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Speech Therapy -> Fluency
Fluency refers to the smooth, forward flow of speech. An individual with a fluency disorder/difference such as stuttering or cluttering experiences disruptions in the forward flow of their speech. Examples of disruptions include repeating sounds or words, prolonging sounds, or blocking (getting stuck) on sounds or words. These disruptions can be accompanied by tension, observable behaviors or avoidance, negative thoughts, and negative feelings that impact the individual’s overall communication.
Fluency shaping therapy is a highly structured approach where techniques are implemented by the SLP to increase the length and complexity of the fluent response of a patient who stutters. Fluency shaping techniques establish fluent speech by eliminating stuttering in a controlled stimulus environment. Through successive approximation, fluency gradually is modified to approximate normal sounding conversational speech. Then efforts are directed to generalize the fluent speech into the person’s natural speaking environments.
Techniques include: manipulation of linguistic length and complexity, speech rate reduction, airflow control, gentle onsets of phonation, and light articulatory contacts. These fluency procedures form the foundation from which other fluency management techniques are based, such as smooth transitions between sounds, proper phrasing, and pitch/loudness control. Singing, choral speaking, and choral reading are quick ways to increase fluent speech. Indications for intervention of a fluency shaping nature include an individual who: stutters openly, does not avoid speaking, perceives annoyance or interference but no personal penalty from stuttering, feels positive about himself as a communicator, and demonstrates a positive response to fluency shaping trial management (Guitar & Peters, 1980; Peters & Guitar 1991; Shaprio 1999; Healey & Scott, 1995).
Stuttering modification therapy is an intervention approach that uses techniques to reduce speech-related avoidance behaviors, fear, and negative attitudes, while modifying the form of stuttering. The SLP helps the patient to reduce struggle behavior, smooth out the form of stuttering, and reduce the tension and rate of stuttering by stuttering in a more relaxed and deliberate manner. Stuttering modification techniques include: stuttering in unison, cancellation, pull outs, and preparatory sets. Stuttering modification teaches the patient to stutter easily, cancel the stutters, and/or voluntary stutters. Stuttering modification is indicated when the person who stutters demonstrates the following: hides or disguises his stuttering, avoids speaking, perceives personal penalty as a consequence of stuttering, feels poorly about himself as a communicator, demonstrates a more positive response to stuttering modification trial management. (Guitar & Peters, 1980; Peters & Guitar, 1991; Shaprio, 1999; VanRiper 1973).
Bilingual (Spanish/English) Evaluation Resources 1Author: Bilinguistics - Dozens of speech, language, fluency, and other evaluation resources for bilingual evaluations
Author: ASHA - Link includes ASHA resources and information related to evaluation and treatment of clients from linguistically and culturally diverse backgrounds. Link includes ASHA resources to: Accent Modification Bilingual Service Delivery Collaborating With Interpreters, Transliterators, and Translators Cultural Competence Voice and Communication Services for Transgender and Gender Diverse Populations Dynamic Assessment Micro Course Cultural Competence Self Assessment Phonemic Inventories and Cultural and Linguistic Information Across Languages Collaboration With Interpreters: Securing Positive Outcomes Practical Assessment and Treatment Strategies for English Language Learners with Language Impairments Serving Clients From Diverse Backgrounds: Speech-Language Difference vs. Disorder Langu Continuing the Dialogue on Dialect: Positive Steps Toward Less Biased Assessments of Children Who Speak African American Englishage and Identity--Shifting Away from a Deficit Perspective on African American English Información en español
Echolalia and Its Role In Gestalt Language Acquisition 0Author: ASHA / Practice Portal / Clinical Topics / Autism Spectrum Disorder / - This view of gestalt language acquisition and the role of echolalia in individuals with ASD is reflected in assessment procedures (e.g., assessing communicative function of echolalia) and treatment approaches to language intervention (see e.g., Blanc, 2012). Gestalt language acquisitionis a style of language development with predictable stages that begins with production of multi-word “gestalt forms” and ends with production of novel utterances. At first, children produce “chunks” or “gestalt form” (e.g., echolalic utterances), without distinction between individual words and without appreciation for internal syntactic structure. As children understand more about syntax and syntactic rules, they can analyze (break down) these “gestalt forms” and begin to recombine segments and words into spontaneous forms. Eventually, the child is able to formulate creative, spontaneous utterances for communication purposes.
The Natural Language Acquisition Guide: Echolalia is All About Gestalt Language Development 0Author: Marge Blanc, M.A. CCC-SLP Illustrated By Jon G. Lyon - 'Echolalic’/gestalt comments, phrases, and others like them are vitally important because they make up the first, crucial stage of language development, real language development, for children and young adults who are ‘echolalic’ — more accurately, gestalt language processors. These gestalt language processors develop language naturally: starting with whole chunks of language: some short, some long — some from media, some from songs, and plenty from the other people in their lives, including you! From now on, you will never see ‘echolalia’ the same way! It is gestalt language processing (GLP), and gestalt language processors use ‘echolalia’ (gestalts) in natural language development!
Fluency Disorders 0Author: The American Speech-Language-Hearing Association - A fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm, and disfluencies (e.g., repetitions of sounds, syllables, words, and phrases; sound prolongations; and blocks), which may also be accompanied by excessive tension, speaking avoidance, struggle behaviors, and secondary mannerisms. People with fluency disorders also frequently experience psychological, emotional, social, and functional impacts as a result of their communication disorder.
Bilingual Service Delivery 1Author: ASHA - Information and resources regarding bilingual service delivery by SLPs (from ASHA)
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Visual Schedule Cards
- Stuttering and other fluency disorders - A fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm, and disfluencies (e.g., repetitions of sounds, syllables, words, and phrases; sound prolongations; and blocks), which may also be accompanied by excessive tension, speaking avoidance, struggle behaviors, and secondary mannerisms (American Speech-Language-Hearing Association [ASHA], 1993). People with fluency disorders also frequently experience psychological, emotional, social, and functional impacts as a result of their communication disorder (Tichenor & Yaruss, 2019a). Stuttering is the most common fluency disorder.
- Childhood apraxia of speech - Childhood apraxia of speech (CAS) is a disorder that involves difficulty in making speech sounds voluntarily and stringing these sounds together in the correct order to make words. A person with childhood apraxia of speech is not intellectually impaired. Speech pathologists assess, diagnose and support people with CAS.
- Autism Spectrum Disorder - Autism Spectrum Disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors. The effects of ASD and the severity of symptoms are different in each person.
- Motor Speech Disorders - Dysarthria can be related to neurological damage, however it can be related to many other causes. Dysarthria is a motor speech disorder above all. A dysarthria diagnoses can come from a weakened Parkinson’s patient, a anatomy damaged TBI patient, a stroke patient with cranial nerve and strength deficits, etc).
Measures stuttering severity in children and adults in four areas of speech behavior; duration, frequency, physical concominants and naturalness of speech.
Therapists who selected this major focus area as their top area of expertise.