Even if we prefer to consider stuttering a motor movement disorder, its features are not confined to the speech system: both adults and children who stutter find it more difficult to learn and master not only novel sequences of sounds but gestures such as tapping a rhythm as well.
Speech motor coordination in both children and adults who stutter is adversely impacted by the linguistic complexity of the utterance they are trying to produce. Finally, many studies continue to show that those who stutter find it much more difficult than other speakers to “multi-task” or respond to two tasks at once. Under such conditions, theie performance tends to slow and/or decline more than we would see in their fluent peers.
Even hearing may interact with stuttering in ways that are as yet poorly understood.
Neuroimaging appears to suggest that adults who stutter have depressed function in areas that tend to be associated with self-monitoring.
One study suggests that adults who stutter demonstrate an atypical profile of activity in circuits that are meant to monitor one’s own speech while speaking, as distinguished from the circuits used in listening to others. Certainly, one unique feature of stuttering in young children is the high degree of awareness that many children who stutter have of their speech difficulties – compare any young child who stutters, even close to onset, with a child who has an articulation or language problem. The differences are obvious and somewhat startling, especially because young typically developing
8
children don’t tend to notice errors in their speech when they talk.
The heightened sensitivity that many children who stutter show to their own speech and to the reactions of others around them is clearly a factor in the development of the so-called affective and cognitive components of stuttering that also distinguish it in major ways from other developmental communication disorders.
Why is any of this research important in working with children who stutter? It’s valuable, in our opinion, to understand that a person who stutters may be working with a language formulation and motor execution system that has challenges that go well beyond the speech motor system; and that fact may require us to integrate best practices from other areas of the field in order to achieve best outcomes.
Even if your goal is to teach your client new ways of “smooth talking” or “sliding out” of disfluent moments, basic research that has broadened our understanding of stuttering suggests that considering linguistic, motor, cognitive and affective components of your client’s profile may aid in achieving better outcomes.
When working on fluency skills, have you considered the strength of your client’s sentence formulation and word retrieval skills? Given the impact that linguistic challenge may have on speech motor coordination in stuttering, have you tried to teach new fluency skills in conversational contexts that begin at simple levels and then
SFA RESEARCH: A BROADER VIEW
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56
