A Multidimensional Approach to the Treatment of Children Who Stutter

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>> Amy Natho:  I want to welcome everyone to the SpeechPathlogy.com e-learning Expert Seminar entitled, “A Multidimensional Approach to the Treatment of Children Who Stutter.” My name is Amy Natho and I'll be your moderator today.  It is my pleasure to introduce E. Charles Healey, Ph.D. Charlie Healey is a Professor of Speech-Language Pathology at the University of Nebraska. He has been a member of the faculty for the past 33 years. During his career, he has received a University Distinguished Teaching Award, the honors of the Nebraska Speech-Language-Hearing Association, and was recently inducted into the University of Kentucky Alumni Hall of Fame. He is also an ASHA Fellow. Dr. Healey is currently an ASHA Board Recognized Specialist in Fluency Disorders and an Associate Editor for the Journal of Fluency Disorders. He has published many journal articles and book chapters concerning adults and children with fluency disorders. Dr. Healey has presented numerous workshops and seminars on the assessment and treatment of school?age children who stutter. Welcome, Charlie, we thank you so much for being here and sharing your expertise with us.

[Applause]

>> Dr. Healey:  Thank you for the opportunity to present this seminar to the group today.  I just want to make a couple of comments before we get going with the lecture material.  First of all, what you see in the handouts and the slides of information I'm going to provide today constitutes much of what I present in an all day workshop.  So we're going to have to go very quickly through the material, which may be confusing at times or there may be things that I leave out that you weren't quite clear on.  But you're welcome to ask a question, and I will address those questions at the end of my talk toward the last five minutes or so of the hour presentation.  If I'm not able to answer your question or did not get to it, you can email me or call me.  My phone number and email are on the first page there on the slides.  I would be happy to answer any questions you have at any time from now for several weeks beyond this course. 

Conceptual Framework

Let's get started with the material.  I want to talk just a little bit about the conceptual framework of stuttering assessment as it leads to treatment, to help all of you understand my perspective on how we're going to manage stuttering, particularly in children.  I'm going to focus this presentation primarily on children ages 7 through 14, 15, 16.  Many of the concepts I talk about will be relevant for that age group.  I'm not going to talk about preschool fluency training.  I'm not going to talk about older adolescents and adults who stutter.  I'm going to focus on the school age group, which I think probably constitutes most of the people who are listening in for this presentation today. 

First of all, we need to understand that children who stutter come with a variety of factors that are different for each child.  The way the child stutters can look pretty consistent from one day to the next, but we know that there are different things that trigger the stuttering moment.  There are different speaking situations, different kinds of listeners, different kinds of feelings and emotions that they have that will prompt whether or not they have a fluent moment or a dysfluent moment.  What we see for most children or from my perspective is that each child who stutters has a unique set of characteristics.  Very rarely do I find two children who stutter alike, who have the same kind of profile.  There is a lot of variability in stuttering and, in fact, one of the prominent features of stuttering that we find in current research by Ann Smith and her colleagues at Purdue University is that there is a lot of motor variability in people who stutter.  She's finding that there is motor variability in children as young as 4 and 5 years of age who stutter.  Not only is there motor variability, but there is also social variability, emotional variability, and cognitive variability.  We need to be aware that what we're dealing with is not a static problem.  It's going to change over time.  For example, if you’re doing therapy here in April and you work with the child through the summer months, you may find in August that you have to go back and kind of redo what you were doing in April because of circumstances that are part of this problem.