Treating Concomitant Language and/or Phonology Impairment in Children Who Stutter

Abstract

Stuttering can co-occur with phonological and/or language impairment in a nontrivial number of children. This article provides a framework for addressing concomitant phonology/language impairment and stuttering through the application of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. Described is a multifactorial approach to understanding stuttering, the application of the ICF to treating children who stutter with concomitant disorders, and models for structuring-related therapy. A case study is explored to illustrate this process and includes a sample treatment plan with goals, short-term objectives, and sample activities.

Keywords

stuttering - children - concomitant disorder - treatment

Publication History

Article published online:
13 June 2022

• References

• 1 Hall NE. Fluency characteristics of language disordered children. Paper presented at: American Speech-Language-Hearing Association Annual Convention. November, 1991; Atlanta, GA
• 2 Kelly EM, Singer CM, Henderson JK, Shaw KO. Stuttering practice self-assessment by school speech-language practitioners. Lang Speech Hear Serv Sch 2020; 51 (04) 1156-1171
• 3 Blood GW, Seider R. The concomitant problems of young stutterers. J Speech Hear Disord 1981; 46 (01) 31-33
• 4 Homzie MJ, Lindsay JS, Simpson J, Hasenstab S. Concomitant speech, language, and learning problems in adult stutterers and in members of their families. J Fluency Disord 1988; 13: 261-277
• 5 Louis St. KO, Murray CD, Ashworth MS. Coexisting communication disorders in a random sample of school-aged stutterers. J Fluency Disord 1991; 16: 13-23
• 6 Arndt J, Healey EC. Concomitant disorders in school-age children who stutter. Lang Speech Hear Serv Sch 2001; 32 (02) 68-78
• 7 Blood GW, Ridenour VJ, Qualls CD, Hammer CS. Co-occurring disorders in children who stutter. J Commun Disord 2003; 36 (06) 427-448
• 8 Sasisekaran J. Exploring the link between stuttering and phonology: a review and implications for treatment. Semin Speech Lang 2014; 35 (02) 95-113
• 9 Spencer C, Weber-Fox C. Preschool speech articulation and nonword repetition abilities may help predict eventual recovery or persistence of stuttering. J Fluency Disord 2014; 41: 32-46
• 10 Usler E, Smith A, Weber C. A lag in speech motor coordination during speech production is associated with stuttering persistence in young children. J Speech Lang Hear Res 2017; 60 (01) 51-61
• 11 Usler ER, Walsh B. The effects of syntactic complexity and sentence length on the speech motor control of school-age children who stutter. J Speech Lang Hear Res 2018; 61 (09) 2157-2167
• 12 Sasisekaran J, Basu S, Weathers EJ. Movement kinematics and speech accuracy in a nonword repetition task in school-age children who stutter. J Commun Disord 2019; 81: 105916
• 13 Smith A, Goffman L, Sasisekaran J, Weber-Fox C. Language and motor abilities of preschool children who stutter: evidence from behavioral and kinematic indices of nonword repetition performance. J Fluency Disord 2012; 37 (04) 344-358
• 14 World Health Organization. International classification of functioning, disability and health. Accessed February 25, 2022 at: http://www.who.int/classifications/icf/en/ 2014
• 15 American Speech-Language-Hearing Association. Scope of practice in speech-language pathology [Scope of Practice]. Accessed February 25, 2022 at: http://www.asha.org/policy 2016
• 16 Conture EG. Stuttering: Its Nature, Diagnosis, and Treatment Needham Heights, MA: Allyn & Bacon. 2001
• 17 Logan KJ, LaSalle LR. Developing intervention programs for children with stuttering and concomitant impairments. Semin Speech Lang 2003; 24 (01) 13-20
• 18 Shapiro D. Stuttering Intervention. 2nd ed.. Austin, TX: Pro-Ed; 2011
• 19 Wolk L. Intervention strategies for children who exhibit coexisting phonological and fluency disorders: a clinical note. Child Lang Teach Ther 1998; 14: 69-82
• 20 Bernstein Ratner N. Treating the child who stutters with concomitant language or phonological impairments. Lang Speech Hear Serv Sch 1995; 26: 180-186
• 21 Byrd CT, Wolk L, Davis BL. Role of phonology in childhood stuttering and its treatment. In: Conture EG, Curlee RF. eds. Stuttering and Related Disorders of Fluency. 3rd ed.. New York: Thieme; 2007: 168-182
• 22 Hall NE, Garbarino J, Bernstein Ratner N. Language and phonological considerations. In: Zebrowski P, Anderson J, Conture EG. eds. Stuttering: Characteristics, Assessment and Treatment. 4th ed.. New York, NY: Thieme; 2022
• 23 Smith A, Weber C. How stuttering develops: the multifactorial dynamic pathways theory. J Speech Lang Hear Res 2017; 60 (09) 2483-2505
• 24 Beita-Ell C, Boyle MP. School-based speech-language pathologists' perceived self-efficacy conducting multidimensional treatment with children who stutter. Lang Speech Hear Serv Sch 2020; 51 (04) 1172-1186
• 25 Shields LW. What constitutes a multidimensional treatment approach for school-age children who stutter?. Semin Speech Lang 2018; 39 (04) 333-341
• 26 Bennett EM. Working with People Who Stutter: A Lifespan Approach Upper Saddle River. NJ: Pearson; 2006
• 27 Healey EC. The Cognitive, Affective, Linguistic, Motor, and Social (CALMS) Assessment for School-Age Children Who Stutter: Clinician's Manual Lincoln,. NE: Board of Regents of the University of Nebraska; 2012
• 28 Healey EC, Scott Trautman L, Susca M. Clinical applications of a multidimensional approach for the assessment and treatment of stuttering. Contemp Issues Commun Sci Disord 2004; 31 (01) 40-48
• 29 Yaruss JS, Quesal RW. Stuttering and the international classification of functioning, disability, and health (ICF): an update. J Commun Disord 2004; 37 (01) 35-52
• 30 Yaruss JS. Application of the ICF in fluency disorders. Semin Speech Lang 2007; 28 (04) 312-322
• 31 Coleman CE. Comprehensive stuttering treatment for adolescents: a case study. Lang Speech Hear Serv Sch 2018; 49 (01) 33-41
• 32 Coleman CE, Yaruss JS. A comprehensive view of stuttering: implications for assessment and treatment. SIG 2014; 15: 75-80
• 33 Stoel-Gammon C, Stone-Goldman J, Glaspey A. Pattern-based approaches to phonological therapy. Semin Speech Lang 2002; 23 (01) 3-14
• 34 Hodson BW. Enhancing phonological patterns of young children with highly unintelligible speech. ASHA Lead 2011;
• 35 Murphy WP, Yaruss JS, Quesal RW. Enhancing treatment for school-age children who stutter I. Reducing negative reactions through desensitization and cognitive restructuring. J Fluency Disord 2007; 32 (02) 121-138
• 36 Murphy WP, Yaruss JS, Quesal RW. Enhancing treatment for school-age children who stutter II. Reducing bullying through role-playing and self-disclosure. J Fluency Disord 2007; 32 (02) 139-162
• 37 Guttormsen LS, Kefalianos E, Næss KAB. Communication attitudes in children who stutter: a meta-analytic review. J Fluency Disord 2015; 46: 1-14
• 38 Boyle JM, McCartney E, O'Hare A, Forbes J. Direct versus indirect and individual versus group modes of language therapy for children with primary language impairment: principal outcomes from a randomized controlled trial and economic evaluation. Int J Lang Commun Disord 2009; 44 (06) 826-846
• 39 Goldman R, Fristoe M. Goldman Fristoe Test of Articulation. 3rd ed.. San Antonio, TX: Pearson; 2015
• 40 Semel E, Wiig E, Secord W. Clinical Evaluation of Language Fundamentals. 4th ed.. San Antonio, TX: Pearson Assessments; 2003
• 41 Riley GD, Bakker K. SSI-4: Stuttering Severity Instrument. 4th ed.. Austin, TX: Pro-Ed, Inc; 2009
• 42 Brutten G. Communication Attitude Test. Carbondale, IL: 1984