Question
I am an SLP who recently observed a 5 year old whose speech pattern is highly unusual. He speaks at a loud and high level of excitation most of the time, often accompanied by hand flapping, and a "press of speech" that is very apparent. As he speaks, he m
Answer
Thanks for your question. I think you are on the right track. When evaluating him, I would definitely assess fluency AND language, as there might be a language component. The other thing I would look for in the evaluation is any signs of other behaviors. Hand-flapping, difficulty monitoring volume, and constant over-excitement might be signs of other behavior components that might need to be evaluated by the proper professionals as well.
In terms of language testing, I would look at word-finding, and language processing in particular. From a fluency standpoint, see what his speech is like when there is a lot of excitement, which seems to be the norm, but also try to have some time where you really try to make things low-key, take away time pressure, and limit speaking demand. See if this makes any difference in his speech fluency. When you are done with the evaluation, if language areas are all ok, and there are no behaviors that warrant a thorough behavioral assessment, you'll know it is just fluency you need to work on. If not, those other areas will need to be addressed as well.
Craig E. Coleman is a Clinical Coordinator at Children's Hospital of Pittsburgh and Co-Director of the Stuttering Center of Western Pennsylvania. He received his Bachelor's and Master's degrees at the University of Pittsburgh. Craig is a member of the National Insurance Advocacy Initiative and Chair of the National Stuttering Association's Insurance Advocacy Committee. In addition, Craig is an elected member of the ASHA Legislative Council.
