Stuttering therapy in the elementary school setting: guidelines for clinician-teacher collaboration.

This article describes guidelines for developing an effective collaborative/consultative approach to the treatment of stuttering in an elementary school setting. Four primary areas of shared clinician/teacher responsibility are discussed, which include: education, observation, facilitation of fluent speech, and generalization of speech fluency. Although the speech-language pathologist should initiate the teacher's involvement in a child's therapy, both the clinician and teacher should work toward developing a mutually influential partnership, through which the specific needs of individual children who stutter can be addressed in a comprehensive manner.

The topography of beginning stuttering.

Presently, there are a number of protocols available to assist speech-language pathologists in the identification of early stuttering (Gordon and Luper, 1992). While such protocols offer guidelines for differentiating children who stutter from those who are normally disfluent, the criteria for doing so is frequently based on clinical observation, and often suffers from limited empirical support. The purpose of this paper is to provide an update and "recalibration" of what we currently know to be the salient behaviors of beginning stuttering, and how specific features of these behaviors distinguish stuttering children form their normally disfluent counterparts. Specifically, studies examining (1) frequency, (2) type, and (3) duration of disfluency, including number of repeated units and additional temporal aspects of instances of sound, syllable, and whole-word repetition, as well as (4) associated speech and nonspeech behaviors produced by children who stutter will be reviewed, and comparisons to normally speaking children will be made when possible. With a few exceptions, discussion will be limited to those studies which specifically examined the speech of preschool children, or which purported to include children close to the onset of stuttering, regardless of age.

Duration of sound prolongation and sound/syllable repetition in children who stutter: preliminary observations.

The purpose of this study was to measure the duration of sound prolongations and sound/syllable repetitions (stutterings) in the conversational speech of school-age children who stutter. The relationships between duration and (a) frequency and type of speech disfluency, (b) number and rate of repeated units per instance of sound/syllable repetition, (c) overall speech rate, and (d) articulatory rate were also examined. Results indicated that for the children in this study the average duration of stuttering was approximately three-quarters of a second, and was not significantly correlated with age, length of post-onset interval, or frequency of speech disfluency. In addition, findings can be taken to suggest that part of the clinical significance of stuttering duration for children who stutter might lie in its relationship to the amount of sound prolongations these children produce, as well as their articulatory rate during fluent speech.

Disfluencies in the conversations of young children who stutter: some answers about questions.

Parents of children who stutter are often advised to reduce the number of questions they ask their children. Implicit in this advice is the assumption that children who stutter will be more disfluent when answering questions. This study assessed parent-child conversational speech for 8 parent-child pairs to determine the relative amounts of disfluency in the child's responses to questions versus making assertions. Length and complexity of the children's utterances and the frequency of the parents' requests by level of demand were also evaluated. Results suggested that the responses made by the children to their parents' requests were significantly less likely to contain disfluencies than were their assertions. Also, longer and more complex utterances were more likely to contain disfluencies, regardless of their designation as assertions or responses. Parents were shown to favor request types of lower levels of demand in conversations. Requests posed with greater levels of demand were somewhat more likely to yield disfluent responses than were those at a lower demand level.

Duration of the speech disfluencies of beginning stutterers.

This study compared the duration of within-word disfluencies and the number of repeated units per instance of sound/syllable and whole-word repetitions of beginning stutterers to those produced by age- and sex-matched nonstuttering children. Subjects were 10 stuttering children [9 males and 1 female; mean age 4:1 (years:months); age range 3:2-5:1), and 10 nonstuttering children (9 males and 1 female; mean age 4:0; age range: 2:10-5:1). Mothers of the stuttering children reported that their children had been stuttering for 1 year or less. One 300-word conversational speech sample from each of the stuttering and nonstuttering children was analyzed for (a) mean duration of sound/syllable repetition and sound prolongation, (b) mean number of repeated units per instance of sound/syllable and whole-word repetition, and (c) various related measures of the frequency of all between- and within-word speech disfluencies. There were no significant between-group differences for either the duration of acoustically measured sound/syllable repetitions and sound prolongations or the number of repeated units per instance of sound/syllable and whole-word repetition. Unlike frequency and type of speech disfluency produced, average duration of within-word disfluencies and number of repeated units per repetition do not differentiate the disfluent speech of beginning stutterers and their nonstuttering peers. Additional analyses support findings from previous perceptual work that type and frequency of speech disfluency, not duration, are the principal characteristics listeners use in distinguishing these two talker groups.

Judgments of disfluency by mothers of stuttering and normally fluent children.

The purpose of this study was to examine the relation between selected aspects of speech disfluency and perceptual judgments of these events by mothers of young stutterers and mothers of age- and sex-matched normally fluent children. Each mother independently listened to and judged as either "stuttered" or "not stuttered" recorded examples of a young stutterer's imitated productions of: (a) five different types of speech disfluency, (b) sound prolongations, and (c) sound/syllable repetitions of five different durations each, along with a comparable number of fluent utterances. Results indicated that although some between-group differences in judgments were observed, both groups most frequently judged sound/syllable repetitions to be stuttered, followed by whole-word repetitions and broken words. Fluent utterances, interjections, and sound prolongations were most frequently judged to be not stuttered by all mothers. Both groups judged sound prolongations averaging 258 ms in duration to be stuttered an average of 25% of the time, increasing to 68% for sound prolongations averaging 1254 ms; however, both groups of mothers judged sound/syllable repetitions of two or more iterations to be stuttered an average of 93% of the time. Findings suggest that there are not appreciable differences between mothers of stuttering and normally fluent children regarding their perceptual judgments of speech disfluencies, but each group might more frequently judge as stuttered those types of speech disfluencies characteristic of their own children's speech.