What causes stuttering?
Stuttering is a complex communication disorder caused by genetic and neurophysiological factors. Two areas interact to impede fluent speech:
- Specific speech behaviors (e.g: sound prolongations, sound/syllable/word repetitions, blocks)
- Internal and external reactions to non-fluent speech (e.g.: physical movements, anticipatory and concurrent thoughts, feelings).
What types of intervention are appropriate?
Traditional stuttering intervention focuses on eliminating speech behaviors (i.e. trying not to stutter); however, addressing internal and external reactions to stuttering was overlooked. My approach to the treatment of adult stuttering is holistic, addressing both speech behaviors and reactions to non-fluent speech. In fact, current research has shown that long-term success requires learning how to smoothly move through and overcome stuttering incidents.
As an example, when sensing a stuttering event, an individual may internally focus on “pushing through” as a coping strategy. However, this is contraindicated as it sustains or exacerbates anxiety, which in turn intensifies the stuttering event. For examples of additional coping strategies that may exacerbate stuttering when used in isolation visit https://pubs.asha.org/doi/10.1044/2014_jslhr-s-13-0041 – Safety Behaviours and Speech Treatment for Adults Who Stutter.
Mindful attention is a promising new addition to treatment options. It more effectively addresses the internal processes involved in stuttering.
Using mindful attention that is focused on the internal and external moment-to-moment experience of stuttering, as opposed to avoidance of stuttering, could result in a clearer and more factually informed response, rather an emotional or cognitive reaction (Brown et al., 2007). Mindful practice could change the thought patterns and emotions associated with the experience of stuttering.
Perspectives on Fluency and Fluency Disorders A Mindful Approach to Stuttering Intervention-Plexico J. Sandage
How much treatment is needed?
The frequency and intensity of my treatment approach is based on assessment results and the individual clients goals and situation.
Research has been unable to support a particular ‘dosage,’ nor that intense treatment has better outcomes when compared to traditional weekly treatment.
“We were unable to demonstrate any clear dose–response relationship, meaning that, currently, interventions with many hours of contact did not seem to offer substantially different outcomes to those with fewer” (Long-Term Results of an Intensive Treatment Program, Journal of speech, language, and Hearing Science Research)
