Fluency Therapy

Hello! My name is Emily and I am a graduate student taking an advanced fluency disorders course. I have a question regarding stuttering/cluttering therapy. I recently worked with a young client who cluttered. His parents reported moderate-severe disfluencies while at home (a rating of 7/10), but I never saw any disfluencies in our therapy sessions. He appeared to be very sensitive when talking about his disfluencies. Does anybody have any creative techniques to target fluency in therapy, when the client presents as fluent? We worked with the parents a lot for techniques they can do at home. Are there any ideas of things you could do in therapy?

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Fluency Therapy — 1 Comment

  1. Hi Emily,
    First I would say if the child seems to be sensitive about their disfluency, then some counseling and desensitization strategies may be a good place to start. When disfluency (stuttering and/or cluttering) isn’t present in the clinic, a way to approach it would be to have the client simulate moments of stuttering and apply strategies to these simulations. In this way the child is learning how to manage moments of stuttering when they do occur. I also do this in cluttering…have the client over-coarticulate in the middle of a sentence, then right after emphasize the word to increase clarity; or increase their rate of speech so they feel like they may start to clutter, then pull back on rate and insert more pauses. One thing to note when you have both stuttering and cluttering is what the cluttering symptoms are and could they be actual cluttering or an avoidance of stuttering? For example, if the client speeds up to avoid stuttering, and this speeding up doesn’t trigger any other cluttering symptoms like over-coarticulation, it’s possible the client is not cluttering but just avoiding stuttering with a rapid rate. These things are important to explore in differential diagnosis in session, so that you know exactly what you are dealing with and need to address. Hope it helps a little, I’m sure others will have things to add!