Semin Speech Lang 2022; 43(02): 117-129
DOI: 10.1055/s-0042-1745715
Review Article

Stuttering and Autism Spectrum Disorders: Assessment and Treatment

John A. Tetnowski
1   Department of Communication Sciences and Disorders, Oklahoma State University, Stillwater, Oklahoma
,
Joseph Donaher
2   Department of Speech-Language Pathology, The Center for Childhood Communication at Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
› Author Affiliations

Abstract

Dual diagnoses of autism spectrum disorders (ASDs) and stuttering have been reported in the literature, but little is known about how often they co-occur, the best practices for assessment, and even less about intervention. In this article, we gathered the data available on these issues and compiled and analyzed the sparse findings to offer suggestions for assessment and treatment. This article begins with a glossary of terms to promote consistency and understanding. Next, suggestions for assessment are provided along with a work sheet to document fluency breakdowns and monitor change. Suggestions for language and cognitive issues are also provided with a sample worksheet. Finally, an outline and explanation of stuttering/fluency goals for clients with these dual diagnoses are included. Case studies of two individuals who stutter and are diagnosed with ASD are presented to provide exemplars of how to assess and treat individuals with these dual diagnoses. Caveats on how to work with individuals with ASD and fluency disorders, based on our current understanding, are presented in the conclusion.

Disclosures

Financial: J.A.T. is paid a salary by Oklahoma State University and receives a supplement through the Jeanette Sias Endowed Chair in Speech Pathology.


Financial: J.D. is paid a salary by Children's Hospital of Philadelphia.




Publication History

Article published online:
13 June 2022

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  • References

  • 1 Blood GW, Seider R. The concomitant problems of young stutterers. J Speech Hear Disord 1981; 46 (01) 31-33
  • 2 Blood GW, Ridenour VJ, Qualls CD, Hammer CS. Co-occurring disorders in children who stutter. J Commun Disord 2003; 36 (06) 427-448
  • 3 Scaler Scott K, Tetnowski JA, Flaitz JR, Yaruss JS. Preliminary study of disfluency in school-aged children with autism. Int J Lang Commun Disord 2014; 49 (01) 75-89
  • 4 Scaler Scott K, Grossman HL, Abendroth KJ, Tetnowski JA, Damico JS. Asperger syndrome and attention deficit disorder: Clinical disfluency analysis. In: Au-Yeung J, Leahy MM. eds. Proceedings of the Fifth World Congress on Fluency and Fluency Disorders in Dublin, Ireland. 2007: 273-278
  • 5 Van Borsel J, Tetnowski JA. Fluency disorders in genetic syndromes. J Fluency Disord 2007; 32 (04) 279-296
  • 6 Schulte K, Louis St. KO. Defining cluttering: the lowers common denominator. In: Ward D, Scaler ScottK. eds. Cluttering: Research, Intervention and Education. East Sussex: Psychology Press; 2011: 233-253
  • 7 Darley FL, Spriestersbach DC. Diagnostic Methods in Speech Pathology. New York: Harper & Row; 1978
  • 8 Ham RE. What are we measuring?. J Fluency Disord 1989; 14: 231-243
  • 9 Tetnowski JA, Scaler Scott K, Rutland BF. Fluency and fluency disorders. In: Damico JS, Muller N, Ball MJ. eds. The Handbook of Speech-Language Pathology. 2nd ed.. Oxford: Wiley-Blackwell; 2021: 414-444
  • 10 Healey KT, Nelson S, Scaler Scott K. A case study of cluttering treatment outcomes in a teen. Proc Soc Behav Sci 2015; 193: 141-146
  • 11 Plexico LW, Cleary JE, McAlpine A, Plumb AM. Disfluency characteristics observed in children with autism spectrum disorders: a preliminary report. Perspect Fluen Fluen Disord 2010; 20 (02) 42-50
  • 12 Brundage SB, Whelan CJ, Burgess CM. Brief report: treating stuttering in an adult with autism spectrum disorder. J Autism Dev Disord 2013; 43 (02) 483-489
  • 13 Yairi E, Ambrose NG. Early Childhood Stuttering: For Clinicians by Clinicians. Austin, TX: Pro-Ed; 2005
  • 14 Santulli M, Parish-Morris J, Ferguson E, Bateman L, Schultz R, Donaher J. Certain Disfluencies Distinguish the Speech of Children with ASD. Baltimore, MD: International Society for Autism Research; 2016
  • 15 Scaler Scott K. Fluency Plus: Managing Fluency Disorders in Individuals with Multiple Diagnoses. Thorofare, NJ: Slack Inc; 2018
  • 16 Friedman L, Sterling A. A review of language, executive function, and intervention in autism spectrum disorder. Semin Speech Lang 2019; 40 (04) 291-304
  • 17 Semel E, Wiig E, Secord WS. Clinical Evaluation of Language Fundamental. 4th ed.. Upper Saddle River, NJ: Pearson; 2008
  • 18 Mullen E. The Mullen Scales of Early Learning. Circle Pines, MN: American Guidance; 1995
  • 19 Wetherby AM, Prizant BM. Communication and Symbolic Behavior Scales Developmental Profile—First Normed Edition. Baltimore, MD: Paul H. Brookes; 2002
  • 20 Yaruss JS, Quesal RW, Coleman C. Overall Assessment of the Speaker's Experience of Stuttering (OASES). McKinney, TX: Stuttering Therapy Resources; 2016
  • 21 Scaler Scott K, Block S, Reeves N, Nelson S. Speech dysfluency and autism in the schools. Proc Soc Behav Sci 2015; 193: 223-227
  • 22 Runyan C, Runyan S. A fluency rules therapy program for young children in the public schools. Lang Speech Hear Serv Sch 1986; 17: 276-284
  • 23 Tetnowski JA, Richels C, Shenker R, Sisskin V, Wolk L. Treating stuttering and concomitant issues: case studies. Paper presented at: Annual Conference of the American Speech-Language-Hearing Association; November 16, 2011; San Diego, CA
  • 24 Tetnowski JA, Richels C, Shenker R, Sisskin V, Wolk L. When the diagnosis is dual: stuttering and concomitant disorders. ASHA Lead 2012; 17 (02) 3-8
  • 25 Van Riper C. The Treatment of Stuttering. Englewood Cliffs, NJ: Prentice-Hall; 1975
  • 26 Mesibov GB, Shea V, Schopler E. et al. The TEACCH Approach to Autism Spectrum Disorders. New York: Springer; 2005
  • 27 Bowers L, Huisingh R, LoGiudice CM. Social Language Development Test. Austin, TX: Pro-Ed; 2016