A comprehensive treatment approach for school-age children, adolescents, and adults includes multiple goals and considers the age of the individual and their unique needs (e.g., communication in the classroom, in the community, or at work). Individuals who stutter consistently report experiencing limitations, discrimination, and glass ceilinglike effects at their jobs and within their careers (Bricker-Katz et al., 2013; Cassar & Neilson, 1997; Klein & Hood, 2004). Stuttering in school-age children: A comprehensive approach to treatment. However, fluency shaping approaches, such as easy onset or continuous phonation, may not be appropriate for the treatment of cluttering. Finding opportunities for social support for individuals with fluency disorders. Family historyAnecdotal reports indicating the presence of cluttering in more than one family member suggest that family history may be a risk factor. Molt, L. F. (1996). Bilingual SLPs who have the necessary clinical expertise to assess the childand are familiar with the languages they speakmay not always be available. Treatment approaches that incorporate support activities also can provide venues to practice learned strategies in a safe environment and help promote generalization. 297325). ), Cluttering: A clinical perspective (pp. https://doi.org/10.1038/s41598-017-00519-8, Chang, S.-E. (2014). https://doi.org/10.1016/0094-730X(88)90004-6, Onslow, M., & OBrian, S. (2012). Journal of Speech, Language, and Hearing Research, 62(12), 43354350. Avoidance Reduction Therapy for Stuttering (ARTS). Parent perceptions of an integrated stuttering treatment and behavioral self-regulation program for early developmental stuttering. Speech modification (including fluency shaping) strategies (Bothe, 2002; Guitar, 1982, 2019) include a variety of techniques aimed at making changes to the timing and tension of speech production or altering the timing of pauses between syllables and words. The plan outlines reasonable accommodations for speaking or reading activities to help ensure a students academic success and access to the learning environment in school. However, the clinician needs to consider the impact of disfluency on communication and quality of life as a whole. https://doi.org/10.1016/j.jfludis.2015.08.001, Han, T.-U., Park, J., Domingues, C. F., Moretti-Ferreira, D., Paris, E., Sainz, E., Gutierrez, J., & Drayna, D. (2014). Possible genetic factors in cluttering. Journal of Fluency Disorders, 34(4), 368381. In addition, clinicians need to avoid using religious or highly familiar texts that individuals may know by rote. deletion and/or collapsing of syllables (e.g., I wanwatevision). The goals of treatment may be (a) to eliminate, greatly reduce, or help the child manage their stuttering and (b) to help them not develop negative emotional reactions related to their stuttering (H. S. Arnold et al., 2011; Yaruss et al., 2006). https://doi.org/10.1044/1092-4388(2008/046, Millard, S. K., Zebrowski, P., & Kelman, E. (2018). School Psychology Review, 30(1), 135141. https://doi.org/10.1044/2017_AJSLP-17-0146, St. Louis, K. O., & Hinzman, A. R. (1986). For example, emotional reactivity/regulation and behavioral disinhibition may affect the childs ability to cope with disfluencies (Choi et al., 2013; Guttormsen et al., 2015; R. M. Jones, Conture, & Walden, 2014; Ntourou et al., 2013). A mutation associated with stuttering alters mouse pup ultrasonic vocalizations. The clinical applications of Acceptance and Commitment Therapy with clients who stutter. https://doi.org/10.1177/152574018200600106. Provider refers to the person providing treatment (e.g., SLP, trained volunteer, family member, or caregiver). Atypical Disfluencies are more concerning and are an indicator that stuttering may not necessarily resolve without some type of intervention. https://doi.org/10.1044/1092-4388(2008/07-0111), Prochaska, J. O., & DiClemente, C. C. (2005). Wampold, B. E. (2001). Differences between children and adults should also be considered when interpreting data from neurological studies. recognize physical concomitant behaviors, locate the point of physical tension and struggle during moments of disfluency, and. Differing perspectives on what to do with a stuttering preschooler and why. Providing prevention information to individuals and groups known to be at risk for fluency disorders and to individuals working with those at risk. Psychological characteristics and perceptions of stuttering of adults who stutter with and without support group experience. (2019). These feelings may come from having a positive perception about the ability to face challenges (Boyle et al., 2019). Course: #10096 Level: Intermediate 1 Hour 2233 Reviews. Some people who clutter tend to decrease volume at the ends of sentences or phrases and, therefore, can benefit from learning to keep a steady volume throughout their utterances. Stuttering: An integrated approach to its nature and treatment. Helping individuals who stutter become more accepting and open about their stuttering may help them have workplace conversations about it, advocate for themselves, and build support systems within the workplace (Plexico et al., 2019). The underlying relationship between stuttering and working memory is not fully understood but may be related to interruptions in sensorimotor timing for developmental stuttering and may involve both the basal ganglia and the prefrontal cortex (Bowers et al., 2018). Some adults lack communication confidence as a result of negative self-perceptions about their stuttering (Beilby et al., 2012a) or due to repeated exposure to people holding stereotypes about stuttering, which, in turn, may create self-stigmatization (Boyle, 2013a). Other identification strategies may include video or pseudostuttering analysis or tallying/freezing. The person exhibits negative reactions (e.g., affective, behavioral, or cognitive reactions) to their disfluency. These modifications are used regardless of whether a particular word is expected to be produced fluently. Psychology Press. Systems that govern self-regulation may underlie cluttering; qualitative interviews with those who clutter suggest that thoughts emerge before they are ready (Scaler Scott & St. Louis, 2011). SIG 4 Perspectives on Fluency and Fluency Disorders. Effortful control, an aspect of temperament that supports self-regulation, may be predictive of stuttering severity and may facilitate positive change in treatment (Kraft et al., 2019). The role of self-help/mutual aid in addressing the needs of individuals who stutter. Healey, E. C., Reid, R., & Donaher, J. Diagnostic and statistical manual of mental disorders (5th ed.). Rethinking covert stuttering. 155192). Parents of bilingual children easily can be trained to provide perceptual ratings of fluency in any language spoken by the child (Shenker, 2013). Persons who stutter also may experience psychological, emotional, social, and functional reactions to stuttering (anxiety, embarrassment, avoidance, tension and struggle, low self-esteem). 4. Integrated treatment focused on parental involvement, self-regulation, and fluency may also be beneficial (Druker et al., 2019). However, as they learn to reduce reactivity (see below), they develop greater comfort while speaking, they assume more positive attitudes about their ability to communicate, and they are better able to accept and manage moments of disfluency as they occur. Neurobiology of Disease, 69, 2331. https://doi.org/10.1016/j.jcomdis.2015.10.003. Support (both giving and receiving) can be valuable for improving attitudes, boosting self-confidence, and reducing feelings of isolation (Yaruss et al., 2007). Desensitization strategies are strategies that help speakers systematically desensitize themselves to their fears about speaking and stuttering by facing those fears in structured, supportive environments. https://doi.org/10.1037/0022-0663.95.1.3, Langevin, M., Bortnick, K., Hammer, T., & Wiebe, E. (1998). What is motivational interviewing? "Atypical" disfluencies include: sound repetitions ("s-s-s-so"); syllable repetitions ("be-be-be-be-because"); prolongations ("Aaaaaaaaaaaaand"); and Some of the most commonly prescribed typical or first-generation antipsychotics include: Haldol (haloperidol) Thorazine (chlorpromazine) Loxitane (loxapine) Moban (molindone) Mellaril (thioridazine) Serentil (mesoridazine) Navane (thiothixene) Trilafon (perphenazine) On the other hand, the following are atypical or second-generation antipsychotics: Motivational interviewing is a person-centered approach that can be useful in developing functional goals and enhancing readiness for change (Miller & Rollnick, 2013; Rollnick & Miller, 1995). Stuttering and its treatment in adolescence: The perceptions of people who stutter. winery in maryland with igloos; thick peeling skin around fingernails; holiday inn st pete beach revolving restaurant; metro approved housing in norwalk ohio https://doi.org/10.1016/S0094-730X(99)00023-6, McGill, M., Siegel, J., Nguyen, D., & Rodriguez, S. (2018). EBP Briefs, 2(4), 18. Disclosing a fluency disorder has many benefits on both the speaker (Boyle & Gabel, 2020; Boyle et al., 2018; Mancinelli, 2019) and the listener (Byrd, Croft, et al., 2017; Byrd, McGill, et al., 2017; Ferguson et al., 2019; Healey et al., 2007). Guttormsen, L. S., Kefalianos, E., & Nss, K. A. The person is having difficulty communicating messages in an efficient, effective manner. https://doi.org/10.1093/med:psych/9780195165791.003.0007, Proctor, A., Yairi, E., Duff, M., & Zhang, J. Greater abnormality of cerebral blood flow in the posterior language loop, associated with processing words that we hear, correlates with more severe stuttering. Bilingual myth-busters series when young children who stutter are also bilingual: Some thoughts about assessment and treatment. Thieme. modifying instructions to accommodate the home language, using exemplars in audio or video format in the home language, and. Journal of Speech and Hearing Disorders, 49(1), 5358. The Lidcombe Program of early stuttering intervention: A clinicians guide. For example, some children from bilingual or multicultural backgrounds may experience stuttering onset or a temporary increase in stuttering as result of being in new and unfamiliar situations, learning a new language, or being exposed to mixed linguistic input (Shenker, 2013). Psychology Press. This may progress to the client analyzing the clinicians or their own pseudostuttering, to analyzing a video of their own stuttering to real-time analysis (Bray & Kehle, 2001; Bray et al., 2003; Cream et al., 2010; Harasym et al., 2015; Prins & Ingham, 2009). Mindfulness is an intentional awareness of the present moment (e.g., through meditation) to help disengage from automatic thoughts and redirect attention, de-escalate emotions, and increase self-acceptance (Boyle, 2011; Harley, 2018). The imbalance of stuttering behavior in bilingual speakers. Such individuals may benefit from treatment strategies that focus on improving speech efficiency by reducing word avoidance and increasing spontaneity in communication. As indicated in the ASHA Code of Ethics (ASHA, 2016a), SLPs are obligated to provide culturally and linguistically appropriate services, regardless of the clinicians personal culture, practice setting, or caseload demographics. social anxiety disorder (Brundage et al., 2017; Craig & Tran, 2014; Iverach et al., 2018), speech sound disorders (St. Louis & Hinzman, 1988; Wolk et al., 1993), and. https://doi.org/10.1016/S0021-9924(03)00052-2, Yaruss, J. S., & Quesal, R. W. (2006). Consistent with treatment approaches for children and adolescents, treatment for adults needs to be individualized, dynamic, and multidimensional. Journal of Fluency Disorders, 37(4), 242252. See ASHAs Practice Portal page on Cultural Responsiveness. Ward, D., Connally, E. L., Pliatsikas, C., Bretherton-Furness, J., & Watkins, K. E. (2015). Lippincott Williams & Wilkins. A comprehensive fluency assessment typically includes the following: See ASHAs resource on assessment procedures: parallel with CPT codes for a breakdown of pre-evaluation, intra-service, and post-service procedures. The transtheoretical approach. ASHA also extends its gratitude to the following subject matter experts who were involved in the reviewand development of thispage: In addition, ASHA thanks the members of the Steering Committee of ASHAs Special Interest Division on Fluency and Fluency Disorders (Division 4) whose work preceded this content. Journal of Fluency Disorders, 36(4), 290295. As suggested earlier, normal disfluencies will appear for a few days and then disappear. Alm, P. A. 178196). B., & Al-Khamra, R. (2015). These are called typical disfluencies or nonfluencies. Journal of Speech, Language, and Hearing Research, 31(3), 377385. Allyn & Bacon. 7184). Perspectives on Fluency and Fluency Disorders, 4(6), 13161326. Service delivery for fluency disorders encompasses, among other factors, treatment format, provider(s), dosage, timing, and setting. Children who stutter typically know how to read (decode) the printed form of words, but they may not be able to speak the printed form fluently. Remaining informed of research in the area of fluency disorders and advancing the knowledge base of the nature of the disability, screening, diagnosis, prognostic indicators, assessment, treatment, and service delivery for individuals with fluency disorders. Stuttering: Research and therapy. American Journal of Speech-Language Pathology, 27(3S), 12351243. ET MondayFriday, Site Help | AZ Topic Index | Privacy Statement | Terms of Use Yaruss, J. S., Quesal, R. W., & Reeves, L. (2007). Prevalence of cluttering in two European countries: A pilot study. https://doi.org/10.1044/2019_JSLHR-S-18-0225. https://doi.org/10.1016/j.jfludis.2017.09.004, Cassar, M. C., & Neilson, M. D. (1997). Review of previous fluency evaluations and educational records. Journal of Speech, Language, and Hearing Research, 62(12), 43564369. (2018). When speakers are able to participate in decisions about treatment goals and select goals they consider important, they may be more motivated to take part in therapy (Finn, 2003; Snsterud et al., 2019). Perspectives on Fluency and Fluency Disorders, 22(1), 3446. (2011). hurricane elizabeth 2015; cheap houses for sale in madison county; stifel wealth tracker login; zadna naprava peugeot 206; 3 days a week half marathon training plan; practice treatment targets with more listeners. Plural. Alternative measures of reading fluencysuch as tests of silent reading fluencymay be more valid measures for children who stutter. The term atypical has been applied to rapid atrial tachycardias with ECG patterns differing from the typical and reverse typical flutter described above, and also to re-entrant tachycardias with circuit configuration different from the typical RA flutter circuit, even if they have an ECG pattern similar to typical flutter. Resilience and stuttering: Factors that protect people from the adversity of chronic stuttering. https://doi.org/10.1016/j.jfludis.2013.06.002, Nwokah, E. E. (1988). Educating families about local support organizations for people who stutter and their families. Therefore, clinicians may want to ask open-ended questions to assess communication across specific situations (e.g., How do you participate in class? How do you talk to strangers? Please describe a situation when you ordered food from a restaurant. How did it feel?). Developing culturally and linguistically relevant intervention plans focused on helping the individual achieve more fluent speech and self-acceptance of disfluency, providing treatment, documenting progress, and determining appropriate dismissal criteria. ), Cluttering: Research, intervention and education (pp. Atypical disfluencies are generally not seen in the majority of children with developmental stuttering (child onset fluency disorder). Scaler Scott, K., & Ward, D. (2013). https://doi.org/10.1044/ffd17.2.4, Murphy, W. P., Yaruss, J. S., & Quesal, R. W. (2007a). https://doi.org/10.1016/j.cub.2016.02.068, Beilby, J. M., & Byrnes, M. L. (2012). Journal of Speech, Language, and Hearing Research, 61(12), 28952905. https://doi.org/10.1016/j.jfludis.2013.09.001, Boyle, M. P. (2015). May 11, 2022 As a speech-language pathologist, you might often face the question of whether a young child is showing early signs of stuttering, or if those disruptions are simply typical speech disfluencies. Cluttering treatment: Theoretical considerations and intervention planning. Self-disclosure involves communicating to others information that reveals ones identity as a person who stutters. The clinical process for an adult involves. Tourettes syndrome (see Van Borsel, 2011, for a review). St. Louis, K. O., & Rustin, L. (1996). Traits of attention deficit/hyperactivity disorder in school-age children who stutter. What is Typical Pneumonia? Clinicians need to understand the interaction of symptoms and the strategies that are most effective for dealing with stuttering and cluttering when they occur together. American Journal of Speech-Language Pathology, 26(4), 11051119. In E. Conture & R. F. Curlee (Eds. Cluttering and autism spectrum disorders. The clinician (a) considers the degree to which the individuals disfluent behaviors and overall communication are influenced by a coexisting disorder (e.g., other speech or language disorders, Down syndrome, autism spectrum disorder, attention-deficit/hyperactivity disorder) and (b) determines how treatment might be adjusted accordingly. https://doi.org/10.1044/0161-1461(2012/11-0044), Yaruss, J. S., LaSalle, L. R., & Conture, E. G. (1998). Human GNPTAB stuttering mutations engineered into mice cause vocalization deficits and astrocyte pathology in the corpus callosum. Adolescents also may be particularly susceptible to peer pressure and bullying at this time. On the other hand, stuttering symptoms may decrease in more comfortable situations. Yairi, E., & Ambrose, N. (2013). Studies of cluttering: Perceptions of cluttering by speech-language pathologists and educators. Teasing/bullying experienced by children who stutter: Toward development of a questionnaire. Rather, the purpose is to determine the extent and impact of the fluency disorder on the individual, the potential benefit from treatment, and the individuals desire and willingness to change. ), Stuttering and related disorders of fluency (pp. Genetic bases of stuttering: The state of the art, 2011. (2018). Treatment approaches for adults should take into consideration career and workplace factors. Screening is conducted whenever a fluency disorder is suspected or as part of a comprehensive speech and language assessment. A recent U.S. study estimated that approximately 2% of children ages 317 years stutter (Zablotsky et al., 2019). Timing refers to the initiation of treatment relative to the diagnosis. Brain, 138(3), 694711. production of words with an excess of physical tension or struggle. https://doi.org/10.1044/persp1.SIG4.55, Byrd, C. T., Croft, R., Gkalitsiou, Z., & Hampton, E. (2017). It is not appropriate to determine a standard score if the norming sample of the assessment is not representative of the individual being assessed. Time and expense are considerations along with attention to generalization and treatment needs following an intensive program (Cooper, 1979). For example, clinicians may use treatment strategies to reduce bullying through desensitization exercises and by educating the individuals peers about stuttering (W. P. Murphy et al., 2007a, 2007b). Academic Press. It may occur only in specific situations, but it is more likely to occur in these situations, day after day. https://doi.org/10.1044/gics4.2.57, Van Zaalen, Y., & Reichel, I. https://doi.org/10.1016/S0094-730X(02)00162-6, Singer, C. M., Hessling, A., Kelly, E. M., Singer, L., & Jones, R. M. (2020). Strategies for reducing impairment in body function have been separated into two categoriesspeech modification and stuttering modification, both of which are described below. The lowest prevalence rates of stuttering were reported in adults aged 2150 years (0.78%) and adults aged 51 years or older (0.37%; Craig et al., 2002). Other treatment approaches described below also may be incorporated as part of a comprehensive treatment approach. 2335). Quick: Talk fast & dont stutter! Fluency of school-aged children with a history of specific expressive language impairment: An exploratory study. In F. L. Myers & K. O. St. Louis (Eds. Adults are likely to have been living with stuttering for a long time. It can also be challenging to assess the reading fluency of bilingual students who stutter. gain insights from others who may be further along in treatment, have opportunities to gain self-confidence from mentoring others, and. There is ongoing debate as to whether persons who stutter have language skills that are equivalent to those seen in well-matched comparison speakers. Understanding and treating cluttering. Psychology Press. Seminars in Speech and Language, 37(3), 145152. Therefore, as with school-age children and adolescents, the purpose of the assessment for adults typically is not to diagnose stuttering. https://doi.org/10.1044/2018_JSLHR-S-17-0353, Guitar, B. Children with normal disfluencies have emergent fluency. Prevalence of stuttering in primary school children in Cairo-Egypt. Individuals learn to identify the thoughts underlying their negative attitudes and emotional reactions and examine the link between these thoughts, attitudes, and emotional reactions and their speech. frequency of exposure to all languages used by the child and their proficiency (comprehension and production) in each language; family history of stuttering or cluttering; description of disfluency and rating of severity; age of onset of disfluency and patterns of disfluency since onset (e.g., continuous or variable); previous fluency treatment and treatment outcomes; exploration of parental reactions to the childs moments of disfluency or speaking frustration; and. Anderson, J. D., Pellowski, M. W., Conture, E. G., & Kelly, E. M. (2003). Journal of Fluency Disorders, 62, 105724. https://doi.org/10.1016/j.jfludis.2019.105724, Gerlach, H., Totty, E., Subraminian, A., & Zebrowski, P. (2018). If treatment is warranted, it is necessary to determine the timing for intervention and to set out a plan for parent education and counseling. They may hesitate when speaking, use fillers ("like" or "uh"), or repeat a word or phrase. Qualitative investigation of the speech-language therapy experiences of individuals who covertly stutter. Individuals and families may have a wide range of beliefs about the best way to treat fluency disorders, ranging from medical and therapeutic intervention to prayer. Lyn Goldberg and Michelle Ferketic served as ex officios. It is important that parents and clinicians acknowledge and respond to a childs verbal and nonverbal reactions in a supportive manner; this helps to minimize the likelihood that the child will develop negative reactions to stuttering. Efforts to conceal stuttering may adversely affect quality of life (Boyle et al., 2018). Identifying correlates of self-stigma in adults who stutter: Further establishing the construct validity of the Self-Stigma of Stuttering Scale (4S). https://doi.org/10.1177/1073858418803594, Chang, S.-E., & Zhu, D. C. (2013). Recovery rates were estimated to be approximately 88%91% by Yairi and Ambrose (2013). International Journal of Language & Communication Disorders, 49(1), 113126. autism (see Scaler Scott, 2011, for a review), word-finding/language organization difficulties (Myers, 1992), and. Engaging parents in treatment helps to achieve carryover in the home environment and helps with treatment across languages (Shenker, 2013). Video self-modeling as a post-treatment fluency recovery strategy for adults. The cost of such avoidance can be great because of the resulting impact on the persons ability to say what they want to say, when they want to say it. See ASHAs Practice Portal resource on Transitioning Youth. Pediatrics, 132(3), 460467. School-age stuttering therapy: A practical guide. The ASHA Action Center welcomes questions and requests for information from members and non-members. Early childhood stuttering for clinicians by clinicians. Genetics and neurophysiology appear to be related to the underlying causes of stuttering. The recommended citation for this Practice Portal page is: American Speech-Language-Hearing Association (n.d.). Supplementing stuttering treatment with online cognitive behavior therapy: An experimental trial. Folia Phoniatrica et Logopaedica, 19. Ward, D. (2006). Journal of Fluency Disorders, 38(2), 6687. Operant treatment (e.g., Palin ParentChild Interaction Therapy, Kelman & Nicholas, 2020; Lidcombe Program, Onslow et al., 2003) incorporates principles of operant conditioning and uses a response contingency to reinforce the child for fluent speech and redirect disfluent speech (the child is periodically asked for correction). excessive coarticulation resulting in the collapsing and/or deletion of syllables and/or word endings; excessive disfluencies, which are usually of the more nonstuttering type (e.g., excessive revisions and/or use of filler words, such as um); pauses in places typically not expected syntactically; unusual prosody (often due to the atypical placement of pauses rather than a pedantic speaking style, as observed in many with autism spectrum disorder). (1984). In fact, stuttering can affect all areas of academic competency, including academic learning, social-emotion functioning, and independent functioning (Ribbler, 2006, p. 15). Speaker and observer perceptions of physical tension during stuttering. Van Riper, C. (1973). https://doi.org/10.1016/j.jfludis.2017.06.001. In D. Ward & K. Scaler Scott (Eds. St. Louis, K. O., Myers, F., Bakker, K., & Raphael, L. (2007). 211230). Social anxiety disorder in adults who stutter. In D. Ward & K. Scaler Scott (Eds. Adults who stutter also may experience job discrimination and occupational stereotyping, including an earnings gap, especially for females (Gerlach et al., 2018). Stages of change and stuttering: A preliminary view. Journal of Fluency Disorders, 31(2), 90115. Other disorders, such as apraxia of speech and/or articulation and phonological disorders, can affect speech intelligibility; assessment of speech production can be used to rule out these causes of reduced speech intelligibility. International Journal of Speech-Language Pathology, 17(4), 367372. Determination of individual strengths and coping strategies. When a bilingual clinician is not available, using an interpreter is a viable option. (2019). It is important for clinicians to verify online sites and virtual support groups recommended to clients and their families. Perspectives on Fluency and Fluency Disorders, 17(2), 49. Arnold, H. S., Conture, E. G., Key, A. P., & Walden, T. (2011). Individuals may experience the impact of fluency disorders in social and emotional, academic, and vocational domains. Direct treatment approaches may include speech modification (e.g., reduced rate of speech, prolonged syllables) and stuttering modification strategies (e.g., modifying a stuttered word, pulling out of a stuttered word) to reduce disfluency rate, physical tension, and secondary behaviors (Hill, 2003). ), More than fluency: The social, emotional, and cognitive dimensions of stuttering (pp. (1982). Differentially diagnosing fluency disorders from disfluencies stemming from language encoding difficulties such as language delay or second language learning. https://doi.org/10.1016/j.jfludis.2017.09.001, Byrd, C. T., & Donaher, J. ), The atypical stutterer: Principles and practices of rehabilitation (pp. When a student stutters: Identifying the adverse educational impact. Sadness/Depression, 6. See ASHAs resource on assessment tools, techniques, and data sources. (2001). Allyn & Bacon. talking about stuttering or treatment of stuttering. Journal of Fluency Disorders, 54, 1423. https://doi.org/10.1044/leader.FTR1.11102006.6, Tichenor, S. E., Leslie, P., Shaiman, S., & Yaruss, J. S. (2017). B. See also ASHAs resources titled Person-Centered Focus on Function: Preschool Stuttering [PDF], Person-Centered Focus on Function: School-Age Stuttering [PDF], and Person-Centered Focus on Function: Adult Stuttering [PDF] for examples of treatment goals consistent with the ICF framework. Code of ethics [Ethics]. 4566). Journal of Speech, Language, and Hearing Research, 45(6), 10971105. The scope of this page includes stuttering and cluttering across the life span. One study showed that children who clutter had 7.6 times more normal disfluencies compared to "atypical" disfluencies when they retold a story (van Zaalen et al., 2009). Stuttering-related podcasts: Audio-based self-help for people who stutter. Expand Search Apply; Program Guide; BOBapp(2023) .

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