Speech 6-12, Part 17

Question 1: Explain stuttering modification therapy.

Answer 1: Stuttering modification therapy: The goal with this type of therapy is not to eliminate stuttering but to reduce its frequency, avoidance behaviors, and negative emotions associated with it. This therapy encompasses four stages:1. Identification: The subject learns to identify the characteristics of his stuttering and the behaviors and emotions connected with it in various situations.2. Desensitization: The subject discloses that he stutters and is made to voluntarily stutter in various situations.3. Modification: The subject is directed to use easier and more fluent stuttering. This is achieved by using cancellations (stopping after a stuttered word, pausing, and saying the word again); pull outs (stopping in midstutter, pausing, and saying the word slowly with deliberate articulation); and preparatory sets (anticipating difficult words and using more fluent stuttering).4. Stabilization: The subject uses the first three stages of the therapy and applies them to all situations.

Question 2: Describe fluency shaping, fluency reinforcement, and altered auditory feedback therapies for stuttering.

Answer 2: Fluency shaping therapy: This therapy focuses on production of normal fluent speech as opposed to more fluent stuttering as in stuttering modification therapy. Teaching airflow management and speech rate reduction through syllable prolongation achieves this. Once this is mastered, the subject is trained in normal speech emotional intonation (prosody) and speech rate. Fluency reinforcement therapy: Typically used in young children, this form of therapy models slow, relaxed, and fluent speech. Through the use of pictures and play items, children are rewarded for using fluent speech.Altered auditory feedback: Delayed auditory feedback devices delay the subjects voice to their ears by a fraction of a second. Masking auditory feedback devices produce sounds that fool the subject into thinking the vocal folds are vibrating. These techniques are very effective in reducing stuttering. However, delayed auditory feedback appears to be more effective in producing more sustained results than masking auditory feedback is.

Question 3: Explain the important aspects of cluttering.

Answer 3: Cluttering is a fluency disorder caused by disorganized language. Speech is difficult to understand because of abnormalities of speech rhythm, rapid rate of speech, large number of dysfluencies, production of spoonerisms, disorganized thought processes, and lack of awareness of speech deficits. Reading and writing disabilities are common. There is no abnormality in the mechanism of articulation, but rather in the organization of thoughts. Although the exact cause is unclear, genetic factors and brain dysfunctions are being studied. Treatment is difficult because the subjects have little awareness, but typically focuses on reducing the rate of speech and speech planning. Treatment directed at increasing the subject’s awareness of abnormal speech are employed and may include the use of auditory devices. zza4zz

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