learn to identify the thoughts underlying their negative attitudes and emotional reactions and examine the link between these thoughts, attitudes, and emotional reactions and their speech. Wiig, E. H., & Semel, E. M. (1984). Covert stuttering: Investigation of the paradigm shift from covertly stuttering to overtly stuttering. https://doi.org/10.1016/j.jfludis.2013.03.001, Coifman, K. G., & Bonanno, G. A. Their skills are developing in this area. The purpose of the screening is to identify individuals who require further speech-language assessment. 341358). Discussions about the physical experience of anxiety and ways to reduce it and the sense of loss of control and time pressure may be of further benefit (e.g., mindfulness and grounding; Beilby et al., 2012a; Boyle, 2011; Harley, 2018). However, a school-age child or adolescent who stutters may not report their experience accurately, possibly due to a lack of awareness or a desire to appease the clinician (Adriaensens et al., 2015; Erickson & Block, 2013). Human GNPTAB stuttering mutations engineered into mice cause vocalization deficits and astrocyte pathology in the corpus callosum. ), Current issues in stuttering research and practice (pp. Perspectives of the ASHA Special Interest Groups 4:4 (615-623) 15 Aug 2019. Merrill. Despite these challenges, some of the therapy that applies to adults can be just as effective with teens/adolescents. A comparison of stutterers and nonstutterers affective, cognitive, and behavioral self-reports. In addition to stuttering-like disfluencies and other typical disfluencies, the children with ASD also produced atypical disfluencies, which usually are not observed in children with typically developing speech or developmental stuttering. The purpose of assessing school-age children and adolescents for fluency disorders is to determine the presence, the extent, andmost importantlythe impact of the fluency disorder and the potential benefit from treatment. Journal of Fluency Disorders, 26(3), 179206. https://doi.org/10.1016/j.jfludis.2013.09.003, Ezrati-Vinacour, R., Platzky, R., & Yairi, E. (2001). Sheehan, J. G. (1970). A recent U.S. study estimated that approximately 2% of children ages 317 years stutter (Zablotsky et al., 2019). Psychology Press. Strategies aimed at altering the timing of pausing are used to increase the likelihood of fluent speech production and to improve overall communication skills (e.g., intelligibility, message clarity). Acceptance; Constantino et al., 2017. Helping individuals who stutter become more accepting and open about their stuttering may help them have workplace conversations about it, advocate for themselves, and build support systems within the workplace (Plexico et al., 2019). Languages differ with regard to developmental milestones, and direct comparison of scores across languages can be misleading, even if the assessments appear similar (Thordardottir, 2006). Without proper intervention, children who exhibit signs of early stuttering are more at risk for continued stuttering. American Journal of Speech-Language Pathology, 26(4), 11051119. The person exhibits physical tension or secondary behaviors (e.g., eye blinking, head nodding) associated with the disfluency. Journal of Fluency Disorders, 38(4), 311324. These simulations and applications of strategies might be most likened to cancellation and pull-out techniques used in stuttering. Journal of Fluency Disorders, 61, 105713. https://doi.org/10.1016/j.jfludis.2019.105713, Douglass, J. E., Schwab, M., & Alvarado, J. https://doi.org/10.1016/j.jfludis.2011.04.005, Boyle, M. P. (2013a). Journal of Speech, Language, and Hearing Research, 62(12), 43564369. The interview process and work environment can be challenging for individuals who stutter. Consistent with treatment approaches for children and adolescents, treatment for adults needs to be individualized, dynamic, and multidimensional. Treatment approaches for adults should take into consideration career and workplace factors. https://scholarworks.bgsu.edu/comm_disorders_diss/7/. In addition, clinicians need to avoid using religious or highly familiar texts that individuals may know by rote. Molt, L. F. (1996). Traditional stuttering modification strategies (Manning & DiLollo, 2018) include the following: These strategies require an individual to identify a moment of disfluency before, during, or after it occurs and to make adjustments to reduce tension and struggle. practice monitoring each others speech and secondary behaviors. Parents of Preschoolers Parents of school-age children Just for Kids Teens Adults Teachers SLPs Physicians Employers News and Blog February 7, 2023 Grace in Advocacy May 11, 2022 As a speech-language pathologist, you might often face the question of whether a young child is showing early signs of stuttering, or if those disruptions are simply typical speech disfluencies. Application of the ICF in fluency disorders. ASHA also extends its gratitude to the following subject matter experts who were involved in the reviewand development of thispage: In addition, ASHA thanks the members of the Steering Committee of ASHAs Special Interest Division on Fluency and Fluency Disorders (Division 4) whose work preceded this content. the diagnosis of a fluency disorder (stuttering, cluttering, or both); a differential diagnosis between fluency disorders and reading disorders, language disorders, and/or speech sound disorders; descriptions of the characteristics and severity of the fluency disorder; judgments on the degree of impact the fluency disorder has on verbal communication and quality of life; a determination if the person will benefit from treatment; a determination of adverse educational, social, and vocational impact; parent or family counseling to determine optimal responses to the childs speech and stuttering; and. The speakers measured speech rate is not always greater than average, but the listener perceives it as rapid. Causes of stuttering are thought to be multifactorial and include genetic and neurophysiological factors that contribute to its emergence (Smith & Weber, 2017). Scaler Scott, K., & Ward, D. (2013). Stuttering and labor market outcomes in the United States. Evidence-based practice for school-age stuttering: Balancing existing research with clinical practice. Language, Speech, and Hearing Services in Schools, 26(2), 162168. For example, clinicians may use treatment strategies to reduce bullying through desensitization exercises and by educating the individuals peers about stuttering (W. P. Murphy et al., 2007a, 2007b). One of the core principles of ACT is mindfulness. More recently, CBT and mindfulness have been applied to stuttering therapy and may support that CBT+mindfulness is more beneficial to clients who stutter than CBT alone (Gupta et al., 2016; Harley, 2018). Logos, 3, 8295. Children who stutter may demonstrate decreased performance for phonological tasks such as nonword repetition (Wagovich & Anderson, 2010). Journal of Fluency Disorders, 21(34), 201214. All approaches should include a plan for generalization and maintenance of skills involved in activities of daily living. Plural. Members were Gordon Blood, Eugene Cooper, Hugo Gregory, John Hanley, Charles Healey, Stephen Hood, Kenneth S. Louis, Theodore Peters, C.W. Trait and social anxiety in adults with chronic stuttering: Conclusions following meta-analysis. SLPs counseling skills should be used specifically to help speakers improve their quality of life by minimizing the burden of their communication disorder. The skilled helper: A problem-management and opportunity-development approach to helping. Universitetsforlaget. (2015). https://doi.org/10.1177/152574018200600106. Journal of Fluency Disorders, 31(2), 90115. Rehabilitation Act of 1973, Section 504. The use of counseling in other areas of the speakers lifethat is, those not directly related to communicationis outside the scope of practice for SLPs (ASHA, 2016b). Children with persistent stuttering showed deficiencies in left gray matter volume with reduced white matter integrity in the left hemisphere. The recommended citation for this Practice Portal page is: American Speech-Language-Hearing Association (n.d.). World Health Organization. https://doi.org/10.1016/j.jfludis.2016.10.002, Blumgart, E., Tran, Y., & Craig, A. (2007). In B. J. Amster & E. R. Klein (Eds. Mindfulness is an intentional awareness of the present moment (e.g., through meditation) to help disengage from automatic thoughts and redirect attention, de-escalate emotions, and increase self-acceptance (Boyle, 2011; Harley, 2018). The goal of Avoidance Reduction Therapy for Stuttering is to decrease fear of stuttering that leads to struggle. Disfluencies are not directly targeted; however, the frequency and intensity of disfluencies decrease as struggle is reduced. For example, an individual might elect to self-disclose in a workplace and educate coworkers about fluency disorders via a group presentation followed by a question-and-answer period. For preschool children who stutter, parent and family involvement in the treatment process is essential, as is a home component (Kelman & Nicholas, 2020). Advocating for individuals with fluency disorders and their families at the local, state, and national levels. EBP Briefs, 2(4), 18. https://doi.org/10.1044/2017_JSLHR-S-16-0371, Leech, K. A., Bernstein Ratner, N., Brown, B., & Weber, C. M. (2019). It discusses types of atypical dysfluency as well as application of current findings to assessment and treatment, including treatment strategies. Review of previous fluency evaluations and educational records. Sociodynamic relationships between children who stutter and their non-stuttering classmates. Strategies for reducing impairment in body function have been separated into two categoriesspeech modification and stuttering modification, both of which are described below. providing opportunities to practice fluency in linguistically and culturally relevant contexts and activities. Pediatrics, 121(2), 369375. Proceedings of the National Academy of Sciences of the United States of America, 116(35), 1751517524. 142185). Journal of Fluency Disorders, 34(4), 368381. Current Biology, 26(8), 10091018. These behaviors often are used unsuccessfully to stop or avoid stuttering (Guitar, 2019; Van Riper, 1973). https://doi.org/10.1016/j.jfludis.2011.04.001, Shenker, R. C. (2013). Covert stuttering. For students who stutter, the impact goes beyond the communication domain. Preliminary research suggests adults who clutter demonstrate differences in cortical and subcortical activity compared to controls (Ward et al., 2015). "I-I-I-I- want the ball") Available 8:30 a.m.5:00 p.m. Measuring lexical diversity in children who stutter: Application of vocd. Their description details the characteristics of each stage, along with treatment goals and processes appropriate for each stage. Ntourou, K., Conture, E. G., & Lipsey, M. W. (2011). the impact of communication impairments on, Relevant case history (as appropriate for age), including. https://doi.org/10.1044/1092-4388(2013/12-0280), Boyle, M. P. (2013b). https://doi.org/10.1159/000331073, Kuhn, M. R., & Stahl, S. A. It is also not unusual for disfluencies to be apparent and then seem to go away for a period of weeks or months only to return again. (2019). Intrajudge and interjudge reliability of the Stuttering Severity InstrumentFourth Edition. For some people, the use of these behaviors can result in little or no observable stuttering. 2335). University Park Press. While uncommon, more and more cases are being reported through online communities by speech-language pathologists seeking guidance for treatment. Psychology Press. https://doi.org/10.1016/j.jfludis.2010.07.001. Seminars in Speech and Language, 24(1), 2732. increased social communication participation (Manning & DiLollo, 2018). Journal of Fluency Disorders, 36(2), 110121. Board Certified Specialists in Fluency are individuals who hold ASHA certification and have demonstrated advanced knowledge and clinical expertise in diagnosing and treating individuals with fluency disorders. (2017). The presence of at least 1 disabling developmental condition was 5.5 times higher in CWS [children who stutter] when compared to children who do not stutter (Briley & Ellis, 2018, p. 2895). Consultation with family members, educators, and other professionals regarding fluency variability (when disfluencies are noticed most and least) and the impact of disfluency. Sheehan, V. M., & Sisskin, V. (2001). increasing self-confidence and self-efficacy. The individual learns strategies for generalization of skills to the classroom, workplace, and community. Given that cluttering may co-occur with other disorders (e.g., autism spectrum disorder, Tourettes syndrome, and attention-deficit/hyperactivity disorder), having any of these disorders may be a risk factor; however, not all individuals with these disorders also exhibit cluttering.