The Pathogenesis, Assessment and Treatment of Speech Fluency Disorders

Background: Speech fluency disorder(SFD), a common disorder is reported in all age groups of people but most commonly in children around the world. Objective: This study aimed to review critically several aspects of SFD, specifically epidemiological parameters, etiological foundations, clinical and treatment perspectives. Methods: Electronic searches of relevant data published (1970-2020) in PubMed, MEDLINE, Google Scholar, and Science Direct databases were made using the Boolean operators and keywords and following iterative process 194 papers selected for this review. Results: Speech fluency disorder presents in a variety of forms including acquired neurogenic and psychogenic stuttering is a complex, challenging neurological disorder. SFD is determined by diverse biopsychosocial and cultural etiologies, commonly afflicts male children at age 2-3 years compared to their counterparts (4:1 ratio). SFD manifests a variety of signs and symptoms, and up to 85% children who stutter improves spontaneously with or without intervention. Childhood developmental stuttering (CDS) persists in 1-2% of adults and persistent developmental stuttering (PDS) is again male-gender condition. Persons who stutter (PWS) are managed by non-pharmacological especially speech therapy and pharmacological interventions in particular dopamine antagonists. Gender, early intervention, chronicity, severity, language skills, and comorbid conditions mainly determine the prognosis and outcome of stuttering. Conclusion: Extensive data concerning different perspectives of SFD is published globally, and projected better understanding of most speech disfluencies. Nonetheless, research need to be conducted to develop and provide better quality services to all PWS and to reduce the discrimination against PWS around the world.

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Relationship between the stuttering severity index and speech rate

Sao Paulo Medical Journal ◽

10.1590/s1516-31802003000200010 ◽

2003 ◽

Vol 121 (2) ◽

pp. 81-84 ◽

Cited By ~ 24

Author(s):

Claudia Regina Furquim de Andrade ◽

Luciana Maluf Cervone ◽

Fernanda Chiarion Sassi

Keyword(s):

Speech Rate ◽

Severity Index ◽

Cross Sectional Study ◽

Important Variable ◽

Index Test ◽

Cross Sectional ◽

Important Indicator ◽

Fluency Disorders ◽

Assessment And Treatment ◽

Developmental Stuttering

CONTEXT: The speech rate is one of the parameters considered when investigating speech fluency and is an important variable in the assessment of individuals with communication complaints. OBJECTIVE: To correlate the stuttering severity index with one of the indices used for assessing fluency/speech rate. DESIGN: Cross-sectional study. SETTING: Fluency and Fluency Disorders Investigation Laboratory, Faculdade de Medicina da Universidade de São Paulo. PARTICIPANTS: Seventy adults with stuttering diagnosis. MAIN MEASUREMENTS: A speech sample from each participant containing at least 200 fluent syllables was videotaped and analyzed according to a stuttering severity index test and speech rate parameters. RESULTS: The results obtained in this study indicate that the stuttering severity and the speech rate present significant variation, i.e., the more severe the stuttering is, the lower the speech rate in words and syllables per minute. DISCUSSION AND CONCLUSION: The results suggest that speech rate is an important indicator of fluency levels and should be incorporated in the assessment and treatment of stuttering. This study represents a first attempt to identify the possible subtypes of developmental stuttering. DEFINITION: Objective tests that quantify diseases are important in their diagnosis, treatment and prognosis.

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Multidimetional Outcome and Long-Term Evaluation of Non-Avoidance Stutterung Therapy

Journal of Special Education and Rehabilitation ◽

10.1515/jser-2015-0003 ◽

2015 ◽

Vol 16 (1-2) ◽

Cited By ~ 1

Author(s):

Dobrinka Georgieva

Keyword(s):

Quality Of Life ◽

Intensive Therapy ◽

International Classification Of Functioning ◽

Language Therapy ◽

Fluency Disorders ◽

Before And After ◽

Assessment And Treatment ◽

Term Evaluation ◽

Life Improvement

AbstractInternational Classification of Functioning, Disability, and Health (ICF, WHO, 2001) is a constructive framework for quality assessment and treatment in Logopedics (Speech Language Therapy). The current research study makes an attempt to introduce this standard into logopedical practice and applied research to measure the quality of life of persons with fluency disorders, such as stuttering. The quality of life is a modern multidimensional construct that covers health-medical, psychological, social and economic factors. Good level of communication and stabilized fluency is of key importance to improve the quality of life of persons who stutter.The purpose of the study was to show a model of assessment, treatment and evaluation of the efficacy of the non-avoidance approach in adult stuttering therapy.Methods: CharlesVan Riper’s non-avoidance approach for an intensive therapy. Participants were 15 adults who stutter with an average age 25.2 years.Results: Specific significant decreasing of the two main parameters: index of dysfluencies immediately after the intensive therapy as well as duration of disfluences in seconds. The changes in speech fluency before and after the intensive therapy as well as 3 years after this therapy were obtained regarding the duration of disfluencies and index of dysfluency.Conclusion: The present model of an intensive non-avoidance therapy format for adults with stuttering disorders was successfully applied for the Bulgarian conditions. Improved fluency is an important factor for quality of life improvement of persons with stuttering disorder.

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An Exploration of Clinicians Views About Assessment and Treatment of Stuttering

Perspectives on Fluency and Fluency Disorders ◽

10.1044/ffd18.1.16 ◽

2008 ◽

Vol 18 (1) ◽

pp. 16-23 ◽

Cited By ~ 25

Author(s):

Glen M. Tellis ◽

Lisa Bressler ◽

Katrina Emerick

Keyword(s):

Basic Knowledge ◽

Speech Language Pathology ◽

Speech Language Pathologists ◽

Graduate Course ◽

Skill Levels ◽

Fluency Disorders ◽

Course Work ◽

Assessment And Treatment ◽

Systematic Training ◽

Language Pathology

Abstract The purpose of this study was to examine school speech-language pathologists’ knowledge of and skill levels with assessing and treating stuttering. This paper provides information on 255 school speech-language pathologists who responded to a 49-question survey about stuttering. The instrument contained questions that addressed specific aspects of assessment and treatment as well as general questions about stuttering. Results indicate that on average, the speech-language pathologists had only treated 12 children who stuttered throughout their careers and averaged 2 children who stuttered on their caseloads per year. Data indicate that regardless of whether the speech-language pathologists took graduate course work in fluency disorders, had their Certificate of Clinical Competence, or attended continuing education workshops in fluency disorders, they lacked basic knowledge and skills in assessing and treating stuttering. Systematic training in specific aspects of assessment and treatment for people who stutter is urgently needed for speech-language pathology students and practicing clinicians.

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Some Contemporary Approaches in Treating Fluency Disorders in Preschool, School-Age, and Adolescent Children

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.2602.115 ◽

1995 ◽

Vol 26 (2) ◽

pp. 115-116 ◽

Cited By ~ 1

Author(s):

Susan Meyers Fosnot

Keyword(s):

Intervention Strategies ◽

School Age Children ◽

School Age ◽

Fluency Disorders ◽

The Past ◽

Wide Range ◽

Assessment And Treatment

This clinical forum focuses on the treatment of preschool and school-age children who stutter. It was developed to provide school clinicians with an up-to-date summary of current intervention strategies and procedures. The articles were written by established scholars in the field who have specialized experience and have presented their therapy ideas nationally and internationally within the past 5 years. These contributors have published a number of articles, books, and programs on the assessment and treatment of fluency disorders spanning a wide range of ages from preschool to the adolescent school-age years.

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ICA International Mosaic on Cluttering: Historic Origins, Research, Assessment, and Treatment

Perspectives on Global Issues in Communication Sciences and Related Disorders ◽

10.1044/gics3.1.5 ◽

2013 ◽

Vol 3 (1) ◽

pp. 5-13 ◽

Cited By ~ 2

Author(s):

Isabella K. Reichel ◽

Kathleen Scaler Scott ◽

Yvonne van Zaalen ◽

Kenneth O. St. Louis ◽

John Van Borsel ◽

...

Keyword(s):

Developing Countries ◽

Diagnosis And Treatment ◽

Research Assessment ◽

Fluency Disorders ◽

Current State ◽

Assessment And Treatment ◽

Origins Research ◽

International Initiative

This article presents the highlights of an International Cluttering Association (ICA) international initiative featuring ten experts in fluency disorders from various countries, describing the historical and current state of awareness, research, diagnosis, and treatment of cluttering across countries and continents. In addition, authors discuss the challenges facing people with cluttering and ways of overcoming them in developed and developing countries.

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The Need for a Broad-Based Model of Phonological Disorders

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.2303.261 ◽

1992 ◽

Vol 23 (3) ◽

pp. 261-268 ◽

Cited By ~ 24

Author(s):

Alan G. Kamhi

Keyword(s):

Speech Production ◽

Phonological Disorders ◽

Production Processes ◽

Assessment And Treatment ◽

Speech Delays ◽

Explanatory Adequacy ◽

State Of Affairs ◽

Assessment Procedures ◽

Treatment Procedures

My response to Fey’s article (1985; reprinted 1992, this issue) focuses on the confusion caused by the application of simplistic phonological definitions and models to the assessment and treatment of children with speech delays. In addition to having no explanatory adequacy, such definitions/models lead either to assessment and treatment procedures that are similarly focused or to procedures that have no clear logical ties to the models with which they supposedly are linked. Narrowly focused models and definitions also usually include no mention of speech production processes. Bemoaning this state of affairs, I attempt to show why it is important for clinicians to embrace broad-based models of phonological disorders that have some explanatory value. Such models are consistent with assessment procedures that are comprehensive in nature and treatment procedures that focus on linguistic, as well as motoric, aspects of speech.

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