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Sunday, February 5, 2012

Stuttering therapy

Stuttering therapy is any of the various treatment methods that attempt to reduce stuttering to some degree in an individual. Stuttering can be a challenge to treat because there is a lack of evidence-based consensus about therapy. Some believe that there is no cure for the condition, and experts have argued that the preferred treatment outcome is one that involves satisfaction on the part of the stutterer, with both his communicative performance and the therapy process. While there is disagreement about acceptable treatment outcomes from stuttering therapy,] a wide range of methods have been developed to treat stuttering, and these have been successful to varying degrees.
Goals
In general, stuttering therapy aims to reduce stuttering to some degree in an individual, although there is disagreement about acceptable treatment outcomes from stuttering therapy. Some believe the only acceptable therapy outcome is a significant reduction in or total elimination of stuttering, others believe that speech which contains some stuttering, as long as the stuttering has become less tense and effortful, is just as acceptable, and yet others believe that the most important therapy outcome is the increased confidence a person has in his or her ability to talk, whether or not stuttering continues to be present. Additionally, the many different methods available for treating stuttering, and a history of promoting unsuccessful treatments, have left both stutterers and clinicians confused and frustrated about what can be accomplished with stuttering treatment.
In 1997, experts argued that in the case of a stutterer seeking professional treatment from a clinician, the "preferred treatment outcome" is that the stutterer will demonstrate feelings, behaviors, and thinking that lead to improved communicative performance and satisfaction with the therapy process. They argued that the criteria for a treatment to be viewed as successful includes the stutterer being satisfied with her therapy program and its outcome, feeling that she has an increased ability to communicate effectively, feeling more comfortable as a speaker, and believing that she is better able to reach her social, educational and vocational goals.
Robert W. Quesal, an associate professor who teaches courses in fluency disorders, anatomy, and speech and hearing science, defined successful stuttering therapy as one that leads to a change in speech fluency, a reduction in the impact of stuttering on an individual's life, and an increased acceptance of stuttering on the part of the stutterer; and J. Scott Yaruss, Ph.D., an assistant professor of Communication Science and Disorders at the University of Pittsburgh, suggests three instruments for clinicians to use to document changes in the stuttering of their clients: the reaction of the stutterer to the fact that she stutters, how much stuttering interferes with the stutterer's ability to perform daily tasks, and the impact that stuttering has on the client's ability to pursue their life goals.
Approaches
There are many different approaches to stuttering therapy. While some believe that there is no cure for the condition, stuttering can be reduced and even eliminated with appropriate timely intervention, and various therapy methods have reduced stuttering in individuals to some degree. In any case, for all persons who stutter, the successfulness of speech therapy depends on the combination of education, training, and individualized treatment provided.
For a child that stutters, the focus of treatment to prevent the worsening of the condition, and families play an important role in the process. Successful elimination of mild stuttering is likely when treatment is initiated before four years of age. For those who have more advanced forms of stuttering and secondary behaviors, therapy is generally a variation or combination of two approaches: a fluency-shaping technique that replaces stuttering with controlled fluency, and stuttering modification therapy, which focuses on reducing the severity of stuttering.
Therapy for children
Treatment of mild stuttering in children younger than six years of age focuses on the prevention or elimination of stuttering behaviors. Families play an important role in the management of stuttering in children: therapy is usually characterized by parental involvement and direct treatment, and providing an environment that encourages slow speech, affording the child time to talk, and modeling slowed and relaxed speech can help reduce stuttering.
For example, the Lidcombe Program, which has become prominent in recent years and is effective in preschoolers who stutter, involves a parent or some significant person in the child's life being trained and delivering treatment in the child's everyday environment. In the program, family members are to provide an environment that encourages a child to speak slowly, and one in which the child receives praise for fluent speech in the child’s daily speaking and, occasionally, correction of stuttering. Some of the most effective preschool intervention programs call for direct acknowledgment of stuttering in the form of contingencies such as “that was bumpy” or “that was smooth.”
Several organizations organize summer programs for children, including summer camps, to help treat stuttering. These programs offer a range of services from providing a fun outdoor experience in a nurturing and supportive environment that is free from ridicule, to providing "intensive work on communication skills". Ellen M. Bennett, an assistant professor who has practicing speech therapy for at least 18 years, encourages "public school therapists to advocate for the establishment of summer programs" for children who stutter.
Fluency shaping
Fluency shaping therapy focuses on changing all the speech of the person who stutters, and not just the portions of speech in which he or she stutters. This type of therapy involves teaching the stutterer to use a speaking style that requires careful and prominent self-monitoring; examples of such therapy include one in which the stutterer slows his speech down and smoothes out all his words, and one in which the physical mechanisms used in the speech production are retrained. Fluency shaping therapies do not address attitudes, feelings, and self-concept issues under the assumption that eliminating the stuttering will eliminate these issues. Proponents of this type of therapy believe that the outcome of any therapy depends directly on its focus:"if clinician and client focus on changing stuttering, they'll get stuttering; if they focus on changing fluency, they'll get fluency". This type of approach can reduce stuttering, although in children its effectiveness decreases if stuttering persists after eight years of age; Woody Starkweather, as at 1998 a Professor of Communication Sciences, asserted that in his experience this type of therapy improves speech only when used with other techniques.
Certain devices, known as fluency-shaping mechanisms, use this approach in an attempt to reduce stuttering. For example, delayed auditory feedback devices encourages the slowing down of speech by replaying the stutterer's words. The stutterer is then forced to slow her rate of speech to prevent distortions in the speech that is heard through the device. The effectiveness of such devices varies with stuttering severity.[3]
Stuttering modification
Stuttering modification therapy, also known as traditional stuttering therapy, was developed by Charles Van Riper between 1936 and 1958. It focuses on reducing the severity of stuttering by changing only the portions of speech in which a person stutters, to make them smoother, shorter, less tense and hard, and less penalizing. This approach attempts to reduce the severity and fear of stuttering, and strives to teach stutterers to stutter with control, and not to make the stutterer fluent. Therapy using this approach tends to recognize the fear and avoidance of stuttering, and consequently spend a great deal of time helping stutterers through those emotions, This approach generally does not eliminate stuttering events, but it helps minimize the impact and occurrence of stuttering. Since its creation, many clinicians have improvised on Charles Van Riper's basic stages and strategies. The stages of Van Riper's therapy can be summarized up in the acronym MIDVAS:
1. Motivation
The person who stutters needs to assess his motivation for seeking therapy, and the speech-language pathologist (SLP) needs to help the person build and maintain the motivation necessary for successfully changing speech behaviors and attitudes.
2. Identification
In this stage the client and clinician identify all of the behaviors, feelings, and attitudes that go along with the person's stuttering.
3. Desensitization
Van Riper designed this stage to help drain away the negative emotions, the fears, and the anxieties associated with the act of stuttering. The most common strategy used in this phase is called voluntary stuttering, in which the person stutters on purpose.
4. Variation
The individual is now able to change how he stutters and his reactions to the stuttering; he learns how to stutter differently in this phase. For example, if the person usually prolongs the initial "s" in "sister", the SLP may have him repeat the sound or stutter on a different sound in the word.
5. Approximation
The individual now learns specific strategies to smooth out and minimize the moments of stuttering. The three most common strategies for altering the stuttering are cancellation, in which the person stutters all the way through a word, stops immediately, and then repeats the word stuttering a different way; pull-out, in which the person gains control over a moment of stuttering while it is happening and smooths it out; and preparatory set, in which the person prepares for a moment of stuttering before it happens, starts it gently and glides through it smoothly.
6. Stabilization
In the stabilization phase, the individual becomes his own clinician by using the new stuttering controls in more and more situations of daily life. The individual also continues to stutter voluntarily and to seek out communication situations which s/he previously avoided.
Integrative approaches
Integrative approaches combine fluency shaping and stuttering modification techniques; there is a wide variety of such approaches.
Contemporary devices
Contemporary devices used to reduce stuttering alters the frequency of the speaker’s voice to mimic the “choral effect”, a phenomenon in which person's stutter decreases or ceases completely when she is speaking with a group of others, or slows the rate of speech through delayed auditory feedback (above). Studies on the long-term outcome of these devices have not been published.
Diaphragmatic breathing


The Freeing Voices, Changing Lives award given by the American Institute for Stuttering to people who stutter who have achieved great professional success.
Several treatment initiatives advocate diaphragmatic breathing (or costal breathing) as a means by which stuttering can be controlled.
Self-therapy and support groups
Self-therapy
This article contains instructions, advice, or how-to content. The purpose of Wikipedia is to present facts, not to train. Please help improve this article either by rewriting the how-to content or by moving it to Wikiversity or Wikibooks. (September 2009)

Some stutterers are only able to seek self-therapy because adequate clinical treatment is not available to them, and some experts in the field believe that stuttering therapy is largely a do-it-yourself project anyway.
As a form of self-therapy, Malcolm Fraser, founder of the Stuttering Foundation of America and life member of the American Speech-Language-Hearing Association recommends the following guidelines for stutterers needing immediate relief, even temporarily, in his book Self-Therapy for the Stutterer:
1. Make a habit of always talking slowly and deliberately whether you stutter or not.
2. When you start to talk, do it easily, gently and smoothly without forcing and prolonging the first sounds of words you fear.
3. Stutter openly and do not try to hide the fact that you are a stutterer.
4. Identify and eliminate any unusual gestures, facial contortions, or body movements which you may possibly exhibit when stuttering or trying to avoid difficulty.
5. Do your best to stop all avoidance, postponement or substitution habits.
6. Maintain eye contact with the person to whom you talk.
7. Analyze and identify what your speech muscles are doing improperly when you stutter.
8. Take advantage of block correction procedures designed to modify or eliminate your abnormal speech muscle stuttering behavior.
9. Always keep moving forward as you speak (keep moving your voice from one word or sound to the next, without repeating or back-tracking).
10. Try to talk with inflection and melody in a firm voice.
11. Pay attention to the fluent speech you have.

Coutsey Wikipedia

Beating stuttering and gain confidence

Beat Stuttering and Gain Confidence Fast Track Solution

gain confidence beat stuttering

You Can Create Unstoppable Self-Confidence even if you don’t possess it now!

There are countless benefits and advantages to having confidence in your self while being stutter free.

Would you like to:

• Speak with authority and presence.

• See fear and anxiety as a challenge not as a prison cell.

• Beat your stutter/stammer

• Learn to be self-assured and feel comfortable in any place anytime.

• Be able to talk to anyone, at anytime and feel completely in control and natural.

• Feel a strong inner "sense of knowing", that you are finally acting in line with your own chosen values.

• Be naturally called to take decisive action – it won’t be forced—because of this you’ll achieve more with less effort!

The secret to virtually all success, in all areas of your life is strong self-confidence.

Real self-confidence allows you to see the life you want… and determine how you’re going to get there… and persist until you achieve that goal.

Stuttering can be a real hurdle to developing a firm belief in yourself.

As it turns out developing self confidence is not complicated once you know a few basics. In fact, it's way easier than “working hard” to achieve your goals....

Wednesday, September 1, 2010

Speech therapy for adults

Although often considered treatment for childhood speech and language issues, speech therapy is sometimes recommended for adults. Adult speech therapy is a part of recovery programs for many illnesses, and may be used to help manage conditions that affect speech, language, eating or swallowing. When choosing an adult speech therapy program, a variety of different settings and treatment options exist depending on diagnosis.

Adult speech therapy helps people gain greater control over speaking and language skills. For many adults, a medical issue such as stroke, or onset of motor-skill affecting conditions like Parkinson's Disease or Multiple Sclerosis. Brain injury and accidents that cause damage to the throat, jaw, or facial structure can also impair speaking ability. Other people may require adult speech therapy due to mental difficulties which affect comprehension of language or the ability to speak intelligibly.


Finding a speech therapist is often done through recommendations from a primary care doctor. After an injury, accident, or stroke, a doctor may suggest adult speech therapy to help language and speaking skills improve or to help a patient better cope with the language disabilities caused by his or her condition. A speech therapist can give a more focused diagnosis of language-based issues, and be able to create a personalized program to improve skills.

Diagnosis of a speech or language disability is done through a variety of tests, both mental and physical. If the problem is not physical in nature, the patient may be assessed for language comprehension and retention skills. Once the specific underlying cause is identified, treatment programs to help the patient can begin.

Treatment done in adult speech therapy may be done in many different ways, as best fits the need of the patient. Some people receiving adult speech therapy have group classes focusing on comprehension and pronunciation, similar to those taken when learning a foreign language. Depending on the nature of the condition, exercises for muscular improvement and homework may also become a part of the program. Some speech therapists even make house calls, particularly for patients that are bedridden or in hospital treatment.
Related topics
Speech Therapy
Pediatric Speech Therapy
Speech Therapy Activities
Aphasia Speech Therapy
Speech Therapy Articulation
Speech Therapy Stuttering
Children Speech Therapy

While adult speech therapy may not be able to cure all speech or language disabilities, it can go a long way to giving adults confidence and focused training. Some patients may see a great improvement and even full recovery of all skills, while others may have to work hard to achieve every bit of increased ability. Struggling to communicate clearly can be greatly frustrating, yet some people may find speech therapy embarrassing or even shameful. A trained speech pathologist should soon be able to put worries to rest, and help to improve the quality of language, and life, for many patients.

Coutsey: wisegeeks.com

Speech therapy for toddlers

Speech Therapy For Children: Tips & Resources for Parents and Speech Therapists

Welcome to Speech for Kids, your online resource for speech and language therapy resources for children. Whether you're a parent looking for answers about your child's speech problems or a professional looking for online resources for speech therapy lessons, speech for kids is a an excellent resource.

NEW SPEECH THERAPY RESOURCES

* Children's Speech and Language Problems: When Does a Child Need Speech Therapy?
* Children and Autism - is my child autistic?
* Why does my autistic child need a diagnosis?
* Speech therapy toys for children with autism
* Funding for speech therapy for working with children with autism
* Frequently asked Questions About Stuttering
Are you concerned that your preschool child is starting to stutter? A certified Speech Language Pathologist can help.
* Speech Therapy Toys and DVD's
Wondering what toys or movie or audio resources might be best for your child's speech therapy needs? Check ou these tips
* Toddler Talking Quiz
How well does your toddler talk? Find out. Take the quiz.


Courtsey: speechforkids.com

Speech therapy courses

Training as a speech and language therapist

This page describes the degree courses in speech and language therapy.

Pre registration speech and language therapy programmes
Most speech and language therapy students will do a three or four year degree or honours degree course. These are provided by a number of universities in the UK.

The courses will include a balance of both theoretical and practical components. The theoretical components will include lectures and seminars in language pathology and therapeutics, speech and language sciences, behavioural sciences, biomedical sciences, education, acoustics, research, methodology and statistics, psychology, sociology and professional issues.

The practical components of the course will give the student the opportunity to apply the theory to practice and to develop their clinical skills by working with a variety of patients in a range of work settings under the supervision of qualified speech and language therapists.

There is an accelerated course available for those who already have an appropriate first degree. The courses will be over two years and are for people who have graduated in other disciplines and wish to qualify as a speech and language therapist.

These courses will lead to either a postgraduate diploma or a masters degree.

All accredited programmes have been approved by the Health Professions Council for regulatory purposes and students who graduate from these programmes will be eligible to apply for registration with the Health Professions Council.

NHS Careers strives to maintain an up to date list of HPC-approved courses. However, for the latest list of approved courses, please visit the HPC website

Courtsey: nhs.co.uk

Stuttering device

Electronic fluency devices (also known as assistive devices, electronic aids, altered auditory feedback devices and altered feedback devices) are electronic devices intended to improve the fluency of persons who stutter. Most electronic fluency devices change the sound of the user's voice in his or her ear.
Types

Electronic fluency devices can be divided into two basic categories.

* Computerized feedback devices provide feedback on the physiological control of respiration and phonation, including loudness, vocal intensity and breathing patterns.

* Altered auditory feedback (AAF) devices alter the speech signal so that speakers hear their voices differently.

Computerized feedback devices

Computerized feedback devices (such as CAFET or Dr. Fluency) use computer technology to increase control over breathing and phonation. A microphone gathers information about the stutterer’s speech and feedback is delivered on a computer screen. Measurements include intensity (loudness), voice quality, breathing patterns, and voicing strategies. These programs are designed to train features related to prolonged speech, a treatment technique which is frequently used in stuttering therapy. No peer-reviewed studies have been published showing the effectiveness of commercial systems in a clinical context. A study of electromyographic (EMG) feedback in children and adolescents found it to be as effective as other treatments (home-based and clinic-based smooth speech training) in the short and longterm.
[edit] Altered auditory feedback devices

Altered auditory feedback (AAF) such as singing, choral speaking, masking, delayed or frequency altered feedback have long been known to reduce stuttering. Early altered auditory feedback devices were large and thus confined to the laboratory or therapy room, but advances in electronics have permitted increasingly portable devices such as Derazne Correctophone, the Edinburgh Masker, the Vocaltech Clinical Vocal Feedback Device, the Fluency Master and the SpeechEasy. Current devices may be similar in size and appearance to a hearing aid, including in-the-ear and completely-in-the-canal models.

Speech therapy techniques

Speech therapy techniques are used are used to treat a variety of problems affecting the clarity of a person’s speech. The techniques vary depending on the particular problem. Most speech therapy is carried out on children, as the treatment is usually more effective while a patient’s speech is still developing.

There are three major types of problem which could require speech therapy techniques. Articulation involves difficulties producing sounds clearly enough for other people to understand what the speaker is saying. Fluency is when there are problems with the pattern of speech, most commonly in the form of a stutter. Resonance covers problems which affect the qualities of the voice’s sound, for example the volume or pitch. These problems can both distract the listener from the message being communicated, and may also cause physical pain to the speaker.


There are three main categories of speech therapy techniques. These do not necessarily match up with the three types of problem. The most appropriate technique will depends not only on the specific problem, but also its causes and the personal circumstances of the patient.

The best known category is articulation therapy. This involves the therapist concentrating on explicitly teaching the patient how to produce particular sounds and syllables. This can include physical demonstrations of how to use the tongue and mouth for specific sounds. The exercises will usually be built into play techniques appropriate for the child’s age.

A second category is language intervention. This can appear much more play- and activity-based and less formal. The goal of such techniques is usually to encourage the child to talk more to help develop their language abilities. The therapist will then use this activity to make sure the child pronounces words correctly.

The final category is oral motor therapy. This is more of a physical exercise routine designed to develop the muscles in and around the mouth. These techniques are more appropriate where the speech problems are caused by a physical issue rather than underdeveloped skills. Some therapists will also use these techniques for problems which don’t necessarily involve speech issues, for example where a child has trouble with eating or swallowing.
Related topics
Speech Therapy
Pediatric Speech Therapy
Speech Therapy Activities
Aphasia Speech Therapy
Speech Therapy Articulation
Speech Therapy Stuttering
Children Speech Therapy

The work of people who research and carry out speech therapy techniques, along with the underlying problems, is known by a variety of names internationally. The field is generally known as speech-language pathology, or SLP in North America. In the United Kingdom, speech and language therapy is a more common term, often with the acronym SALT. Australia simply calls it speech pathology.

Courtsey: wisegeek.com