Fluency AND articulation?

Hi professionals! I am a first year graduate student in speech language pathology at UNC-Chapel Hill. The other week we heard from a guest speaker that mentioned she will not work on articulation issues in her clients while addressing fluency. It is not until after she feels the disfluencies are approriately and sufficiently managed that she will begin to work on articulation. Our professor disagreed in that if a client is mispronouncing words to an extent in which they cannot be understood, it is important to address articulation with the disfluencies. How do you all feel about this topic? Do you focus on one before addressing the other? Thank you for your insight!

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Fluency AND articulation? — 3 Comments

  1. Great question. I feel it depends upon the individual case. There are cases where someone is working on articulation and begins stuttering, exhibiting lots of tension and struggle. If that were the case, I might let articulation work take a back seat until I could teach the client an easier way to approach speech, to reduce the tension and struggle. Once that was achieved, I’d bring the artic work back in. I think sometimes people are afraid to work on both b/c for artic work you emphasize sounds, and in fluency too much emphasis can be counter productive. However, I find that if you focus on accurate but gentle placement in articulation work, there is not an issue. Hope it helps! Will love to hear what others say.

  2. Very relevant and important question, and just to be sure; when you say “fluency and articulation”, do you mean fluency in relation to stuttering? If so, I support Scaler-Scott’s response by being gentle in the approach. Anyhow, I think you sometimes can combine the work by choosing activities and exercises which include for example specific words intended for training the articulation too – with or without the child’s awareness (depending on the child’s awareness in beforehand and degree of the disorder). You can play games or having a good time with the child while you in the same time are working specifically on something which is needed. Scaler-Scott is starting by saying that it depends upon the individual case, and this aspect I support fully. I have also met children who stutter, and who have asked for support related to their articulation in addition to their stuttering. I also would like to know other experiences or opinions from others as well.

  3. Just a quick addition to Dr. Scott’s superb answer. There are also indirect artic approaches that keep the clinician from spending half the session encouraging relaxed speech and the other half requesting that speech be precise.